High AST ALT

[trtchin]

44M on a TRT dose of 150 mg / week M/W/F. Been on TRT for 6+ months.

One of my nips was a bit sore so I wanted to test my E2. Stopped on the way to work this morning. I also added a liver test as I haven't tested since being on TRT.

I lifted the day prior, took all my regular supplements the day prior lunch and dinner time. The morning before my test i did some LISS on my bike for 30 mins with 7.5 mg yohimbine.

Drank about a liter of water before my test and had some black coffee.

AST - 45 (ref 5-34)
ALT - 223 (ref <55)
GGT - 66 (ref 12-64)

I haven't had alcohol for more than a week before the test and im not a big drinker. My last test in 2023 was all normal.

I assume this result is skewed by my regular supplements, and/or the morning exercise and/or the yohimbine? Just want to make sure this isn't a huge concern. Will get a follow up in 2 weeks.

 

[b6798045]

It could be many things.
Take at least 1 week rest from training (walking and stretching max).
Stop taking yohimbine.
Take your TRT as you did.
Re-test: AST, ALT, GGT, alkaline phosphatase (ALP), BUN, Total protein, Albumin, Uric Acid.

 

[Eddie.]

I would not worry about ast and alt even if it's high but that ggt is not good. This is the one you have to monitor closely. I'd start taking 2gr of NAC and 1gr tudca and retest in a month.

 

[trtchin]

Thanks both! I already am doing what @b6798045 suggested.

Taking this week off the gym and supplements and will retest on Monday.

Depending on the levels I will then move to adding Tudca and NAC and potentially milk thistle. I have a dr appointment set up but it's not until early July.

 

[trtchin]

I've been reading non stop about non alcoholic fatty liver since then. I have all the comorbities like hashimotos hypothyroidism, insulin resistance, visceral fat, high cholesterol, low test etc.

I've recently started metformin and tirz along with being stricter on macros and my waist is finally moving in the right direction. Just hoping it's elevated levels due to losing fat off my liver which I understand can be common. Let's see!

 

[BigBoy0689]

4 weeks 500mg Tudca 1g Milk Thistle 1.5g NAC then check again

 

[BamaCrazy]

Add Glutathione injections along with NAC and TUDCA. Glutathione is likely more effective than the other two.

 

[Ghoul]

I've been reading non stop about non alcoholic fatty liver since then. I have all the comorbities like hashimotos hypothyroidism, insulin resistance, visceral fat, high cholesterol, low test etc.

I've recently started metformin and tirz along with being stricter on macros and my waist is finally moving in the right direction. Just hoping it's elevated levels due to losing fat off my liver which I understand can be common. Let's see!

NAFLD is a silent epidemic. You're right,, Tirz is highly likely to reverse it, and mobilizing fat out of the liver will bump up enzymes temporarily. Alt>Ast and near normal GGT is a good sign it's not irreversible liver damage,

Still, the next test will give you a better idea. If Alt is dropping, probably indicates Tirz is doing its job. I'd personally lay off the booze until I knew things were moving in the right direction though.

 

[trtchin]

No more alcohol for me for sure for a while. I was a moderate drinker wuth a couple drinks per day for about a decade plus getting smashed here and there. Cut that out a couple years ago and have reduced to near zero in 2025.

 

[Ghoul]

No more alcohol for me for sure for a while. I was a moderate drinker wuth a couple drinks per day for about a decade plus getting smashed here and there. Cut that out a couple years ago and have reduced to near zero in 2025.

I think the remarkable ability of Tirz and Reta to reverse fatty liver disease, which often goes undiagnosed until the irreversible cirrhosis stage, is probobly just as important for public health as the weight loss they enable. Ironically, most people cured won't even know they had it to begin with.

 

[trtchin]

I think the remarkable ability of Tirz and Reta to reverse fatty liver disease, which often goes undiagnosed until the irreversible cirrhosis stage, is probobly just as important for public health as the weight loss they enable. Ironically, most people cured won't even know they had it to begin with.

Ya lots of uses for it it seems. I had no issues counting calories or sticking to my macros. I lost 40 lbs just working hard and dieting. But at some point the weight didnt want to come off anymore and my arms and legs were skinny enough, that's when I started connecting the dots between hashis insulin resistance visceral fat and now liver issues.

Seems GLP1s are helping a lot of those points. Hashis hypothyroidism users also swear by it for inflammation relief.

 

[Ghoul]

Ya lots of uses for it it seems. I had no issues counting calories or sticking to my macros. I lost 40 lbs just working hard and dieting. But at some point the weight didnt want to come off anymore and my arms and legs were skinny enough, that's when I started connecting the dots between hashis insulin resistance visceral fat and now liver issues.

Seems GLP1s are helping a lot of those points. Hashis hypothyroidism users also swear by it for inflammation relief.

There are so many research side quests sparked by GLPs researches in all the relevant areas are going to be maxed out for decades.

Consider improved neuron insulin sensitivity, because GLPs cross the blood brain barrier. It means neurons are more responsive, leading to improved cognition and memory formation. Mood improvement from enhanced dopamine function. Reduced inflammation means slower age related degeneration of the brain.

It's endless. The real trick is to find a dose that doesn't excessively reduce appetite while providing the other benefits.

Reta is leading the way on this. We have members using it primarily for insulin sensitivity, and it seems pretty easy to find a dose that accomplishes that without killing the ability to eat.

 

[trtchin]

Reta is leading the way on this. We have members using their it primarily for insulin sensitivity, and it seems pretty easy to find a dose that accomplishes that without killing the ability to eat,

Right now for me it's 2.0 to 2.5 mg Tirz per week otherwise I can't get in my daily macros Im just too full.

I source UGL and Im still new to this which is why I didnt go with Reta as there wasn't as much anecdotal discussion on it but I would look to make the switch in the future.

 

[trtchin]

Well not sure what happened but after taking a week off the gym and basically stopping all supplements a half week before the test i tested again and it's all in range

AST - 23 (ref 5-34)
ALT - 45 (ref <55)
GGT - 34 (ref 12-64)
ALP - 54 (ref <128)
Bilirubin - 0.7 (ref 0.3-1.2)
Choline - 5204 (ref 5100-11700)
Total Protein - 70 (ref 64-83)
Albumin - 47 (ref 75-140)

I feel relieved thanks for all your comments.

Choline is a bit low so may look to supplement there.

Also checked a bunch of other stuff HCT is creeping up at 47.6%. That still ok right? I forgot to drink a ton of water only went in having drank 500 ml an hour before.

 

[BamaCrazy]

Well not sure what happened but after taking a week off the gym and basically stopping all supplements a half week before the test i tested again and it's all in range

AST - 23 (ref 5-34)
ALT - 45 (ref <55)
GGT - 34 (ref 12-64)
ALP - 54 (ref <128)
Bilirubin - 0.7 (ref 0.3-1.2)
Choline - 5204 (ref 5100-11700)
Total Protein - 70 (ref 64-83)
Albumin - 47 (ref 75-140)

I feel relieved thanks for all your comments.

Choline is a bit low so may look to supplement there.

Also checked a bunch of other stuff HCT is creeping up at 47.6%. That still ok right? I forgot to drink a ton of water only went in having drank 500 ml an hour before.

47% is fine. I’m always around 47-48% and never get concerned until it’s over 50.

 

[Sgt.LincolnOsiris]

4 weeks 500mg Tudca 1g Milk Thistle 1.5g NAC then check again

How are you injecting NAC? It has such poor bioavailability orally that it doesn’t seem worthwhile. IV appears to be the only way to get the effects, but everything I can find said to do it in a drip. Do you just go straight into the vein?

 

[Eddie.]

How are you injecting NAC? It has such poor bioavailability orally that it doesn’t seem worthwhile. IV appears to be the only way to get the effects, but everything I can find said to do it in a drip. Do you just go straight into the vein?

You're maybe confused with glutathione. NAC is fine orally.

 

[BamaCrazy]

You're maybe confused with glutathione. NAC is fine orally.

This post got me curious. So I looked it up.

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks) - PMC

To review the clinical usefulness of N-acetylcysteine (NAC) as treatment or adjunctive therapy in a number of medical conditions. Use in Tylenol overdose, cystic fibrosis, and chronic obstructive lung disease has been well documented, but there is ...

pmc.ncbi.nlm.nih.gov

“The bioavailability of oral NAC in humans is between 4 and 9.1% in one study [20] and between 6 and 10% in another [21]; thus, studies using less than 1200 mg per day may show no significant benefit.”

Do they even make NAC injections? Oral unless taken in insanely high doses might be a waste of time.

 

[Sgt.LincolnOsiris]

This post got me curious. So I looked it up.

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks) - PMC

To review the clinical usefulness of N-acetylcysteine (NAC) as treatment or adjunctive therapy in a number of medical conditions. Use in Tylenol overdose, cystic fibrosis, and chronic obstructive lung disease has been well documented, but there is ...

pmc.ncbi.nlm.nih.gov

“The bioavailability of oral NAC in humans is between 4 and 9.1% in one study [20] and between 6 and 10% in another [21]; thus, studies using less than 1200 mg per day may show no significant benefit.”

Do they even make NAC injections? Oral unless taken in insanely high doses might be a waste of time.

400mg (2ml) Injections come from India for about $1.50 each.

 

[Ateam2023]

400mg (2ml) Injections come from India for about $1.50 each.

IME , word of advice, getready for "that junkie look" from doing iv route, unless your a seasoned pro, its hard not to mark yourself up with unsightly needle puncture marks, if you have tattoos on your arms (sleeves) then no need to worry about the junkie marks,,