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c/bloodwork·posted 1 months ago by u/santiago_szabo

ALT — 6 things I got wrong before I got it right

Concerning Long Haul ×9

Been lurking in c/intlshipping for about 2 months and finally have something worth posting.

Short version: week 55, 2.4mg, and ALT is the bit I still cannot get a straight answer on. I have read the wiki, I have read the last 39 threads, and the answers split roughly down the middle.

What I actually want to know is whether the people saying it does not matter have measured it, or whether it is just repeated confidently. Happy to be told I am overthinking this — I probably am — but I would rather overthink it now than at week 49.

824 up / 171 down83% upvoted31 commentsid 15qm2322 Jun 2026

31 comments

22 in this archive, depth 5

best — the order this archive was captured in

u/coldchain_karencold chain100 points·1 months ago

I love that this community will spend 40 comments on a detail. That pedantry is why the numbers here matter.

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u/santiago_szaboOP65 points·1 months ago

Strongly agree. ALT is where you catch the liver story early.

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u/santiago_szaboOP42 points·1 months ago·edited

eGFR noise on rapid loss is real. 6 week noise, 30 week trend. Do not panic at week 18.

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[deleted]15 points·1 months ago

[deleted]

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u/forest_plot_fionastats82 points·1 months ago

Sceptical. If this were true we would see it reflected in the data and we do not.

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u/diego_almeida68 points·1 months ago

redact identifying details from lab PDFs before posting

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u/cold_chromatogram31-13 points·1 months ago

ApoB over LDL-C, that is the hierarchy

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u/hedda_adeyemi65 points·1 months ago·edited

This is correct. ApoB is the better marker.

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u/noor_cardoso55 points·1 months ago

post reference ranges with your numbers, units differ by country and lab

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u/santiago_szaboOP24 points·1 months ago

Strongly agree. ALT is where you catch the liver story early.

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u/karl_fischer_kev37 points·1 months ago

ferritin tanks quietly on a reduced appetite, check it

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u/whois_wanda12 points·1 months ago·edited

Yeah, baseline matters more than any later number.

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u/employer_carveout29 points·1 months ago

No. This is the kind of confident post that gets copied into a screenshot and repeated for years. Where is the evidence.

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u/heart_rate_bump17 points·1 months ago

the 9 month eGFR check is the routine

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u/signe_grimaldi48 points·1 months ago

Same lab both times?

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u/gentle_correctionMOD19 points·1 months ago

Removed a chain here. The rule is one line long and it is not negotiable.

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u/kofi_balogun35 points·1 months ago

ALT from 4 to 26 is movement, not noise

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u/nnt_nate21 points·1 months ago

Is that fasted?

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u/coring_the_stopper16 points·1 months ago

ApoB from 10 to 11 is movement, not noise

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u/flair_enthusiast13 points·1 months ago

HOMA-IR is crude but free and useful for tracking

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u/gentle_correctionnice about it44 points·1 months ago

ALT from 4 to 26 is movement, not noise

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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About c/bloodwork

What to measure before you start, what to re-measure, and how to interpret movement without panicking. ApoB over LDL-C, HOMA-IR as a crude free tool, ALT and the fatty-liver story, eGFR noise during rapid loss, and the deficiencies that a 1,100-calorie appetite will hand you.

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