OpenHealth Q&A

Inquiries Regarding AST/ALT Levels and Next Steps

Greetings. I'm a 35-year-old woman, measuring 5’4” and weighing 130 lbs, who has struggled with excessive drinking intermittently throughout my life. There have been periods when I consumed alcohol moderately or even refrained completely, particularly during my pregnancies and while breastfeeding. At times, I stopped drinking because the effects on my body became unbearable, although I never experienced serious withdrawal symptoms. Recently, however, I engaged in heavy drinking, consuming a few bottles of wine and multiple shots of hard liquor daily. Over a week ago, I made the decision to quit drinking for good. Initially, I experienced severe heart palpitations, and at one point, I had alarming chest pain that radiated to my neck, throat, and arms—leading me to believe I might have suffered a heart attack. Despite this, I didn’t go to the hospital right away. Although the pain eventually eased, the abnormal heart rhythms continued. The following day, I encountered similar symptoms again and chose to visit the emergency room. I also experienced bizarre hallucinations while awake, hearing things like threats and perceiving frightening faces when I closed my eyes, alongside sounds of doors slamming. It felt surreal, as if I was on the brink of losing my sanity. Thankfully, after receiving Librium to aid in my home tapering process, the intense symptoms diminished. I had a blood test performed, revealing significantly elevated AST and ALT levels. The ER doctor suggested this was likely a consequence of my recent binge drinking, but I doubt he fully grasped the extent of my alcohol dependency, which has persisted for years. My past is quite traumatic, and I often turned to self-medication instead of seeking necessary mental health support. I have been diagnosed with PTSD, major depressive disorder, and generalized anxiety disorder. Now, seven days sober, I feel a newfound energy and can eat full meals—something I hadn’t done in a while. I’m eager to learn more about my lab results. Additionally, my TSH levels are high, while my T4 remains normal. My hair is thinning and my skin feels dry, which I initially attributed to dehydration resulting from my alcohol use. I recognize the importance of consulting my primary care physician and perhaps other specialists, but it may take time due to scheduling delays. I am resolute in regaining my health and focusing on my mental well-being, as I know this is crucial for maintaining my sobriety. The information regarding my lab results and concerns raised by online sources have prompted me to take action and regain control of my life. I would greatly appreciate any insights or discussions regarding my lab findings. Thank you!

Answers (1)

2/12/2026, 4:50:41 PM

OpenHealth AI

It's great to hear that you are seven days sober and feeling more energized! You've made a commendable decision to prioritize your health and sobriety. Your situation is complex, and it’s understandable to seek clarity on your health, especially with the elevated AST and ALT levels and your overall wellbeing.

Main Points:

1. Elevated AST and ALT levels typically indicate liver stress or damage, commonly associated with alcohol use.
2. High TSH levels alongside normal T4 may suggest hypothyroidism, which can also impact your energy and overall symptoms.
3. Monitoring your symptoms and maintaining open communication with healthcare providers is essential for recovery and overall health.

Explanation:

• AST and ALT Levels: These are enzymes found in the liver. Elevated levels can occur due to liver inflammation or damage, often related to alcohol consumption. Since you’ve stopped drinking, you should monitor these levels over time, as they may improve with continued sobriety and proper nutrition.

• Thyroid Function: High TSH levels may indicate that your thyroid isn't producing enough hormones (hypothyroidism). This can lead to symptoms like fatigue, hair thinning, and dry skin. A healthcare provider may recommend further testing to confirm this and discuss treatment options.

Next Steps:

1. Continue Sobriety: Stick to your commitment to sobriety. Seek support groups or counseling as needed to aid your recovery journey.

2. Nutrition and Hydration: Nourish your body with balanced meals rich in fruits, vegetables, healthy fats, and lean proteins. Staying hydrated is crucial, especially as your body recovers from alcohol use.

3. Monitor Symptoms: Keep a symptom diary noting your physical and mental health changes, especially concerning heart rhythms, skin condition, and energy levels. This record can be beneficial for your healthcare provider.

4. Schedule Follow-Ups: Even though you might experience delays in seeing your primary care physician, if any symptoms become severe (like chest pain, significant mood changes, or hallucinations), seek immediate medical attention.

5. Explore Mental Health Support: Continue to address the PTSD, depression, and anxiety with mental health professionals. Therapy can provide you with coping mechanisms that help you handle stress and recover from past trauma.

Your journey toward better health is possible, and by taking these steps, you are actively working toward a healthier future. Keep fostering that hopeful mindset, and remember, you’re not alone in this process.