liver function tests

[Guest guest]

Judy,

Would the (maybe) drug- induced hepatitis be from the Celebrex or would it be

from the Minocycline? I am not a doctor, but I was thinking it might be

the celebrex, vs. the minocycline? Just a thought.

I too am having swollen hands, (can't get my rings on), swollen feet/ankles, and

the tops of my feet (right above my toes) and legs. I am on 10 mg of predisone,

and my physician says that often causes some swelling as well. I feel as

though I have side effects and some reaction from predisone - flares if you

will. I have hurt on my right side (over my liver) tests have been done, all if

within the normal ranges, but diarrhea for weeks. Dr. thinks it was one of the

medications ( I am now off of it) it was glucophage now I am on prantin for

diabetes (predisone induced) Yikes!!! well, enough of my soap opera, but

just wanted to drop you an e-mail and let you know I am tired of the edema.

At times, I feel as though I could go into congestive heart failure; it is hard

to breathe with swollen extemities, etc. and keep feeling half way decent,

as my Mom used to say.....Martha from St. Augustine, Fl. RA, fibro,

diabetes, asthma, reflux, hyperthyroidism, osteopenia,HBP.osteoarthritis.

rheumatic Liver Function TestsFrom: " Judy Knee " <judy@...>

Hi Group,

Sorry, I've just logged on after a week or so (because I've been feeling so rotten and didn't even want to get on the 'puter) and have just received so many back emails, it will take me time to go through them.

I've got a problem, started getting swollen ankles, wrists, hands, fingers and feet and doc did some Liver function tests. Seems that I've got drug induced Hepatitis. The test results are as follows:

Alkaline Phosphatase 111 H

GGT 179 H

ALT 149 H

RF is 38

ESR is 47

Gold has been stopped - thank goodness, but then, they have also stopped my minocycline!!!!

Now, if I need to change my antibiotics, I don't know if my doc will agree - it was hard enough trying to persuade him to let me have the Mino.

I don't know what I want to ask here - first off, can I pass this hepatitis on?

How bad is my liver?

My remission may be over, however the readings of ESR and RF may be from the hepatitis and not RA. So I'd rather think I was in remission still until the liver business is out of the way.

If you can put a light on any of my questions I would truly appreciate it.

Regards,

Jude.

Western AustraliaNew Email address: to reply delete knee from address.

RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)Minocycline OFF

Folic Acid 5mg dailyPrednisilone - back at 10mg daily

Panadeine Forte 2 tabs dailyEffexor 75mg dailyInderal 20mg dailyMyocrisin OFF

Celebrex 200mg daily

[Guest guest]

Hi Martha,

Thanks for your letter - I think the DUHepatitis is more due to the gold injections than anything else. Could possibly be the minocycline but I don't think so - from what I can gather the minocycline stays in the system about 24 hours, but the gold stays in the system about 6 months!!!! Don't think I've been on Celebrex long enough for it to have taken effect. But then again, my logic could be wrong!! LOL, as sometimes it is!!!!

And again, thank you for putting things in their right perspective. I read your bio - and I knew there was a blessing here somewhere!! It is terrible to have the swellings and I sometimes too panic a little when I can't breathe quite right. I'm used to walking funny and using a wheelchair at times to help, and I don't mind the swelled ankles and fingers, but when you can't breathe - well that's it!! Nice thing about this is that I've cancelled all my students for the week - just wonderful!

When you say you have hurt over where your liver is, that's happened to me as well - I mentioned it to my doc a couple of times and he had the LFT's done but then they showed normal. My stomach would swell (the part in between the ribs) and would only go down after I'd used my bowels (which was more often than not like diarrhea). At the moment I'm swelled up like anything - have put on about 12 kilos in about 6 weeks (massive!!) and it just keeps going on! Sigh - never mind, I just hope that when I go to heaven, it won't be with all this weight on me - I'd never be able to stay up there!!! LOL

Regards,

Jude.

rheumatic Liver Function TestsFrom: "Judy Knee" <judy@...>

Hi Group,

Sorry, I've just logged on after a week or so (because I've been feeling so rotten and didn't even want to get on the 'puter) and have just received so many back emails, it will take me time to go through them.

I've got a problem, started getting swollen ankles, wrists, hands, fingers and feet and doc did some Liver function tests. Seems that I've got drug induced Hepatitis. The test results are as follows:

Alkaline Phosphatase 111 H

GGT 179 H

ALT 149 H

RF is 38

ESR is 47

Gold has been stopped - thank goodness, but then, they have also stopped my minocycline!!!!

Now, if I need to change my antibiotics, I don't know if my doc will agree - it was hard enough trying to persuade him to let me have the Mino.

I don't know what I want to ask here - first off, can I pass this hepatitis on?

How bad is my liver?

My remission may be over, however the readings of ESR and RF may be from the hepatitis and not RA. So I'd rather think I was in remission still until the liver business is out of the way.

If you can put a light on any of my questions I would truly appreciate it.

Regards,

Jude.

Western AustraliaNew Email address: to reply delete knee from address.

RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)Minocycline OFF

Folic Acid 5mg dailyPrednisilone - back at 10mg daily

Panadeine Forte 2 tabs dailyEffexor 75mg dailyInderal 20mg dailyMyocrisin OFF

Celebrex 200mg daily

[Guest guest]

Martha: I'm sort of new to the list but have been reading the e-mails here for a few weeks. I've been on no RA drugs yet, except for Minocin and some Motrin. (Think I am in early stages with mild symptons.) My question: Did the predisone induce diabetes as you indicated? Wow, that's no good. I don't know what you've been through or for how long, but ..... well would you recommend someone like me to stay away from the stronger drugs for as long as possible? I'm assuming the answer is yes, so what I am really asking is: what you would do differently if you were in the early/mild stages? It is a "lessons learned" sort of question.

I'm am so very sympathetic to your medical problems and appreciate all the info. you've shared with the group. Thanks, Pam, Atlanta

rheumatic Liver Function TestsFrom: "Judy Knee" <judy@...>

Hi Group,

Sorry, I've just logged on after a week or so (because I've been feeling so rotten and didn't even want to get on the 'puter) and have just received so many back emails, it will take me time to go through them.

I've got a problem, started getting swollen ankles, wrists, hands, fingers and feet and doc did some Liver function tests. Seems that I've got drug induced Hepatitis. The test results are as follows:

Alkaline Phosphatase 111 H

GGT 179 H

ALT 149 H

RF is 38

ESR is 47

Gold has been stopped - thank goodness, but then, they have also stopped my minocycline!!!!

Now, if I need to change my antibiotics, I don't know if my doc will agree - it was hard enough trying to persuade him to let me have the Mino.

I don't know what I want to ask here - first off, can I pass this hepatitis on?

How bad is my liver?

My remission may be over, however the readings of ESR and RF may be from the hepatitis and not RA. So I'd rather think I was in remission still until the liver business is out of the way.

If you can put a light on any of my questions I would truly appreciate it.

Regards,

Jude.

Western AustraliaNew Email address: to reply delete knee from address.

RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)Minocycline OFF

Folic Acid 5mg dailyPrednisilone - back at 10mg daily

Panadeine Forte 2 tabs dailyEffexor 75mg dailyInderal 20mg dailyMyocrisin OFF

Celebrex 200mg daily

[Guest guest]

Martha, I, too, suffered from severe edema for a while. It turned out that mine was caused from my albumin being too low. My protein was being eliminated through the urine and the cells were filling up with water instead of the protein. Check your albumin levels just in case they are low. Just a thought. Carol/Piney

rheumatic Liver Function TestsFrom: "Judy Knee" <judy@...>

Hi Group,

Sorry, I've just logged on after a week or so (because I've been feeling so rotten and didn't even want to get on the 'puter) and have just received so many back emails, it will take me time to go through them.

I've got a problem, started getting swollen ankles, wrists, hands, fingers and feet and doc did some Liver function tests. Seems that I've got drug induced Hepatitis. The test results are as follows:

Alkaline Phosphatase 111 H

GGT 179 H

ALT 149 H

RF is 38

ESR is 47

Gold has been stopped - thank goodness, but then, they have also stopped my minocycline!!!!

Now, if I need to change my antibiotics, I don't know if my doc will agree - it was hard enough trying to persuade him to let me have the Mino.

I don't know what I want to ask here - first off, can I pass this hepatitis on?

How bad is my liver?

My remission may be over, however the readings of ESR and RF may be from the hepatitis and not RA. So I'd rather think I was in remission still until the liver business is out of the way.

If you can put a light on any of my questions I would truly appreciate it.

Regards,

Jude.

Western AustraliaNew Email address: to reply delete knee from address.

RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)Minocycline OFF

Folic Acid 5mg dailyPrednisilone - back at 10mg daily

Panadeine Forte 2 tabs dailyEffexor 75mg dailyInderal 20mg dailyMyocrisin OFF

Celebrex 200mg daily

[Guest guest]

Judy,

I see from your list of meds that you're taking Celebrex. Someone on

our last list year was diagnosed with having drug-induced hepatitis that

was determined to be caused from taking Celebrex for only 9 days (I

can't remember who it was, maybe she'll come out of the woodwork to help

you out). Anyway, seems to me, that's one of the meds your doctor

should be investigating, more so than the mino. I believe the person

who developed the hepatitis later reported that it had been remedied

with treatment and stopping the Celebrex. Hope you'll find the same but

I'd definitely call your doctor about the Celebrex.

Hugs,

a Peden

> Judy Knee wrote:

>

> From: " Judy Knee " <judy@...>

>

> Hi Group,

>

> Sorry, I've just logged on after a week or so (because I've been

> feeling so rotten and didn't even want to get on the 'puter) and have

> just received so many back emails, it will take me time to go through

> them.

>

> I've got a problem, started getting swollen ankles, wrists, hands,

> fingers and feet and doc did some Liver function tests. Seems that

> I've got drug induced Hepatitis. The test results are as follows:

>

> Alkaline Phosphatase 111 H

> GGT 179 H

> ALT 149 H

>

> RF is 38

> ESR is 47

>

> Gold has been stopped - thank goodness, but then, they have also

> stopped my minocycline!!!!

>

> Now, if I need to change my antibiotics, I don't know if my doc will

> agree - it was hard enough trying to persuade him to let me have the

> Mino.

>

> I don't know what I want to ask here - first off, can I pass this

> hepatitis on?

> How bad is my liver?

> My remission may be over, however the readings of ESR and RF may be

> from the hepatitis and not RA. So I'd rather think I was in remission

> still until the liver business is out of the way.

>

> If you can put a light on any of my questions I would truly appreciate

> it.

>

> Regards,

> Jude.

>

>

> Western Australia

> New Email address: to reply delete knee from address.

>

> RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)

> Minocycline OFF

> Folic Acid 5mg daily

> Prednisilone - back at 10mg daily

> Panadeine Forte 2 tabs daily

> Effexor 75mg daily

> Inderal 20mg daily

> Myocrisin OFF

> Celebrex 200mg daily

> ----------------------------------------------------------------------

>

> ----------------------------------------------------------------------

[Guest guest]

You might want to review this web page and discuss with your doctor:

http://pharminfo.com/pubs/msb/minocy.html

Be sure to read the final sentence before you get too worked up.

Mark

> >

> > From: " Judy Knee " <judy@...>

> >

> > Hi Group,

> >

> > Sorry, I've just logged on after a week or so (because I've been

> > feeling so rotten and didn't even want to get on the 'puter) and

have

> > just received so many back emails, it will take me time to go

through

> > them.

> >

> > I've got a problem, started getting swollen ankles, wrists, hands,

> > fingers and feet and doc did some Liver function tests. Seems

that

> > I've got drug induced Hepatitis. The test results are as follows:

> >

> > Alkaline Phosphatase 111 H

> > GGT 179 H

> > ALT 149 H

> >

> > RF is 38

> > ESR is 47

> >

> > Gold has been stopped - thank goodness, but then, they have also

> > stopped my minocycline!!!!

> >

> > Now, if I need to change my antibiotics, I don't know if my doc

will

> > agree - it was hard enough trying to persuade him to let me have

the

> > Mino.

> >

> > I don't know what I want to ask here - first off, can I pass this

> > hepatitis on?

> > How bad is my liver?

> > My remission may be over, however the readings of ESR and RF may

be

> > from the hepatitis and not RA. So I'd rather think I was in

remission

> > still until the liver business is out of the way.

> >

> > If you can put a light on any of my questions I would truly

appreciate

> > it.

> >

> > Regards,

> > Jude.

> >

> >

> > Western Australia

> > New Email address: to reply delete knee from address.

> >

> > RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)

> > Minocycline OFF

> > Folic Acid 5mg daily

> > Prednisilone - back at 10mg daily

> > Panadeine Forte 2 tabs daily

> > Effexor 75mg daily

> > Inderal 20mg daily

> > Myocrisin OFF

> > Celebrex 200mg daily

> > ----------------------------------------------

------------------------

> >

> > ----------------------------------------------

------------------------

[Guest guest]

I can't help but wonder if this might be one of the reasons Dr. Brown

preferred the pulse method of taking Minocin i.e. Monday, Wednesday and

Friday.

(RA 23+ years, AP since Nov. 97)

> From: " Mark Holmes " <mholmes@...>

>

> You might want to review this web page and discuss with your doctor:

> http://pharminfo.com/pubs/msb/minocy.html

> Be sure to read the final sentence before you get too worked up.

> Mark

>

>

>

> > >

> > > From: " Judy Knee " <judy@...>

> > >

> > > Hi Group,

> > >

> > > Sorry, I've just logged on after a week or so (because I've been

> > > feeling so rotten and didn't even want to get on the 'puter) and

> have

> > > just received so many back emails, it will take me time to go

> through

> > > them.

> > >

> > > I've got a problem, started getting swollen ankles, wrists, hands,

> > > fingers and feet and doc did some Liver function tests. Seems

> that

> > > I've got drug induced Hepatitis. The test results are as follows:

> > >

> > > Alkaline Phosphatase 111 H

> > > GGT 179 H

> > > ALT 149 H

> > >

> > > RF is 38

> > > ESR is 47

> > >

> > > Gold has been stopped - thank goodness, but then, they have also

> > > stopped my minocycline!!!!

> > >

> > > Now, if I need to change my antibiotics, I don't know if my doc

> will

> > > agree - it was hard enough trying to persuade him to let me have

> the

> > > Mino.

> > >

> > > I don't know what I want to ask here - first off, can I pass this

> > > hepatitis on?

> > > How bad is my liver?

> > > My remission may be over, however the readings of ESR and RF may

> be

> > > from the hepatitis and not RA. So I'd rather think I was in

> remission

> > > still until the liver business is out of the way.

> > >

> > > If you can put a light on any of my questions I would truly

> appreciate

> > > it.

> > >

> > > Regards,

> > > Jude.

> > >

> > >

> > > Western Australia

> > > New Email address: to reply delete knee from address.

> > >

> > > RA: Diagnosed September 1997 .. In Remission since Dec 1999(???)

> > > Minocycline OFF

> > > Folic Acid 5mg daily

> > > Prednisilone - back at 10mg daily

> > > Panadeine Forte 2 tabs daily

> > > Effexor 75mg daily

> > > Inderal 20mg daily

> > > Myocrisin OFF

> > > Celebrex 200mg daily

> > > ----------------------------------------------

> ------------------------

> > >

> > > ----------------------------------------------

> ------------------------

>

>

> ------------------------------------------------------------------------

> MAXIMIZE YOUR CARD, MINIMIZE YOUR RATE!

> Get a NextCard Visa, in 30 seconds! Get rates as low as

> 0.0% Intro or 9.9% Fixed APR and no hidden fees.

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>

>

[Guest guest]

Jen,

thanks for your reply. I had wondered about dosage on the milk thistle...my

son is 15 and 6' tall, so he's not a little kid -- I have given him some

extra today, and kind of wondered if it was ok to do that, so I appreciated

your post. And I did go to the health store and asked for the very best,

standardized milk thistle. I've sure learned some of this the hard way. Why

buy cheaper if it's no good, huh?!!

Our LLMD is not at all good about answering questions like this -- he just

says, " I'm not a supplement guy... " which is SO frustrating! Plus he wasn't

in today, so I am sort of stuck till Monday. The nurse didn't get specific,

but she just said the numbers were up enough that she was concerned and felt

she should call me.

Another e-mail friend responded to me that her Lymie son was on I.V. for many

months, and when his LFT did go up she was told it wasn't a huge concern

because of his youth -- he didn't have other issues that would damage his

liver (like drinking, old age, etc) and when he is better from the Lyme, the

counts will even out, and they have. She said she just really felt that when

the Rocephin was working and killing off huge loads of spirochetes, the liver

was trying to flush it all out and it was taxing, but not dangerously so.

Thanks again so much!

Judie

[Guest guest]

Hi Judie,

When we went through this a couple of years ago (no IV's - but just

elevated liver enzymes a few mos post-abxs), it was suggested to me

(by someone on this list, I believe) not only to do the milk thistle,

but also to take a quality probiotic & lots of (the latter).

I have a good site link (no affiliation at all) - has raspberry

flavored wafer to provide to mouth tissue, as well a 5 different

probiotics.

Hope this helps!

Blessings!

PS - please write off list if you'd like the link - I only check

messages here occasionally.

PPS - I smile every time I see " good little Dobie " screen name...

> Hi all,

>

> Just had a call from our home nurse, who wanted to let me know the

blood

> results from yesterday's draw from my son Cort showed increased

levels on the

> liver function tests. She is very concerned.

>

> We are nearing the end of the 8-week course of I.V. Rocephin, and I

am hoping

> to urge our LLMD to order longer treatment, but now I'm getting a

bit

> worried. He's showing slow, steady improvement while on I.V.

treatment, just

> as he did earlier this year, and I don't want the treatment to stop

too soon,

> as I feel it did before. Just as he was starting to feel better,

they stopped

> treatment, and in a very short time he was right back to where we

had

> started. He is herxing every three weeks TO THE DAY. If they stop

I.V. at

> eight weeks, he will be just three days shy of the next herx.

>

> I am going to go out and get more good milk thistle today, which

our

> original LLMD had suggested during I.V. treatment to help protect

the

> liver...I just ran out of it over this past weekend and have still

been

> giving him some, but it's not the better stuff.

>

> Any other ideas from any of you would be appreciated...both on the

liver

> function AND the idea of trying to extend treatment!

>

> Thanks a lot,

>

> Judie

>

>

>

[Guest guest]

Hi Judie,

Just remembered the other thing that holistic doc suggested

was " margarite " chinese herbal pills. (check with doc 1st) In

Chinese medicine, the purpose is to sweep toxins & " internal heat "

(generated by toxins).

Hope that helps!

[Guest guest]

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Both ALT and AST levels are reliable indicators of liverdamage.This test is done on a blood sample taken from a vein.Why It Is Done The alanine aminotransferase (ALT) test is done to:Diagnose liver disease, especially hepatitis and cirrhosis.Determine whether heart or liver damage is present (by combining theALT value with the results of an aspartate aminotransferase test). Formore information, see the medical test Aspartate Aminotransferase(AST).Determine whether jaundice is caused by a blood disorder or liver disease.Monitor the effects of cholesterol-lowering and other medications thatcan damage the liver.How To Prepare Strenuous exercise can affect alanine aminotransferase (ALT) testresults. For this reason, avoid strenuous exercise just before havingthis test done.Many medications can interfere with test results. Your healthprofessional may instruct you to stop taking certain medications forseveral days before this test is done. Some herbal medicines andnatural products (such as echinacea, valerian, and Chinese fructusschizandrae sinensis) also can affect ALT results. Tell your healthprofessional if you are taking any of these products.Talk to your health professional about any concerns you have regardingthe need for the test, its risks, or how it will be done. Complete themedical test information form to help you understand the importance ofthe test.How It Is Done The health professional drawing blood will wrap an elastic band aroundyour upper arm to temporarily stop the flow of blood through the veinsof your arm. This makes it easier to put the needle into a veinproperly because the veins below the band get larger and do notcollapse easily.The needle site is cleaned with alcohol and the needle is inserted.More than one needle stick may be needed if the needle is not placedcorrectly or if the vein cannot supply enough blood.When the needle is properly placed in the vein, a collection tube willbe attached to the needle and blood will flow into it. Sometimes morethan one tube of blood is collected.When enough blood has been collected, the band around your arm will beremoved. A gauze pad or cotton ball is placed over the puncture siteas the needle is withdrawn. Pressure is applied to the puncture sitefor several minutes and then a small bandage is often placed over it.How It Feels You may feel nothing at all from the needle puncture, or you may feela brief sting or pinch as the needle goes through the skin. Somepeople feel a stinging pain while the needle is in the vein. However,many people do not feel any pain (or have only minor discomfort) oncethe needle is positioned in the vein. The amount of pain you feeldepends on the skill of the health professional drawing the blood, thecondition of your veins, and your sensitivity to pain.Risks There is very little risk of complications from having blood drawnfrom a vein. You may develop a small bruise at the puncture site. Youcan reduce the risk of bruising by keeping pressure on the site forseveral minutes after the needle is withdrawn.Rarely, the vein may become inflamed after the blood sample is taken.This condition is called phlebitis and is usually treated by applyinga warm compress several times daily.Continued bleeding can be a problem for people with bleedingdisorders. Aspirin, warfarin (Coumadin), and other blood-thinningmedications can also make bleeding more likely. If you have bleedingor clotting problems, or if you take blood-thinning medication, tellthe health professional before your blood is drawn.Results An alanine aminotransferase (ALT) test is a blood test that measuresthe level of alanine aminotransferase enzyme found mainly in theliver, but also in smaller amounts in the kidneys, heart, muscles, andpancreas.NormalNormal results may vary from lab to lab.Alanine aminotransferase0–35 units per liter (U/L)Greater-than-normal values may meanVery high levels of alanine aminotransferase (up to 50 times greaterthan normal) may be caused by poor blood flow to the liver, viralhepatitis, or liver damage from a drug or chemical, such asacetaminophen (Tylenol) overdose, lead poisoning, or exposure tocarbon tetrachloride.Mildly or moderately high levels may be caused by mononucleosis,hepatitis, cirrhosis, liver cancer, or alcohol dependence. People whodrink excessive amounts of alcohol and take acetaminophen (such asTylenol) can have high alanine aminotransferase (ALT) blood levels.The ALT level in a person with hepatitis can be 20 times the normalvalue. In cases of cirrhosis or liver tumors, ALT levels often areonly 2 to 4 times above normal.A heart attack usually causes only a slight rise in ALT levels.Elevated ALT levels may be caused by thyroid disease, polymyositis,severe burns, or shock.Injury to the pancreas, kidneys, or muscles can occasionally increaseALT levels.The ALT level may be elevated in people who exercise vigorously.Medications may cause an increase in alanine aminotransferase (ALT)values. These medications include methotrexate, griseofulvin,phenytoin (Dilantin), methyldopa (Aldomet), phenothiazines (such aschlorpromazine), barbiturates, heparin, salicylates (such as aspirin),and many antibiotics (such as isoniazid, tetracycline,nitrofurantoin).Narcotics occasionally may cause mildly increased ALT levels.Herbal medicines and natural products (such as echinacea, valerian,and Chinese fructus schizandrae sinensis) may increase ALT levels.http://my.webmd.com/hw/lab_tests/hw20645.asp Aspartate Aminotransferase (AST) Test Overview Aspartate aminotransferase (AST) is an enzyme found in red bloodcells, liver and heart cells, and muscle tissue. It also is found inother organs, such as the pancreas and kidneys. AST formerly wascalled serum glutamic oxaloacetic transaminase (SGOT). See anillustration of the liver, the pancreas, or the kidneys.When body tissue or an organ such as the heart or liver is diseased ordamaged, additional AST is released into the bloodstream. The amountof AST in the blood is directly related to the extent of the tissuedamage. After severe damage, AST levels rise in 6 to 10 hours andremain high for about 4 days. The AST test may be done at the sametime as a test for alanine aminotransferase, or ALT. The ratio of ASTto ALT (AST:ALT) sometimes can help determine whether the liver oranother organ has been damaged. AST also can help determine the causeof the liver damage. Both ALT and AST levels are reliable indicatorsof liver damage.An AST test is done on a blood sample taken from a vein. Sometimesblood samples for AST testing are collected daily for several days, todetermine if the AST level is going up or down.Why It Is Done An aspartate aminotransferase (AST) test is done to:Help diagnose liver disease, especially hepatitis and cirrhosis. Liverdisease may produce symptoms such as pain in the upper abdomen,nausea, vomiting, and, sometimes, jaundice.Monitor recovery from or treatment for liver disease.How To Prepare Strenuous exercise can affect aspartate aminotransferase (AST) testresults. For this reason, avoid strenuous exercise just before havingthis test done.Many medications can interfere with test results. Your healthprofessional may instruct you to stop taking certain medications forseveral days before this test is done. Some herbs and natural products(such as echinacea, valerian, and Chinese fructus schizandraesinensis) also can affect AST results. Tell your health professionalif you are taking any of these products.Talk to your health professional about any concerns you have regardingthe need for the test, its risks, or how it will be done. Complete themedical test information form to help you understand the importance ofthe test.How It Is Done The health professional drawing blood will wrap an elastic band aroundyour upper arm to temporarily stop the flow of blood through the veinsin your arm. This makes it easier to put a needle into a vein properlybecause the veins below the band get larger and do not collapseeasily.The needle site is cleaned with alcohol and the needle is inserted.More than one needle stick may be needed if the needle is not placedcorrectly or if the vein cannot supply enough blood.When the needle is properly placed in the vein, a collection tube willbe attached to the needle and blood will flow into it. Sometimes morethan one tube of blood is collected.When enough blood has been collected, the band around your arm will beremoved. A gauze pad or cotton ball is placed over the puncture siteas the needle is withdrawn. Pressure is applied to the puncture sitefor several minutes and then a small bandage is often placed over it.How It Feels You may feel nothing at all from the needle puncture, or you may feela brief sting or pinch as the needle goes through the skin. Somepeople feel a stinging pain while the needle is in the vein. However,many people do not feel any pain (or have only minor discomfort) oncethe needle is positioned in the vein. The amount of pain you feeldepends on the skill of the health professional drawing the blood, thecondition of your veins, and your sensitivity to pain.Risks There is very little risk of complications from having blood drawnfrom a vein. You may develop a small bruise at the puncture site. Youcan reduce the risk of bruising by keeping pressure on the site forseveral minutes after the needle is withdrawn.Rarely, the vein may become inflamed after the blood sample is taken.This condition is called phlebitis and is usually treated by applyinga warm compress several times daily.Continued bleeding can be a problem for people with bleedingdisorders. Aspirin, warfarin (Coumadin), and other blood-thinningmedications can also make bleeding more likely. If you have bleedingor clotting problems, or if you take blood-thinning medication, tellthe health professional before your blood is drawn.Results NormalNormal values may vary from lab to lab.Aspartate aminotransferase17–59 units per liter (U/L)Greater-than-normal valuesVery high levels (10 to 20 times greater than normal) of aspartateaminotransferase (AST) can indicate recent or severe liver damage,such as hepatitis caused by a viral infection or drug overdose, decayof a large tumor (necrosis), or shock.Moderately high levels (5 to 10 times greater than normal) of AST can indicate:A heart attack or heart failure.Having taken high doses of vitamin A.Kidney or lung damage.Liver damage, such as from cirrhosis.Mononucleosis.Duchenne muscular dystrophy.Some types of cancer.A rare autoimmune disease that affects muscles (myositis).Slightly high levels (2 to 5 times greater than normal) of AST may indicate:A heart attack or heart failure.Hepatitis caused by alcohol dependence.Hemolytic anemia, such as that caused by sickle cell anemia or areaction to blood transfusion.Some types of cancer.Pancreatitis.AST levels may be high when a disease first develops, which is oftenwhen tissue damage is most severe. Decreasing levels of AST in theblood may be a sign of recovery from the disease or injury.Many conditions may cause elevated AST levels, including severe burns,traumatic injuries, pulmonary embolism, or heat exhaustion andheatstroke. Ingestion of poisonous mushrooms also may cause elevatedAST levels.Lower-than-normal valuesLow levels of AST may indicate a vitamin B6 deficiency.Low levels of AST may also be caused by long-term kidney dialysis.AST levels may decrease slightly during pregnancy.Low levels of AST may also be caused by some medications, such asmetronidazole, and some herbs and natural products, such as Chinesefructus schizandrae sinensis.1What Affects the Test Many medications can affect the results of the test. Talk with yourhealth professional about all the prescription and nonprescriptionmedications you are taking. You may be instructed to stop taking yourmedications for several days before the test.Large doses of vitamin A can increase AST levels.Some herbs and natural products (such as echinacea, valerian, andChinese fructus schizandrae sinensis) can affect AST results.Strenuous exercise, injury to a muscle, or injections into a musclecan raise AST levels.Recent cardiac catheterization or surgery may raise AST levels.Rough handling, contamination, or inadequate refrigeration of theblood sample can cause inaccurate test results.What To Think About The aspartate aminotransferase (AST) test is more effective than thealanine aminotransferase (ALT) test for detecting liver damage causedby alcohol dependence. The AST to ALT ratio may sometimes helpdetermine if liver damage is related to alcohol dependence. For moreinformation, see the medical test Alanine Aminotransferase (ALT).Many different conditions can raise AST blood levels. Therefore, othertesting is usually needed to interpret an abnormal AST result.http://my.webmd.com/hw/liver_disease/hw20331.asp Coumadin may be taken with or without food. Since Coumadin ismetabolized by the liver and excreted by the kidneys, dosages need tobe lowered in patients with liver and kidney dysfunction. Frequentblood tests are performed to measure blood clotting time (protime)during Coumadin treatment. Protime results help doctors adjustmedication dose to avoid excessive blood thinning and risk ofbleeding.Why the test is performed Return to topThis test is used to evaluate blood glucose levels. It may be used todiagnose or screen for diabetes and to monitor control in patients whohave diabetes.Most dietary carbohydrate eventually ends up as glucose in the blood.Excess glucose is converted to glycogen for storage by the liver andskeletal muscles after meals. Glycogen is gradually broken down toglucose and released into the blood by the liver between meals. Excessglucose is converted to triglyceride for energy storage.Glucose is a major source of energy for most cells of the body. Somecells (for example, brain and red blood cells), are almost totallydependent on blood glucose as a source of energy. The brain, in fact,requires that glucose concentrations in the blood remain within acertain range in order to function normally. Concentrations of lessthan about 30 milligrams per deciliter (mg/dL) or greater than about300 mg/dL can produce confusion or unconsciousness.The major hormone regulating glucose concentration in the body isinsulin (although other hormones such as glucagon, epinephrine, andcortisol also affect it).Glucose levels are measured most commonly to diagnose diabetes or tomonitor adequacy of diabetic control. Diabetes is a very commondisease, affecting about 2% of the general population, that resultsfrom insulin deficiency or insensitivity by the body to the level ofinsulin present. People with type 1 diabetes require daily injectionsof insulin to control their disease. Injection of too much or toolittle insulin can be dangerous because there is a limited range ofblood sugar levels in which the brain can function normally.Normal Values Return to topLevels up to 100 mg/dL are considered normal.Levels between 100 and 126 mg/dl are referred to as impaired fastingglucose or pre-diabetes. These levels are considered to be riskfactors for type 2 diabetes and its complications.Diabetes is typically diagnosed when fasting blood glucose levels are126 mg/dl or higher.Note: mg/dL = milligrams per deciliterWhat abnormal results mean Return to topGreater than normal levels (hyperglycemia) may indicate:Acromegaly (very rare)Cushing's syndrome (rare)Diabetes mellitus -- fasting blood glucose of greater than 126 mg/dLImpaired fasting glucose -- 110 to 126 mg/dL -- a prediabetic stateHyperthyroidismPancreatic cancerPancreatitisPheochromocytoma (very rare)Insufficient amount of insulinExcessive food intake