Seeking Clarity on Elevated Liver Enzymes Post ER Visits
Hello! I’m a 28-year-old woman (I'll be turning 29 on July 17) and I’m seeking some perspective on my recently increased levels of AST and ALT. This rise in liver enzymes has occurred alongside numerous trips to the emergency room and a recent change in my medication. I'm curious to determine if this condition is merely transitory or indicative of a more serious health concern. **Profile Information:** **Age/Sex:** 28/Female **Height/Weight:** 5’4”, 140 lbs **Smoking Habits:** I occasionally vape disposable e-cigarettes, about once a week, but do not use tobacco or THC. **Alcohol Consumption:** I drink socially; I refrained from alcohol for six days prior to my lab tests, although I have experienced heavier drinking patterns in the last year following the unexpected loss of my mother. **Medication List:** - Adderall XR 20 mg (prescribed, usage is not daily) - Alprazolam 0.5 mg (taken as necessary) In September, during a routine physical, my liver enzymes appeared normal. In late December, I experienced severe pain in my ribs, chest, and back which severely disrupted my sleep. A trip to the ER resulted in a diagnosis of intercostal muscle strain, and my enzyme levels were still normal. In January, my husband had to call an ambulance as the pain persisted; I woke from a nap in excruciating pain that felt as though my ribs were caving in, making breathing difficult. The same diagnosis was given, and I was discharged with steroids, which provided immediate relief. However, liver enzymes at that point were recorded as mildly elevated. Just recently, I faced a similar situation and returned to the ER. Again, I was diagnosed with a pulled back muscle and was sent home with steroids. This time, my blood tests indicated that my AST and ALT levels were elevated once more, and this increase was more significant than before. I have scheduled an appointment with my doctor tomorrow to discuss further blood tests, and until I receive the results, I am committed to abstaining from alcohol and avoiding medications like Tylenol or ibuprofen. **Update:** On both ER visits, the attending physician downplayed the significance of my elevated liver enzyme levels, suggesting they were within an acceptable range. My regular doctor echoed this sentiment following my initial ER follow-up.
Answers (1)

7/9/2025, 4:50:43 AM
OpenHealth AI
It's understandable to feel concerned about elevated liver enzyme levels, especially in light of your recent health history. Elevated AST (aspartate aminotransferase) and ALT (alanine aminotransferase) levels can indicate liver stress or damage, but they often vary based on different factors, including medication changes, alcohol intake, and acute stress from pain or injury.
Explanation
AST and ALT are enzymes that help indicate liver health. Elevated levels can result from various causes, including:
- Medication Effects: Some medications can temporarily increase liver enzymes.
- Alcohol Consumption: Any recent alcohol use, especially heavier patterns, can elevate liver enzymes, even if you abstained right before testing.
- Muscle Strain: Given your recent intercostal muscle strains, it’s possible that muscle injury can also lead to temporary elevations in these enzymes, as they can be released from muscle tissue.
- Fatty Liver Disease: This is another common cause of elevated liver enzymes, particularly with changes in lifestyle or weight.
Your healthcare providers appear to suggest that while your enzymes are elevated, they may not be alarmingly so. However, the fact that you are experiencing persistent issues warrants careful monitoring.
Next Steps
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Discuss Test Results: At your upcoming doctor's appointment, thoroughly discuss the significance of your enzyme levels, especially any changes since your last normal tests. Seek clarification on what “acceptable range” means in your specific context.
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Follow-Up Testing: Request follow-up blood tests to track liver function over time. This will help determine if the elevation is transient or persistent.
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Lifestyle Adjustments:
- Continue Abstaining from Alcohol: This will support liver health and provide clearer results in your upcoming tests.
- Avoid Toxins: Stick to your plan of avoiding medications like Tylenol or ibuprofen until your doctor provides guidance. They can impact liver function and its ability to heal.
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Monitor Symptoms: Keep a log of any symptoms like pain, fatigue, or changes in weight—this can help your doctor assess any correlations with enzyme levels.
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Stay Hydrated and Nourished: Maintain a balanced diet rich in fruits, vegetables, and whole grains, which can support overall liver health.
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Emotional Support: Given your recent loss and lifestyle changes, consider seeking emotional support through counseling or support groups to help manage stress and grief.
By focusing on these steps, you can actively participate in your health management while working with your doctor to ensure your liver health remains a priority. Please let me know if you have more questions or need further assistance!
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