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Ask Dr. Abid Your Own Question

Dr. Abid
Dr. Abid, Doctor
Category: Medical
Satisfied Customers: 4212
Experience:  MBBS, FCPS(R)
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Have had ALT enzyme retested several times. Unsure if what

Customer Question

Have had ALT enzyme retested several times. Unsure if what I am doing is helping to lower it or not. As Dr believed it to be fatty liver related.

Timeline:
Routine blood test gave a ALT ot 63, lab range was 44.
Switched Dr and Lab two days later 67. Lab range 55
Same Lab 12 days later 72. Lab range 55
Same lab 4 weeks later 62. Lab range 55 ( Have lost 10 lbs, began exercising, eating healthy).

Are these simply margin of error or actually decreasing?
Do the labs healthy range make a differance as I was orginally 20 points from norm and only 7 now?
Dr mentioned possible cause of autoimmune diseases A1A and autoimmune hepatitis as causes. Though he didn't believe this to be cause he did not state why. Should I be concerned of this.

Happy to share any other lab results needed, though all appear to be normal.
Submitted: 8 months ago.
Category: Medical
Expert:  Dr. Abid replied 8 months ago.

Dr. Abid :

Hi there. Welcome to Just Answer and thank you for the question. I am Dr.Abid a Medical Internist and will help you out.

Dr. Abid :

Please tell me have you had your ultrasonography?

Dr. Abid :

What about your alcohol consumption?

Dr. Abid :

Regards.

Customer:

I had ultrasound it was negative

Customer:

I do not drink often, have not drank in 3 weeks. just had the test revealing the 62 this morning.

Customer:

Negative also for all hepatitis and hemochromatosis.

Dr. Abid :

Ok,do you have ultrasonography negative for fatty liver?

Customer:

Yes

Customer:

Dr said may have mild amount that doesnt show up

Customer:

But yes ultrasound showed no fatty liver

Dr. Abid :

Ok ,have you had test to rule out autoimmune hepatitis?

Customer:

NO

Customer:

Do you believe these number suggest that

Customer:

or A1A

Customer:

I was hoping that my liver was healing as the number is XXXXX

Dr. Abid :

I don't think so but unexplained mild to moderate increase in liver enzymes in the presence of normal alkaline phosphatase need evaluation for that .

Dr. Abid :

Have you tested for viral infection?

Customer:

I feel fine

Customer:

I can give you my lab results if that will help

Dr. Abid :

Yes sure please...

Customer:



































































































































































































































































































































































































































































Test Name
Full Size Image
Result
Full Size Image
Units
Full Size Image
Reference Range
Full Size Image
Date
Full Size Image
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Albumin5.3 (#)g/dl3.3-5.010/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]PT-INR1.00.9-1.110/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Alk Phos92U/L45-11510/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Bilirubin (Total)0.4mg/dl0.0-1.010/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Bilirubin (Direct)0.1mg/dl0-0.410/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Total Protein7.6g/dl6.0-8.310/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]AST (SGOT)30U/L10-4010/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Globulin2.3g/dl2.3-4.110/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]PT13.0sec11.0-14.010/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]ALT (SGPT) (U/L)62 (#)U/L10-5510/27/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]TIBC300mcg/dl230-40409/25/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Iron45mcg/dl45-16009/25/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]TTG Ab, IgG0.25
Negative
U/mL0-1509/24/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Celiac Disease Panel/Interpretation
Serologic markers for celiac disease are useful [More]
09/24/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV e AbNegative
Reference range: Negative
09/24/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]TTG Ab, IgA0.21
Negative
U/mL0-1509/24/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV e Ag (+Ab)Negative
Reference range: Negative
09/24/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HAV Ab, IgMNegativeNEG09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HAV Ab(s)NegativeNEG09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HCV AbNegative09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV Core Ab(s)NegativeNEG09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV Surface Ab8.37
Results less than 10.00 mIU/mL are not consistent [More]
mIU/mL09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV Surface AgNegative09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HBV Core Ab, IgMNegativeNEG09/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]IgA122mg/dl69-30909/23/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]MCH28.6pg/rbc26.0-34.009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]MCHC34.4g/dl31.0-37.009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]RDW12.7%11.5-14.509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Chloride99 (#)mmol/L100-10809/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Potassium4.0mmol/L3.4-4.809/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Carbon Dioxide26.5mmol/L23.0-31.909/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Anion Gap10mmol/L3-1509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Eos0.3%0-809/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Basos0.2%0-309/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Lymphs18.5 (#)%22-4409/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Monos7.6%4-1109/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Eos#0.02th/mm30.0-0.909/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Baso#0.01th/mm30.0-0.309/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Lymph#1.15th/cmm1.0-4.809/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Mono#0.47th/mm30.2-1.209/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Neutrophils73.2 (#)%40-7009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Neutrophil #4.56th/cmm1.8-7.709/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Diff MethodAuto09/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Sodium135mmol/L135-14509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]BUN11mg/dl8-2509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Calcium9.7mg/dl8.5-10.509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Creatinine1.02mg/dl0.60-1.5009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Glucose110mg/dl70-11009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]TSH0.79uU/ml0.40-5.0009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]WBC6.2th/cmm4.5-11.009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]HCT46.8%41.0-53.009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]Hgb16.1gm/dl13.5-17.509/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]NRBC#, auto0.00th/cmm009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]RBC5.63mil/cmm4.50-5.9009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]PLT208th/cumm150-40009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]GFR (estimated)>60
Abnormal if <60 mL/min/1.73m2. If patient [More]
mL/min/1.73m209/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]MCV83fl80-10009/21/2013
[IMAGE][SRC][/SRC][ALT][/ALT][WIDTH]100[/WIDTH][HEIGHT]100[/HEIGHT][STYLE][/STYLE][/IMAGE]NRBC(%)0/100 wc009/21/2013

A complete list of results that are not shown in Patient Gateway is available in this Master Exclusion List.

Customer:

easier to read with the attachement

Dr. Abid :

Your all lab work is normal except mild increase in liver enzyme,you have negative test for hepatits virus along with normal AST and Alkaline phosphatase level,Blood CP ,kidney function is ok.

Dr. Abid :

Protein,albumin levels are ok...

Customer:

The ultrasound report said everything looked normal too

Dr. Abid :

So only issue is little raised ALT level.

Customer:

YEs

Customer:

Dr scared me when he mentioned the autoimmune stuff

Customer:

Didnt know if he was just covering himself legally by mentioning it

Customer:

Or if was an actual concern

Customer:

I am very very anxious

Dr. Abid :

I don't think it is autoimmune stuff first autoimmune hepatitis is more common in females second autoimmune hepatitis often related with other health issues your all other test are negative and 62 number is XXXXX too much high so i don't think it is autoimmune .

Customer:

Your confident in this

Customer:

and the A1A

Customer:

I really appreciate your time Dr.

Customer:

It was mentioned that with A1A i would expect to see AST high as well

Dr. Abid :

You are welcome and I am confident it is neither autoimmune nor AIA because in both conditions ALT is moderately to severe high,at this stage I will suggest you to completely avoid alcohol ,avoid junk foods,adopt healthy life styles ,use fresh fruit juices and repeat test after 1 month and see levels.

Customer:

Do you think that it has actually decreased.

Customer:

Or is this in margin of error still

Customer:

As i said, the first test of 63 was completed at different doctor office and diff lab

Customer:

that had diff range

Customer:

The second, third and fourth were completed at one office. with 5 weeks total time from the first to the fourth test

Customer:

I have lost a pants size, and 10 lbs.

Customer:

I was 207 and 6 foot 3. Now am 195

Customer:

At my peak weight in last few months i was 215 though.

Dr. Abid :

It has decreased from 72 so mean you lost weight and adopted healthy life styles that's why your no decreased,it doesn't seems to be a lab error you will maintain healthy weight and life styles your no will hopefully come down.

Customer:

Finally, my LDL when checked 18 months ago was 133, i had a very poor diet with fast food and had continued to eat badly until on month ago when i received the report.

Dr. Abid :

Continue regular exercise ,so that your BMI may become normal that will help you out to normalize ALT.LDL is a bad cholestrol it shouldn't be high keep eye on it and adopting such healthy life styles that I mentioned will also help you to maintain normal LDL level.

Customer:

One question. it was only 63 first time i was tested but that was a different lab than all others. Should i throw out that result when comparing it to the 67 and then 72 because it uses a totally different reference range.

Customer:

That 63 makes it hard for me to understand if what I am doing is working

Customer:

Or if that number was off because the lab was different.

Customer:

Does that make sense.

Dr. Abid :

Actually test range varies lab to lab and you should compare your no with highest range of normal no of that lab so don't worry,no need to throw any test its lab variations.In last test your no is 63 and reference range of high normal value is 55 your no is little high means mild elevation of ALT you shouldnt worry just follow instructions that I advised you.

Customer:

So if you were me you wouldnt be worried about the autoimmune disease at all?

Customer:

Do you believe its still fatty liver?

Dr. Abid :

Yes I should not worry because I have reasons first I mentioned that autoimmune disease is common in females,second it is rare as autoimmune hepatitis has an incidence of 1-2 per 100,000 per year, and a prevalence of 10-20/100,000. As with most other autoimmune disease it affects women much more often than men and in autoimmune hepatitis only ALT is not elevated but bilirubin may also be high.Important thing is that autoimmune hepatitis can also have association with other autoimmune disease so highly unlikely in your case.

Customer:

And your reasoning for not suspecting the A1A. sorry i know you explained already. but it helps me

Dr. Abid :

Same as for autoimmune hepatitis.Actually you are worried and I can understand your problem but you should think that your all other lab work is fine except ALT which is slightly elevated you are obese so it could be because of obesity.

Dr. Abid :

Just follow advise as I asked you and repeat test after one month.

Dr. Abid :

Nothing need to worry hopefully everything will be ok.

Customer:

Ok. helps me that your confident

Dr. Abid :

Autoimmune hepatitis has an incidence of 1-2 per 100,000 per year, and a prevalence of 10-20/100,000. As with most other autoimmune diseases, it affects women much more often than men

Dr. Abid :

As I already mentioned above incidence...

Customer:

I was more concerned with Alpha one antitrypsin

Dr. Abid :

As far as A1a is concerned forget it I am 100 percent sure it is not A1A because it mostly effects lungs and presents with emphysema and COPD .

Customer:

I read that it sometimes effects liver

Customer:

Thats why it concerned me and he mentioned it

Dr. Abid :

It mainly effects lungs and in some cases liver so do not think about it.

Customer:

Ok again helps that your confident

Customer:

When he brought it up i wasnt sure what to think

Dr. Abid :

Regards XXXXX XXXXX luck.Please leave positive feedback for me.

Dr. Abid :

I will simply say

Dr. Abid :

Don't worry

Dr. Abid :

And relax just adopt healthy life styles ,good diet,reduce weight this number will come to normal and don't think of rare diseases.

Customer:

Ok thank you so much Dr.

Dr. Abid :

Positive feedback will be appreciated.

Dr. Abid, Doctor
Category: Medical
Satisfied Customers: 4212
Experience: MBBS, FCPS(R)
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