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Asked by John, Austin, Texas
I'm a 29-year-old male who recently went to the doctor for a routine physical and was told my liver enzymes (AST specifically) were very high. My doctor immediately diagnosed it as a drinking problem and told me to cut back. The problem is, I don't really drink a whole lot. I do admit to the weekly happy hours at the end of the week where I sometimes drink more than I should, but it certainly is not a daily habit. (I don't even have any beer or liquor in my house.) I had happened to be out drinking a few nights before my blood test, and I read that strenuous exercise can also cause this. (I've run two marathons, and I am currently training for another.) Should I get another opinion or just simply cut back on the drinking?
Conditions Expert
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
Dear John:
There are two enzymes that are commonly measured in blood. Some refer to them as SGOT and SGPT; others refer to them as ALT and AST. These enzymes can come from muscle or liver. They can be elevated in the 24 hours after extreme exercise because of muscle damage. They can also be elevated because of liver damage from alcohol, infection of the liver, or even the spread of cancer to the liver or trauma to the liver.
Certain drugs other than alcohol can also cause an elevation of these enzymes. It would be to your advantage to get these measured after several days of no alcohol. You doctor may ask the lab to fractionate the enzymes to determine whether they are from muscle damage or liver damage. Your physician will look at the ratios of the enzymes and look at other liver enzymes. This could be no problem at all or a major problem.
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