ALT and AST

ALT (ALanine Aminotransferase) test is one of the most common tests used to detect liver damage. ALT values are usually compared to the levels of other enzymes, such as aspartate aminotransferase (AST), to help determine which form of liver disease is present.

Here are a few values reported by the Internet users on various medical forums, blogs and microblogging sites:

	Normal	Moderately Elevated									High
ALT	0-55	40	50	59	66	70	92	109	119	214	227	227	258	434	533	670
AST	0-40	37	43	132	106	90	212	122	281	34	131	288	34	72	114	217

According to different sources, normal values are supposed to be between:
4–36 units per liter (U/L) or 0.07–0.62 microKat/L for ALT and 8–35 units per liter (U/L) or 0.14–0.58 microKat/L for AST; 8-20 for both ALT and AST, 0-40/0-45 IU/L for ALT and AST respectively. Lab Corp considers 0-55 IU/L as normal values for ALT, while Covance lists 6-43 U/L.
Some sources list separate references for males and females.

Higher AST were observed for women with a family history of diabetes, when adjusted for age and BMI.

In acute liver injury, such as viral hepatitis, the ALT and AST may be as high as 1000U/L. In chronic hepatitis or cirrhosis of the liver, ALT and AST may be 10 to 100 times their normal values.

Besides severe liver damage, lead poisoning, exposure to carbon tetrachloride, severe drug reactions, necrosis of large tumors and shock, elevated levels of ALT may be caused by:

• Alcohol abuse.
  
• Celiac disease
• Fatty deposits in the liver
• Long-term (chronic) diseases that affect the liver, such as Cirrhosis
• Medicines, such as statins, antibiotics, chemotherapy, aspirin, narcotics, and barbiturates. People who take acetaminophen (such as Tylenol) can have high ALT blood levels.
• Mononucleosis
• Hepatitis (viral, autoimmune) /ALT can be 20x normal value/
  
• Hereditary hemochromatosis
• Liver ischemia (blood flow deficiency to the liver)
• Liver tumor
• Quickly growing young children
  
• Use of drugs that are poisonous to the liver

ALT test is a part of a liver panel, also known as liver function tests or LFT, is used to detect, evaluate, and monitor liver disease or damage. It usually consists of seven tests that are run at the same time on a blood sample.

ALT - ALanine Aminotransferase, also known as Glutamate-pyruvate transaminase (EC 2.6.1.2), catalyzes the reversible conversion of L-alanine and alpha-ketoglutarate to L-glutamate and pyruvate. It has 2 distinct molecular and genetic forms: one cytoplasmic (soluble) (GPT1) and one mitochondrial (GPT2; MIM 138210).
AST - ASpartate Aminotransferase, also known as Glutamic-oxaloacetic transaminase is a pyridoxal phosphate-dependent enzyme which exists in cytoplasmic and mitochondrial forms, GOT1 and GOT2, respectively. GOT plays a role in amino acid metabolism and the urea and tricarboxylic acid cycles. See also HPRD:00687; MIM:138180; HPRD:00684; MIM:138150


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Celiac Disease and Gluten Intolerance

The history of Celiac sprue disease started with the description of Arataeus the Cappadocian, 250 A.D. He referred to his patients as "koiliakos," aka "suffering in the bowels." Francis Adams translated these observations from Greek to Englishin 1856, calling the patients "celiacs."

In 1888, Dr. Samuel Gee first presented a set of clinical accounts of both children and adults with Celiac Disease. September 13th is designated National Celiac Disease Awareness Day in honor of Gee’s birthday. Dr. Willem Karel Dicke, a Dutch pediatrician, recognized in 1952 that the disease is caused by the ingestion of wheat proteins. Heubner described celiac disease in Germany. At the beginning of the 20th century the disease was called Gee-Heubner-Herter's Celiac disease is also called Gee-Herter disease; Gee-Thaysen disease; gluten enteropathy; gluten intolerance; Gluten-sensitive enteropathy; Huebner-Herter disease; idiopathic steatorrhea; nontropical sprue.

Dr. Samuel Gee

See the official 2009 definition

Celiac disease has become much more common in the last 50 years. Researchers found that young people today are 4.5 times more likely to have celiac disease than young people were in the 1950s, while those whose birth years matched the Warren AFB participants were four times more likely to have celiac disease.

Celebrities with Celiac Disease:

John F. Kennedy
Joe C
Rich Gannon's daughter Danielle
Elizabeth Hasselback
Keith Obermann
Katherine, Duchess of Kent

and others

Check out SlideShare Presentation about this condition:

Basic Introduction To Gluten Related Health Issues

View more presentations from William Beverly.

Related articles by Zemanta

• Gluten Intolerance, Wheat Intolerance, Wheat Allergy, Celiac Disease (healthhype.com)
• Resources: Celiac Disease Websites & Blogs (fightingfatigue.org)

IBS Resources

Mirrored from Aurametrix

IBS is a disorder of heterogeneous pathophysiology for which there are no good diagnostic tests nor effective treatments (online study on unmet needs conducted by IFFGD and UNC). Existing tests are performed to exclude diseases such as IBD, colorectal cancer, diseases associated with malabsorption, systemic hormonal disturbances, and enteric infections.
Routine serologic screening for celiac sprue in patients with IBS-D or IBS-M may be useful.
Lactose intolerance can cause IBS-D, intolerances to other food groups such as

Image via Wikipedia

fructose could be also implicated. Problems with serotonin signaling, or the transmission of messages between the nerves, can lead to IBS-C

• New Guidelines Issued for Management of IBS (download pdf)
  

The guidelines, issued by the American College of Gastroenterology were published in the January2009 issue of The American Journal of Gastroenterology.

Most IBS treatments relieve symptoms rather than resolve the condition itself.

The new guidelines encompass existing evidence on conventional treatments for IBS as well as new therapies (probiotics, for example) and alternative therapies (acupuncture and more).

Fiber products -- including psyllium, anti-spasmodic medications and peppermint oil -- may be effective in some people. "The evidence is poor, but some patients say they feel better,"

More data is needed on probiotics, live microorganisms (usually bacteria) similar to the "good" organisms found normally in the gut. The dichotomous data suggest that all probiotic
therapies have a trend for being efficacious in IBS, whereas the
continuous data indicate that Lactobacilli have no impact on
symptoms; probiotic combinations improve symptoms; and
there is a trend for Bi fidobacteria to improve IBS symptoms.Researchers and practitioners still need to figure out the species of bacteria used, how many species, and dosages.

Non-absorbable antibiotics -- those targeted to the gut only, such as rifaximin (Xifaxan) -- also seem to help some people, especially those who have "diarrhea-predominant IBS."

Selective C-2 chloride channel activators, notably lubiprostone (Amitiza), are effective for "constipation-predominant IBS."
5HT 3 antagonists such as alosetron (Lotronex) relieve symptoms of diarrhea but can cause constipation and colon ischemia, a restriction of blood flow.
5HT 4 agonists, though effective against constipation, are not available in North America because of a heightened risk of cardiovascular problems.

There is yet to be conclusive evidence on Chinese herbal mixtures, and the mixtures run the risk of causing liver failure and other problems. Differences in the content of compounds and the purity of ingredients complicate evaluation of benefits.

Similarly, the evidence on acupuncture remains inconclusive.

There is no evidence at this point that testing for food allergies or following diets that exclude certain foods alleviates IBS symptoms.

Routine diagnostic testing for IBS is not recommended, although some testing should be performed in certain subgroups of patients.

More about IBS at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases site.

• IBS medications: http://www.ibsgroup.org/medications. compiled by IBS Self Help and Support Group
  

To ease IBS with diarrhea, avoid fried foods, too much fiber, especially insoluble such as apple skins, chocolate, alcohol, caffeine, carbonated drinks, the artificial sweetener sorbitol (found in sugarless gum and mints), and fructose (the simple sugar found in honey and many fruits). These can worsen diarrhea symptoms. Drink six to eight glasses of plain water a day - not with meals, but an hour before or an hour after meals. Avoid drinking hot teas.

To ease IBS with constipation, drink water and exclude beverages as suggested above. Eat small frequent meals and be careful with fiber. Soluble is better at reducing severety of symptoms, as was shown in this 2005-2007 clinical trial, but all types of fiber could potentially worsen the syndrome. You may also want to exclude broccoli and other dark green vegetables from your diet. Keep an IBS symptom journal, it would help you and your doctor to find what foods and situations trigger your IBS symptoms.

Not Censored IBS Diet Links:

• IBS Resources from About.com
• IBS diet and recipes from helpforibs
  
• Diet for IBS by Diettrific
  
• IBS Diet suggestions
  
• IBS Diet Resources

• Irritable Bowel Syndrome / IBS Health Center - WebMD

• Irritable bowel syndrome - Wikipedia, the free encyclopedia

• Irritable bowel syndrome - MayoClinic.com

• Irritable Bowel Syndrome - Family Doctor

• IBS articles on pubmed
  
• IBS Video from NHS
  
• Coping with IBS by WebMD
• American College of Gastroenterology
• International Foundation for Functional Gastrointestinal Disorders
• Symptoms f IBS by symptomsofibs.org
  
• Irritable Bowel Syndrome Association folded into the INS support group in 2009
• IBS Resource on Squidoo
• Irritating IBS on Diabetes Self-Management Blog
• Managing IBS by American Family Physician
  
• is IBS linked to foods?
  
• Causes of Irritable Bowel Syndrome © Irritable Bowel Syndrome
  
  

More Links:

• The Irritable Bowel Syndrome Self Help and Support Group is an award-winning patient advocate group in support of self-management for IBS sufferers. Learn how sufferers are living day-to-day with IBS. Read success stories about strategies that sufferers use to cope with IBS. At the Irritable Bowel Syndrome Self Help and Support Group: You are not alone
• IBS group on twitter
• Digestive Health SmartBrief News and Briefs on Digestive Health and Foodborne illnesses
  
• Body Odor Support Group: An online support group for people with all types of body odor disorders, including TMAU, IBS and other medically not recognized or characterized conditions.
• Only 8% of IBS patients are satisfied with existing solutions, many agree to assume risks to be symptom free
• Unmet needs of IBS patients (view survey report (pdf))
  
• Children whose celiac disease is detected early do better over time

  Image via Wikipedia

• From 3% to 10% of IBS also have celiac disease
• Too much fruit is not good for you
• Daily recommended fiber intake
• 45% of IBS patients have lactose intolerance
• 65% of children with IBS have SIBO

• Diarrhea-prominent IBS: wheat, beef, pork, and soybean. Constipation-prominent IBS: wheat, lamb, beef, and pork. Alternating IBS: wheat, beef, and pork, 2005 study

• IBS is on the rise Dr. Hildreth
• IBS is on the rise, Times of India
  
• Fructose and IBS by Dr. Mirkin
• Fructose, Sucrose and IBS, by D. Brown
• Food additives, packaging chemicals and IBS
  
• Dr. Groves on IBS and other unrecognized health conditions

International Foundation for Functional Gastrointestinal Disorders (IFFGD) sites:

Chronic Constipation	aboutConstipation.org
Acid Reflux Disease (GERD)	aboutGERD.org
Motility Disorders	aboutGImotility.org
Irritable Bowel Syndrome (IBS)	aboutIBS.org IAMIBS.org
Incontinence or Urgency	aboutIncontinence.org
Digestive Disorders in Kids and Teens	aboutKidsGI.org
Digestive Health Research	giResearch.org

• Y! answers
• IBS Blood test by Prometheus
• Only 8% of IBS patients are satisfied with existing solutions, many agree to assume risks to be symptom free, results from a survey based on 1,966 qualifying responses (see pdf-formatted report)
  

Participate in IBS survey

Related articles by Zemanta

• Irritable Bowel Syndrome Around the Web (fightingfatigue.org)
• ME/CFS, Fibromyalgia & IBS News Around the Web (fightingfatigue.org)
• IBS Relief (5min.com)
• Resources: IBS Message Boards/Online Support Groups (fightingfatigue.org)
• Bowel Problems ~ Symptoms Diagnosis by a Doctor (healthhype.com)

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