Slightly raised liver tests

Resolved question:
Hello,

I am a 32 year old man, (6'1, 200 lbs and moderately active) and I am not experiencing any symptoms. I recently got blood work done and the following values were flagged:

ALT (SGPT): 75 (normal 0-44 IU/L)
AST (SGOT): 48 (normal 0-40 IU/L)
Alkaline Phosphatase, S : 33 (normal 39-117 IU/L)

I am wondering if I have anything to worry about. Google shows that these are all liver enzymes.

I am only a weekend drinker, but I do hit it pretty hard on the weekends. The only medication I am currently taking is Avodart (Dutasteride) for hair loss. I am not taking any painkillers.

Seven weeks prior to testing, I stopped using injectable testosterone ethanate (600mg/ week). I used the following medications for five weeks to kickstart my natural testosterone production: clomid (clomiphene) 50mg every day and nolvadex (tamoxifen) 30mg every day.

I feel perfectly fine however I wonder if the elevated liver enzymes are anything to worry about and what my followup action should be.

Submitted: 4 Days
Category: Hepatologist

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Yes AST and ALT are liver enzymes and you have a mild elevation of those. These are called transaminases and hence called mild elevation of transaminases. This is a common clinical scenario. There are a number of causes of elevated AST and ALT, and the first thing we look for is for intake of any medication in (current or recent past). And not to mention you have plenty. Dutasteride, Clomid, testosterone all can cause elevated liver enzymes which can persist.

The elevated liver enzymes show that there is kind of a stress on your liver by these medications, to be put in a simple way. I wonder what the indications of the above drugs. It sure looks like a dangerous combination to me.

To answer your specific query - anything to be worried about ?, no you do not appear to be in risk or danger as of now BUT this is warning sign. You should not user off label drugs. (I assume so, pardon me if I am wrong.)

Get a PT and INR test.
Monitor the LFT after 3 months. If still the values are elevated at that time few other tests will be needed (Ultrasound, TIBC, HBSAg, Anti HCV)

Avoid OTC pain medications, alcohol (till the AST, ALT normalised)

Hope this helps
Feel free to ask followups
Thank you

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