Labs (Possibly) Out Of Whack?

Diet is high protein, 0 carb, low fat (keto). Exercise heavy with cardio 4x/week. No drinking or liver toxic drugs (Tylenol, AAS, etc.)

I’m on TRT (250mg T:E) pinned once weekly and 2iu growth daily. Other supplements are 5g creatine, collagen peptides, and UC-II.

Liver results:

AST (GOT): 157 (Range 13-30)

ALT (GPT): 123 (Range 10-42)

r-GTP (GGT): 13 (Range 13-64)

And Creatine (CK): 4690 (Range 59-248)

I’ve never had those bad of results, even on 17aas. The GGT, per ChatGPT, says that there isn’t real damage, and that the high AST/ALT could be a result of:

  1. Hard exercise on Monday

  2. Creatine intake pulling water into the muscle

  3. Blood donation on Tuesday

  4. Blood test on Wednesday

I’m taking a week off from exercise and removing creatine to see if it’s from exercise and potentially dehydration.

Anyone have any insight as to why AST/ALT would be elevated with the low GGT other than the possible contributing factors leading up to the blood draw?

Your bloodwork means 0 without the lab ranges.

Thanks. Updated the OP with exact CK and ranges for each.

This sounds terrible. What is low fat keto?

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This is the upper end of where “ok” becomes not ok.
Let’s see what bloods look like when you take a break from training for a week.

Spell this out. What does low fat mean? A protein only diet is not gonna cut it. You need at least 50-60g of good fats for your body to run properly.

Only fats from red meats, chicken, and fish. To clarify, I meant low fat in addition to that like low fat from whole milk (9g) and peanut butter (16g).

Non alcoholic fatty liver can present like this. When you retest, grab a thyroid panel and Cystatin V.

Only fats from red meats, chicken, and fish. To clarify, I meant low fat in addition to that like low fat from whole milk (9g) and peanut butter (16g).

Your clarification left me more confused, and that’s as someone who is very vested in the ketospace.

How much fat are you eating?

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I suppose I got keto and carnivore mixed up. I thought I was “cheating” the diet by adding in other sources of fat. Syntax aside, I don’t measure my fats as closely because that is all that — and protein — I was consuming.

I monitored my water intake and drank like I had rhabdo; cut creatine; kept exercise at the bare minimum over the last week, not even exceeding 2000 steps a day; and added 30-40 carbs daily.

My results came back as:

AST (GOT): 17 (Range 13-30)

ALT (GPT): 32 (Range 10-42)

y-GTP (GGT): 12 (Range 13-64)

And Creatine (CK): 158 (Range 59-248)

So now the question(s) are:

Was the first lab even correct with that sharp of a decline in 7 days?

Is exercise while in ketosis hard on the liver?

Is it safe to end this 5 month cut with 17-aas (6th being on cycle)?

The week long wait without exercise was boring, but I only tweaked a few things just slightly to get a significant result of improvement, which were my target numbers to tell me 17-aas are good to go, but the last lab threw me for a loop.

Look up gluconeogensis. Did you feel like crap exercising a ton with zero carb. I never understand if the true carnivore diet really means zero carbs. Your body will produce carbs if you eat zero (out of protein). And your liver does this. And if you just looked it up, it is associated with higher ast levels. I only recall this because when I did keto once, I actually did zero ish carbs for a while, was doing a lot of cardio, and felt like complete shit, weird body issues, etc, and figured it was linked to this. Don’t know if this is the reason though.

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No, I felt absolutely fine once I broke the wall: The first few weeks. Been doing it months since. I only added the 30-40 carb this week to kind of have the same mechanics as creatine for when I start (loading? Do I need to load again) creatine.

I just chalked it up to the blood donation, dehydration, and exhaustion (but not my definition of exhaustion as I never felt that I overworked) close to the test — if that first test are my results to begin with.

Down roughly 10.5kg and strength is still progressive every 2-5 weeks (as my T trough is 1200-1300 and is supported by 2iu GH with a high protein diet).