Elevated ALT and AST Levels in a 23-Year-Old Woman: Seeking Insight
After undergoing blood tests on July 1st, I received the results about a week later, revealing an ALT reading of 60 and an AST of 39. Then, on July 9th—early this morning—I had my bloodwork analyzed again, and this time my ALT surged to 118, while the AST also increased to 66, indicating both assays are elevated. The emergency room doctor I consulted expressed no worries about these findings, attributing them to my antidepressant medication. I am on Venlafaxine at a dosage of 75mg, which potential evidence suggests can elevate ALT levels in about 1% of users. Additionally, I take Vraylar at 3mg and Vyvanse at 70mg. I’m curious if it is indeed likely that my medications are the cause or if there might be another underlying reason for these spikes. I have a follow-up appointment with my psychiatrist, who ordered the initial tests, scheduled for the 11th of this month, and I'm also meeting a new primary care physician on the 23rd. I would appreciate any insights regarding whether the rapid increase and significant highs in my liver enzyme levels are alarming. For reference, my bilirubin levels were recorded at 0.2 both times I was tested. Thanks in advance for your help!
Answers (1)

7/9/2025, 7:01:21 PM
OpenHealth AI
Key Points: Your elevated ALT and AST levels could indeed be influenced by your medications, but monitoring and further evaluation are essential. Significant changes in liver enzymes should be understood and observed carefully.
Explanation: ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes mainly found in the liver. They can indicate liver health when measured in blood tests. Elevated levels, such as your ALT at 118 and AST at 66, may suggest liver irritation or damage. Medications like Venlafaxine, as mentioned by your emergency room doctor, can contribute to changes in liver enzyme levels in a small percentage of users. However, other factors, such as alcohol consumption, viral infections, or underlying liver conditions, can also cause elevations.
Your bilirubin levels are normal (0.2), which is a positive sign indicating that there may not be widespread liver dysfunction. Nevertheless, because your enzyme levels have risen quickly and significantly, it’s prudent to remain aware of how your body responds and to follow up.
Next Steps:
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Monitor Symptoms: Pay attention to any new symptoms like fatigue, abdominal pain, yellowing of skin or eyes, or changes in appetite. These could provide important clues regarding your liver health.
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Continue Communication: Keep your follow-up appointment with your psychiatrist on July 11th. Discuss the recent test results and your concerns regarding the medications potentially impacting your liver function.
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Document Medications and Symptoms: Maintain a list of all medications and any symptoms you experience to discuss with your healthcare providers in detail.
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Prepare for Primary Care Appointment: For your appointment on the 23rd, mention the spikes in your liver enzymes and ask about any necessary tests or lifestyle modifications that might support liver health.
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Lifestyle Considerations: Focus on a balanced diet, stay hydrated, and avoid alcohol and unnecessary medications, which can further stress your liver. Additionally, practicing stress-reduction techniques could be beneficial since stress can impact overall health.
Stay proactive in monitoring your health and communicating openly with your healthcare providers. They are your best resource for understanding your test results and managing your medications effectively. If you notice any alarming new symptoms before your appointments, do not hesitate to seek medical attention.
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