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Forum Name: Liver Diseases

Question: Elevated Bilirubin and ALT


 AR1 - Mon Aug 06, 2007 11:21 am

I'm a 38 year old male with no history of excessive alcohol consumption (aside from my college days) and have never used tobacco. I've always been in very good shape and exercise on a regular basis. I've always had a clean bill of health, however, something has come up during standard blood-work when applying for life insurance.

In short, my total bilirubin came in at 1.6 (.1-1.2 MG/DL), while my ALT was 84 (1-45 U/L), with everything else coming in "normal," such as AST 40 (0-41 U/L). Test were negative for Hep B and C. Follow-up tests included a complete scan of my liver, kidneys, etc. with nothing significant being found. Additional blood work included the typical test for iron, copper, and a full hep panel, all coming back as normal. These same follow-up tests found my AST up a wopping 1 point to 41, however, my ALT had now dropped to 76 and my biblirubin was up to 3.0. My doctor does not seem to be overly concerned about things and has scheduled a follow-up set of tests for three months. It is also his opinion the Gilbert's syndrome is not the cause.

I can't seem to find anything anywhere that would adequately explain elevated bilirubin and alt with everything else remaining in the normal range. For several years I've replace my morning meal with a protein shake/meal supplement from GNC, and often have one after working out, but I can't imagine that would have any effects on liver function as it does not contain things such as creatine. Having a three year old and a one year old now depending on me, I've become a little concerned.

Any thoughts on the matter that someone could pass along would be greatly appreciated. Thank you!
 Dr. Chan Lowe - Mon Aug 13, 2007 5:21 pm

User avatar Hi AR1,

It may turn out not to be your liver at all. ALT can come from red cell break down. The red cells that are broken release hemoglobin which is broken down into bilirubin.

If you have something causing your red cells to break down faster it can cause an elevated ALT and bilirubin.

Gilbert's syndrome would not typically cause an elevation in ALT. Rather it is an isolated minor elevation of the bilirubin.

I would recommend having your hemoglobin and hematocrit tested to see if they are low.

Best wishes.

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