What Is Alanine Aminotransferase Test (ALT) Blood Test

An alanine aminotransferase (ALT) test weighs the level of ALT in your blood. ALT is commonly present in your liver, but in the case of damaged or inflamed liver, ALT is found in your bloodstream. As a result, your serum ALT level elevated. Your doctor recommends this ALT blood test to see how your liver is performing or determine the underlying cause of your liver problems. An ALT test usually belongs to the part of the screen tests for liver disease. ALT test is also known as a serum glutamic-pyruvic transaminase (SGPT) test or an alanine transaminase test.

The cost of an ALT blood test is Rs.60- Rs.200, depending on your location and place.

Please check the price of the ALT blood best in Delhi/NCR, your nearby centers and other details.

Test summary in the table structure

Also known as	serum glutamic-pyruvic transaminase (SGPT), alanine transaminase test
Test Type	Blood
ALT test includes	Monitors how properly your liver is functioning
Preparation	Doesn’t need any special preparation
Reporting	Within 24 hrs
Test price	The cost of an ALT blood test is Rs. 60- Rs.200, depending on your location and place.
Also included in	Health Insurance Plans
Related tests	Kidney Function Test, CBC, SGOT, Alkaline Phosphatase, Albumin

Why does your doctor recommend an ALT test?

Your doctor will suggest this ALT test to check how your liver is functioning. Some people perform this test as part of a metabolic panel. A doctor suggests this test if you are suffering from various symptoms of liver disease or damage. These symptoms could be,

• Yellow eyes and skin (jaundice)
• Pain in the upper abdomen
• Pain in the right shoulder
• Easy bleeding or bruising
• Severe itching
• Clay-colored stools
• Inflammation in the legs or abdomen

These symptoms indicate that you are having liver problems. Healthcare conditions that can cause elevated ALT levels include are,

• Hepatitis
• Nonalcoholic fatty liver disease
• Cirrhosis
• Celiac disease
• Thyroid disorders
• Preeclampsia in pregnant or immediately postpartum women
• Some infections, including mononucleosis and sepsis
• Wilson’s disease
• Polymyositis
• Liver cancer
• Some medicines may also uplift your ALT levels

When a doctor identifies a liver injury early, he goes for the proper line of treatment to prevent further injury.

People at risk of liver damage or disease include

• Those who have a family history of liver disease
• People who have diabetes
• People who are obese
• People who consume a lot of alcoholic beverages
• People who take certain medications

An ALT Test Preparation

This test doesn’t demand any special preparation. But if you are taking any medications for your underlying diseases, you must inform the doctor about the same. Some medications may hamper the test results of ALT. Your doctor might advise you in reducing the dosage of the medication or may stop it temporarily before the test.

An ALT Test Procedure

• First, a healthcare professional will clean the area of your hand before taking the sample.
• Then, he will tie an elastic band around your upper arm to identify your vein
• Now, he will insert a needle to collect your blood sample
• Your blood sample will be collected in a tube
• Once the process is finished, the healthcare professional will remove the elastic band and the needle.
• He will place gauze or bandage at the puncture site
• Your sample will be sent to the laboratory for further analysis.

The Interpretation of the Test Results

Normal Results

According to the American College of Gastroenterology, the normal values for ALT in the blood are,

29 to 33 international units per liter (IU/L) (for males)

 19 to 25 IU/L (for females)

ALT levels may vary from lab to lab.

The test results can be affected by several factors including sex and age.

Abnormal Results

ALT blood test high value may indicate liver damage. Elevated levels of ALT could be the result of

• Hepatitis (chronic inflammation of the liver)
• Cirrhosis (severe scarring of the liver)
• Death of liver tissue
• Liver cancer or tumor
• Inadequate blood flow to the liver
• Hemochromatosis (a disorder where iron gets built up in the body)
• Mononucleosis
• Diabetes

Though lower ALT values indicate a healthy liver, still, you may have some underlying health conditions that need to be discussed with your doctor.

FAQs

What are the risks associated with this ALT test?

This blood test is safe and convenient for people. But you may feel some temporary issues like

1. Excessive bleeding where the needle was inserted
2. A bruise under your skin
3. Dizziness or lightheadedness
4. Local infection at the puncture site

Is the ALT test done on empty stomach?

No fasting or special preparations are required for this test. But if you are taking any supplements or over-the-counter medications, inform your doctor about the same.

Is 70 a high ALT?

The upper limit of normal for ALT is 55 IU/L. If your ALT level is triple the upper limit of normal, it is considered mildly elevated. In the case of liver disease, your ALT level is 50 times the upper limit of normal.

What are the symptoms of an elevated ALT level?

Symptoms of an elevated ALT level are,

1. Abdominal pain
2. Dark-colored urine
3. Fatigue
4. Itching
5. Jaundice
6. Light-colored stools
7. Loss of appetite
8. Nausea and vomiting

What diseases cause high ALT levels?

Prolonged liver disease
1. Excessive use of alcohol
2. Cirrhosis
3. Blockage in the bile ducts
4. Heart attack or heart failure
5. Kidney damage
6. Muscle injury
7. Damage of RBCs

Why Are My Dog Or Cat’s ALT Blood Levels Abnormal – Ron Hines’ Vetspace – 2nd Chance – The Animal Health Website

Alanine Aminotransferase ALT, previously called SGPT aka Glutamic Pyruvic Transaminase, GPT

Ron Hines DVM PhD

The source of elevated ALT enzyme in your dog or cat’s lab report is primarily from injured (“leaking”) liver cells (hepatocytes). The ALT test is the frontline test for liver disease in dogs, cats and people. Results are usually included within the group of tests called a liver panel (=bilirubin, AST, ALT, GGT, and Alkaline phosphatase).  

Health Problems That Can Cause too Much ALT To Be Present In Your Cat Or Dog’s Blood:

In cats, cholangiohepatitis, hepatic lipidosis are two common causes. Hyperthyroidism,   IBD and diabetes are occasionally associated with elevated ALT in cats as well. In dogs, underlying Cushing’s disease or pancreatitis can be responsible.

Exposure to toxins, certain medications and corticosteroid administration can also elevate your dog and cat’s ALT level. In dogs, Trazodone, given to reduce anxiety has also been associated with liver damage and elevated ALT. (read here) 

In dogs, heartworm disease or its treatment of the disease with Immiticide®/Diroban® elevates ALT levels.  Hemolytic anemia, insufficient oxygen reaching the body (hypoxia), various metabolic disorders, over-exertion, severe body trauma and all the diseases that result in elevated AP can also elevate your pet’s ALT level.

Although the ALT is associated with the liver, occasionally adjoining bile duct disease that obstructs the normal flow of bile from your pet’s liver to its intestine can cause the amount of free ALT in its system to be elevated too.

Mild-to-moderate increases in ALT can also occur in pregnancy and, as I mentioned before, hyperthyroidism can cause a moderate increase in the ALT level of your cat. 

Significant gum/dental disease in your dog or cat can also cause a moderate elevate in its ALT level. So can the NSAIDs given long term to dogs to treat arthritis or joint pain. Those NSAID drugs include Rimadyl®, Deramaxx®, Previcox®, Metacam®, Galliprant® etc. (read here)

An accidentally hemolyzed blood sample – particularly from a cat – can report a falsely elevated ALT result.

On rare occasions, chronic hepatitis might follow a leptospirosis infection. That can result in an elevation of a number of liver function tests. (read here)

It is not that unusual for a pet that appears healthy to occasionally have moderately higher than normal ALT, bilirubin or Alkaline Phosphatase levels with no apparent explanation or health consequences. Physicians face the same problem as veterinarians do when deciding what to do in those situations. (read here) I generally suggest that the test be repeated in 2-3 weeks to see if the results are still abnormal or dropping. Many times they have improved. I am also more concerned when a number of liver-related tests are a bit high than when only one of the tests is. Of course, if your pet is feeling poorly, has lost weight or the test result was quite high, waiting is not a good option.

Health Problems That Can Cause Too Little ALT To Be Present:

I know of none. Have the test repeated at a commercial veterinary laboratory or wait a few weeks and have the test run again at your local animal hospital.

Complementary tests:

fPL® in cats or cPL® test in dogs for possible pancreatitis in cats or in dogs, ultrasound examination of the liver, and all the complimentary tests that accompany a liver panel. It is often wise to repeat the ALT test in 3 weeks and thereafter to monitor the situation.  The liver has a great capacity to regenerate. When liver cell damage has ceased, usually your pet’s ALT level will drop by one half in about 1-3 days and be normal within ~ 1-3 weeks.

Drugs associated with elevated ALT levels are the same ones that sometimes cause liver damage that raises your pet’s AP levels. They include:
Corticosteroids (such as prednisone/prednisolone), acetaminophen (Tylenol™), Non-steroidals such as Rimadyl® and Metacam® for arthritis. Griseofulvin dispensed to treat ringworm infections. Ketoconazole or fluconazole used to treat a variety of fungal infections.  Isoflurane, halothane and methoyflurane anesthetic gases. Metronidazole (Flagyl®) dispensed for a variety of intestinal issues involving diarrhea.  Fenbendazole (Panacur®) or mebendazole give to eliminate intestinal parasites. Various antitumor (“chemo”) medications. Phenobarbital given to treat seizures. Sulfonamide antibiotics and tetracycline.

Your pet will rarely face a toxicity issue with any of these medications if they are given in the accepted doses and intervals. Liver-related issues are often due to giving several of these drugs in combination or giving them at or above their maximum suggested doses. There will always be a pet now and then that does not react as expected to a drug that most pets have no problem receiving. We veterinarians blame that on genetic variation. One genetic variation that is commonly blamed are variations in P450.   (read here)

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Mitotane, blood plasma (Mitotane, o, p′-DDD, plasma)

Method of determination
Gas chromatography with mass selective detection.

Test material
Blood plasma (EDTA)

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Synonyms : Lysodren; Chlorditan; Ortho-para-DDD; 1-Chloro-2-[2,2dichloro-1-(4-chlorophenyl)ethyl]benzene.

Lysodren; Chlordithane; 1,1-(Dichlorodiphenyl)-2,2-dichloroethane; o,p’-DDD

General information about the study “Mitotan, blood plasma”

Drug monitoring of mitotane therapy.

Mitotane, 1-(2-chlorophenyl)-1-(4-chlorophenyl)-2,2-dichloroethane (o, p′-DDD), is the basic and currently non-alternative substance used in adrenocortical cancer chemotherapy, starting from 1970. Refers to derivatives of the insecticide DDT, studies of its effect on animals at one time served as an impetus for the development of a drug: under the influence of DDT, a sharp atrophy of the adrenal glands was noted.

Adrenocortical cancer is a rare malignant tumor originating from the adrenal cortex, which can be hormonally active, causing subclinical or overt Cushing’s syndrome (ICS) and/or viril syndrome. In some patients, a hormonally inactive tumor may be discovered incidentally. Adrenocortical cancer is characterized by late detection and aggressive clinical course. The mechanisms of the chemotherapeutic action of mitotane are based mainly on its adrenolytic effect, which leads to cellular degeneration of the adrenal cortex, selectively affecting the fascicular, partially reticular zone, without affecting the glomerular zone.

Mitotane is a difficult drug to control dosage due to its long half-life, toxicity, and narrow therapeutic window. Mitotane can accumulate in adipose tissue, which becomes its main reservoir, thus lengthening the half-life, which can increase from 18 to 159 days with gradual release from primary accumulation sites. In connection with this feature, even with the same daily dose, the concentration of the drug in the blood may increase, which dictates the need for its monitoring and constant dose adjustment. The most effective effect on the tumor with an acceptable degree of toxicity was observed at the concentration range of mitotane in serum/plasma from 14 to 20 μg/ml. Levels above 20 µg/ml increase the risk of severe side effects (including gastrointestinal and neurological), with no further benefit in terms of efficacy. Achieving the target concentration of mitotane does not always depend on the current dose of the drug, but is more determined by the cumulative dose, which is associated with its long half-life.

Dosage adjustment does not result in an immediate change in plasma drug levels.

Dose selection is based on control of drug concentration in the blood and its clinical tolerability until reaching the therapeutic range.

Dose increases are carried out gradually, target concentrations are usually reached within 3-5 months.

In accordance with the Clinical guidelines “Adrenocortical cancer” (Ministry of Health of the Russian Federation, 2018), it is necessary to assess the level of mitotane in the blood: every 4-8 weeks until the target zone is reached; upon reaching it – every three months for two years, then at longer intervals, as well as in the event of side effects.

According to the recommendations of the drug manufacturers, when selecting the dosage, the achieved blood concentration should be monitored frequently, for example, after each dose change until the optimal therapeutic values ​​​​are reached, and also regularly and after they are reached, for example, monthly. Monitoring may also be appropriate after discontinuation of therapy (for example, at intervals of two months), since due to the long half-life in the blood, significant concentrations of the drug may persist for a long time. More frequent monitoring of achieved concentrations is recommended in the treatment of patients with overweight or recent weight loss (for example, every two weeks).

What is the purpose of determining the level of mitotane in blood plasma

The test is used for the purpose of drug monitoring during chemotherapy of adrenocortical cancer using mitotane.

Insulin

Insulin is a hormone secreted by the endocrine part of the pancreas. It regulates the metabolism of carbohydrates, maintaining blood glucose at the required level, and also participates in the metabolism of fats (lipids).

Synonyms Russian

Pancreatic hormone, regulator of carbohydrate metabolism.

Synonyms English

Insulin.

Test method

Immunochemiluminescent assay.

Detection range: 0.2 – 1000 mcd/ml.

Units

Mq/mL (micro unit per milliliter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for an examination?

• Do not eat within 12 hours before the study.
• Completely exclude the use of drugs the day before the study (as agreed with the doctor).
• Do not smoke for 3 hours prior to the study.

General information about the study

Insulin is synthesized in the beta cells of the endocrine part of the pancreas. Its concentration in the blood directly depends on the concentration of glucose: after a meal, a large amount of glucose enters the blood, in response to this, the pancreas secretes insulin, which triggers the mechanisms for moving glucose from the blood to the cells of tissues and organs. Insulin also regulates biochemical processes in the liver: if there is a lot of glucose, the liver begins to store it in the form of glycogen (glucose polymer) or use it for the synthesis of fatty acids. When insulin synthesis is impaired and less than necessary is produced, glucose cannot enter the cells of the body. Cells begin to lack the main substrate they need to generate energy – glucose, since it remains in the blood, hyperglycemia develops. If such a condition is chronic, then metabolism is disturbed and pathologies of the kidneys, cardiovascular, nervous systems begin to develop, vision suffers. A disease in which there is a lack of insulin production is called diabetes mellitus. It comes in several types. In particular, type one develops when the pancreas does not produce enough insulin, type two is associated with a loss of cell sensitivity to insulin. The second type is the most common. For the treatment of diabetes in the initial stages, a special diet and drugs are usually used, which either increase the production of insulin by the pancreas, or stimulate the cells of the body to consume glucose by increasing their sensitivity to this hormone. In the event that the pancreas completely ceases to produce insulin, its administration with injections is required. An increased concentration of insulin in the blood is called hyperinsulinemia. At the same time, the content of glucose in the blood drops sharply, which can lead to hypoglycemic coma and even death, since the work of the brain directly depends on the concentration of glucose. Therefore, it is very important to control glucose levels during parenteral administration of insulin preparations and other drugs used to treat diabetes. Elevated levels of insulin in the blood can also be caused by a tumor that secretes it in large quantities – an insulinoma. With it, the concentration of insulin in the blood can increase tenfold in a short time. Diseases associated with the development of diabetes mellitus: metabolic syndrome, pathology of the adrenal and pituitary glands, polycystic ovary syndrome.

What is research used for?

• For diagnosing insulin (tumors of the pancreas) and to determine the causes of acute or chronic hypoglycemia (together with glucose and C-peptide tests).
• To monitor endogenous insulin produced by beta cells.
• For the detection of insulin resistance.
• To find out when patients with type 2 diabetes should start taking insulin or hypoglycemic drugs.

When is the examination scheduled?

• Low blood glucose and/or symptoms of hypoglycemia: sweating, palpitations, regular hunger, blurred consciousness, blurred vision, dizziness, weakness, heart attacks.
• If necessary, find out whether the insulinoma was successfully removed, as well as diagnose possible relapses in time.
• When monitoring the results of islet cell transplantation (by determining the ability of transplants to produce insulin).

What do the results mean?

Reference values: 2.6 – 24.9 mcw/ml.

Causes of elevated insulin levels:

• acromegaly,
• Itsenko-Cushing syndrome,
• fructose or glucose-galactose intolerance,
• insulinoma,
• obesity,
• insulin resistance, as in chronic pancreatitis (including cystic fibrosis) and pancreatic cancer.

What can influence the result?

The use of drugs such as corticosteroids, levodopa, oral contraceptives, increases the concentration of glucose.

Important Notes

• Currently, biochemically synthesized insulin is used as an injection, which makes it most similar in structure and properties to endogenous (produced in the body) insulin.