What causes high ALT and AST levels. How to interpret abnormal liver enzyme test results. When should you be concerned about elevated liver enzymes. What are the potential underlying conditions associated with high ALT and AST.

What Are Liver Enzymes and Why Are They Important?

Liver enzymes, specifically ALT (alanine transaminase) and AST (aspartate aminotransferase), play a crucial role in monitoring liver health. These enzymes are normally found within liver cells, but when the liver is damaged or inflamed, they can leak into the bloodstream. Elevated levels of ALT and AST in blood tests often indicate potential liver issues.

ALT is primarily found in the liver, making it a more specific indicator of liver health. AST, on the other hand, is present in various tissues including the heart, muscles, and brain, in addition to the liver. This means that elevated AST levels could potentially signal problems in other parts of the body as well.

Normal Ranges for ALT and AST

The normal ranges for ALT and AST can vary slightly depending on the laboratory and testing method used. However, generally accepted ranges are:

• ALT: 7-55 units per liter (U/L) for males, 7-45 U/L for females
• AST: 8-48 U/L for males, 6-34 U/L for females

It’s important to note that these ranges may differ for children and older adults. Always consult with your healthcare provider for interpretation of your specific test results.

Common Causes of Elevated Liver Enzymes

There are numerous reasons why ALT and AST levels might be elevated. Some of the most common causes include:

1. Viral hepatitis (particularly hepatitis B and C)
2. Alcohol-related liver disease
3. Non-alcoholic fatty liver disease (NAFLD)
4. Medication side effects
5. Obesity
6. Autoimmune liver diseases
7. Liver cancer
8. Heart failure

In some cases, temporary elevations can occur due to strenuous exercise or certain dietary supplements. It’s crucial to consider the overall clinical picture and not just rely on a single test result.

Interpreting AST/ALT Ratios: What Do They Mean?

The AST/ALT ratio can provide valuable insights into the nature of liver damage. Here’s what different ratios typically indicate:

• AST/ALT ratio < 1: This is considered normal and is often seen in viral hepatitis or NAFLD
• AST/ALT ratio > 2: This may suggest alcohol-related liver disease
• AST/ALT ratio > 1 but < 2: This could indicate cirrhosis or more advanced liver disease

It’s important to remember that these ratios are not definitive diagnoses but rather guidelines that help healthcare providers in their assessment.

Can AST Be Elevated Without Liver Problems?

Yes, AST can be elevated due to conditions unrelated to the liver. Since AST is present in other tissues, elevated levels could indicate issues such as:

• Muscle damage or injury
• Heart problems, including heart attacks
• Kidney disease
• Certain medications
• Strenuous exercise

This is why ALT is often considered a more specific indicator of liver health, as it is primarily found in liver cells.

When Should You Be Concerned About Elevated Liver Enzymes?

While minor, temporary elevations in liver enzymes are common and often don’t indicate a serious problem, there are situations where elevated levels warrant further investigation:

• Persistent elevation: If ALT or AST levels remain elevated over multiple tests
• Significant elevation: Levels more than 3 times the upper limit of normal
• Accompanying symptoms: If you experience symptoms like jaundice, abdominal pain, or unexplained weight loss
• Risk factors: If you have risk factors for liver disease, such as heavy alcohol use or obesity

In these cases, your healthcare provider may recommend additional tests to determine the underlying cause of the elevation.

Diagnostic Procedures for Evaluating Elevated Liver Enzymes

If your liver enzyme tests show persistent or significant elevations, your doctor may recommend further diagnostic procedures to identify the underlying cause. These may include:

1. Additional blood tests: To check for specific liver diseases, viral infections, or autoimmune conditions
2. Imaging studies: Such as ultrasound, CT scan, or MRI to visualize the liver and check for structural abnormalities
3. Liver biopsy: In some cases, a small sample of liver tissue may be taken for microscopic examination
4. Elastography: A non-invasive test to assess liver stiffness, which can indicate fibrosis or cirrhosis

The choice of diagnostic procedures will depend on your specific situation, symptoms, and risk factors.

Treatment Approaches for Elevated Liver Enzymes

The treatment for elevated liver enzymes depends on the underlying cause. Some general approaches include:

• Lifestyle modifications: Such as reducing alcohol intake, losing weight if overweight, and increasing physical activity
• Dietary changes: Adopting a liver-friendly diet low in saturated fats and high in fruits, vegetables, and whole grains
• Medication adjustments: If certain medications are causing the elevation, your doctor may adjust dosages or switch to alternative treatments
• Treatment of underlying conditions: Such as antiviral therapy for hepatitis or management of autoimmune liver diseases
• Liver support supplements: In some cases, supplements like milk thistle or vitamin E may be recommended, though their efficacy is still being studied

It’s crucial to work closely with your healthcare provider to develop a personalized treatment plan based on your specific situation.

Preventing Liver Enzyme Elevations: Lifestyle and Diet Tips

While some causes of elevated liver enzymes are beyond our control, there are several lifestyle and dietary measures you can take to support liver health and potentially prevent enzyme elevations:

1. Limit alcohol consumption: Excessive alcohol intake is a leading cause of liver damage
2. Maintain a healthy weight: Obesity is closely linked to non-alcoholic fatty liver disease
3. Exercise regularly: Physical activity helps maintain a healthy weight and can improve liver function
4. Eat a balanced diet: Focus on fruits, vegetables, whole grains, and lean proteins
5. Stay hydrated: Adequate water intake supports overall liver function
6. Avoid unnecessary medications: Only take medications as prescribed and inform your doctor of all supplements you’re taking
7. Protect against hepatitis: Get vaccinated for hepatitis A and B, and practice safe sex to prevent hepatitis C

By incorporating these habits into your daily life, you can support your liver health and potentially reduce the risk of elevated liver enzymes.

Long-term Outlook and Monitoring of Liver Enzyme Levels

For many individuals, elevated liver enzymes can be successfully managed through lifestyle changes, treatment of underlying conditions, or a combination of both. However, long-term monitoring is often necessary to ensure that enzyme levels remain stable or improve over time.

Follow-up Testing

Your healthcare provider may recommend regular follow-up testing to monitor your liver enzyme levels. The frequency of these tests can vary depending on the severity of the elevation and the underlying cause. It may range from every few months to annually.

Potential Complications

If left untreated, persistently elevated liver enzymes can potentially lead to more serious liver conditions, including:

• Cirrhosis: Scarring of the liver that can impair its function
• Liver failure: When the liver can no longer perform its vital functions
• Increased risk of liver cancer: Chronic liver disease can increase the risk of hepatocellular carcinoma

This underscores the importance of addressing elevated liver enzymes promptly and maintaining ongoing monitoring.

Prognosis

The long-term outlook for individuals with elevated liver enzymes varies greatly depending on the underlying cause and how quickly it is addressed. Many people can achieve normal liver enzyme levels with appropriate treatment and lifestyle changes. However, in cases of advanced liver disease, the prognosis may be more guarded.

It’s important to work closely with your healthcare provider to develop a comprehensive management plan and adhere to recommended follow-up care. With proper management, many individuals with a history of elevated liver enzymes can maintain good liver health and overall well-being.

Remember, liver health is an essential component of overall health. By understanding the significance of liver enzyme tests and taking proactive steps to maintain liver health, you can contribute significantly to your long-term well-being. Always consult with healthcare professionals for personalized advice and treatment plans based on your specific health situation.

AST (SGOT): Liver Function Test

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AST (SGOT): Liver Function Test

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AST (SGOT): Liver Function Test

Hepatitis C

AST, or aspartate aminotransferase, is one of the two liver enzymes. It is also known as serum glutamic-oxaloacetic transaminase, or SGOT. AST is a protein made by liver cells. When liver cells are damaged, AST leaks out into the bloodstream and the level of AST in the blood becomes elevated. AST is different from ALT because AST is found in parts of the body other than the liver—including the heart, kidneys, muscles, and brain. When cells in any of those parts of the body are damaged, AST can be elevated.

Explanation of test results:

A high AST level often means there is some liver damage, but it is not necessarily caused by hepatitis C. A high AST with a normal ALT may mean that the AST is coming from a different part of the body. It is important to realize that the AST level in most patients with hepatitis C goes up and down. The exact AST level does not tell you how much liver damage there is, or whether the liver is getting better or worse, and small changes should be expected. However, for patients receiving treatment for hepatitis C, it is helpful to see if the AST level goes down.

Other things to know:

• The AST level is not as helpful as the ALT level for checking the liver.
• Many patients with hepatitis C will have a normal AST level.
• Patients can have very severe liver disease or cirrhosis and still have a normal AST level.

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What Does It Mean When They Are Elevated

While going for a series of routine blood tests can be overwhelming, it is still important to understand the test results and what they could mean for your health. Out of which, one such common blood test to undergo is the liver function test (LFT).

The purpose of a Liver Function Test is to examine the various liver enzymes levels in your body. Liver enzymes are produced by liver cells. When infected or inflamed, these injured liver enzymes will leak into the bloodstream – resulting in a condition otherwise known as elevated liver enzymes.

While liver enzyme levels may be temporarily elevated and do not pose much of a concern, it’s crucial to know that they may signal some underlying issues as well. Let’s take a look at the elevation of two enzymes, ALT and AST, and what you can do to regulate these enzyme levels.

What is the AST and ALT?

When there are high levels of ALT and AST, it signals that the liver is infected and inflamed, hence releasing both enzymes into the bloodstream at a rate higher than usual

Possible causes include hepatitis B and C, side effects from medication, non-alcoholic fatty liver disease (NAFLD) and alcohol.

As one of the most common chronic liver disorders in Singapore, NAFLD is a possible cause of an abnormal ALT and AST. Most patients with NAFLD do not have symptoms. In some patients, they may experience upper abdominal discomfort or tiredness. Look out for signs of severe liver condition such as jaundice and gastrointestinal bleeding if it has progressed to liver hardening.

If persistent increments in your AST and ALT levels are observed without any visible health issues, it’s best to consult a professional gastroenterologist for further evaluation. This can come in the form of screening for liver disease or an ultrasound of the liver, if necessary.

What is considered to be an abnormal AST/ALT ratio?

The AST/ALT ratio tells you the relative concentrations of the enzymes aspartate transaminase (AST) and alanine transaminase (ALT) in your blood.

A typical AST/ALT ratio would be less than 1. Sometimes, minor increments in AST/ALT ratio levels can be observed after vigorous exercise or suggest signs of skeletal muscle injury. But, an average of 70% of patients with alcoholic liver disease have an AST/ALT ratio of more than 2.

How do I regulate my AST and ALT levels?

But not to worry, lowering your AST and ALT levels can be achieved by changing lifestyle habits. For instance, cultivating a habit of regular exercise would improve insulin sensitivity and reduce liver inflammation.

Another way to keep your AST and ALT levels in check is to review your diet. Consider reducing your sugar intake and animal fat consumption. These foods can over-work your liver cells. Instead, consume foods rich in folate and the water-soluble B vitamin. Folate is key in helping your liver function at its best, so include foods such as avocado and spinach as part of your diet.

Conclusion

When it comes to protecting your liver, it’s crucial to keep your AST and ALT levels in check to be aware of potential infections or diseases you might have contracted. If your AST and ALT levels have been persistently high, consult a professional as soon as possible to steer clear of any dangerous developments.

Aspartate aminotransferase (AST)

Aspartate aminotransferase (AST) is an enzyme that is found in all cells of the body, but mainly in the cells of the heart and liver, and to a lesser extent in the kidneys and muscles. Normally, AST activity in the blood is very low. When liver or muscle tissue is damaged, it is released into the blood. Thus, AST is an indicator of liver damage.

Synonyms Russian

Serum glutamine-oxaloacetic transaminase, serum glutamate-oxaloacetate transaminase (SGOT), aspartate transaminase, AST/ALT ratio.

Synonyms English

Aspartate aminotransferase.

Test method

UV kinetic test.

Units

U/L (unit per litre).

What biomaterial can be used for research?

Venous, capillary blood.

How to properly prepare for an examination?

• Do not eat for 12 hours before the test.
• Exclude physical and emotional overexertion within 30 minutes prior to the study.
• Do not smoke for 30 minutes before the test.

Study Overview

Aspartate aminotransferase (AST) is an enzyme found in all cells of the body, but primarily in the heart and liver, and to a lesser extent in the kidneys and muscles. In healthy patients, AST activity in the blood is low and the AST norm has low values. When the liver or muscles are damaged, AST is released, and the level of AST in the blood rises. In this regard, the activity of this enzyme is an indicator of liver damage. An analysis for AST is part of the so-called liver tests – studies that diagnose disorders in the liver.

The liver is a vital organ located in the upper right side of the abdomen. It is involved in many important bodily functions – helping with nutrient processing, bile production, the synthesis of many important proteins such as blood clotting factors, and breaking down potentially toxic compounds into harmless substances.

A number of diseases lead to damage to liver cells, which increases the activity of AST.

The most common test for AST is to check if the liver is damaged due to hepatitis, toxic drugs, cirrhosis. However, AST does not always reflect only liver damage; the activity of this enzyme can also increase in diseases of other organs, in particular, in myocardial infarction.

What is research used for?

• To detect liver damage. Typically, an AST test is ordered along with an alanine aminotransferase (ALT) test or as part of a general liver function test. AST and ALT are considered the two most important indicators of liver damage, although ALT is more specific than AST. In some cases, AST is directly compared with ALT and their ratio (AST/ALT) is calculated. It can be used to find out the causes of liver damage.
• Blood AST is often compared with other tests, such as alkaline phosphatase (AP), total protein, and bilirubin, to determine a specific form of liver disease.
• To monitor the effectiveness of the treatment of liver diseases.
• To monitor the health of patients taking drugs that are potentially toxic to the liver. If AST activity rises, the patient may be switched to other medications.

When is the test ordered?

• For symptoms of liver disorder:
  • weakness, fatigue,
  • loss of appetite,
  • nausea, vomiting,
  • abdominal pain and bloating,
  • yellowing of the skin and whites of the eyes,
  • dark urine, light stool,
  • itching.

• If there are factors that increase the risk of liver disease:
  • previous hepatitis or recent exposure to hepatitis infection,
  • excessive alcohol consumption,
  • hereditary predisposition to liver diseases,
  • taking drugs that can damage the liver,
  • overweight or diabetic.
  • On a regular basis throughout the treatment process to determine its effectiveness.

What do the results mean?

Reference values ​​(AST norm for men, women and children):

Normally, the activity of AST in the blood is low.

Excessively high AST activity (more than 10 times normal) is usually caused by viral infections. It can also increase significantly as a result of taking drugs or other substances that are toxic to the liver, as well as due to diseases that slow blood flow to the liver (ischemia).

In chronic hepatitis, AST activity usually exceeds the norm by no more than 4 times. It fluctuates between normal and somewhat elevated, so often an analysis is prescribed to determine the degree of the disease. Diseases such as obstruction of the biliary tract, cirrhosis, and some types of liver cancer contribute to a moderate increase in AST. After a heart attack and with muscle damage, AST activity can also increase, usually much more than ALT.

In most liver diseases, ALT activity in the blood is higher than AST activity, so the AST/ALT ratio will be low. However, there are a few exceptions: alcoholic hepatitis, cirrhosis, and muscle damage.

Important notes

• During pregnancy, AST activity may decrease.
• Intramuscular injections of drugs, as well as intense physical activity, increase the activity of AST in the blood.
• In some patients, liver damage and, as a result, an increase in AST activity can be caused by taking dietary supplements. Therefore, it is necessary to inform the attending physician not only about all medications taken, but also about nutritional supplements.

Also recommended

• Alanine aminotransferase (ALT)
• Alkaline phosphatase, total
• Gamma-glutamyl transpeptidase (gamma-GT)
• Serum albumin
• Total protein in whey

Who orders the examination?

Therapist, cardiologist, hepatologist, gastroenterologist, general practitioner, surgeon, pediatrician.

“Why are ALT and AST elevated in the blood, what does this mean?” — Yandex Q

Yandex.Zdorovye

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The abbreviation ALT is deciphered as an indicator of the blood enzymes of alanine aminotransferase, AST – asparagine aminotransferase. Indicators of AST and ALT are included in the study of biochemical blood analysis.

They were discovered in medicine relatively recently. A blood test for AST and ALT is carried out jointly and, accordingly, their norm should be the same, and fully dependent on each other.

Such an indicator of analysis as an increase in ALT and AST in the blood by 2 or more times should make you think about the occurrence of certain diseases. First you need to understand what ALT and AST are. What is the norm of these compounds in the blood and what should be done if at least one indicator is elevated?

What does an increase in ALT and AST above normal mean?

In adults, the content of ALT and AST in different organs is not the same, so an increase in one of these enzymes may indicate a disease in a particular organ.

• ALT (ALAT, alanine aminotransferase) is an enzyme that is found mainly in the cells of the liver, kidneys, muscles, heart (myocardium – heart muscle) and pancreas. When they are damaged, a large amount of ALT is released from the destroyed cells, which leads to an increase in its level in the blood.
• AST (AST, aspartate aminotransferase) is an enzyme that is also found in the cells of the heart (in the myocardium), liver, muscles, nerve tissues, and to a lesser extent in the lungs, kidneys, pancreas. Damage to the above organs leads to an increase in the level of AST in the blood.

Basically, the norm of ALT and AST in the blood depends entirely on the work of the most important parenchymal organ – the liver, which performs such functions as:

1. Protein synthesis.
2. Production of biochemical substances necessary for the body.
3. Detoxification – removal of toxic substances and poisons from the body.
4. Storage of glycogen – a polysaccharide, which is necessary for the full functioning of the body.
5. Regulation of biochemical reactions of synthesis and decay of most microparticles.

Normal blood levels of ALT and AST depend on gender. In an adult woman, the level of ALT and AST does not exceed 31 units / l. In men, normal ALT does not exceed 45 U / l, and AST 47 U / l. Depending on the age of the child, the level of ALT and AST changes, while the content of ALT should not exceed 50 U / l, AST – 140 U / l (from birth to 5 days) and not more than 55 U / l for children up to 9years.

Depending on the equipment used for the study, it is possible to vary the norms and reference values ​​of the level of enzymes. An increase in the rate of enzyme renewal, cell damage leads to an increase in the level of transaminases in the blood.

Reasons for increasing ALT and AST

Why are ALT and AST elevated in adults, what does this mean? The most likely cause of elevated liver enzymes in the blood are:

1. Hepatitis and other liver diseases (

   cirrhosis of the liver

   , fatty hepatosis – replacement of liver cells with fat cells, liver cancer, etc. ).

2. Increased ALT and AST as a result of diseases of other organs (autoimmune thyroiditis, mononucleosis).

3. myocardial infarction

   – this is necrosis (death) of a section of the heart muscle, as a result of which ALT and AST are released into the blood.

4. Diffuse liver damage, which may be caused by alcohol, drugs and/or viral exposure.
5. Extensive injuries with muscle damage, as well as burns, cause an increase in ALT in the blood.
6. Acute and chronic pancreatitis.
7. Metastases or neoplasms in the liver.
8. Reaction to drugs.
9. Taking anabolic steroids.

AST and ALT are important indicators of the condition of various organs. An increase in these enzymes indicates damage to organs such as the liver, heart, muscles, pancreas, etc. Thus, a decrease in their level in the blood occurs independently when the underlying disease is eliminated.

Prevention

In order to ensure that the norm of indicators does not exceed the permissible limits, it is recommended to avoid long-term use of drugs.

If this is not possible due to a chronic disease, then it is better to regularly take an analysis for AST so that it is not elevated or a serious increase is prevented in time. Periodically, you need to visit a gastroenterologist and a hepatologist who can identify a possible disease and prescribe treatment.

What to do if ALT and AST are elevated

In order to quickly and objectively understand the true reason for the increase in the levels of activity of ALT and AST enzymes, it is necessary to additionally pass biochemical tests.

First of all, it is advisable to determine

total bilirubin levels

, alkaline phosphatase and GGTP (gamma-glutamyltransferase) and assess the degree of preservation of the main functions of the liver. To exclude the viral nature of liver damage (acute viral hepatitis), which is also accompanied by an increase in ALT and AST in the blood, you will need to donate blood for specific antigens of viral hepatitis and specific antibodies to these antigens.