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Talk to General Physician on High ALT

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Asking For Self, Male 32, Abbottabad

sallam,

got my LFTs test recently done and found out that my ALT is 121. also did hepatitus A,B,C tests, all were negative.

i was also asked for an ultrasound of liver, it came that i also have a fatty liver.

a doctor advised me to start hepamerz syrup or silimyrin capsules.

i just wanted to cross check my doctors advice and want an opinion from specialists here. are you satisfied what my doctor advised me and please also let me know which is better to use hepamerz or silimyrin, i mean which is more effective.

thanks in advance

Internal Medicine Specialist in Lahore - Assoc. Prof. Dr. Somia Iqtadar

Assoc. Prof. Dr. Somia Iqtadar - Internal Medicine Specialist

MBBS, FCPS (Medicine), FRCP (London) | Lahore

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380 Positive Reviews

u can take either.Also get your fasting loud profile.What is your weight and height?

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Fasting glucose =102
HBA1C = 5.7
WEIGHT : 75 KG
HEIGHT : 5 FEET 5 INCHES

1 month ago

Internal Medicine Specialist in Lahore - Assoc. Prof. Dr. Somia Iqtadar
Assoc. Prof. Dr. Somia Iqtadar - Internal Medicine Specialist

MBBS, FCPS (Medicine), FRCP (London) | Lahore | Book Appointment

review-stars 380 Positive Reviews

get ur lipid profile too.

1 month ago

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lipid profie:

cholestrol 178
hdl cholestrol 31
cholestrol to hdl ratio 5.7
LDL Cholestrol 126
VLDL 21
TRIGLYCERIDIES 230

1 month ago

Internal Medicine Specialist in Lahore - Assoc. Prof. Dr. Somia Iqtadar
Assoc. Prof. Dr. Somia Iqtadar - Internal Medicine Specialist

MBBS, FCPS (Medicine), FRCP (London) | Lahore | Book Appointment

review-stars 380 Positive Reviews

Your triglycerides are a bit high.cut down on your fat intake.Do regular exercise.

1 month ago

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ok thankyou so much for the early response

one last question do i need any medication for cholestrol?

or i should only take hepa merz and regular exercise

please comfirm

1 month ago

Internal Medicine Specialist in Lahore - Assoc. Prof. Dr. Somia Iqtadar
Assoc. Prof. Dr. Somia Iqtadar - Internal Medicine Specialist

MBBS, FCPS (Medicine), FRCP (London) | Lahore | Book Appointment

review-stars 380 Positive Reviews

I think you can try dietary control first and repeat lipids after a month.If still high I can prescribe you medication.

1 month ago

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ok thankyou so much.

1 month ago

General Practitioner in Faisalabad - Dr. Adil Ayoub

Dr. Adil Ayoub - General Practitioner

MBBS | Faisalabad

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22 Positive Reviews

What is your weight and Hight?
Some other investigations are also required
Like
CBC
LFT
Urine Complete
RBS
Complete Lipid Profile

Then follow the advise as by doctor

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height : 5 feet 5 inches
weight 75 kg

lipid profie:

cholestrol 178
hdl cholestrol 31
cholestrol to hdl ratio 5.7
LDL Cholestrol 126
VLDL 21
TRIGLYCERIDIES 230

LFt's
Total Billrubin 05
ALT 121
serum Alkaline phosphate 130.7
serum total proteins 72.2
serum Gama GT 141.6


blood cp

RBC 5.60
hemoglobin 15.8
pcv 48.4
mcv 86.4
mch 28.2
mchc 32.6
Esr 12
Wbc 8.58
platelets 326

1 month ago

General Practitioner in Faisalabad - Dr. Adil Ayoub
Dr. Adil Ayoub - General Practitioner

MBBS | Faisalabad | Book Appointment

review-stars 22 Positive Reviews

Just reduce your weight by 5 kg and increase fiber intake
Take more salad with your meal
Don't use white flour mix it with oats and barley.
Take regular exercise.
Avoid fast food. Naan etc and oily things
If you take one or two garlic clove daily with food or bread it will helpful to reduce Lipid Profile

1 month ago

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ok thankyou sir

1 month ago

General Physician in Lahore - Dr. Kashif Ijaz Ahmed

Dr. Kashif Ijaz Ahmed - General Physician

MBBS, MRCP (UK), MRCP (E), MRGP (UK), FRSPH, CCT (UK), Family Medicine, PGDip (London), PGDip Diabetes (USW) | Lahore

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10 Positive Reviews

hi
interesting debate. it again appear you have been a victim of the typical psyche of clinician that something has to be offered, i am glad in this forum very sensible advice has been offered .few things to add.2/3 outstanding things stands out
you are slightly over wt if you do your BMI it will be in obese range
2/ raised tramsaminase (ALT) WITH NORMAL ALPO4 AND GGT
3/Your lipid profile is deranged certainly TGshigh so is chol/hdl ratio
4/usg showing some fatty changes
based on above one would like to know
1/ anyh/o alcohol use

2/ life style
3/any use of medication prescribed or recreational
IF there is no obvious risk from above this condition is called NASH/NAFLD
(NON ALCOHLIC STETOHEPATITIS/OR NON ALCOHLIC FATTY LIVER DISEASE
treatment of this condition is to modify lifestyle and reduce visceral fat (internal fat)
this is one of most common cause of liver transplant in young in the west if not treated
when ALT reash 3 times the upper normal limit this is the indication for liver biopsy which seems the case with your bloods but no need to get panic this is one off readings so first thing is repeat lfts in 4-6 wks .
nowadays one can get away with biopsy by having fibroscan but this is fairly specialized and expensive not sure about its availability in Pakistan though the machine is small cost 150k pounds (not the test )
purpose of biopsy /scan is to find is it just fat silently sitting in or it is causing inflammation and fibrosis of liver cell (indirectly reflected by raised alt)
bottom line is
1/ no medication what so ever at all
2/ intense life style change //plan to wt reduce
3/repeat lfts in 6 wks
if alt still above 100 see some more than competent sincere/ethical clinician
regards
Dr Kashif I jaz Ahmad
Consultant family physician/Community diabetologist
MBBS, MRCP(UK),MRCGP(UK), FRSPH,CCT, PGDip (LONDON)

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very nice response sir.

thankyou so much. i appreciate

1 month ago

General Physician in Rawalpindi - Dr. Abdul Naeem

Dr. Abdul Naeem - General Physician

MBBS, MRCP (Ireland) | Rawalpindi

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21 Positive Reviews

Hi
1st check ur BMI by Google and decide for metabolic syndrome that ll give u
perfect cure
Rgds
Dr.A.Naeem

Member of Marham-Forum

Hi.
I have a very deep concern kindly tell me how can i reduce my ALT AND BILURIBN, MY ALT IS 144 AND BILURUBIN IS 2...
MY WEIGHT 64KG
HEIGHT 5.8"
KINDLY GUIDE ME AS ALL OF NY A, B, C, E HEP TEST ARE NEGATIVE....

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