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Old 11-26-2009, 12:08 PM   #1
Nick Martinez
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Extremely high ALT enzymes in blood, Liver or muscle damage?

I have been on a roller-coaster of emotions the last two weeks; I'll try to keep it short.

About two weeks ago I went to the Doctor for a blood test, and he had my liver enzymes checked as well (AST and ALT). He called me back two days later and had me in for an appointment, where he reported that my ALT enzyme count was a whopping .1005! (The normal/safe upper limit is .47). People with this number are usually jaundiced and should go to the emergency room if their liver is this damaged.
He was convinced I had something major and ordered an ultrasound for me the same day. I thought that my love for drinking on the weekends had gotten the better of me and that I was now in serious trouble. I had drunk a lot of booze on Thursday, Friday and Saturday before the blood test (which was on a Tuesday). Needless to say, I cut out the booze. I took another blood test the same day as my ultrasound and had an appt in a week.

Fast forward one week (yesterday) - the doctor reports my ALT count to be .106 - still concerning but over 10x less than the week before. I tested negative for all form of Hepatitis, and the ultrasound showed no damage whatsoever. Here is the kicker:

On the Friday before my initial blood test (the one that scored .1005) I had done Angie Rx'd for the first time in my life. The days after resulted in the worst DOMS I ever experienced in my life. My whole Latissimus Dorsi was sore to the point that if I made the slightest move while sleeping I woke up from the pain. I iced my back and biceps constantly for 5 days. I could not extend my arms and was walking around like a T-Rex. My Pull Up numbers have gotten worse since Angie but that is a topic for another post.

In doing research, I have found out that ALT and AST enzymes found in the liver also reside in muscle tissue. When the muscles are damaged, these enzymes will leak out into the blood. I am thinking that this must be the reason to have such a high ALT level without being jaundiced.

Does this make any sense to the more medically-inclined out there? Has anyone else ahd the same experience with EXTREME musce soreness after Angie? I would be really interested to hear your thought.

FYI-This episode has changed me and I will never drink the way I did before, even if it was only on weekends. Time to grow up.
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Old 11-26-2009, 02:52 PM   #2
Katherine Derbyshire
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

I think you're either misquoting or misunderstanding those numbers.

0.47 is more than 0.106, which is more than 0.1005. So if 0.47 is normal, and 0.1005 is bad, then the problem was that your enzyme level was dangerously *low*, not dangerously high.

I'm not a doctor, so I'm not going to speculate on what any of this means, but you might ask your doctor for clarification before you jump to any conclusions.

With that said, drinking less is probably not a bad idea. Heavy drinking combined with a case of DOMS that severe won't make your kidneys any happier than your liver.

Katherine
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Old 11-26-2009, 04:16 PM   #3
Steven Low
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

Did you tell your doctor you did a workout where you probably almost induced rhabdo?
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Old 11-26-2009, 05:31 PM   #4
Nick Martinez
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

Katherine, I wanted to be accurate with the decimal places and I ended up making an eroor with the numbers! The normal upper limit is .0047, my initial blood test came in at .1005, and my most recent one (taken a week later) was .107. Sorry about that.

Steven, Does it sound like Rhabdo to you? I've never researched Rhabdo other than at a very general level, but I always thought that Rhabdo was cause by going too far with met-con. After the workout I did need WAY more recovery time than normal (It was about 15 mins before I left the gym), but I generally felt ok other than the muscle pain. Thanks for the reply and if you think this may have been rhabdo I'll research it in depth.
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Old 11-26-2009, 06:23 PM   #5
Steven Low
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

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On the Friday before my initial blood test (the one that scored .1005) I had done Angie Rx'd for the first time in my life. The days after resulted in the worst DOMS I ever experienced in my life. My whole Latissimus Dorsi was sore to the point that if I made the slightest move while sleeping I woke up from the pain. I iced my back and biceps constantly for 5 days. I could not extend my arms and was walking around like a T-Rex. My Pull Up numbers have gotten worse since Angie but that is a topic for another post.
Sounds like 'almost' rhabdo. No dark urine though so..

You definitely destroyed a lot of muscle fibers since you've had a large amount of strength loss.
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Old 11-26-2009, 06:35 PM   #6
Nick Martinez
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

I neglected to mention that I did have dark urine. Untill about 3 days after. I thought that it was from the booze. I didn't know that you could lose strength as well.

I am going to bring this up with my Doctor. Thanks a lot Steven!
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Old 11-26-2009, 07:56 PM   #7
Steven Low
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

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Originally Posted by Nick Martinez View Post
I neglected to mention that I did have dark urine. Untill about 3 days after. I thought that it was from the booze. I didn't know that you could lose strength as well.

I am going to bring this up with my Doctor. Thanks a lot Steven!
Yeah, you had rhabdo then... so...

At least you didn't die from kidney failure.
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Old 11-26-2009, 08:23 PM   #8
Jason Wilbarger
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

Funny you should mention this...I just recently went through this as well and here are the numbers or normal ranges straight from my lab results (theyre still sitting on my desk). Now, just remember that all labs quote normal ranges differently...but usually only by a few points.
  • AST 0-33
  • ALT 0-45

But, you also have to look at other numbers as well. How was your phosphate? Bilirubin? GGT?

At any rate, I too went to my doc when I had slightly elevated numbers. He recommended a retest which I gladly did....after a workout. My ALT/AST went from 71/105 respectively to 291/104. Admittingly I had a few drinks the night before the test but was told that that wouldnt really make a difference. The doctor, perplexed, ordered another round of bloodwork which returned to my baseline of 71/105.

Long story short...ya really cant judge anything on one battery of tests after a workout like that. I'd let your body recover go back to see your doc and redo the test to see if its lowered. 1K and up is pretty high but as Steven said, it may have been rhabdo.

-J

Sorry, just saw that you did redo the test and it was significantly lower. I'd say rhabdo too. As for your new 106 reading...whats your body composition? I'm over weight and was told that I have mild fat infiltration in the liver....thus my new found love of crossfit and diet. Good luck and congrats on doing Angie as rx'd!!

Last edited by Jason Wilbarger : 11-26-2009 at 08:45 PM. Reason: I'm an idiot...LOL.
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Old 11-27-2009, 10:23 AM   #9
Nick Martinez
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

Thanks for the reply Jason.

My body composition is 26.2% Body fat. As you can see I am not hard-core into training (I was but in the last few years have only been doing an avg of 2-3 WODs per week).

My diet is something I have cleaned up completely since this little incident. Thanks to you guys for all the info, now I will have something to bring back to the Doctor.

If anyone is still reading, I have one more question: My pullups took a dive after Angie. The kipping pullups are ok but my dead-hang max is down to 1 or 2 when it was at 9 or 10. My lats have also gotten MUCH smaller. I can't do as many ring dips either (previous max was 10 new max is 5).

Does this mean that My muscle has effectively died and needs to be rebuilt again, and might this happen the next time I try something like Angie?

Really appreciate all the responses!
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Old 11-27-2009, 11:12 AM   #10
Frank E Morel
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Re: Extremely high ALT enzymes in blood, Liver or muscle damage?

it means alot of fluid consumption for quite some time.
and your on a serious rest cycle... your days of WOD are for the most part on hiatus. Active rest like yoga would be a smart play.

Your body is going to need a serious amount of time to heal, repair and renew the damage done. Eventually you will be back doing them, but its a time will tell thing. Work capacity is largely dependent on strength, and strength is from the amount of energy you muscles can produce.

I would be sure to ask your GP for a consult to internal medicine specialist. And since your in canada, makes sure he doesnt wait til he has all the reports before he gives you the referral.
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