Help! What do raised AST &ALT MEAN

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vampira
New Member


Date Joined Jan 2016
Total Posts : 8
   Posted 1/30/2016 7:57 AM (GMT -6)   
Hi everyone
I really need some advice from supportive people who know what they're talking about.
My husband drinks roughly 3 times the recommended units a week. He loves Real Ale which has put weight on him. Despite 2 stone weight gain over about last 2 yrs, he eats well and walks for miles for fitness. He went to the dr who said his ALT and AST Levels were significantly high, especially ALT, through alcohol. She told him to sort out his drinking but isn't going to do anymore tests or follow it up in anyway.
Please will someone explain to me what this actually means. Is he ill or going to be? Has he got liver damage? Someone said ALT levels are muscular. What does this all mean? Please will someone help me understand what's happening and if I've got anything I seriously need to worry about. Can someone please help as can't sleep for worrying. Thank you so much

MamaLama
Forum Moderator


Date Joined Oct 2010
Total Posts : 4786
   Posted 1/30/2016 9:29 AM (GMT -6)   
vampira,

Welcome to the Healing Well Liver forum. We are a group of patients and their loved ones who are affected by many kinds of liver disease. Though there are many causes for liver disease, the course of the disease is quite the same whether it is from alcohol, fatty liver, viruses, or various poisons, or even Auto Immune Hepatitis, where your own body attacks the liver.

I will assume from your post that you live in the UK (or perhaps AU, not 100% sure). The weight measurement stones is different that the US where I live and we measure in pounds.

Their health system is a bit hard on alcoholics, won't do much while the patient is actively drinking. I have heard on posts here that the patient needs to demonstrate an intention to live a sober life by actually being sober for a year. That can be hard.

It IS likely he has liver damage, but only the doctors and the tests could confirm that. When the AST/ALT tests are quite close to each other, the cause can be many things. When they are both high, and one much higher than the other, alcohol is the suspected cause.

My partner had 3 things going on with his liver: alcoholism, Hep C, AND liver cancer. He was a sick man and needed to quit drinking for 6 months (the UNOS requirement for transplant). He decided he wanted to live after many years of loving the bottle more than his own life. He has been sober since fall 2010. Post Transplant, Post Hep C, and of course the liver tumor was removed with that old cirrhotic liver.

It is amazing, but a person can live quite a long time while actively drinking. My partner was diagnosed with cirrhosis in 2003 and told if he were to be sober, he could easily live 15 years with that old liver. He did that for a while, but went back to his old ways and completely destroyed his liver in half the time.

Mike always figured he was dying anyway, might as well die happy. But happy he was NOT. The advanced stages of liver disease are quite unpleasant. They can have uncontrolled bleeding from mouth, nose or with the stool if a vein breaks. (If that happens, call the emergency medics right away.) Those with advanced liver disease don't clot well. They can have changes in mood and temperament...they call this hepatic encephalopathy...where the waste products don't leave the body since the liver cant process them, and the chemicals created go to the brain and cause the changes. Mike was horrible, very aggressive, ugly, mean, etc. Watch for that. Sometimes they gather fluid in the belly, called ascites. This can be drained. You mentioned he gained weights, it could be that. Etc Etc.

I don't mean to frighten you. And I need to share with you that the spouses, children, parents are pretty much helpless. Only the patient can decide to change their ways. We recommend AA for the alcoholic and Alanon or Alateen for the families. Mike needed to go to AA for 6 months, have his calendar signed by a group leader each time, and had an alcohol blood test once a week for that 6 months. Very regimented. Some go to counselors instead.

We are sorry to hear that so far, he has not decided to live a sober life, but if his symptoms get really bad, he might.

My best to you and your family.

Mama Lama
MamaLama, Forum moderator - Hepatitis
Partner received liver transplant (May 1, 2011) FL
Hep C 1a Treatment - Sovaldi/Olysio (March - May 2014)
Undetected since week 4. Undetected 12 weeks post treatment.

vampira
New Member


Date Joined Jan 2016
Total Posts : 8
   Posted 1/30/2016 10:05 AM (GMT -6)   
Thank you Mama lama. Yes I live in the UK and 2 stone is 28 pounds. Would the fact that he is otherwise healthy and exercises a lot make any difference or at least help? Here the recommended alcohol allowance is 14 units a week, I'd say he drinks about 25 units a week sometimes more sometimes less. If he could have liver damage why isn't the dr meeting with him or taking regular checks? Should she be? She told him to cut down on his drinking and that was all. I can't stop him drinking I've tried frequently but just won't listen. What does it mean if the liver is inflamed

**David**
Veteran Member


Date Joined Nov 2009
Total Posts : 3708
   Posted 1/30/2016 11:53 AM (GMT -6)   
Your husband needs to cease drinking alcohol and listen to his doctor. He's only fooling himself and by the time he crashes, it may be too late. If his liver is inflamed that means damage is already taking place. It will only get worse.
nullum beneficium impunitum...

ppm guy
Veteran Member


Date Joined Apr 2010
Total Posts : 1077
   Posted 1/30/2016 1:28 PM (GMT -6)   
hi vampira,
yes you do need to be concerned. you are in the dark. yes i feel your dr should use imaging or non invasive staging to let you know what your dealing with. he may have inflamation, and he could be developing cirrhosis. no one knows!!!!!! regardless, inflamation can lead to cirrhosis. liver disease is also asymptomatic for most. so appearing healthy means nada.

ast/alt are LIVER ENZYMES, that rarely are associated with muscle wasting.

stopping drinking before cirrhosis, is the only way to stop the need for a transplant. and stopping can start the healing process.
best to you
barry

vampira
New Member


Date Joined Jan 2016
Total Posts : 8
   Posted 1/31/2016 2:30 AM (GMT -6)   
Thank you everyone your help is so important because I don't know what to do.I'm not going to be able to stop him drinking but would a big reduction in alcohol at least help a bit? Sometimes he'll go a week without drink then work will stress him and he'll drink about 5 nights a week and 4-5 of ale which is highly calorific. I can't follow him around to keep him out of pubs but I'm changing his lifestyle as it's the only thing I can control. He's vegetarian anyway but has just started to eat lots of fish, salad and fruits. I've also bought some milk thistle, vitamin C and ALA supplements. Will lifestyle changes and less drink help his liver to mend? His liver isn't inflamed but his alt levels were higher than they should be. She asked about his lifestyle and said the elevation was due to alcohol and he needed to cut down alcohol and change his lifestyle. He's just started to change his eating habits and cut down by half but then had a bad week at work so drank every night. Taking it week by week as is the same with most people, he knows he drinks too much but likes it. England also has a very strong pub culture and it's considered normal to drink after work or go to the pub at night. I don't think it's quite the same in America so he doesn't see drinking as doing anything more than everyone else he knows does. Like I said he has just started to eat better and cut a lot of fat from his diet and drinking a lot less. Do you think it'll help or is it too little to late? Also the night before he had the blood test he'd drank a lot. Would this give a higher reading?

MamaLama
Forum Moderator


Date Joined Oct 2010
Total Posts : 4786
   Posted 1/31/2016 10:03 AM (GMT -6)   
vampira

We are not doctors. When the liver is seriously damaged, the patient needs to see a consultant/specialist in liver disease, a hepatologist, not a family practice doctor. We can not diagnose at all, only know the symptoms we or our loved one faced with liver disease.

I have read about this a lot, as you can imagine, and find that only about 15% of heavy drinkers get cirrhosis...they are genetically different than other drinkers. My partner had the bad luck to be from one of the cirrhosis gene lines. He is of Irish background and in his world (like yours) everyone drinks lots of alcohol....and no one thinks anything is wrong with that. That is my background also, so I didn't think much about it either, but for driving home from places when he was too far gone. But symptoms he had and with the Hep C, well that was a dangerous combination. Your hubby does not have the A, V, Or Hep C viruses, right?

The liver is amazing. It can regenerate itself. Did you know that some transplants are done with donor "lobes" from live patients? They docs take a piece of a donor's liver (usually a family member with close genetic match) and transplant it into the cirrhotic patient. Both livers grow to normal size over time. It is a hard surgery, and there are risks for the donor...but that is how some choose to do it.

HOWEVER, cirrhotic liver cells do not generate new liver cells. So the sooner the damage stops, the better.

I would think someone in the 15% should STOP drinking. But that is up to hubby and his doctor. I cannot state my opinion as FACT.

Mike occasionally will have a non-alcoholic wine or beer to be part of the fun, but I'd say he hasn't really done that but 3 or 4 times in the past year. He was so close to death, he KNOWS what can happen. He definitely is in the 15% category!

You might want to try an online Alanon forum also and ask some questions there...tell them how this makes you feel, etc.

Hugs,

Mama Lama
MamaLama, Forum moderator - Hepatitis
Partner received liver transplant (May 1, 2011) FL
Hep C 1a Treatment - Sovaldi/Olysio (March - May 2014)
Undetected since week 4. Undetected 12 weeks post treatment.
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