Hi guys,
Just listened to your recent bloods podcast and read your article on how exercise can affect liver markers. I just had some bloods taken due to ?bone pain and difficulty gaining weight (both have pretty much resolved). All of the bloods came back within the reference range except for ALT, which came back as 93 (was previously 25 when measured in Jan 2025) The only other thing potentially of note was a serum protein at the top of reference range of 79 (also 79 when measured in January).
I’m not concerned about things such as NASH or other metabolic health issues that may affect the liver as my metabolic health markers don’t seem concerning:
HbA1C - 5.0%
Blood pressure - 112/77
HDL - 58
TGs - 79
BMI - 23.5
Waist circumference - 34 inches
My doctor wants to discuss these results in a few days but I was just wondering what your next course of action would be? I’m guessing the doctor may want to repeat bloods (possibly after a period of reduced training?) and have a discussion about alcohol intake, lifestyle, etc. I’m hoping they don’t request a scan or something more invasive.
My hunch is that it may be exercise-related as I think I did a fairly novel and potentially damaging workout a couple of days prior to the blood test.
Yeah, based on what you’ve provided don’t have much more to add beyond what was discussed in the liver tests article. I would agree with repeating/monitoring the test, ideally without strenuous training immediately before, and having that discussion. If imaging is pursued, an ultrasound is usually the first step and would be inexpensive, non-invasive, and involve no radiation – although it is unlikely to yield much diagnostic information in this scenario.
Thanks Doc.
As expected, doctor repeated bloods and this time ALT was in the middle of the reference range. The doc however ordered some other bloods, including immunoglobulins. IGa and IGm were normal but IGg was elevated to 19.5g/L. Not sure what to make of this as the healthcare professionals comment on the test says “satisfactory - no further action”. Unless an isolated elevated IGg is meaningless without additional clinical context?
Do you mind if I ask another question here to avoid starting a new thread? My partner recently had some bloods done and had a Ferritin of 15. This is right at the bottom of the reference range. As within normal range, this did not flag up any concerns. I’m not sure, but did you say on a recent podcast that you think the “normal range” for Ferritin should be higher?
It depends a bit on why they checked the immunoglobulin levels. For example, elevated IgG levels are among the diagnostic criteria for autoimmune hepatitis, which may have been what they were thinking about here. With that said, you’d need other additional findings to support that type of diagnosis, which seems quite unlikely here.
Regarding your partner, yes – I strongly disagree with a lower limit of “normal” at 15 ng/mL. It should be at least 30 ng/mL, although I typically aim for levels of 50 ng/mL. Here are some supporting references:
Thanks again, Austin.
I had a hepatitis B vaccination around 10 weeks ago. Not sure if this could potentially explain the slightly raised IgG at this stage?
Thanks for the info about iron deficiency. Her Hb is 140 , so the low Iron is not resulting in anaemia. But it looks like treatment for iron deficiency may be warranted based on the references you sent. Will encourage her to talk to her doctor about it.
I would not attribute the ALT elevation to HBV immunization.
And yes, I typically address a ferritin of 15 ng/mL regardless of whether the person has anemia.
1 Like