Fatty Liver Diagnosis
Most people discover they suffer from a fatty liver disease following a routine blood test performed for a completely different reason, or after donating blood that followed a rejection. This usually happens when some abnormalities are found in the blood test, suggesting some type of liver disorder.
The next step in fatty liver diagnosis is to take an additional, second blood test, but this time the test should be focused on liver functionality.
This blood test will usually include tests to rule out some common liver conditions, such as Hepatitis B and Hepatitis C, and other tests to check liver enzyme levels.
The most important blood tests regarding fatty liver diagnosis are two liver enzymes: SGOT (also called AST), and SGPT (also called ALT).
If other liver disorders have been ruled out, elevated levels of AST and/or ALT may suggest a fatty liver. Detailed information regarding liver function blood test could be found in understanding liver function blood test results article.
The next step in fatty liver diagnosis is taking a liver ultrasound. An ultrasound test would reveal some liver properties, such as the fat buildup in the liver, and whether or not the liver is enlarged. All of these will help diagnosing a fatty liver disease.
A quick summery of a typical Fatty Liver Diagnosis process
- A blood test is taken.
- If the blood test shows elevated liver enzymes, a second blood test is ordered.
- A second blood test is taken to rule out other liver diseases, and focusing specifically on liver functionality.
- No signs of Hepatitis B or Hepatitis C found in the blood test.
- An abdominal ultrasound scan is taken to confirm a fatty liver.
- The liver ultrasound scan reveals enlarged liver and/or a liver with abnormal levels of fat.
- If alcohol is not a factor, non-alcoholic fatty liver is diagnosed.
Although a liver function blood test and a liver ultrasound are usually enough for fatty liver diagnosis, in some cases – a liver biopsy could be needed.
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April 16th, 2011 at 5:27 AM
I need information on Hepatitis treatment to be forwarded to my email box. Thanks.
June 7th, 2011 at 2:53 AM
I had noticed that the Total Bilirubin level is increasing in my blood test. In Jan 2011,I had 29.8 mmol/L and now in may 2011 it has risen to 34.2 mmol/L. I understand the normal is between 3.4 to 20 mmol/L.
ALT and AST is normal… On may 2011, it ALT = 30.1 IU/L and AST = 25.3 IU/L.
Please advice is this increase in Total Bilirubin due to Fatty Liver?
I am 33 years old male, 173 cm height and 90 Kg weight.
June 11th, 2011 at 2:19 AM
Hello George,
If the Total Bilirubin levels are elevated, without ALT and AST, it could be a sign of Gilbert Syndrome, which basically means that you have an elevated bilirubin levels, but without any medical implications.
Regards,
Dr. Mark Bar-Gomel
June 11th, 2011 at 4:23 PM
I (29 y.o. male) just got my yearly physical. Blood work came back normal except for elevated ALT and AST. I donated blood back in the fall and never heard anything from the agency that did it, so I assume the blood I gave them “passed inspection.” The day before I went in for my physical I lifted weights for about an hour, I’ve heard that this can cause your enzyme levels to rise especially if you haven’t exercised in a while (which I haven’t). I’m getting an ultrasound done to eliminate doubt, but is it more or less safe to believe that my elevated enzymes could be due to exercising?
June 12th, 2011 at 11:28 AM
Hi Robby,
Yes – exercise close to a blood test can cause elevated liver enzymes, especially ALT and AST.
I actually wrote about this situation not that long time ago. Read this article: Elevated enzyme levels after exercise for more information.
Regards,
Dr. Mark Bar-Gomel
June 15th, 2011 at 1:50 PM
Is it possible that strenuous exercise could lead to Fluctuation in AST but not ALT levels? I’m 44, 5’8″ 155 lbs, and a runner & cyclist. My ALT levels (they only reported ALT) in 1998 were high, then normal on a re-test. Never had need to go to dr until physical in Jan 2011. AST 43, ALT 22. March 2011 AST 41, ALT 22. April 2011 AST 35, ALT 22. June 2011 AST 47, ALT 22. I have 1/2 glass wine with dinner 3-4 times/week over the last 2 years. No painkillers. All other hepatitis and other associated bloodwork were negative or within normal ranges. I am going for an ultrasound next week. My wife is totally freaked out, especially with the AST/ALT ratio. Should I be really worried? Thanks.
June 15th, 2011 at 1:57 PM
Dear Kenneth,
There is no need to freak out.
1) Sometimes AST could be elevated while ALT isn’t.
2) Your AST levels are slightly higher than normal, but it’s not as much to consider it risky, at all.
3) It could be something related to the exercises.
4) Your liver ultrasound will reveal a fatty liver if you have one. And even you do, it’s totally reversible.
Please keep me posted regarding the ultrasound scan.
With you best,
Dr. Mark Bar-Gomel
June 18th, 2011 at 10:22 PM
I have had a recent blood test that show my ALP, AST, ALT arell increased. My cholesterol levels have been high for many years and am now starting to take medication again. I had a ultrasound which showed fatty infiltration into the liver. Can increased cholesterol contribute to this.???? I have started to keep out staurated fat from my diet…restrict alcohol intake (which was mainly on a weekend babis anyway and never was to excess amounts). I exercise at least 3 times per week. Will this help in normalising my LFT’s and Cholesterol. My Triglycerised are also increased.
What is the best way to approach this situation????
June 20th, 2011 at 12:38 PM
I am 31 yrs old female, 5’3 height and 111 lbs. went for my routine physical and blood work and found the ALT (41) and AST (33) high. the doc suggested we do another blood test after few months. 1 yr back the ALT and AST levels were even more higher and the doc suggested a liver ultrasound and results were fine. i am confused on what to do. i am very thin and my BMI is only 20. the doc asked me to increase a little more weight. the doc said could be becos of pregnancy ?? my child is 18 months old ( normal pregnancy no complications nothing)
so i am wondering what could be the cause?
June 22nd, 2011 at 3:35 PM
Dr. Bar-Gomel:
Thank you for your reply last week. The ultrasound was done today and it came back as a hemangioma on my liver. Doctor wants to send me for a MRI or CT to better check on size/involvement. He also wants to send me to a gastroenterologist. Why would he do that? It seems from the brief reading I have done that it pretty much is just a monitoring situation. He still doesn’t know why my AST level is slightly elevated either. Thank you for your time.
June 24th, 2011 at 8:47 AM
Dear Kenneth,
The fact that your AST levels are elevated with no logical reason may be the reason you doctor sends you to these tests. There are some rare cases where elevated ALT levels are symptoms of various diseases, and some of them are not very common.
I strongly suggest to visit a gastroenterologist before you do MRI or CT scan. Make sure he knows your medical history.
Regards,
Dr. Mark Bar-Gomel
June 24th, 2011 at 4:37 PM
for the past 5 years my ALT IS FLUCTUATING , NOW ITS 128 ,BUT AM ASYMPTAMATIC ,OTHER FUNCTION TESSTS ARE NORMAL.
August 26th, 2011 at 4:47 PM
Please Help!
I am a 54 year old woman who has had elevated amylase levels (ranging from 195-210) for the past 3 years. My general physician had me do an MRI of the pancreas, liver areas about 2 years ago, and there was no problem other than a “mildly fatty liver,” which the dr was not concerned about.
I went to a gastroent. w/ the info at my dr’s suggestion, who simply said, “Maybe that’s just how you are.”
I’m always vaguely worried about it, but at my last blood test the results were Amylase 202.
My cholesterol is also always high, this time the Lipid panel was 210.
Also, Creatine is 0.70, which dr says means I need to drink more water.
After these years of this high amylase level, the dr is quite puzzled and now, says he is concerned as it never resolves.
The only medications I take are: zoloft, allegra and benicar.
I eat NO sugar, not much carbs and maintain a gluten free diet.
I do not drink alcohol. Never did.
I am very concerned. The dr says he does not want to “have” to have me get a PET scan, and I do not want to be exposed to radiation. I am hoping that someone can tell me how to proceed (and if to proceed). I am very worried and of course, would like to simply forget about it. Does anyone know what this might be?
Thank you very much,
Jackie
October 6th, 2011 at 11:22 PM
dear kenneth…
i just got my LFT result. all shows normal but only the ALT were high 102U/L…..
im scared… please help me…
October 6th, 2011 at 11:24 PM
sorry wrong name…
i just got my LFT result. all shows normal but only the ALT were high 102U/L…..
im scared… please help me…
October 29th, 2011 at 11:10 AM
Dear Dr. Bar-Gomel:
Could ALT AST levels be elevated due to consuming alcohol before test before the required fasting period? It was about 17 hours before the blood test. Thank you in advance.
Kat
November 1st, 2011 at 6:51 AM
My Alt Ast came quite elevated. I rarely drink but I was little anxious about tests and have a large beer (I think .75 mill) it took me 2 hours to finish it. Now I am not sure if the alcohol could cause elevated enzymes or if my liver was healthy it should take care of it and have enzymes in normal range. I am overweight so the fatty liver is a possibility too.
TIA
November 9th, 2011 at 7:19 AM
Hello Kat,
There are two types of fatty liver: alcoholic fatty liver disease, and non-alcoholic fatty liver.
Your case is not very clear, as you’re consuming a lot of alcohol, but also overweight.
Can you please share your blood test results so I could take a better look at your situation?
Regards,
Dr. Mark Bar-Gomel
November 9th, 2011 at 7:21 AM
Hello Kat,
Consuming any type of drinks can greatly affect the blood test results.
Yours,
Dr. Mark Bar-Gomel
November 9th, 2011 at 11:05 AM
Hello,
No, I don’t consume a lot of alcohol that is why I was hoping that the results were off because of fact that I have the whole (large) bottle of beer quite close to the test. I drink so rarely that it didn’t accur to me that this could be a problem. Otherwise it could be a fatty liver as I was putting on weight for the last four years (quit smoking). My AST were 129, ALT 227, ALK Phosphorate 111
Sincerely,
Kat
November 9th, 2011 at 11:08 AM
P.S. But I was properly fasting for 12 hours. The beer I had about 17 hours prior to the test.
k
November 15th, 2011 at 5:42 PM
All I could find that is also related to liver were: albumin 4.5 g/dl and bilirubin .4 mg/dl. Basically all my lab-work was within normal range except for ALT, AST and triglycerides that were 158.
Thanks again
k
January 15th, 2012 at 9:13 PM
I am a generally healthy 32 year old male, During a routine exam at my Doctor, we discovered some Elevated Bloodwork… As far as I know, I am not having any problems or symptoms, but these eleveated or decreased numbers concern me…
Inital Blood Draw
SGPT/ALT – 72
Ammonia – 35
Two Months Later
SGPT/ALT – 76
Ammonia level 10
ALL THE OTHER LABS ON BOTH DATES WERE WITH IN NORMAL LIMITS…
January 17th, 2012 at 4:57 PM
Well I’ve being going to the VA and have had two blood tests done showing elevated liver enzymes. I’m going for a ultrasound tomorrow. I’m really worried about this. I used to drink a lot in the military and now that im out, i no longer drink. I just take my prescription medicines which i see can both cause elevated liver enzymes. Ativan. 0.5 m.g. Twice a day. And Ambien 10 mg once at night. I’m only 23. 6’1 weigh 180 pounds. I’m really really worried. Hence the prescription ativan for anxiety. It’s hard to focus on my college work when im freaking out over this test. I’m also taking milk thistle now, and ordered liv 52. Which from my research online is one of the best liver support supplements as rated by body builders. I don’t wanna have a life threatening ailment when i don’t think i’ve partied anymore or less then a college student when i was in the service. I’m really worried.
January 19th, 2012 at 11:23 AM
I am 32 year old male. I had my complete health checkup done. My ultrasound scan shows fatty liver grade 1. Scan does not reveal any enlarged liver or any other abnormality. My AST and ALT are normal. I never take any alcohol. What does this mean?
February 3rd, 2012 at 11:31 AM
hi im 23, 189lbs 5’9, female with ulceritive proctitus, & i just got my results my ALT is 91 & AST is 41, i jus had a baby 2 months ago with a healthy pregancy, i dont have any symptoms, i feel perfectly healthy. what could be wrong with me?