Q: I am a 36 yrs male weighing 116 kgs and 187 cms tall. My problem is that my ALT/SGPT levels are high for the last 5 years. This much I could understand that it could be due to alcohol intake. I had been taking heavy amount of whiskey in the years 1991 - 1995 & afterward my intake has been very occasional, never more than 5 days at a stretch & that too at very few times in a year. My present ALT levels are 164 & AST 65. As if they are going by a pattern. One time a year they are near to normal like SGOT is very normal & SGPT around 65(0-50).Rest of all the tests for liver functions are normal. There are small stones in my Gall Bllader. Liver is little enlarged, Spleen at one time was enlarged, however, it has returned back to normal. On comparision of the last ultrasounds, the sonologist doctor says the condition is improved. The very diffuse fatty infilitration is now less. All my Viral serologies are negative with PCR tests. At present my alcohol intake is very less: once or twice a year. I feel easily fatigued, a malaise like feeling is there throughout the day. I do not have Diabetes. Is my condition esentially that of alcohol induced hepatitis or NASH? I fear cirrhosis very much. Can overweight cause this type of condition. Should i go for all kind TORCH Viral tests for acute fatigue? Though the US was full of fatty infilitrations, even then the doctors did not consider for Biopsy. Is that OK? Albumin is 4.6, Bilirubin is 1.1 (normal 0-1.3), Alk Phos 55 (normal 0-145)

A:The elevation in liver tests is minimal, now. The diagnosis is likely to beNASH. There is no need for worry; however, weight reduction would help.Ideal body weight would be around 81 kg. Weight loss should not be more thanabout 2 kg per month.