My wife has had high blood pressure recently and her doctor ordered blood work. The AST and ALT were high and out of range. Her doctor has ordered more blood work and an ultrasound of the liver. In the meantime, can exercise raise these numbers? She is also taking Tylenol frequently for recent back pain (the reason she went to the doctor in the first place).
Yup. At least in my case. I had a kidney stone a couple of years ago. It hit just after my final long run/ride before FLA70.3. That night, I was in the hospital with the stone. During the bloodwork, they found that my liver markers were out of wack. I ended up with 6 months of blood tests and assorted proddings. I never had a second odd test result. All my liver doc said was that the initial results “Could have been a typo”. I even told him I was training for a 1/2 and showed him an article on how endurance exercise can alter these markers, but he said no way. The good news is, bad liver markers don’t always mean liver problems.
Brad
Exercise usually doesnt raise AST/ALT…was the CPK ( or CK) high??
Liver test could be from drugs, alcohol, virus…etc…
If tests okay may just watch ( and cut back on tylenol)
Mark R
After IM Austria 2002 I ended up in an Italian hospital for four days with elevated ALT/AST numbers that were off the charts. They never diagnosed me. I still have the charts in my medical records. It might be a coincidence but I have pre-hypertension (130/80s) as well. I am 36, 5’9"/155, 5% body fat, and I don’t smoke/drink/drugs/caffeine. Would love to here what the docs tell your wife…
I bet it is more than likely the Tylenol that caused the elevated levels.
Tylenol can cause havoc on the liver
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People taking up to the max FDA recommended dose of acetaminophen (Tylenol), 800mg per day (200mg 4x), may exhibit moderately elevated ALT and AST levels that resolve after three to four weeks, even while continuing acetaminophen medication.
Certain medications taken with acetaminophen can augment serum ALT/AST. Off the top of my head, warfarin (Coumadin), isoniazid (antibiotic Tx for TB patients), and Orlistat (Alli). Also, taking 800mg of acetaminophen per day is easier than you think…many over-the-counter drugs contain it (Nyquil, Midol, others).
The liver is rather amazing. Once you identify the cause, it rebuilds and returns to normal rather quickly.
.
My riding partner is a cardiologist who is also a hypochondriac. He had some blood work done after some intense training. His liver enzymes (ALT/AST) were very high, but no cause was ever found.
Hepatitis A,B, & C can all throw the AST/ALT ratio out of whack.
Liver function panels can give funny results if the phlebotomist didn’t use the right tubes (red top for HEPfx), got a short-draw, or they were not stored properly.
We also used to see some pretty outrageous numbers in the detox clinic (ALT 200+). Apparently drinking isopropyl is bad for your liver.
I’ve been to my regular doc a few times on days when I’ve done hard workouts beforehand. He’s always noted elevated liver enzymes and has ordered all sorts of tests. I’ve also been hospitalized a few times for bike accidents and, when the bloodwork is reviewed after a few days of just laying around in the hospital, everything’s normal.
There is no easy answer to this one because almost anything can raise AST and ALT. Your doc will take a careful history looking for family predisposition, external factors, etc and order the appropriate tests. Treatment can be as simple as stopping the offending agent or as complex as treating the underlying disease of which there are many. I will tell you that the majority of patients I see for elevated liver enzymes worried that their liver is failing have marginal elevations that are easily explained.
Your dosing seems off: 2 ES Tylenol = 1000 mg. Max acute dose recommended < 7000 mg/day. Chronic max dose < 4000 mg/day.
Regular tylenol = 325 mg. You can take 2 every 4 hours. (Limits based on chronic max dose recs)
Extra-strength = 500 mg. You can take 2 every 6 hours.
Dave
I know this thread is a little old, but thought I would post my experience in case anyone searches this in the future and it might be of help.
I just went through this same thing. I went in for some routine blood work a couple days after a 150km run, and my AST and ALT were way high. The doc ordered more tests (Hep A, B, C, mono, etc) as well as a re-test of the liver markers. I was worried for a while, but while waiting for the results I found this article and stopped worrying:
EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY
Volume 99, Number 4, 443-447, DOI: 10.1007/s00421-006-0362-y
Biomarkers of muscle and cartilage damage and inflammation during a 200 km run
http://www.springerlink.com/content/r726332m1u05888t/
In the study, over the course of the 200km run, the participants AST raise 15 fold, and ALT raised 3.9 fold. Mine had raised in similar proportion and in my re-test everything came out normal. I read somewhere else (sorry I can’t remember where) that the levels can remain high for 5-7 days.
My doctor was surprised. I think he was convinced I was an alcoholic.
-Mike