May 26, 2010
I would like to start by being honest and mentioning that I DO NOT have HIV. I frequent this site b/c I have someone very close to me who is HIV +, and have noticed a degree of authentic care and professionalism on this website. I would appreciate it if you could give me some insight on a personal health issue of mine. I recently had a CMP done and my ALT came back at 59, AST at 19. The lab I was at had a standard range for ALT at 30-65 U/L. My question is this. Almost every medical site I look at says 59 is elevated, even though the lab I was at says its fine (apparently). Why is there so much discrepancy on what is considered normal with this number? Do different machines have different sensitivities or something? Or maybe it is the "director" or whatever or the supervising members of the labs consider to be normal, in their own professional point of view? Just a little worried. Male 26 yrs old 5'9" 182 lbs. Very muscular some body fat. I don't think that I am at increased risk for Hepatitis. No drug use, no blood transfusions, no homosexual encounters. I did drink pretty heavy in late high school/early college. Now don't get drunk but maybe every few months. Any thoughts? I understand that this question may not be appropriate for your forum and understand if it is ignored as such. If you do respond, thank you very much for your time.
Response from Dr. McGovern
First off I want to say that I don't ignore any questions to the site. I unfortunately don't get to answer all questions because of the sheer volume. I am happy to answer yours.
Your body mass index is 26.7 which is into the overweight category. I have calculated this with your height and weight. You can do this yourself on the NIH site: http://www.nhlbisupport.com/bmi/
I suspect that some alcohol in the past and some fatty liver are contributing to your ALT level. I also agree that the lab where your ALT is being processed has an elevated range of normal. Laboratories do differ in this and how they calibrate their ranges based on patient samples in their own hospital or clinic. I would consider yours to be elevated.
I would also get your cholesterol and triglycerides checked. If there is a family history of diabetes, you may want to consider a simple blood test for insulin resistance.
In the meantime, increase your exercise and decrease your calorie intake and see what happens to your ALT over time.
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