High ALAT/SGPT levels, seeking more info

Answered on August 19, 2014
Created September 21, 2011 at 7:29 PM

I am aiding a friend with weight loss struglles and adaptation to a more Paleo approach of eating.

He recently had a physical and blood work after, this is after 3 weeks of strict VLC Paleo. The Doc called the day after saying he wanted to do a second blood test 3 weeks later as the ALAT(SGPT) levels were in the 90's where he said normal levels should sit in the 40's. Liver disease is apparently in the 1000's. However my friend is slightly worried that while he is seeing significant improvements in all areas, he is worried about having liver damage as a product of this life style change.

I found no correlation between liver damage/fatty liver and LC diets, nor for LC and high ALT. I want to tell him to continue on and that this is probably a preexisting condition from prior to Paleo and that continuing will fix this..

Does anyone know of more information re this? Is this something to garner legitimate concern? Should I have him incorporate more carbs from veggies in his diet and starches? He has informed his doc of his nutrition change, and his doc suggested reducing the amount of fat in his diet as high ALAT is often a symptom of high triglycerides. Odd though as I thought it was pretty consistent that Paleo+LC brought down triglyceride levels.

Appreciate any help!



on September 21, 2011
at 11:10 PM

Doc is wrong: he needs to listen to Dr. Johnson. It's the sugar/fructose, styoopid. If you have fatty liver, Gary Taubes and Dr. Lustig are your best friends.



on September 21, 2011
at 11:08 PM

There is a very direct correlation between fatty liver (proxy = high alt/ast) and LC diets. LC diets ==> less processed carbs & sugar/fructose ==> liver enzymes plummet ==> triglycerides plummet. Most people who do serious VLCing have very low trigs, and by extension, low ALTs. No, you do not want a high starch or high carb Paleo if you have fatty liver: do low carb or VLC Paleo, and then, after your enzymes have stabilized, then start your moderate/higher-carb Paleo.

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2 Answers


on September 22, 2011
at 12:22 AM

Elevated liver enzymes can be related to gallbladder disease/distress as well, and other gastric system related disorders. Often there is at least discomfort in the R upper abdomen with GB dysfunction, but not always. Sometimes, there are no symptoms.

I feel sure your friend's Doc will be looking at the whole picture and getting more labs to zero in on things as well a maybe some imaging.

Whatever is going on is not the product of 3 weeks of paleo eating. And other than paying attention to his/her body (for instance, nausea/ discomfort after high fat intake, or fatty/diarrhea blast/burning stools) to moderate fat intake if necessary, and keeping track of any other symptoms/discomfort, I would say forge ahead. I am not saying eat low fat. I'm saying track your body responses. In ancestral eating circles, you will see great variation in fat tolerance between individuals, with nausea as a response in some people.

Additionally, people can eperience transient rises in liver enyzymes sometimes related to alcohol intake, and no, the intake doesn't have to be hugely excessive/chronic. Someone who in fact drinks rarely and then drinks quite a few drinks on a single occasion can sometimes eperience gastritis symptoms and transiently elevated liver enzymes.

And I very much agree with Namby-Pamby, if the issue is found to be fatty liver disease.


on September 21, 2011
at 11:00 PM

Ur talking about ALT/SGPT. If your ALT is that high, you need to be tested for fatty liver, and if you aren't sure about hepatitis immunity, you probably need a hepatitis panel. A normal person (i.e, Paleoing0 with minimal inflammation has their ALT in the low teens: 10-15.

My guess is he's overweight, is a carboholic, and has very high trigs, and probalby low HDL. If not, then he should be more concerned, as you want the etiology of out of wack liver enzymes to be fatty liver, not something more serious!

When I had fatty liver, I was 50 lbs. overweight, my ALT skytocketed to 120, and my triglycerides were 660. My LDL wasn't measurable since it hit the Trig bomb. Now, my ALT is ~15 and my trigs are under 100. Can be done with Paleo or VLCing. Can be totally reversed with a new diet and lifestyle.

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