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Mainstream medical question about liver panels


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I am looking over old lab tests at past liver panels, because DS12 is having a problem with copper metabolism (low ceruloplasmin and high unbound copper). I am trying to decide whether to push for a consultation with a liver specialist.


A question for any of you who know this, just to tell me if the following is something of concern: DS12 has had numerous liver panels done over the past few years and have never raised the concern of his doctors. But what I have just realized is that, although his AST and ALT are always within normal range, the AST is always higher than the ALT and it's supposed to be the other way around. The ratios have ranged from 1.1 to 1.7. I have learned that such an ALT/AST inversion is of concern for liver damage, but is that true even when they are both within normal limits? I can't seem to find that answer for myself by searching.


His bilirubin has ranged from 0.2 to 1.4 and his Alb:Glob ratio is usually high-normal or very slightly elevated. But my main question is about that ALT/AST inversion.


Am probably going to ask for a consult with a specialist, but it's always nice to have knowledge ahead of time.

Thank you!

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I took a look back through DDs records. Oh, dear.


Her AST has always been higher than ALT, although within normal ranges.


The only time ALT has been higher than AST was when we first started treatment and she was Rxed bactrim, which she ended up developing an allergic reaction to. At that point both were higher than normal. After we changed abx and started taking milk thistle both measures came back down, but the inversion came back as well.


Sorry, I'm no help at all. Our LLMD just seems satisfied that both are now within range and have been there since the initial blip. She didn't mention about an inversion.


Keep us updated.

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Seems like I remember somewhere along the line that Liver panel levels in Pediatrics cannot be interpreted the same as in adults due to "growth" in children. What you may be concerned about may be considered entirely normal to mainstream MD's and that's why they have never mentioned a problem. I would not bet my first born on this... but this seems to creep up somewhere out of the cobwebs of my mind:) If researching these levels to come up with appropriate ratios...be sure to look specifically for pediatric information.

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