Concerns About Rising ALT and AST Levels Post-Mono Recovery
Hello, I’m a 25-year-old male. I recently underwent a follow-up blood test for mono, after being diagnosed on June 24. Yesterday, my results showed an ALT level of 100 and an AST level of 40. To provide some context, when I was hospitalized on June 24, my ALT was recorded at 51 and my AST at 38. I initially had hoped these values would reflect improvement, but instead, they appear to have worsened, and I’m particularly anxious about the elevated ALT. What could be the reasons for this decline? Just to note, prior to my mono diagnosis, my ALT levels typically hovered around 22, and my AST was about 15. I appreciate any insights you might have!
Answers (1)

7/18/2025, 2:01:52 PM
OpenHealth AI
It’s understandable to feel anxious about your laboratory results, especially after recovering from mono. Your recent liver enzyme levels, particularly with an ALT of 100 and an AST of 40, suggest that there might be ongoing liver stress or damage, which can happen after a viral infection like mononucleosis.
Explanation: ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes often used to assess liver health. Elevated ALT levels indicate possible liver cell injury, while AST can signal broader issues, including damage to various tissues, not just the liver. In cases of mono, liver inflammation can occur, leading to elevated enzyme levels. The fact that your ALT has increased from 51 to 100 after recovery is concerning and may indicate ongoing liver stress.
Several factors could explain your elevated ALT and AST levels:
- Post-Viral Hepatitis: After viral infections, it’s not uncommon for the liver to remain inflamed and produce higher enzyme levels.
- Medications or Alcohol: If you've taken any medications or consumed alcohol during or after your mono diagnosis, these could impact your liver enzymes.
- Increased Physical Activity: If you resumed exercise too aggressively after your illness, muscle strain could contribute to elevated AST levels.
- Fatty Liver or Other Conditions: Conditions such as non-alcoholic fatty liver disease or autoimmune hepatitis can also raise ALT levels.
Next Steps:
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Monitor Symptoms: Keep track of any new symptoms such as fatigue, jaundice (yellowing of the skin), dark urine, or abdominal pain. This information can be important for your healthcare provider.
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Avoid Alcohol and Medications: Refrain from consuming alcohol and be cautious with medications, especially those that can strain the liver (e.g., acetaminophen).
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Maintain a Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Hydration is also crucial.
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Rest and Reduce Intensity: Ensure you’re getting plenty of rest and avoid intense exercise for now, allowing your body to heal.
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Follow-Up Testing: Consider scheduling a follow-up blood test in a few weeks to monitor your ALT and AST levels again, especially if they remain elevated.
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Keep a Diary: Document any changes in symptoms or lifestyle factors that could provide insights into your liver health.
If you experience any concerning symptoms or if your levels do not trend downwards on follow-up, it may be essential to discuss further evaluation with a healthcare professional. Remember, you are not alone in this, and many people recover from similar issues with time and proper care.
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