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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 56620
Experience:  Medical Doctor Trained at a Top Academic Institution
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I went to urgent care this weekend, from dizziness and

Customer Question

I went to urgent care this weekend, from dizziness and fatigue. I had low sodium hence why I was dizzy, and dehydration. I was anemic also, and they did not tell me then, but when I was given the lab results, my ALT and AST were elevated. They have never been elevated, I went thought all my test, online, for past 15 years, and they are always like 19, and they both were 57 and 59 with ranges of 4-42, and 4-41. My bilirubin was below normal at .10, with a range of .20-1.10.I am very worried, what could cause this, could doing subcutaneous immunoglobulins before the test have any effect, I do them 3 days a week. Or could hydration or anemia?
Submitted: 9 months ago.
Category: Medical
Expert:  Dr. Phil, MD replied 9 months ago.

Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

Expert:  Dr. Phil, MD replied 9 months ago.

How old are you?

Expert:  Dr. Phil, MD replied 9 months ago.

any other medical issues?

Customer: replied 9 months ago.
I am 52, I have lupus, sjogrens, adrenal insuffinecy and osteopenia. I have looked up all my labs via the web, online and I am always at 19 on both liver enzyme number. My bilirubin is below normal at .10, my albumin is mid range, my AP is low end of normal, all those point against liver issues? I did have anemia on the test, which happens sometimes, I am in menopause, but still get anemia sometimes.
Customer: replied 9 months ago.
I also have common variable immune defiecny and do weekly subcutaneous immungloblins, which I did the day of the test.
Expert:  Dr. Phil, MD replied 9 months ago.

what meds do you take?

are you overweight?

drink alcohol?

Customer: replied 9 months ago.
I weigh 117, am 5 6, and I drink like once every 3 months, a glass of wine, I take a lot of meds, but same meds for 10 years and always have 19 or 20 as my enzymes. Never been this high, can dehydration affect, or could the sub q injections before affect?
Expert:  Dr. Phil, MD replied 9 months ago.

Yes, keep in mind this is only a very small elevation in liver function tests

so just a small irritation of your body can do it

dehydration, viral illness, meds, etc could all do it

I would wait a week or so and retest

I bet they go back to normal

let me know if you have other questions.

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Customer: replied 9 months ago.
what would the most likely cause be? and would the low bilirubin and normal albumin and normal AP, argue against liver damage?
Expert:  Dr. Phil, MD replied 9 months ago.

yes, it would argue against it
I suspect the dehydration is the most likely cause

Customer: replied 9 months ago.
Can you explain briefly why dehydration might cause it?
Expert:  Dr. Phil, MD replied 9 months ago.

The liver is a highly vascular organ. It loves a good blood supply

when you are dehydrated, this blood supply goes down and irritates the liver and voila

Customer: replied 9 months ago.
Ok because i searched all over the web and no where does it list dehydration, but do the low bilirubin and normal albumin and AP point to not liver involved?
Expert:  Dr. Phil, MD replied 9 months ago.

I have seen it many times regardless of what the web says

Don't trust Dr. Google

Yes, that means the liver is likely fine