From the Guidelines
An AST level of 58 U/L is considered mildly elevated and warrants further evaluation to determine the underlying cause. This elevation suggests possible liver cell damage or injury, but is not severely abnormal. According to the most recent study 1, the severity of abnormal aminotransferase can be classified as mild, moderate, or severe, with mild being less than 5 times the upper reference limit. In this case, an AST level of 58 U/L is approximately 1.45 times the upper reference limit, which is considered mild. No specific medication is needed for this level alone, but further evaluation is recommended. A comprehensive metabolic panel including other liver enzymes (ALT, alkaline phosphatase, bilirubin), complete blood count, and assessment of alcohol use, medications, and other potential causes should be performed. Common causes of mild AST elevation include:
- Medication effects
- Alcohol consumption
- Fatty liver disease
- Viral hepatitis
- Muscle injury If symptoms like fatigue, abdominal pain, or jaundice are present, prompt medical attention should be sought. For now, it is recommended to avoid alcohol, acetaminophen, and other potentially hepatotoxic substances. AST is released when liver cells are damaged, which is why it serves as a marker for liver health, though it's also found in muscle tissue, which is why context and additional testing are important for proper interpretation, as noted in 1 and 1.
From the Research
AST Levels
- An AST level of 58 is considered elevated, as the normal range for AST is typically around 0-40 IU/L 2, 3, 4.
- Elevated AST levels can be indicative of liver damage or disease, as well as other conditions such as myocardial infarction or muscle damage 2.
Possible Causes
- Hepatocellular injury or disease, such as non-alcoholic fatty liver disease, alcoholic liver disease, or viral hepatitis 3, 4.
- Cholestatic injury or disease, such as primary biliary cholangitis or primary sclerosing cholangitis 4.
- Other conditions, such as autoimmune hepatitis, hemochromatosis, or Wilson's disease 3, 4.
Evaluation and Diagnosis
- The evaluation of elevated AST levels should include testing for viral hepatitis, assessment for non-alcoholic fatty liver disease and alcoholic liver disease, and screening for hereditary hemochromatosis, autoimmune hepatitis, and other conditions 4.
- A liver biopsy may be considered if serologic testing and imaging fail to elucidate a diagnosis, or if multiple diagnoses are possible 4.
- It is crucial to interpret liver biochemical tests accurately, as appropriate further workup, treatment, and referral can greatly benefit the patient 3.