Hello doctor, I am 42 years male with controlled hypertension. I did my annual check-up, and I found ALT and AST are 192 and 142, which are elevated. I had an ultrasound, and I found fat from marked to moderate on my liver. Lipid profile results are in the optimal level, CBC and kidney results also fine. There is no sign for hepatitis as all result for A, B, and C are negative. What will be the reason for having this elevated result for ALT and AST, and what should I do?
Hello. Certain prescription and over-the-counter drugs may also cause increased liver enzyme levels. In studies, we have seen that Candesartan (Atacand 8 mg) that you are taking, can cause deranged hepatic function and also inflammation of the liver (hepatitis) to some extent. That is why this drug should be taken cautiously if the patient is a regular alcohol consumer. It interacts with the alcohol and may cause significant liver issues. In the setting of having no viral hepatitis (A, B, C being negative in screening) and a raised ALT (alanine transaminase) and AST (aspartate transaminase). I would refer you to see a hepatologist in person for detailed investigations. He may go for more sophisticated studies of liver including but not limited to ultrasound of liver (elastography studies) and thorough blood work related to liver health that may screen and detect a lot of factors of liver health. Also, keep an eye on liver enzymes and go for serial follow-ups with your Liver doctor (hepatologist) in future too. This way, you may be able to keep a check on liver cancers and or and other issues related to the liver. Liver cancer has many risk factors, and one of them is liver cell damage. AST is released when liver cells (or heart cells) are damaged. So, a raised AST may be a sign of liver cell damage. Further probing is warranted here. ALT is also raised in cases of liver (and or kidney) issues. I hope it helps. Please feel free to ask more if you need further assistance.