I would usually trust my family doc to interpret test results but I have yet to encounter anyone as thoroughly knowledgeable on blood markers as Austin.
Had bloodwork done as per family doc’s recommendations (new doc), and ALT came back as 82 U/L (ref: <50). A1C was 5.3, in range but high (test was non-fasted, unsure if that matters). I don’t drink, waist is about 35.5-36" (Bf estimated at 20%). I frustratingly seem to carry a lot around the abdomen, and it seems somewhat hereditary. I don’t have any abnormal symptoms, and am rarely sick. I don’t consume any SSBs (although we do drink Zevia quite often), and don’t eat a lot of added sugars or saturated fats, although I do eat white rice and yellow potatoes frequently.
I’ve heard Peter Attia talk about insulin resistance occasionally arising from chronic sleep interruption and stress in combo. Could this be early stage NAFLD or similar? Should I simply follow up with a family doc (is this generally well understood in the medical community), or is this generally manageable in situations with no red flag symptoms?
If this is the first time it’s ever been elevated, and is an isolated elevation (i.e., no other abnormalities on the hepatic panel ) I would simply repeat the test in a few weeks before doing anything else, in case it resolves on its own. This could potentially be paired with a creatine kinase or aldolase measurement at the time, to provide supporting evidence in case it is simply related to routine muscle damage in the context of your training.
If not, I’d be thinking about possibilities such as fatty liver (which could be evaluated further as discussed in our fatty liver podcast), toxicity from medications or supplements, and would want to rule out chronic infection (e.g. hepatitis B/C) before progressing to less and less likely causes from there such as hemochromatosis or autoimmune diseases).
Thanks! Didn’t know you guys had an article on it. I’ve never had it tested before to my knowledge, and it’s elevated in isolation (ALP is within range although AST wasn’t measured). Thanks for the advice, will request that if it’s not recommended outright. Will also give the fatty liver podcast a listen.