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Posted 5/24/2014 8:49 AM (GMT 0)
I have non-alcoholic fatty-liver disease.
so far, i did 8 tests and always ALT level was greater than AST level even in normal tests.
Today, I did another blood test and all liver enzymes were normal but it was the first time that
AST (32 U/L) is greater than ALT (=27 U/L).
I have read from many websites that a ratio of AST/ALT>1 may be a sign of cirrhosis.
I have pain my left chest and arm and I afraid that it may be liver related.

Is AST/ALT>1 in diagnosing cirrhosis in non-alcoholic fatty liver valid for elevated liver enzymes or is this ratio also valid for normal enzymes?

I will be happy for your comments.
Posted 5/24/2014 12:26 PM (GMT 0)
" In fact, I asked my doctor 1 month ago about the possibility of Cirrhosis when I did the blood test and she told me not to worry and said in case of cirrhosis, your liver would shrink and they would notice this
in the ultrasound and ct scan done about one year ago."

This was one of the first post you made here.

" i am extremely stressed because of my health problems and my job and now i worried if the itching could be due to liver. not easy situation! "

This is another post you made later.


Find another doctor if you are this concerned about her misdiagnosis. She has clearly indicated you didn't have liver disease. Is these test results coming from the same doctor? If not what did they say? It appears your obsessing about liver disease regardless of diagnosis. I'd suggest finding a Hepatologist if these issues continue to plague you. Reading online medical papers aren't going turn up the results your looking for. Spend the money and see a professional.



Ziff
Posted 5/24/2014 1:36 PM (GMT 0)
Ziff,
the problem is these are different doctors and they are family doctors.
it is very hard and expensive to go regularly to specialists.
Posted 5/24/2014 1:59 PM (GMT 0)
I understand about cost and inconvenience but the people you are dealing with (Internal Medicine, Family practitioners or whatever) don't seem to be able to diagnose the problem to your satisfaction. We can't diagnose your problem, We are here to help once you have been diagnosed. If you find out you have liver disease eventually, how will you go about treating it? Butter knife, sewing kit, rubbing alcohol and youtube video on surgical procedures? I suspect not, so therefore you have to see a real specialist and a surgeon. We can guess for days what you may have just as you seem to be doing but in the end it's still just a guess and your no better off.



Ziff
Posted 5/24/2014 2:17 PM (GMT 0)
"the problem is these are different doctors and they are family doctors.
it is very hard and expensive to go regularly to specialists."

It's even harder and more expensive to find out that you have a problem and didn't catch it as soon as possible. Go see a hepatologist.
Posted 5/24/2014 2:26 PM (GMT 0)
Ditto what Ziff said! Also, AST/ALT ratio issues are basically useless if the enzyme levels are within normal limits - which yours are. And pain in your left chest/arm is not indicative of liver disease - your liver is on your right side. One more thing, elevated AST levels are not 'specific' to liver damage, because it can also be used as a cardiac marker.

Post Edited (Splashdancer) : 5/24/2014 8:29:24 AM (GMT-6)

Posted 5/26/2014 1:56 PM (GMT 0)
Since your levels are normal, I wouldn't worry about it. I'm guessing the chest pain anxiety related.
What are you doing to take care of the fatty liver disease? How did the doctor diagnose you with that? If you're exercising, eating well, losing weight if needed, then you're on a good track.
How often are you having lab work?
Posted 5/26/2014 3:12 PM (GMT 0)
Here is a pretty good chart: en.wikipedia.org/wiki/AST/ALT_ratio

Note the last sentence, when the ASL/ALTs are low, the ratio generally is meaningless. I think you are okay, but always recommend someone see their doctor for definitive analysis.

Hugs,
Mama Lama
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