Thom,

My contention, based on a study I found cited somewhere else in this
group, is that many or most labs are using a reference range for ALT
that is simply incorrect because the upper limit for that range is set
too high. To be clear, although my pre-Tx ALT of 48 U/L is well within
the reference range of 12-59 U/L set by the lab, it is also a value
that places me in the top 1% of the population at large. Only when
compared to values found in a population containing an extraordinary
percentage of hepatitis patients is my ALT then something that is
plausibly viewable as normal. Thus, I see my ALT as being abnormally
high, *elevated* by definition, and therefore a likely culprit for the
pre-Tx symptom of intermittent itching.

Bilirubin seems to get the first attention when symptoms of itching for
the chronic hep-c patient crop up, but this value as measured by the
labs for me was truly normal. I understand how abnormal uric acid and
albumin levels would cause problems, but related objective symptoms are
absent and blood work for these values produce truly normal results
also.

Thank you for bringing my attention to the fact that there are profound
limitations imposed on labs by constraints necessarily inherent to
biological testing. I admit I am substantially naive in this area and
suspect that should I gain an improved understanding, doing so might go
far toward resolving the hubris I now suffer in regard to certain lab
findings. Until then, and as long as I remain under the incredibly
irritating influence of interferon and ribavirin therapy, I will likely
continue to perceive ALT lab findings as a lot of mealy-mouthed caw-caw
that is being skewed and spewed by a majority of labs that presently
fall well short of having their collective sh.t together.

Cheers,

BG in Seattle