This is very good information! LFTs are so intimidating to me I honestly don’t know where to start. This video really helped me with that. Thank you! ^_^
Awesome video. I wanted to know about a mildly elevated ALT and it really helps to look at this in combination with the other Liver values, recent history of each one and symptoms to see the whole picture and rule many things out.
Hello so I’m 41 obese with hx of fatty liver.yesterday I had my cmp all were normal except for my ALT which is at 30..as per quest diagnostic range is only until 29u/l ....my ast and alp is normal..pls tell me what to do thanks
I just came across your RUclips channel and wow! Blown away. Loved it. I am a NP in Sexual Reproductive HIV BBV in Melbourne Australia. Just not forgetting to test for acute hepatitis A as well with a IgM HAV as that could be another cause of raised ALT / AST and also, Syphilis, as that causes hepatitis with raised LFTs as well and often under tested especially ante-natally. And of course, they if sexually active, a pee test for Chlamydia would not go astray
what is your approach on a pt who who is requiring statin therapy and has elevated LFTs (etoh or fatty liver). Do you start statins and monitor LFTs? Any LFT range specifically where you will d/c the statin. Thanks
I believe the FDA and consensus practice recommends checking baseline LFTs and only retesting if clinically indicated, not routinely anymore. I found some general consensus recommendations to reduce the dose or change statins if they're >3x ULN confirmed x 2 readings
i know Im asking the wrong place but does anyone know a tool to log back into an Instagram account..? I somehow forgot the login password. I would appreciate any tips you can offer me!
@Hezekiah Abdiel i really appreciate your reply. I found the site through google and im in the hacking process now. Takes quite some time so I will get back to you later when my account password hopefully is recovered.
Thank you for the great info. Can jogging or running a couple of days before a blood test result in increased ALT/AST numbers? I am going back for a follow up after my numbers were a little high and I don't want this to be a factor at all. Thank you again!
I'm 51 years old and throughout my adult life I have always been active, and have been either at a 'normal' or 'overweight' but fit bmi. I had never had normal range liver enzymes. Finally my doctor sent me for a fibroscan. It showed moderate fibrosis and over 66% fat in my liver. The ONLY thing that brought these liver enzymes to 'normal' range for the first time in my entire adult life was 1. intermittent fasting, 2. 10pct body weight loss 3. Eliminating orange juice from my diet. 4. adding choline and vitamin E supplements. 5. some other minor adjustments to my diet. I will say that both of my parents have always had elevated liver enzymes their entire lives too. I have to stay almost 'skinny' and stay away from fruit juice in order to 'fix' my liver. Doing well though. All bodies are different.
This was super helpful. I was curious if you notice a one point elevation past the 40 upper range and the patient retests two weeks later the number drops back within range, would there be cause for alarm if all other results from the hepatic function are normal?
Generally no but each patient is different. You have to consider the patient medical history, social history, and medications. We cover this topic in depth with our Lab Crash Course. Check it out here: www.realworldnp.com
I just discovered your channel recently. Your videos are amazing! I listen to them every day on my way into work, which brings me to my question. Do you have a podcast, or have you thought about podcasting? You explain concepts in such a helpful way for APNs. That has been hard to find on podcasts channels. Every time I’ve looked for NP channels providers just seem to be reading from a script the whole time. Sorry if this has been answered before. Great channel!
@@RealWorldNP Viewers can tap in the video, then the settings icon, then scroll down to playback speed and select their preference. Thanks for the excellent presentation..
@@RealWorldNP Thank you very much for the response, i had vertigo so in like 5 days i had a handful of food, bit soup and drank around 4 liters of water, after that i took the blood test, my liver enzymes were up, like readings were ast around 130 and alt around 100, so i was wondering if that whole situation could have caused it.
this video was very helpful, thanks for putting all this information together! i have listened to it a few times. Might try to talk a little slower though, sometimes it's hard to understand, but overall well done!
The typical over prescription of statins causes elevated ast/alt. So when I got smart and went ketovore and removed statins my levels went right to normal. Diet is everything, not drugs.
This is in relation to the AST levels ratio to ALT levels. When evaluating abnormal AST/ALT levels an elevation of 2:1 or greater is suggestive of liver disease.
thanks, so helpful. My professor sent us a link to this video to accompany her lecture. I have more understanding now!
Glad it was helpful!
I just had a patient with this scenario but the culprit was 60mg of protein powder daily. Once she stopped the protein supplement lfts wnl.
Great catch… history is so important!
This was the best explanation of eleved liver enzymes I have found
Yay, so glad you found this useful!
This is SO helpful. You are a Godsend. Thank you.
You're so welcome!
This is very helpful. I just had a patient with elevated ALT and AST. I will be working on my SOAP note on this case. Thank you for the video.
Awesome you're welcome!
This is very good information!
LFTs are so intimidating to me I honestly don’t know where to start. This video really helped me with that.
Thank you! ^_^
Glad it was helpful!
Awesome video. I wanted to know about a mildly elevated ALT and it really helps to look at this in combination with the other Liver values, recent history of each one and symptoms to see the whole picture and rule many things out.
Yes! and I believe that is true for medicine in general. You should look at the whole person/picture when assessing any situation.
Hello so I’m 41 obese with hx of fatty liver.yesterday I had my cmp all were normal except for my ALT which is at 30..as per quest diagnostic range is only until 29u/l ....my ast and alp is normal..pls tell me what to do thanks
Hi there - I can’t advise due to safety and legal reasons. We always recommend you follow up with your primary care provider. Thanks!
Thank You! This was sooo informative !
Glad it was helpful!
Great video...I pretty much can diagnose myself with fatty liver...lol
lol! Thanks!
Great video, i wonder how long can take liver enzymes to come back to their normal ranges after elevation?
Thanks so much! It depends, but if the source of the injury has been removed, it should start decreasing over days to weeks
That was great! Thank you
Glad you enjoyed it!
Very informative and easily understandable. Thank you🙌🏼😊
You are so welcome
You’re a literal lifesaver , thank you!!!
Happy to help!
I just came across your RUclips channel and wow! Blown away. Loved it. I am a NP in Sexual Reproductive HIV BBV in Melbourne Australia. Just not forgetting to test for acute hepatitis A as well with a IgM HAV as that could be another cause of raised ALT / AST and also, Syphilis, as that causes hepatitis with raised LFTs as well and often under tested especially ante-natally. And of course, they if sexually active, a pee test for Chlamydia would not go astray
Thank you!
what is your approach on a pt who who is requiring statin therapy and has elevated LFTs (etoh or fatty liver). Do you start statins and monitor LFTs? Any LFT range specifically where you will d/c the statin. Thanks
I believe the FDA and consensus practice recommends checking baseline LFTs and only retesting if clinically indicated, not routinely anymore. I found some general consensus recommendations to reduce the dose or change statins if they're >3x ULN confirmed x 2 readings
Thank you! So glad to have found you. I just graduated FNP last Dec.
You're welcome!! So glad our paths have crossed 😊 Congratulations on graduating!!
i know Im asking the wrong place but does anyone know a tool to log back into an Instagram account..?
I somehow forgot the login password. I would appreciate any tips you can offer me!
@Saul Castiel instablaster :)
@Hezekiah Abdiel i really appreciate your reply. I found the site through google and im in the hacking process now.
Takes quite some time so I will get back to you later when my account password hopefully is recovered.
@Hezekiah Abdiel It did the trick and I actually got access to my account again. I'm so happy!
Thank you so much, you saved my ass!
Thank you for the great info. Can jogging or running a couple of days before a blood test result in increased ALT/AST numbers? I am going back for a follow up after my numbers were a little high and I don't want this to be a factor at all. Thank you again!
Typically body movement like running doesn't affect AST/ALT!
@@RealWorldNP Thank you for taking the time to respond! Been doing a lot of 10 km runs recently so I wanted to be sure. Cheers.
So practical and helpful! Thank you!
You're so welcome!!
9o
I'm 51 years old and throughout my adult life I have always been active, and have been either at a 'normal' or 'overweight' but fit bmi. I had never had normal range liver enzymes. Finally my doctor sent me for a fibroscan. It showed moderate fibrosis and over 66% fat in my liver. The ONLY thing that brought these liver enzymes to 'normal' range for the first time in my entire adult life was 1. intermittent fasting, 2. 10pct body weight loss 3. Eliminating orange juice from my diet. 4. adding choline and vitamin E supplements. 5. some other minor adjustments to my diet. I will say that both of my parents have always had elevated liver enzymes their entire lives too. I have to stay almost 'skinny' and stay away from fruit juice in order to 'fix' my liver. Doing well though. All bodies are different.
Thank you for sharing your experience. You are a great example of the benefits of lifestyle changes.
Thank you this very informative video.
You’re so welcome!
Hi thanks for posting nice lectures. Can you please speak little slower you speak too fast. I love to watch your videos. Thanks.
Sorry for that. If you click on the wretch (settings button) you can slow the speed of the video down.
This was super helpful. I was curious if you notice a one point elevation past the 40 upper range and the patient retests two weeks later the number drops back within range, would there be cause for alarm if all other results from the hepatic function are normal?
Generally no but each patient is different. You have to consider the patient medical history, social history, and medications. We cover this topic in depth with our Lab Crash Course. Check it out here: www.realworldnp.com
This was great. Thank you
You're so welcome! Thank you for watching!
I just discovered your channel recently. Your videos are amazing! I listen to them every day on my way into work, which brings me to my question. Do you have a podcast, or have you thought about podcasting? You explain concepts in such a helpful way for APNs. That has been hard to find on podcasts channels. Every time I’ve looked for NP channels providers just seem to be reading from a script the whole time. Sorry if this has been answered before. Great channel!
I do have a podcast - check it out here! www.realworldnp.com/podcast and thank you!
Don’t talk so fast
Thanks! I've definitely improved on my speed since this was recorded :)
@@RealWorldNP your speed is totally fine. Just a hater lol 😂
@@RealWorldNP Viewers can tap in the video, then the settings icon, then scroll down to playback speed and select their preference.
Thanks for the excellent presentation..
Your speed is excellent. In other presentations I would, in most instances increase the speed.
I love your speed . We can always slow our own speed using the setting controls .
Any supplements to consider that helps reduce liver enzymes beside dieting and exercises
Hi there! None that I would recommend, unfortunately!
Very useful lecture. Thanks so much.
You are welcome! Thank you!
Does fatty liver go hand in hand with high blood sugar? Great vid!
Not always but a person can have both.
@@RealWorldNP Thank you very much for the response, i had vertigo so in like 5 days i had a handful of food, bit soup and drank around 4 liters of water, after that i took the blood test, my liver enzymes were up, like readings were ast around 130 and alt around 100, so i was wondering if that whole situation could have caused it.
Young people tend to talk too fast😊
I'm sorry about that. If you click the wrench under the video you can adjust the playback speed to your preference. Hope this helps
Superb! Please speak slower?
Thanks! There is a gear on the bottom of the video where you can slow down the speed of the video. I definitely get better in the more recent videos!
Is there a cheat sheet that you have for LFT's?
I have a Lab Interpretation Crash Course that covers it in full - www.realworldnp.com/labs. Check it out!
Talks too fast-slow down!
If you'd like you can click on the wrench tool and it will allow you to slow down the video to your preferred speed. Thanks for watching
I have seborrea dermatitis, gastritis, and liver enzymes problem. I need help !
I'm sorry to hear that! Definitely check in with your primary care provider, and your insurance can help you find one if you don't have one!
Real World NP i have but they say I don’t have anything. It’s all up to God.
this video was very helpful, thanks for putting all this information together! i have listened to it a few times. Might try to talk a little slower though, sometimes it's hard to understand, but overall well done!
Thank you! You can always find the "gear" icon under the video and slow down the speed. I will always keep this in mind, though - thanks!
Great information. Thank you
Glad it was helpful!
Ty for doing these!
Thank you!
Love my NP!! ❤️
Wonderful!!! Thanks for watching!
The typical over prescription of statins causes elevated ast/alt. So when I got smart and went ketovore and removed statins my levels went right to normal. Diet is everything, not drugs.
Thanks for your feedback!
Excellent!!!!
I'm so glad you liked it!!
Thank you, I've been watching videos about why I have raised AST, ALT levels and you explained it clearly. 9
I am so glad! Thank you!
What’s the 2:1 ratio?
This is in relation to the AST levels ratio to ALT levels.
When evaluating abnormal AST/ALT levels an elevation of 2:1 or greater is suggestive of liver disease.
Hi
My Alt 81 and AST is 80
Is that considered mild ?
Hi Jim, I am sorry, but for legal and safety reasons I can't advise you on this. I recommend you refer to your primary care provider.