After donating blood, my boyfriend received a note in the mail saying that his blood could not be accepted because it showed high ALT levels. I know this relates somewhat to liver functioning, and wonder how likely it is that alcohol use (abuse) would cause these elevated levels. He went to see a physician, and she is doing a sonagram on his liver. She mentioned that, perhaps, his working out a lot with weights might be the cause but not once did she bring up the topic of alcohol. He does drink on a daily basis, and has been doing so since the age of 20 (he's now 37).

Do you think they should be running a different type of test? He doesn't have medical insurance and is currently unemployed so we can't afford a large number of costly tests.

Reply ------------------------------

ALT is a liver test for liver cell damage. I agree that alcohol use would be the first thing to worry about. Hepatitis B and C would be next on the list. Hepatitis B is a sexually transmitted disease. I would not usually get a sonogram of the liver. Gallbladder disease could cause this but usually the patient would have abdominal pain and bloating after eating.

The first question though, is how high was the ALT. If it is less than three times the upper limit of normal. I would usually just have the patient stop alcohol and acetaminophen or other medications that can affect the liver, then repeat the test in several weeks. If you are worried about alcohol, I would also get a blood count. The MCV (mean corpuscular volume, ie size of the red blood cells) is elevated if the alcohol irritates the bone marrow.

You may want to consider attending Alanon, the twelve step group for friends and family of alcoholics, to see if your boyfriend is affecting your life the way an alcoholic would.

Here is my general health message:
To improve your health, please

• don't smoking cigarettes;
• don't use marijuana or cocaine and especially don't use iv drugs;
• drink no more than one beer, one glass of wine, or one shot of hard liquor in a day;
• have sex with only one person who has sex only with you;
• don't eat fried food (like hamburgers) or other high fat foods.

P. H. MD
Family Physician
Correspondent for General Medical Clinic
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