What are AST and ALT enzymes. How do elevated levels impact liver health. What causes high AST and ALT ratios. When should you be concerned about abnormal liver function tests. How can you lower elevated liver enzymes naturally.

The Importance of Liver Function Tests

Liver function tests (LFTs) play a crucial role in assessing overall liver health. These blood tests measure various enzymes, proteins, and other substances produced or processed by the liver. Two key enzymes commonly evaluated in LFTs are aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

Why are AST and ALT levels significant? These enzymes are normally found inside liver cells. When liver cells are damaged or die, AST and ALT are released into the bloodstream, causing their levels to rise. Elevated AST and ALT levels can indicate liver inflammation, injury, or disease.

What is AST?

AST, also known as serum glutamic-oxaloacetic transaminase (SGOT), is an enzyme found in various body tissues, including the liver, heart, muscles, and brain. While elevated AST levels often suggest liver damage, they can also indicate issues in other organs.

What is ALT?

ALT, formerly called serum glutamic-pyruvic transaminase (SGPT), is more specific to the liver than AST. Elevated ALT levels are generally considered a more reliable indicator of liver damage or disease.

Interpreting AST and ALT Test Results

Understanding AST and ALT test results can be complex, as the interpretation depends on various factors. Generally, the normal range for AST is 5 to 40 units per liter of serum, while the normal range for ALT is 7 to 56 units per liter of serum. However, these ranges may vary slightly between laboratories.

Are slightly elevated AST or ALT levels always cause for concern? Not necessarily. Temporary elevations can occur due to factors such as intense exercise, certain medications, or even normal fluctuations. Persistent or significantly elevated levels, however, warrant further investigation.

The AST/ALT Ratio

The AST/ALT ratio can provide additional insights into liver health. In most cases of liver damage, ALT levels rise more than AST levels, resulting in an AST/ALT ratio less than 1. An AST/ALT ratio greater than 2 may indicate alcoholic liver disease or advanced liver damage.

Common Causes of Elevated Liver Enzymes

Numerous factors can contribute to elevated AST and ALT levels. Understanding these potential causes is essential for proper diagnosis and treatment.

• Viral hepatitis (B and C)
• Alcoholic liver disease
• Non-alcoholic fatty liver disease (NAFLD)
• Medication side effects
• Autoimmune hepatitis
• Liver cancer
• Cirrhosis
• Heart failure
• Muscle disorders

Can lifestyle factors influence liver enzyme levels? Indeed, obesity, excessive alcohol consumption, and certain dietary habits can contribute to elevated AST and ALT levels. Additionally, intense exercise or muscle injury can temporarily increase these enzyme levels, particularly AST.

Non-Alcoholic Fatty Liver Disease (NAFLD): A Growing Concern

NAFLD has emerged as one of the most prevalent chronic liver disorders worldwide, including in Singapore. This condition occurs when excess fat accumulates in liver cells, potentially leading to inflammation and damage.

How does NAFLD affect liver enzyme levels? In many cases, NAFLD causes a mild to moderate elevation in AST and ALT levels. However, it’s important to note that some individuals with NAFLD may have normal enzyme levels, highlighting the need for comprehensive evaluation beyond just AST and ALT tests.

Symptoms and Progression of NAFLD

Many patients with NAFLD remain asymptomatic, making regular check-ups crucial. Some individuals may experience upper abdominal discomfort or fatigue. As the condition progresses, it can lead to more severe liver damage, potentially resulting in cirrhosis.

What are the warning signs of advanced liver disease? Jaundice (yellowing of the skin and eyes), gastrointestinal bleeding, and fluid accumulation in the abdomen (ascites) are indicators of severe liver conditions that require immediate medical attention.

When to Seek Medical Advice

While occasional, mild elevations in liver enzymes may not be cause for alarm, certain situations warrant prompt medical evaluation.

1. Persistent elevations in AST or ALT levels
2. AST or ALT levels more than three times the upper limit of normal
3. Symptoms of liver disease (jaundice, abdominal pain, swelling)
4. Risk factors for liver disease (alcohol abuse, obesity, diabetes)
5. Family history of liver disease

What diagnostic procedures might a doctor recommend? Depending on the severity and persistence of elevated liver enzymes, a healthcare provider may order additional tests such as ultrasound imaging, CT scans, or liver biopsies to determine the underlying cause and extent of liver damage.

Natural Ways to Lower Liver Enzyme Levels

For individuals with mildly elevated liver enzymes, lifestyle modifications can often help improve liver health and normalize enzyme levels.

• Maintain a healthy weight
• Limit alcohol consumption
• Exercise regularly
• Follow a balanced, liver-friendly diet
• Avoid unnecessary medications
• Manage stress levels
• Stay hydrated

Can dietary changes significantly impact liver enzyme levels? Yes, adopting a diet rich in fruits, vegetables, whole grains, and lean proteins while limiting processed foods, saturated fats, and added sugars can help reduce liver inflammation and improve overall liver function.

Supplements for Liver Health

Some natural supplements may support liver health and potentially help lower elevated enzyme levels. These include milk thistle, turmeric, and N-acetyl cysteine (NAC). However, it’s crucial to consult with a healthcare provider before starting any supplement regimen, as some supplements can interact with medications or have adverse effects.

The Role of Regular Health Screenings

Regular health check-ups, including liver function tests, play a vital role in early detection and prevention of liver diseases. These screenings can help identify potential issues before they progress to more severe conditions.

How often should liver function tests be performed? For individuals without known liver issues or risk factors, annual or biennial screenings may be sufficient. However, those with existing liver conditions, risk factors, or abnormal previous results may require more frequent monitoring.

Comprehensive Liver Health Assessment

While AST and ALT levels provide valuable information about liver health, they are just one piece of the puzzle. A comprehensive liver health assessment may include additional tests such as:

• Alkaline phosphatase (ALP)
• Gamma-glutamyl transferase (GGT)
• Bilirubin
• Albumin
• Prothrombin time

These tests, combined with a thorough medical history and physical examination, provide a more complete picture of liver function and overall health.

Advances in Liver Disease Diagnosis and Treatment

Medical advancements have significantly improved our ability to diagnose and treat liver diseases. From non-invasive imaging techniques to targeted therapies, the field of hepatology continues to evolve.

What new technologies are revolutionizing liver disease diagnosis? Fibroscan, a non-invasive alternative to liver biopsy, uses ultrasound technology to assess liver stiffness and fat content. This technique provides valuable information about liver health without the risks associated with invasive procedures.

Emerging Treatments for Liver Diseases

Research into novel treatments for various liver conditions is ongoing. Some promising areas include:

• Gene therapy for inherited liver diseases
• Immunotherapies for liver cancer
• Antifibrotic drugs to combat liver scarring
• Microbiome-based treatments for fatty liver disease

These advancements offer hope for improved outcomes in patients with liver diseases, potentially reducing the need for liver transplantation in some cases.

Understanding AST and ALT levels is crucial for maintaining optimal liver health. While elevated liver enzymes can be concerning, they often serve as early warning signs, allowing for timely intervention and treatment. By staying informed, practicing healthy lifestyle habits, and undergoing regular check-ups, individuals can take proactive steps to support their liver function and overall well-being. Remember, your liver plays a vital role in numerous bodily functions, making its health essential for your quality of life.

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.