Elevated AST and ALT After Bariatric Surgery: Is it normal?

Written by Kristen Carli, RD and medically reviewed by Dr. Stephen Boyce, MD

Liver enzyme levels, specifically AST and ALT, are commonly used as markers for liver health. High levels can indicate liver stress or damage. If you’ve had bariatric surgery recently and your AST and ALT levels are changing, don’t fret! This is a common experience after bariatric surgery. It’s not always a cause for alarm. This article will explore why AST and ALT rise after bariatric surgery. It will also cover when to seek further medical help.

Understanding AST and ALT Levels

Two liver enzymes that have a role in indicating liver health are aspartate aminotransferase (AST) and alanine aminotransferase (ALT). AST is primarily used as an indicator of liver injury, while ALT is a common indicator of liver health. Both have a key role in protein metabolism. 

Incorporating bariatric multivitamins or bariatric vitamins chewable can support liver function during this period of adjustment. Elevated levels of either of these values can signal liver damage or disease including conditions like hepatitis, fatty liver disease, non-alcoholic fatty liver disease, or cirrhosis. This is why it’s important to keep an eye on these values in order to monitor your overall health. 

Common Causes of Elevated AST and ALT Post-Bariatric Surgery

After bariatric surgery, it’s possible you may experience elevated levels of AST or ALT. One reason for this is that you may have fatty liver or non-alcoholic fatty liver disease, as these diseases are often correlated with excess body weight. By completing bariatric surgery, you are already on your way to healing this type of condition. 

It’s also possible that these values are elevated as a result of the rapid weight loss. When you undergo bariatric surgery, and lose a lot of weight, your body taps into your fat stores more often than it is used to. This can lead your liver to process a lot more fat than is typical, thus raising your AST and ALT levels.

Certain medications and supplements such as bariatric calcium chews or liquid bariatric vitamin, can strain the liver. Some painkillers, commonly prescribed after bariatric surgery, can overwhelm the liver if taken in high doses. Additionally, supplements, while often necessary for proper recovery, can also inflame the liver if dosages are not properly monitored.

On the other hand, too little of certain nutrients is also a concern. After bariatric surgery, proper intake of certain micronutrients and protein is essential. If you are deficient in these nutrients, your liver may not be well supported, and these enzymes can be raised. This deficiency could also impact your blood sugar levels after bariatric surgery, requiring additional monitoring and management.

While rare, it’s also possible that complications like biliary issues, infections, or auto-immune responses could be the cause of elevated ALT and AST levels. 

Diagnostic Approaches

After bariatric surgery, your healthcare team will monitor your liver function in a few ways. Liver function tests (LFT) will be conducted every few months in the first year after surgery in order to keep a close eye on your liver stress. In these tests, your doctor will look at not only your AST and ALT levels, but also ALP, bilirubin, albumin, total protein, and GGT.

Your doctor may also want to conduct imaging studies like an ultrasound, MRI, or a CT to evaluate the liver structure and detect issues like obstructions or masses. 

If needed, you may undergo a liver biopsy. Since this is an invasive procedure, it’s typically only recommended when there’s a strong indication of more serious liver disease.

Management and Treatment of Elevated AST and ALT

If your doctor notices elevated levels of AST and ALT, there are a few things you will want to do. The first is regular follow up appointments with your healthcare team. This allows your provider to monitor and check your liver function over time, hopefully noticing improvement. 

It’s also recommended to make a few dietary changes to support liver health. This includes eating more fruits, vegetables, whole grains, and healthy fats, while eating less saturated fats, added sugars, and refined carbohydrates. It’s also necessary to avoid alcohol and hepatotoxic substances like some herbal supplements including kava and comfrey.

Your doctor may also review and adjust your medications should they find anything concerning. It’s also possible that your provider will complete interventions for liver complications like steatosis if necessary. 

Prognosis and Long-Term Outcomes

The prognosis for liver function post-surgery can vary depending on factors such as the severity of pre-existing liver conditions, how well a patient adheres to lifestyle and dietary guidelines, and their overall health trajectory after surgery. In the months following surgery, AST and ALT levels generally begin to decrease as weight loss continues. Regular monitoring of AST, ALT, as well as adherence to lifestyle recommendations, is key to ensure that the liver is continuing to function at its best. Monitoring additional factors like weight gain after bariatric surgery will also help in maintaining long-term outcomes.

Conclusion

While elevated AST and ALT levels post-bariatric surgery can be concerning, they are often a normal part of the healing process as the body adjusts to rapid weight loss. With proper monitoring, dietary adjustments, and regular follow-ups with your healthcare provider, most individuals see improvements in their liver function over time. By staying proactive about your liver health, adhering to lifestyle recommendations, and addressing potential complications early, you can ensure that your liver continues to thrive.

If you want to learn more, why not check out these articles below: 

Share

More Bariatric Articles

Bad Breath After Bariatric Surgery: Why It Happens & How to Stop It

Bariatric surgery is a life-changing decision for many individuals struggling with obesity. While it can lead to significant weight loss and improved overall health, it’s not without its side effects.  One of the most common and embarrassing side effects is bad breath, also known as halitosis. Bad breath can be frustrating and demoralizing. It’s worse […]

Fatty Liver Bariatric Surgery: Everything You Need to Know!

Key Takeaways Fatty liver, a condition known as non-alcoholic fatty liver disease (NAFLD), happens when fat builds up in your liver. It can lead to more serious liver issues and other complications over time. Many people with obesity have fatty livers that improve after bariatric surgery. However, there are some things you need to be […]


What are your tips and tricks to post-bariatric success?

Share your thoughts or questions in the comments below – we want to hear from you!

Submit a Comment

Your email address will not be published. Required fields are marked *

Share

×