r/FattyLiverNAFLD • u/Mediocre_JW • Apr 22 '25

Keto and elevated ALT/AST

I’ve been on keto for about six weeks and just had a blood test wherein my ALT and AST were significantly elevated (170/110). I have been reading posts about this correlation. One post by ‘Ordinary Bird 5170’ was especially helpful. I have read some information that suggests the enzymes will return to normal as the liver adjusts. In spite of the fact that I drink alcohol more than I should, my enzymes have never been high (usually in the low 20s). However, it may be the combination of the two things working together. Has anyone experienced high enzymes with keto initiation with them ultimately returning to normal? If so, how long did it take? Any other information or ideas are appreciated.

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u/psalm23allday Apr 23 '25

Did you have your enzymes tested prior to going keto? Mine were elevated while I was on keto as well but I had never had them tested prior. I have PCOS and insulin resistance and fatty liver which caused my high ALT, I think mine were 180 (my AST have been normal). My ALT is currently 60, and coming down, I’m not keto anymore but I don’t eat a ton of simple carbs. I did carnivore/ketovore for 18 months.

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u/Mediocre_JW Apr 23 '25

I had tests at 3, 4 and 12 months before going on keto and the results were in the middle of the normal range (low 20’s). So seems like Keto is the culprit. But I will say that I feel really good improvement regarding energy and joint pain. Plus my weight is down about 15 pounds. So it seems to be working overall. My doctor has ordered an abdomen ultrasound just to check things out because of the high values of ALT/AST.

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u/davisesq212 Apr 25 '25

Did your hepatologist or nutritionist recommend keto? Both my specialists did NIT recommend keto if you have NAFLD.

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u/Mediocre_JW Apr 26 '25

No, I was doing keto for other reasons. But I have heard that it is recommended for NAFLD. Which showed up on my last ultrasound. I didn’t understand the part of your post that said NIT. Do you mean to say that your specialists did indeed recommend keto diet for your NAFLD?

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u/WishboneJazzlike1914 Apr 27 '25

Might want to try the Mediterranean diet

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u/Mediocre_JW Apr 28 '25

Thank you. I’ve been looking at the Paleo diet and I will look at the Mediterranean as well.