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What Causes Elevated TSH And ALT Levels?

Posted on Tue, 27 Oct 2015

Question: Good afternoon. I had some bloods taken recently on admission to ER with paroxysmal AF who required cardioversion after oral pill in the pocket flecainide at home was unsuccessful. All bloods were normal apart from raised ALT and slightly raised TSH. All LFT normal apart from raised ALT OF 74. TSH was elevated at 6.2 with normal T3 and T4. No other medical history apart from paroxysmal AF. I am now on 5mg bisoprolol.. Low alcohol intake and normal cholesterol and glucose. Otherwise well. Iron levels within normal range but at high end of normal. Have had course of hepatitis B immunisations 10 years ago and negative hepatitis c result at work (healthcare worker). Bloods taken again a month or so after admission demonstrated raised ALT at same amount. Concerned about this result. Please advise...

Answered by Dr. Hardik Sanghvi (28 minutes later)

Brief Answer:
Raised alt may be due alcohol or fatty changes in liver.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have slightly high alt level.

It is liver enzyme and its level increase in liver damage. Your other liver function test results are normal. So nothing to worry much about that. It can be due to mild fatty change in liver or due to alcohol. You should avoid alcohol completely. Take low fat diet. Repeat ths test after 3 months. Don't worry. Just be relaxed. It will come back to normal.

You have slightly high tsh with normal t3 and t4. It suggest subclinical hypothyroidism. You should regularly check your thyroid hormone levels. If tsh increase further or t3 and t4 levels are decreased then drug treatment is required. According to my opinion no treatment is required right now.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (10 minutes later)

Thanks. Could the raised ALT be anything sinister such as carcinoma or would other enzymes be elevated? Thanks

Answered by Dr. Hardik Sanghvi (3 minutes later)

Brief Answer:
Don't worry about carcinoma.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Slight high alt is common in alcohol and fatty liver. If any serious disease is there then other enzymes are also elevated and other liver function test are also impaired. You have normal results for other tests so no need to worry. Just be relaxed.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (9 minutes later)

Thanks yes alcohol intake is low but am overweight 6 foot 2 and 16 stone. I have had repeat LFT and TFTs. If they are still elevated would you recommend thyroid antibodies and tests for autoimmune hep, HBV, HCV, copper, celiac etc? Thanks

Answered by Dr. Hardik Sanghvi (12 minutes later)

Brief Answer:
Further investigations are needed if level remains high.

Detailed Answer:
Hi, dear
I can understand your concern.
If your tsh level further increased then you should go for investigation for hashimotos thyroiditis. Thyroid auto antibodies level should be done to search the cause of hypothyroidism.

Hbv and hcv is not needed. If your alt level remains high then ultrasound abdomen should be done once. Copper and coeliac disease test are not required from your clinical features. But regular follow up is the only thing you required right now.

Don't worry much about that. Just be relaxed.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (3 minutes later)

Thanks for your quick and reassuring replies

Answered by Dr. Hardik Sanghvi (2 minutes later)

Brief Answer:
You are most welcome.

Detailed Answer:
You are most welcome.
If you don't have any questions then please close the discussion and rate the answer.
Thanks for using health care magic.
Wish you a very good health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar