Alt and ast levels?

[Conner]

I was referred to a gastroenterologist about a year and half ago because of slightly elevated ast and alt liver enzymes. They did there own bloodwork and said bloodwork showed possible celiac disease. She wanted to do an upper endoscopy to confirm but said if I couldn’t afford it would be ok by her. 
since then I have bloodwork done by my regular doctor every 3 months. My elevated levels have gone down and up over the last year but this last time they were higher than they have ever been. AST 57 Alt 94. Is this normal with celiac disease?

also over the last year my stools are all over the place. Light brown yellowish color. Loose most of time and firm sometimes. Also discomfort at localized spot at right of abdomen below ribs. 
does anyone have any input or similar situation?

[trents]

Welcome to the forum, Conner!

Elevated liver enzymes are very common in the celiac population but generally, once going gluten free, they return to normal. This is my story and chronically elevated liver enzymes are what eventually led me to a celiac diagnosis. Having said that, like many other health threats, if left to its own too long it can result in irreversible damage.

Please give more information.

1. Are you on a gluten free diet yet?

2. What "bloodwork" was done that "showed possible celiac disease"? Can you be more specific? What tests are you referring to?

 

The tender spot at right of abdomen below the ribs could by an inflamed liver or pancreas.

[Conner]

I am not on gluten free diet 

 

Celiac Disease Comprehensive

Deamidated Gliadin Abs, IgA speaker_notes

Current Result:

13 

0

units

19

Deamidated Gliadin Abs, IgG speaker_notes

Current Result:

3 

0

units

19

t-Transglutaminase (tTG) IgA speaker_notes

Current Result:

<2 

t-Transglutaminase (tTG) IgG speaker_notes

Current Result:

8 

Flag: 

High 

0

U/mL

5

Endomysial Antibody IgA 

Current Result:

Negative 

Reference Int: 

Negative 

Immunoglobulin A, Qn, Serum 

Current Result:

360 

90

mg/dL

386

TSH+Free T4

TSH 

Current Result:

1.550 

0.45

uIU/mL

4.5

T4,Free(Direct) 

Current Result:

1.26 

0.82

ng/dL

1.77

NASH FibroSure

Fibrosis Score 

Current Result:

0.11 

0

0.21

Fibrosis Stage 

Current Result:

F0 - No fibrosis 

Reference Int: 

Steatosis Score 

Current Result:

0.57 

Flag: 

High 

0

0.3

Steatosis Grade 

Current Result:

- 

Reference Int: 

S1 - S2 Minimal Steatosis - Moderate Steatosis

NASH Score 

Current Result:

0.50 

Flag: 

High 

Reference Int: 

0.25 

Unit:

NASH Grade 

Current Result:

- 

Reference Int: 

N1 - Borderline or probable NASH

Height: 

Current Result:

66 

Reference Int: 

Unit:

in

Weight: 

Current Result:

201 

Reference Int: 

Unit:

LBS

Alpha 2-Macroglobulins, Qn 

Current Result:

135 

110

mg/dL

276

Haptoglobin 

Current Result:

134 

23

mg/dL

355

Apolipoprotein A-1 

Current Result:

168 

101

mg/dL

178

Bilirubin, Total 

Current Result:

0.6 

0

mg/dL

1.2

GGT 

Current Result:

47 

0

IU/L

65

ALT (SGPT) P5P 

Current Result:

74 

Flag: 

High 

0

IU/L

55

AST (SGOT) P5P 

Current Result:

46 

Flag: 

High 

0

IU/L

40

Cholesterol, Total 

Current Result:

205 

Flag: 

High 

100

mg/dL

199

Glucose, Serum 

Current Result:

99 

65

mg/dL

99

Triglycerides 

Current Result:

75 

0

mg/dL

149

 

[trents]

Thanks for the additional data. May I ask your age?

Out of the several antibody tests designed to diagnose celiac disease, you have one that is positive (high), namely the tTG-IGG, but it is not strongly positive. It definitely would be helpful for diagnostic purposes to have the endoscopy/biopsy done as that is considered to be the diagnostic gold standard for celiac disease.

Your other tests show signs of early stage fatty liver disease which could be caused by celiac disease. It also suggests some dietary/lifestyle changes are in order. I would take this seriously.

If you cannot afford an endoscopy/biopsy I would consider a gluten free trial diet. Commit to 6 months of gluten-free eating and see if the liver enzymes normalize. But realize that if you go on a gluten-free diet then you will invalidate any further testing for celiac disease, whether serum antibody tests or endoscopy/biopsy. If you wanted at some later time to go for further celiac disease testing you would need to go back on gluten for at least two weeks for a biopsy or 6-8 weeks for serum antibody testing.

If you decide to go on a gluten-free diet now, realize there is a significant learning curve involved in achieving a truly gluten-free state as gluten is found in so many things you would never expect to find it in. This can be complicated by terminology in the food industry and then there is also the phenomenon of CC (Cross Contamination of gluten free food by gluten-containing food, cookware, utensils, etc. Eating out is particularly a challenge with regard to CC. Perhaps this will help: 

 

[Conner]

I am 48 and thanks for the info

[knitty kitty]

You may want to talk to your doctor about supplementing with thiamine.  

My non alcoholic fatty liver disease resolved after I supplemented with high dose thiamine.

Thiamine is essential for making liver enzymes.

High-dose vitamin B1 therapy prevents the development of experimental fatty liver driven by overnutrition

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7988776/

The gall bladder under your right ribs can get "sludgy" without sufficient thiamine.  The gall bladder makes digestive enzymes that helps with digestion.  Without sufficient thiamine, the gall bladder's production of enzymes can vary causing changes in color and consistency of stools.  

Hope this helps.

[Conner]

Thanks for info

[Posterboy]

Conner,

Here is another article that might be helpful to you!

Entitled "Elevated Lactate Secondary to Gastrointestinal Beriberi"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699997/

They also had mildly elevated liver enzymes at the time time of diagnsosis that supplementing with Thiamine helped!

I hope this helpful but it is is not medical advice.

Posterboy,

[mimizmamma]

I once had high levels of liver enzymes before being diagnosed and since going gluten free they’ve been normal. I’m now 43 and the first few years after diagnosis my older brother (48 at the time) believed celiac disease wasn’t a real thing. After a few years of severe liver issues and drs insisting he stop drinking (he doesn’t drink any alcohol) he finally mentioned his sister having celiac disease and they tested him. His labs and endoscopy were all positive and since he went gluten free his liver is fine now. Just our experience with it. 

[Scott Adams]

Very interesting @mimizmamma! This category has past summaries of research articles on the topic of liver issues and celiac disease in case anyone wants to know more:

https://www.celiac.com/celiac-disease/celiac-disease-amp-related-diseases-and-disorders/liver-disease-and-celiac-disease/