Brief Answer:
Elevated liver enzymes

Detailed Answer:
Hello and welcome,

AST and ALT are liver enzymes. These show up in the blood from the liver's regular metabolism. There is a certain expected range for each of them. When the result is higher, it means that liver cells are inflamed or injured by something and are spilling out more of these enzymes.

Normal range for these two enzymes are:
AST 10 - 40 units per liter
ALT 7 - 60 units per liter

The reference range can vary depending on the laboratory doing the test, but this is a good approximate range.

An AST of 60 and ALT of 91 is a mild elevation (these numbers are sometimes seen in the hundreds). Still, it means that your liver is a bit unhappy.

Possible causes are fatty liver which can be from excess weight, particularly with metabolic syndrome, alcohol intake, medications, and sometimes from a virus such as those that affect the gastrointestinal tract or liver. More rarely there can be a genetic disorder (such as hemochromatosis and Wilsons disease). In patients with congestive heart failure there can be an effect on the liver too. Autoimmune disorders, Crohn's disease, and ulcerative colitis can increase liver enzymes, as can gall stones.

Medications that can affect the liver include:

Acetaminophen (Tylenol or other medications with a Tylenol component)
The pain medications Diclofenac (Voltaren) and naproxen (Naprosyn, Anaprox, Aleve, Naprelen)
Cholesterol-lowering medications, in particular the statins
Some antibiotics
Some tuberculosis medications, for example, isoniazid (Nydrazid, Laniazid, INH)
Some anti-fungal medications, for example, fluconazole (Diflucan) and itraconazole (Sporanox)
Some psychiatric medications, for example, tricyclic antidepressants
Some seizure medications, for example, phenytoin (Dilantin), carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol), and valproic acid (Depakote, Depakote ER, Depakene, Depacon)

Depending on which of the things I've listed might apply, your doctor may want to do further evaluation. Given your age, you should have a Hepatitis C test done one time (regardless of your liver enzyme test results) as this is now recommended for people our age.

Given that they are mild elevations, your doctor may just want you to make some lifestyle modifications (such as decrease or eliminate alcohol, or lose weight if that is a consideration) and recheck in a few months. It takes many weeks for the liver cells to regenerate, so retesting should not be for a few months.

Or, your doctor may want to get an ultrasound of the liver/gall bladder to see if there is any sign of something going on such as fatty liver.

I hope this information helps. Please let me know if I can provide further information.

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