High ALT

Question

sallam,

got my LFTs test recently done and found out that my ALT is 121. also did hepatitus A,B,C tests, all were negative.

i was also asked for an ultrasound of liver, it came that i also have a fatty liver.

a doctor advised me to start hepamerz syrup or silimyrin capsules.

i just wanted to cross check my doctors advice and want an opinion from specialists here.
are you satisfied what my doctor advised me and please also let me know which is better to use hepamerz or silimyrin, i mean which is more effective.

thanks in advance

Assoc. Prof. Dr. Somia Iqtadar · Answer

u can take either.Also get your fasting loud profile.What is your weight and height?

Dr. Adil Ayoub · Answer

What is your weight and Hight?
Some other investigations are also required
Like
CBC
LFT
Urine Complete
RBS
Complete Lipid Profile

Then follow the advise as by doctor

Dr. Kashif Ijaz Ahmed · Answer

hi
interesting debate. it again appear you have been a victim of the typical psyche of clinician that something has to be offered, i am glad in this forum very sensible advice has been offered .few things to add.2/3 outstanding things stands out
you are slightly over wt if you do your BMI it will be in obese range
2/ raised tramsaminase (ALT) WITH NORMAL ALPO4 AND GGT
3/Your lipid profile is deranged certainly TGshigh so is chol/hdl ratio
4/usg showing some fatty changes
based on above one would like to know
1/ anyh/o alcohol use

2/ life style
3/any use of medication prescribed or recreational
IF there is no obvious risk from above this condition is called NASH/NAFLD
(NON ALCOHLIC STETOHEPATITIS/OR NON ALCOHLIC FATTY LIVER DISEASE
treatment of this condition is to modify lifestyle and reduce visceral fat (internal fat)
this is one of most common cause of liver transplant in young in the west if not treated
when ALT reash 3 times the upper normal limit this is the indication for liver biopsy which seems the case with your bloods but no need to get panic this is one off readings so first thing is repeat lfts in 4-6 wks .
nowadays one can get away with biopsy by having fibroscan but this is fairly specialized and expensive not sure about its availability in Pakistan though the machine is small cost 150k pounds (not the test )
purpose of biopsy /scan is to find is it just fat silently sitting in or it is causing inflammation and fibrosis of liver cell (indirectly reflected by raised alt)
bottom line is
1/ no medication what so ever at all
2/ intense life style change //plan to wt reduce
3/repeat lfts in 6 wks
if alt still above 100 see some more than competent sincere/ethical clinician
regards
Dr Kashif I jaz Ahmad
Consultant family physician/Community diabetologist
MBBS, MRCP(UK),MRCGP(UK), FRSPH,CCT, PGDip (LONDON)

Dr. Abdul Naeem · Answer

Hi
1st check ur BMI by Google and decide for metabolic syndrome that ll give u
perfect cure
Rgds
Dr.A.Naeem

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Assoc. Prof. Dr. Somia Iqtadar - Internal Medicine Specialist

MBBS, FCPS (Medicine), FRCP (London) | Lahore

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