Expert: John Thai, M.D. - 10/21/2009

Question
Dear Doctor,
I have the following question:
Last year I did the blood test and it showed elevated ALT-46 and total bilirubin of 27. alkaline phosphatase was normal as well as other indicators. This year I repeated the blood test and the ALT returned the value of 97 and total bilirubin -27. My doc said nothing to worry about. I think it is some kind of problem with the liver maybe if it leaking so much ALT? Also i was diagnosed with the gallbladder stone of 6mm, but the ALK PHOS is normal! I have ran the hepatitis tests for all them and it was negative. Don't know what to think. What is your opinion?
Summary in brief:
30 yo male. 187cm, 73kg. No health problem. Alcohol on weekends ~ 2 glasses of whine.  6mm stone in the gallbladder. H.pylory in history, now eradicated - titer <15. No family history of liver disease. No occupational hazards.
ALT - 97
TOTAL BILIRUBIN - 27
Urine normal, cloudy
PH-8
all others are normal.
THank you,
alex

Answer
Hi Alex,

An abnormality of ALT does not always mean liver disease. It is definitely highly sensitive for liver dysfunction. However, an abnormality of ALT could be due to a dysfunction in the heart, muscle, pancreas, or kidneys. If the ALT rises more than 3-folds, then we can presumptively say there is active liver cell destruction within the past week. A mild 2-fold increase of 97 may mean either non-alcoholic fatty liver, medication induced, over-the-counter alternative/herbal products induced, viral infections such as those that cause the common cold, or simply ingesting alcohol the night prior to testing.