ALT Liver enzyme

Hello All, Just wondering if any of you have had experience with this. My ALT liver enzyme came back at 31 and then 33 two weeks later. My endo says I have to see a gastrointerologist. But all I have read it seems like I’m in a normal range. Before starting metformin in May, it was 13. I am wondering if she is worrying me needlessly as she said in a note to me that I’m not at a dangerous level and its not concerning. Mixed messages! Not concerning but she wants me to see a gastrointerologist? Anyone have experience with this? All other blood levels are well within normal on a CBC panel including AST. Could it be the metformin doing it? This is another new medical issue for me so I don’t understand all of it yet. …sigh…

A few years ago I had high ALT and AST numbers and the cause was Pravastatin. I had to switch to simvastatin and I haven’t had any trouble since. Myself and my doctor knows for sure that pravastatin was the cause because I would go off of Pravastatin for a month get my blood tested and my numbers would drop to normal and then I would go back on pravastatin wait a month get another blood test and they would go way up and then I would to do that again and the result was always the same. Proof positive that it was the Pravastatin causing my liver numbers to go Haywire. Also my legs were weak and I didn’t even realize that it was another side effect of Pravastatin


Thanks! I am hoping it’s not an issue because metformin is really working well for me…sigh


Some years ago, my liver enzymes were very high, one was 360. As a result of liver stuff, I was put on insulin early because, at that time at least, oral meds would have put more stress on liver enzymes. Now on insulin pump, when a new doctor looks at blood work and sees an ezyme of, say, 60 and comments about it being high, my reaction is ‘you haven’t seen anything’.

No test, not even a liver biopsy, showed any cause. After I switched to organic coffee, veggies, and fruit, and thus my liver didn’t need to process pesticides, my enzyme levels dropped quite a lot.

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Wow thanks! I can do organic! I think its the metformin because before I started it, the ALT was at 13. Now 6 montgs later, it’s at 31-33 which I believe is nothing! And, all my other mumbers are totally fine. I’m just a little annoyed that in one sentence my endo says that those number are not dangerous or concerning in her words but want a me to see a gastroenterologist for it…sigh…

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I went organic after reading a book, “Fat Lush” by Amy Louise Gittleman. Now there is a bunch of stuff about it online and Amazon books has stuff. All that wasn’t there when I read it, but I did do the initial flush thing. At first, I was taken off of metformin and put on insulin. Later, I was put back on it and told it was the other diabetic med that was bad for me. So, for the last 12 -15 years, I have been on both metformin and insulin (pump). My enzymes are a bit high, one maybe near 60, but not my endo nor my family practice doctor are worried about it.

Depending on your age, 30 may be in range of high normal. Elevated liver enzymes can be from weight (fat around liver), alcohol, hepatitis,or maybe ‘just because’. So, I am not fanatical about organic, but do get organic fruits, veggies, coffee and grains (flour).

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Thanks Susan… I am 58 soon and don’t drink or do herbal supplements so I think its the Met. I do have a few pounds I can lose but I’m not obese. So we shall see what she says this week! Thanks for your comments

And ALT of 31 is elevated, but not extremely so. ALT and AST are used as diagnostic indicators of liver damage. Metformin itself isn’t associated with causing liver damage, but if you have liver damage, Metformin may not be appropriate. If you have an impaired liver then you have an increased risk of lactic acidosis (which is largely zero otherwise).

You were referred to a gastroenterologist, an expert on among other things, the liver. The fact that your ALT enzyme was slightly elevated was apparently enough to warrant the referral, but not serious enough to your doctor for them to stop Metformin, but you should get it checked out.

ps. There are variety of reasons for ALT and AST to be elevated, including just “diabetes.” So this doesn’t necessarily indicate something serious, permanent or necessarily “wrong.”

Thanks Brian. I’m going to GI doc thurs so we shall see!