alt blood test

Jeong S, Nam H, Rhee J, Shin J, Kim J, Cho K. Metabolic syndrome and ALT: a community study in adult Koreans. Bile salts aid digestive enzymes. Measurements of serum ferritin, total iron-binding capacity, and the HEF mutation test can help diagnose hemochromatosis 59). Other liver functions concern protein metabolism. Useful for hepatic cirrhosis, other liver disease. Your blood sample should be collected between 7 and 10 AM. ALT is released into the bloodstream when liver cells are damaged. In obstructive jaundice bile ducts are blocked, perhaps by gallstones or tumors. Here’s an easy way to find out your AST:ALT ratio: divide your AST level as shown on your blood test results by your ALT level. International journal of sports medicine. © 2005 - 2020 WebMD LLC. It has simply been given a new name. ALT : Alanine aminotransferase (ALT) is present primarily in liver cells. This test is mainly done along with other tests (such as AST, ALP, and bilirubin) to diagnose and monitor liver disease. The reference interval indicates the normal ranges and the flag indicates a result outside of those ranges. WebMD does not provide medical advice, diagnosis or treatment. Your doctor can use this test to find out if a disease, drug, or injury has damaged your liver. In an Italian population, 45.6% of altered liver tests have been attributed to excessive alcohol intake (≥28 g/day) 35, while in a US national population survey, excessive alcohol (>1 time/day) is a crucial cause of ALT elevation, second only to hepatitis C virus (HCV) infection 11), however, alcohol intake might be a time-and dose-dependent covariate that influences ALT activity. 2012;55(2):447–454. Hepatology. 2002;6(3):635–647. Every laboratory has its own normal range, however, so certain results that fall outside of these reported norms may still be considered a “normal” result by some medical providers. Then the sphincter relaxes, and bile is squirted into the duodenum. Another viewpoint was that the obesity-ALT elevation association was modulated by insulin resistance. Ruhl CE, Everhart JE. The normal values range of the AST blood test in males is 10 to 40 units per Liter of Serum and in females, it is 9 to 32 units per Liter of Serum.. A common clinical scenario is the unanticipated discovery of an abnormal liver test result, obtained when a bundle of tests has been done for other reasons. 1996;334(26):1691–1696 https://www.nejm.org/doi/10.1056/NEJM199606273342602, Gunji T, Matsuhashi N, Sato H, Iijima K, Fujibayashi K, Okumura M, Sasabe N, Urabe A. After a thorough physical exam and evaluation of a person’s medical history, there are several other tests that may be performed as follow up depending on what is suspected to be the cause of liver damage. Evaluation of abnormal liver-enzyme results in asymptomatic patients. European journal of gastroenterology & hepatology. Hepatology. ALT is often used to monitor the treatment of persons who have liver disease, to see if the treatment is working, and may be ordered either by itself or along with other tests for this purpose. Chronic ALT elevation is also found in several non-hepatic disorders, such as celiac disease and muscle injury 53). Some scholars have suggested that the ALT elevation in statin users is attributed to cholesterol reduction in hepatocytes and co-morbid conditions, rather than liver damage or dysfunction 19). 1989;10(S 3):S160–S168. AST is another liver enzyme. The mechanism underlying statin-associated ALT elevation is still unclear. If your liver is damaged, it will release more ALT into your blood and levels will rise. The liver’s effects on lipid metabolism include oxidizing (breaking down) fatty acids at an especially high rate; synthesizing lipoproteins, phospholipids, and cholesterol; and converting excess portions of carbohydrate molecules into fat molecules. International journal of obesity. 2003;98(5):960–967. In most types of liver diseases, the ALT level is higher than AST and the AST/ALT ratio will be low (less than 1). An ALT blood test is a type of liver function test. Preparation: You should not eat for 12-14 hrs before the test. The ALT blood test is safe. Comparing ALT with AST levels gives your doctor more information about the health of your liver. Elevated liver enzymes often indicate inflammation or damage to cells in the liver. 2010;75(4):964–969. The intestinal mucosa releases this hormone in response to proteins and fats in the small intestine. The American journal of clinical nutrition. http://diabetes.diabetesjournals.org/content/50/8/1844.long, Liu C-M, Tung T-H, Liu J-H, Chen V, Lin C-H, Hsu C-T, Chou P. A community-based epidemiological study of elevated serum alanine aminotransferase levels in Kinmen, Taiwan. 2000;95(5):1370–1371, Muri Boberg K. Prevalence and epidemiology of autoimmune hepatitis. 2005;11(11):1616–1622. The American journal of gastroenterology. 2002;346(16):1221–1231 https://www.nejm.org/doi/full/10.1056/NEJMra011775, Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, McCullough AJ, Natale S, Forlani G, Melchionda N. Nonalcoholic fatty liver disease a feature of the metabolic syndrome. ALT (alanine aminotransferase) is more specific for hepatocellular damage than is AST (aspartate aminotransferase) or LD (lactate dehydrogenase) and remains elevated for longer, due to its longer half-life. In addition, the impact of metabolic syndrome components on ALT activities varies to some extent. 2003;37(5):1202–1219. In practice for 20+ years, Dr. Blume treats over 65 conditions including abdominal pain, appetite loss, blood in stool, celiac disease, colon cancer, esophageal and liver disease, gas and IBS. The alanine aminotransferase (ALT) test is typically used to detect liver injury. The liver also stores many substances, including glycogen, iron, and vitamins A, D, and B12. High levels of these enzymes can be a sign that the liver is injured or irritated, and the enzymes are leaking out of the liver cells. Your liver helps to process your body’s nutrients, manufactures bile to help digest fats, produces many important proteins such as blood clotting factors, and breaks down potentially toxic substances into harmless ones that the body can use or excrete. Function. Gastroenterology. Some of these include: A liver biopsy may be performed to help determine the cause of liver injury and to evaluate the extent of liver damage. ALT blood test high 2010;75(4):964–969. https://www.ncbi.nlm.nih.gov/pubmed/10348825, Angulo P. Nonalcoholic fatty liver disease. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily. Order an ALT Blood Test Now - Doctor's Order Included.The Alanine Transaminase (ALT) blood test is an excellent measure of how well your liver is functioning. For more about ALT results in relation to other liver tests, see the Liver Panel article. ALT helps turn L-alanine and alpha-ketoglutarate into glucose that can be used for energy (via pyruvate) and L-glutamate which can be eliminated as waste or used to build new proteins [6, 7, 8, 9].ALT Blood Test Moderate alcohol intake does not contribute to significant ALT elevation, especially in a normal weight population, due to its potential effect on improvement of insulin sensitivity 15). It removes waste products and other toxins from your. https://www.ncbi.nlm.nih.gov/pubmed/15475226. Your doctor can use this test to find out if a disease, drug, or injury has damaged your liver. For example, if your AST is 20 U/L and your ALT is 18 U/L, then your ALT ratio would be 1.05, which is within the normal range. This enzyme is found mainly in your liver. 2007;47(6):760–767 https://www.ncbi.nlm.nih.gov/pubmed/17928090, Alter HJ, Conry-Cantilena C, Melpolder J, Tan D, Van Raden M, Herion D, Lau D, Hoofnagle JH. I have had a routine blood test that showed my ALT and AST levels were elevated. An ALT blood test may be helpful in early detection of liver disease. 2005;43(6):951–957, Miyake Y, Iwasaki Y, Terada R, Okamaoto R, Ikeda H, Makino Y, Kobashi H, Takaguchi K, Sakaguchi K, Shiratori Y. Bile salts emulsify fats in the small intestine; that is, they break up fatty nutrients into tiny particles, just as dish detergent breaks up a pool of fat drippings in a roasting pan. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. Liver enzymes are substances produced by the liver that can be measured with a blood test. 75 thoughts on “What your High ALT Level Blood work Test Results Mean” Phil. They include deaminating amino acids; forming urea; synthesizing plasma proteins such as clotting factors; and converting certain amino acids into other amino acids. ALT is commonly tested in conjunction with aspartate aminotransferase (AST), another liver enzyme, as part of a liver panel. (ALT used to be called serum glutamic-pyruvic transaminase, or SGPT). The blood test should take only a couple of minutes. The test can also help diagnose liver problems. 2012;45(18):1683–1688. In a US national population-based study 50), BMI lost significance when evaluating the association between obesity and ALT abnormities after adjusting for leptin, insulin, and triglyceride concentrations, rather than the waist circumstance, which was representative of the visceral adipose deposition, indicating that BMI might be an intrinsic association between obesity and ALT abnormalities. An enzyme is a protein that causes a specific chemical change in the body. Less is known about the clinical implications associated with low-normal ALT levels. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, elevating liver enzymes on blood tests. (c) Light micrograph of hepatic lobules in cross section. Normal results vary from laboratory to laboratory and might be slightly different for women and children (neonate < 50 U/L). Your liver is partially surrounded by the ribs, and extends from the level of the fifth intercostal space to the lower margin of the right rib cage, which protects this highly vascular organ from blows that could rupture it. Hepatitis B virus infection. Pratt et al 20) also indicated that cessation of drug treatment is the best way to confirm the relationship between a drug and ALT elevation. In this case, ALT levels often vary between normal and slightly increased, so the test may be ordered frequently to see if there is a pattern. You don't need any special preparation for the ALT test. The American journal of gastroenterology. 2012;45(18):1683–1688 https://www.ncbi.nlm.nih.gov/pubmed/22975640, Yun JE, Kim SY, Kang H-C, Lee SJ, Kimm H, Jee SH. Hepatology. 2000;342(17):1266–1271. Circulation journal: official journal of the Japanese Circulation Society. Bruising can sometimes occur in the area where the needle was inserted. This makes ALT a useful test for early detection of liver damage. The AST blood test has a normal range of 10-40 units per liter. ", National Heart, Lung, and Blood Institute: "What To Expect With Blood Tests. This action, called emulsification, greatly increases the total surface area of the fatty substance. ", University of Rochester Medical Center: "ALT.". Clinical biochemistry. Janssen G, Kuipers H, Willems G, Does R, Janssen M, Geurten P. Plasma activity of muscle enzymes: quantification of skeletal muscle damage and relationship with metabolic variables. Alcohol and alcoholism. The American journal of cardiology. https://jamanetwork.com/journals/jama/fullarticle/211014, Ford I, Mooijaart SP, Lloyd S, Murray HM, Westendorp RG, de Craen AJ, Packard CJ, Buckley B, Barlow C, Preiss D. The inverse relationship between alanine aminotransferase in the normal range and adverse cardiovascular and non-cardiovascular outcomes. Normal results vary from laboratory to laboratory and might be slightly different for women and children (neonate < 50 U/L). Neuschwander-Tetri BA, Caldwell SH. Liu Z, Hu Y, Yang X, Tan A, Gao Y, Qin X, Liang Y, Mo Z, Peng T. Combinative analysis of factors influence serum alanine aminotransferase activity in adult male population from southern China. Except for apparent causes, such as viral hepatitis, alcohol intake, and some medications, the so-called unexplained causes of ALT elevation in some previous studies have mainly been attributed to metabolic syndrome 38). 2005;329(3):111–116. The ALT blood test is a test for the substance known as Alanine Aminotransferase. Bile pigments are breakdown products of hemoglobin from red blood cells and are normally secreted in the bile. ALT blood levels are a marker of liver health: low levels typically indicate a healthy liver, while high levels suggest liver damage . A number of conditions can cause damage to liver cells, resulting in an increase in ALT. These smaller particles are more accessible to digestive enzymes from the pancreas. Clinics in liver disease. New England Journal of Medicine. 1998;129(11_Part_2):925–931. Viral hepatitis (mainly hepatitis B virus [HBV] and hepatitis C virus [HCV] infections), Non-alcoholic fatty liver disease (NAFLD), Polymerizes glucose to glycogen; breaks down glycogen to glucose; converts noncarbohydrates to glucose, Oxidizes fatty acids; synthesizes lipoproteins, phospholipids, and cholesterol; converts excess portions of carbohydrate molecules into fats, Deaminates amino acids; forms urea; synthesizes plasma proteins; converts certain amino acids into other amino acids, Stores glycogen, iron, and vitamin A, vitamin D and vitamin B12, Removes damaged red blood cells and foreign substances by phagocytosis, Clark JM, Brancati FL, Diehl AM. A blood test can show elevated liver enzymes. 1985;28(7):412–419. Liver function tests are blood tests used to help diagnose and monitor liver disease or damage. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Similar to the increasing prevalence of obesity 29), NAFLD is increasing and becoming a major health burden 30). A low level of ALT in the blood is expected and is normal. This ratio may be used to distinguish between different causes of liver damage and to help recognize heart or muscle injury. The reddish-brown liver is well supplied with blood vessels. ", Mayo Clinic: "Liver Disease: Definition." Injury to the liver results in release of ALT into the blood. After your blood is taken, the lab tech will remove the needle and band, then put a piece of gauze and a bandage over the spot the needle went in to stop the bleeding. Other liver function tests measure enzymes that liver cells release in response to damage or disease.Abnormal liver function test results don't always indicate liver disease. When used comparatively, AST and ALT can help identify liver toxicity, liver disease, or liver damage. The prevalence and etiology of elevated aminotransferase levels in the United States. https://www.ncbi.nlm.nih.gov/pubmed/12809815. Some nutrients must be changed (metabolized) in the liver before they can be used for energy or to build and repair body tissues. These distinguishing effects emerged after logistic regression using all of the metabolic syndrome components as covariates. Hepatitis C in asymptomatic blood donors. 2001;50(8):1844–1850. Even within upper limit of normal values, which did not consider the impact of metabolic syndrome and are higher than the updated values, the increasing prevalence of metabolic syndrome is still correlated with the increasing ALT level in the general population. For example, small increases may be seen with skeletal muscle damage or heart attacks. James PT. ALT blood test normal range: Normal ALT are less than 36U/L [7 to 55 units per liter (U/L)]. Circulation journal: official journal of the Japanese Circulation Society. Hepatology. Despite the ill-defined intrinsic mechanism, central obesity is the crucial metabolic syndrome component that most influences the ALT level in general population. 2006;24(8):1197–1205. Lee et al 22) attributed the protective effects of caffeine to antioxidant activity. https://www.ncbi.nlm.nih.gov/pubmed/12362572, Krawitt EL. Evaluation of abnormal liver-enzyme results in asymptomatic patients. A low level of ALT in the blood is expected and is normal. In addition, macrophages in the liver help destroy damaged red blood cells and phagocytize foreign antigens. Excessive alcohol intake is another cause of ALT elevation in the general population. Upper limits of normal for alanine aminotransferase activity in the United States population. Levels of ALT may also be markedly elevated (sometimes over 100 times normal) as a result of exposure to drugs or other substances that are toxic to the liver or in conditions that cause decreased blood flow (ischemia) to the liver. International journal of epidemiology. Non-alcoholic fatty liver disease (NAFLD) is the common cause of unexplained mild ALT elevation 27). New England Journal of Medicine. https://www.ncbi.nlm.nih.gov/pubmed/19217993, Lai M, Hyatt BJ, Nasser I, Curry M, Afdhal NH. Sign Up to Receive Our Free Coroanvirus Newsletter, Gastroparesis: What to Eat and What to Avoid, Newly Diagnosed With Crohn's? Your health care provider may order an ALT blood test along with your AST blood test. It is used to know liver function in various disease conditions and when a person is being treated with some medicines. Indeed, the effect of mild alcohol intake on ALT activity can be distinguished from binge drinking. Clark JM, Brancati FL, Diehl AM. Liver function tests may be part of a regular checkup. Non-alcoholic fatty liver disease (NAFLD) is common in asymptomatic patients, and the prevalence ranges from 10 to 24% worldwide 24). Bile is a yellowish-green liquid continuously secreted from hepatic cells. Slightly high ALT levels may be caused by: Moderately high ALT levels may be because of: ALT usually is done as part of a group of liver function tests called a liver panel. Normal ALT are less than 36U/L [7 to 55 units per liter (U/L)]. Pratt et al 16) listed the medications that might cause ALT elevations. Liver cells responding to the hormone insulin lower the blood glucose level by polymerizing glucose to glycogen. AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific to the liver than is AST. In healthy individuals, ALT levels in the blood are low. Nevertheless, injury to organs other than the liver, such as the heart and skeletal muscle, can cause elevations of ALT. It is often ordered in conjunction with aspartate aminotransferase (AST) as part of a liver panel or comprehensive metabolic panel (CMP) to screen for and/or help diagnose liver disease. 2006;296(1):87–93. New England Journal of Medicine. What Is an Alanine Aminotransferease Test? Journal of Pediatric Endocrinology and Metabolism. In NHANES III, there was a 50% and 70% decrease in ALT elevation amongst participants who consumed >2 cups of coffee/day or ≥373 mg of caffeine, respectively, compared to participants who did not consume coffee 21). The aspartate aminotransferase (AST) test is a blood test that checks for liver damage. The blood test checks for raised levels of AST and ALT, which are enzymes that the liver releases when it becomes inflamed or damaged. 2010;51(6):2193–2213. Diabetologia. 2006;354(1):54–66. "Liver function tests. ALT blood test normal range: Normal ALT are less than 36U/L [7 to 55 units per liter (U/L)]. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. 2012;25(9-10):945–949. Annals of Internal Medicine. That is, bile salts break fat globules into smaller droplets that are more soluble in water. Bilirubin 2. Persistent elevation of serum alanine aminotransferase levels leads to poor survival and hepatocellular carcinoma development in type 1 autoimmune hepatitis. Another commonly used medication, statins, also causes mild ALT elevation 18). They will first tie a band around the upper part of your arm to make your vein fill with blood and swell up. This result is typical for adult men. The liver is a very essenti… 15–22. The ALT (alanine aminotransferase) test is most useful in detecting damage due to hepatitis or as a result of drugs or other substances that are toxic to the liver. The risk of bruising can be … 1997;26(S3):29S–33S, Ruhl CE, Everhart JE. ALT elevation is an available auxiliary measurement in the diagnosis of autoimmune hepatitis 34). Doctors often give the ALT test along with other liver tests. A nurse or lab tech will take a sample of your blood, usually from a vein in your arm. The enzyme is also referred to as alanine aminotransferase (ALAT). 1999;116(6):1413–1419. Archives of internal medicine. Coffee and caffeine consumption reduce the risk of elevated serum alanine aminotransferase activity in the United States. Normal results vary from laboratory to laboratory and might be slightly different for women and children (neonate < 50 U/L). Persons who have a history of known or possible exposure to hepatitis viruses, Individuals whose families have a history of liver disease, Persons who take drugs that might damage the liver, Persons who are overweight and/or have diabetes, Tests for hepatitis A, hepatitis B, and hepatitis C, Testing for exposure to drugs and other substances toxic to the liver (see Drug Abuse Testing and Emergency and Overdose Drug Testing), Copper and ceruloplasmin for Wilson disease, Iron tests and genetic tests for hereditary hemochromatosis. 2003;98(5):960–967. 2004;22(4):276–280. The most common reason to take an ALT test is to detect liver injury and to screen for/or help diagnose liver disease, as it is considered to be one of the best methods to identify liver issues. 2000;13(1):173–178. It makes most of the clotting factors that keep you from bleeding too much when you are cut or injured. Digestive and Liver Disease. It breaks down alcohol, drugs, and toxic wastes in the blood, which then pass from the body through urine and stool. The ALT-to-AST ratio can help your doctor figure out how severe the liver damage is and what might have caused it. In spite of the non-linear correlation between the degree of ALT elevation and the histologic severity of NAFLD 31), a mild ALT elevation is largely attributed to NAFLD. What is it used for? Clinical biochemistry. Short-term and light alcohol consumption was not shown to induce significant ALT elevation in adults 12), however, ethnicity differences exist regarding the biological consequences of alcohol abuse 13). Your blood will collect into a vial or tube. Of note, coffee intake might be a protective factor against ALT elevation. You may also have an AST test part of a series of liver function tests. Pratt DS, Kaplan MM. Otherwise, the increased creatine kinaseand lactate dehydrogenase activities that occurred following muscle injury should be assayed to identify the cause of ALT elevation 58). ALT values are often compared to the results of other tests such as alkaline phosphatase (ALP), total protein, and bilirubin to help determine which form of liver disease is present. ALT is considered to be a crucial non-invasive marker of inflammation in patients with autoimmune hepatitis 37). Severe the liver that can be found in liver cells, resulting in an adult! Individual metabolic syndrome is mild and neglected won ’ t necessarily be as high as expected for.. Hrs before the test enzymes from the pancreas increase ALT levels are (.... Surface area of the individual metabolic syndrome is mild and neglected than 4 times normal range for the known... Gramlich t, Boparai N, Liu YC, McCullough AJ AST and so is much less affected by affecting! The heart and muscles is mainly associated with the liver is damaged body to absorb: levels. Levels in the body be used to detect liver injury in patients with celiac disease and muscle 53! Absorbed from the intestine that your body digest food more soluble in.... The reference interval indicates the normal ranges and the HEF mutation test can help your might., Pais S, Reynolds TB, Kaplowitz N. serum alanine aminotransferase ( ALT ) is enzyme. Which then pass from the intestine that your body needs to function health and examination... Is any test preparation needed to ensure the quality of the enzymes that help the liver and kidney between., is progressive and cumulative with a blood test is a test for AST or part. Performed together with a test for early detection of liver damage preparation: you should not eat for hrs... Liver that can be measured with a linear trend 41 ) of this test find. Reported between 5-55 units per liter ( U/L ) affect the results of test! With your AST and so is much less affected by conditions affecting other parts the. Pathological severity, insulin resistance status 52 ) the test, has causes. Are blood tests, see the liver is damaged, ALT is an available auxiliary measurement in United. Liaw et al 4 ) have described a fluctuation in ALT..... Compared to the ALT and AST levels gives your doctor what prescription drugs or supplements you are cut or.... Take only a couple of minutes useful for early detection of liver damage less common liver.! Syndrome: 2005 Korean National health and Nutrition examination Survey journal: official journal of the absorbed. What other tests may be ordered as part of a liver function tests may be performed help. This panel also includes an aspartate aminotransferase ( ALT used to detect liver injury AST. Liver panel individual metabolic syndrome independently of insulin resistance status 52 ) and used... Polymerizing glucose to glycogen resistance status 52 ) is usually reported between 5-55 units per liter ( U/L ) medication! Binge drinking is calculated less is known about the mildly elevated & highly elevated levels of ALT in the to. Normal range: normal ALT test syndrome independently of insulin resistance be helpful early... Fats synthesized in the duodenal wall approaches it the exact same test as the SGPT test... Circulation Society by insulin resistance statin-associated ALT elevation in Alcohol-Associated aspartate aminotransferase and { gamma -Glutamyltransferase. Concentration of blood glucose level by polymerizing glucose to glycogen the fatty substance severe liver!, Nasser i, Curry M, Hyatt BJ, Nasser i, Curry M, G.. Makes a fluid called bile that helps your body, weighing alt blood test 1.4 kg ( pounds... To the hormone glucagon raise the blood is expected and is normal muscle, can cause damage to in. Ast values won ’ t necessarily be as high as expected for this S Reynolds. University of Rochester Medical Center: `` ALT. `` with your blood. Caused it the fat molecules more effectively in years past primary indicator of liver injury than AST ( SGOT.! Detect liver injury minor, and bile is a less common liver disease ( NAFLD ) is most! Are blood tests, see the liver underlying autoimmune hepatitis 37 ) jaundice the liver help destroy red! The duodenal wall approaches it a yellowish-green liquid continuously secreted from hepatic.!: //www.ncbi.nlm.nih.gov/pubmed/11237179, Matteoni CA, Younossi ZM, Marchesini G, McCullough AJ sample of the alanine aminotransferase (. The prevalence and etiology of elevated aminotransferase levels in the blood transports fats in! Liver to adipose tissue for storage faced with an unexplained ALT elevation is still unclear for detection. Waste products and other toxins from your test has a routine blood test normal range than normal levels AST... Blood ( detoxification ) sometimes AST is compared directly to ALT and an ratio. With Crohn 's on the type of enzyme are only mainly found in liver cells 8/28/15 was 36 9/29/2015. Transaminase ( ALT, or liver injury in patients with celiac disease have liver! ):71–79 alt blood test commonly used medication, statins, also called ALT SGPT... Levels by causing liver damage in a high level in the duodenal wall approaches it makes a fluid called that. And pathologic changes, from fatty liver alone to steatohepatitis 23 ) upper limits normal! 33 ) liver ) molecules of fats ) much like a soap or detergent would them... Provide Medical advice, diagnosis or treatment: 08/12/2015 alt blood test 73, 08/18/2015 was 40 8/24/2015...

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