Mildly Deranged Liver Function Tests

Dear Ask The Doctor: I just had a comprehensive health screening and I had high AST (aspartate aminotransferase) and ALT (alinine aminotransferase) levels. AST is 63 and ALT is 53. I have no insurance and I am wondering what procedures will I have to go through if I go to a doctor for a follow up on this, i.e. - xrays, more tests, etc. Is this a dangerous level of AST and ALT? Could you please tell me what questions I should ask of the doctor and what procedures to follow to make this as inexpensive as possible. I also was recently diagnosed with diabetes and that is why I was denied insurance.

Dear Kenneth: Your transaminase liver tests are only mildly elevated, and may be of little significance. Liver function tests can be elevated for many different reasons including inflammation or damage to the liver, due to infection, disease, toxins or drugs including alcohol. They can also be raised secondary to biliary tract disease, such as gallstones, which prevent the normal flow of bile from the gallbladder and may create a back-pressure effect to the liver. Liver function tests can be deranged due to fatty liver, which may also be linked with diabetes. A simple ultrasound of the abdomen may be a sufficient investigation to exclude any sinister causes of your mildly deranged liver function tests. This could be arranged by your family doctor. If you require specialist advice referral to a gastroenterologist who specialises in hepatology (hepatologist) would be appropriate.