A Stepwise Approach to Patients With Abnormal Liver Enzymes

[StephenCastlecrag]

Readers may find this article interesting: https://www.gastroendonews.com/Priority-Report-Hepatology-Insights/Article/11-23/abnormal-liver-enzyme-patients/72355?sub=4C55C5630E93618BB5BC5103818CA65D911B8A2DAFEEA2D88A31872C32E&tken=4CC4F71BB2E9937C086D224907A3499F71D63C5DCC74012D371F0B7B489EA8&enl=true&dgid=&utm_source=enl&utm_campaign=20240430&utm_content=3&pos=3&utm_medium=button
Some useful info:
The terms “liver function tests,” or “LFTs,” are not exactly correct. Although some liver tests—such as bilirubin, albumin, and international normalized ratio—do relate to liver function, liver tests such as AST, ALT, and alkaline phosphatase relate more to liver injury and/or other structural issues. For this reason, this article uses the terms abnormal liver chemistries, tests, or enzymes and specifically focuses on the evaluation of patients with abnormal ALT, AST, alkaline phosphatase, and/or bilirubin.
In the 2017 clinical guideline on abnormal liver chemistries from American College of Gastroenterology (ACG), based on many studies and surveys of many of the world’s leading hepatologists, we proposed that the true ULN for ALT should be 29 to 33 U/L in males and 19 to 25 U/L in females.

[melcul]

Thanks, Stephen! It's a good insight. I too am dealing with higher ALT, at around 70-80 even on TDF, since my viral load was undetected, we assume it's fatty liver (BMI 29, tryglicerides 204.9 (<150) mg/dL and fibrosis/fatty liver on ultrasound, working hard on getting my weight down/ sports and healthy diet so we can confirm this was the cause.

[StephenCastlecrag]

Hepatitis B patients are very sensitive to ALT numbers. Good luck with your weight control.