What are liver enzymes and why are they important. How does an ALT blood test work. What can cause elevated ALT levels. What are the symptoms of high ALT.

The Role of Liver Enzymes in Body Function

Liver enzymes play a crucial role in maintaining overall health and proper bodily functions. These specialized proteins are primarily produced by the liver and assist in various metabolic processes. Understanding the significance of liver enzymes, particularly ALT (Alanine Transferase), is essential for monitoring liver health and detecting potential issues early on.

Key Liver Enzymes and Their Functions

There are three main liver enzymes that medical professionals focus on when assessing liver health:

• Alkaline Phosphatase (ALP)
• Alanine Transferase (ALT)
• Gamma-Glutamyl Transpeptidase (GGT)

Each of these enzymes serves a specific purpose in the body and can provide valuable insights into liver function when measured through blood tests.

Alanine Transferase (ALT): A Key Indicator of Liver Health

Alanine Transferase, commonly known as ALT, is an enzyme primarily found in liver cells. It plays a vital role in protein metabolism and is considered one of the most important markers for liver function.

The Function of ALT in the Body

ALT is instrumental in breaking down proteins, facilitating their absorption by the body. This process is crucial for maintaining proper metabolism and overall health. When liver cells are damaged or die, ALT is released into the bloodstream, which is why elevated ALT levels can be an indicator of liver issues.

Normal ALT Levels and What They Mean

In healthy individuals, ALT levels in the blood are typically low. The normal range can vary slightly between laboratories, but generally, it falls between 7 to 56 units per liter (U/L) for men and 7 to 45 U/L for women. However, it’s important to note that what’s considered “normal” can depend on factors such as age, gender, and overall health status.

Causes of Elevated ALT Levels

Increased ALT levels in the blood can be a sign of liver damage or disease. There are various factors that can lead to elevated ALT:

• Hepatitis (viral or alcoholic)
• Fatty liver disease
• Liver cirrhosis
• Certain medications
• Excessive alcohol consumption
• Obesity
• Muscle damage or intense exercise

It’s worth noting that ALT levels can sometimes be temporarily elevated due to short-term factors, which is why doctors often recommend retesting to confirm persistent elevation before making a diagnosis.

Symptoms Associated with High ALT Levels

One of the challenges with liver issues is that they often don’t present obvious symptoms in the early stages. This is why regular blood tests, including ALT measurements, are crucial for early detection of liver problems.

Common Symptoms of Liver Damage

When liver damage progresses, individuals may experience the following symptoms:

• Jaundice (yellowing of skin and eyes)
• Itching
• Nausea and vomiting
• Fatigue
• Unexplained weight loss
• Swelling around eyes, stomach, or legs

If you experience any of these symptoms, especially in combination with known risk factors for liver disease, it’s important to consult a healthcare professional promptly.

The ALT Blood Test: Procedure and Interpretation

The ALT blood test is a simple and straightforward procedure that provides valuable information about liver health. Understanding how the test works and what the results mean can help individuals take a more active role in their health management.

How is the ALT Blood Test Performed?

The ALT test is typically part of a comprehensive metabolic panel or liver function test. Here’s what you can expect during the procedure:

1. A healthcare professional will clean an area on your arm with an antiseptic.
2. A small needle will be inserted into a vein to draw a blood sample.
3. The sample is collected in a vial or tube.
4. The needle is removed, and the puncture site is covered with a bandage.
5. The blood sample is sent to a laboratory for analysis.

The entire process usually takes just a few minutes and causes minimal discomfort.

Interpreting ALT Test Results

When you receive your ALT test results, they will typically be presented as a number representing the units of enzyme per liter of blood (U/L). Here’s a general guide to interpreting these results:

• Normal range: 7-56 U/L for men, 7-45 U/L for women
• Mildly elevated: 2-3 times the upper limit of normal
• Moderately elevated: 3-20 times the upper limit of normal
• Severely elevated: More than 20 times the upper limit of normal

It’s important to remember that slightly elevated ALT levels don’t always indicate a serious problem. Your doctor will consider your results in the context of your overall health, other test results, and any symptoms you may be experiencing.

Other Important Liver Enzymes: ALP and GGT

While ALT is a crucial marker for liver health, other enzymes like Alkaline Phosphatase (ALP) and Gamma-Glutamyl Transpeptidase (GGT) also play important roles in assessing liver function. Understanding these enzymes can provide a more comprehensive picture of liver health.

Alkaline Phosphatase (ALP)

ALP is an enzyme found in several organs, including the liver, bones, and intestines. In the context of liver health, elevated ALP levels can indicate:

• Liver inflammation
• Gallbladder issues
• Bone diseases
• Certain types of cancer

ALP levels can also be affected by pregnancy, certain medications, and bone growth in children and adolescents.

Gamma-Glutamyl Transpeptidase (GGT)

GGT is primarily found in the liver and is particularly sensitive to alcohol consumption. Elevated GGT levels can be indicative of:

• Liver disease
• Bile duct obstruction
• Pancreatic disease
• Excessive alcohol consumption

GGT is often used in conjunction with other liver enzymes to provide a more accurate picture of liver health and to help identify the underlying cause of liver issues.

Lifestyle Factors Affecting Liver Enzyme Levels

Various lifestyle factors can influence liver enzyme levels, particularly ALT. Understanding these factors can help individuals make informed decisions about their health and potentially prevent liver damage.

Diet and Nutrition

A balanced diet plays a crucial role in maintaining liver health. Some dietary factors that can affect liver enzyme levels include:

• Excessive sugar and refined carbohydrate intake
• High consumption of saturated and trans fats
• Inadequate intake of fruits and vegetables
• Excessive calorie intake leading to obesity

Adopting a liver-friendly diet rich in fruits, vegetables, whole grains, and lean proteins can help maintain healthy liver enzyme levels.

Physical Activity

Regular exercise is generally beneficial for liver health, but intense physical activity can temporarily elevate ALT levels. This is due to muscle breakdown rather than liver damage. It’s important for healthcare providers to consider recent physical activity when interpreting ALT test results.

Alcohol Consumption

Excessive alcohol intake is one of the most common causes of elevated liver enzymes. Even moderate alcohol consumption can affect liver enzyme levels in some individuals. Limiting alcohol intake or abstaining completely can help maintain healthy liver function.

Prevention and Management of Elevated Liver Enzymes

Taking proactive steps to maintain liver health can help prevent elevated liver enzymes and associated health issues. Here are some strategies to consider:

Lifestyle Modifications

• Maintain a healthy weight
• Exercise regularly
• Limit alcohol consumption
• Avoid unnecessary medications
• Practice safe sex and avoid sharing needles to prevent viral hepatitis

Dietary Changes

Adopting a liver-friendly diet can significantly impact liver health. Consider incorporating the following into your diet:

• Leafy green vegetables
• Berries and other antioxidant-rich fruits
• Fatty fish high in omega-3 fatty acids
• Nuts and seeds
• Whole grains

Simultaneously, it’s important to reduce intake of processed foods, sugary drinks, and excessive amounts of red meat.

Regular Health Check-ups

Regular medical check-ups, including liver function tests, can help detect potential liver issues early. This is particularly important for individuals with risk factors for liver disease, such as a family history of liver problems, obesity, or a history of alcohol abuse.

When to Seek Medical Attention

While mildly elevated liver enzymes may not always indicate a serious problem, there are situations where prompt medical attention is necessary. Consider seeking medical help if you experience:

• Persistent fatigue or weakness
• Yellowing of the skin or eyes (jaundice)
• Abdominal pain or swelling
• Dark urine or pale stools
• Unexplained weight loss
• Nausea or vomiting

Additionally, if you have known risk factors for liver disease and experience any unusual symptoms, it’s advisable to consult with a healthcare professional.

Follow-up Testing and Monitoring

If initial liver function tests reveal elevated enzyme levels, your doctor may recommend follow-up testing to determine the underlying cause and monitor your liver health over time. This may include:

• Repeat blood tests
• Imaging studies such as ultrasound or CT scan
• Liver biopsy in some cases

Consistent monitoring and appropriate interventions can help manage liver enzyme levels and prevent progression of liver disease.

Future Developments in Liver Health Assessment

As medical research advances, new methods for assessing liver health are being developed. These innovations may provide more accurate and comprehensive insights into liver function and disease progression.

Non-invasive Liver Fibrosis Tests

Researchers are developing non-invasive tests to assess liver fibrosis, which could potentially reduce the need for liver biopsies. These include:

• Transient elastography (FibroScan)
• Magnetic resonance elastography
• Serum biomarker panels

These technologies aim to provide more detailed information about liver health without the risks associated with invasive procedures.

Personalized Medicine Approaches

Advances in genetic testing and biomarker discovery may lead to more personalized approaches to liver health assessment and treatment. This could involve:

• Genetic risk profiling for liver diseases
• Tailored treatment plans based on individual genetic and metabolic profiles
• More accurate prediction of disease progression and treatment response

These developments hold promise for improving the diagnosis, management, and prevention of liver diseases in the future.

R Factor for Liver Injury

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The principal investigators of the study request that you use the official version of the modified score here.

INSTRUCTIONS

Use the first lab values (ALT and ALP) indicating acute liver injury to calculate the R factor.

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Dr. Christian Bénichou

Christian Bénichou, MD, (d. 1999) was a rheumatologist and advocate for drug safety. He served as the head of drug safety at Roussel Uclaf in France, expert reviewer for the World Health Organization’s Uppsala Monitoring Centre, and on all drug safety working groups for the Council for International Organizations of Medical Sciences (CIOMS). Dr. Bénichou’s research interests were primarily monitoring of drug safety.

To view Dr. Christian Bénichou’s publications, visit PubMed

Content Contributors
• Zaid Tafesh, MD
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Dr. Christian Bénichou

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• Zaid Tafesh, MD

what they do and how to test them

Your liver, an organ found in your abdomen, produces a variety of enzymes to help it carry out its many functions. Measuring your liver enzymes is a useful way to check your liver function and health. A blood test is used to test your liver health and liver enzymes.

What are liver enzymes?

Measuring your liver enzymes is a useful way to check your liver health. There are 3 main liver enzymes:

• alkaline phosphatase (ALP) 
• alanine transferase (ALT) 
• gamma-glutamyl transpeptidase (GGT) 

What is alanine transferase (ALT)? 

Alanine transferase (ALT) is an enzyme found mainly in your liver. ALT is sometimes called alanine transaminase, alanine aminotransferase, or serum glutamic-pyruvic transaminase (SGPT). 

What is the function of ALT?

ALT helps break down proteins so your body can absorb them — so it’s important for your metabolism. 

What can cause your ALT levels to change?

Levels of ALT in the blood are normally quite low, as it’s mostly found in liver cells. So high ALT levels in your blood can be a sign of liver damage.

What are the most common symptoms?

High ALT levels often happen before symptoms of liver damage are obvious. So it’s a good way to check for early signs of damage.

Some common symptoms for high ALT can include: 

• jaundice — yellow skin and eyes 
• itching
• nausea and vomiting 
• tiredness 
• unexplained weight loss
• swelling around your eyes, stomach, or legs

What is alkaline phosphatase (ALP)

Alkaline phosphatase (ALP) is an enzyme produced mainly by your liver. It’s also found in your bones, pancreas, and small intestine. An ALP blood test can help check that your liver and gallbladder are functioning properly.

What is the function of ALP?

Like ALT, ALP is important for your metabolism, as it helps break down proteins so your body can absorb them.

What can cause your ALP levels to change?

High ALP levels can be a sign of liver inflammation, damage to your gallbladder, or bone disease due to very low vitamin D levels. Low ALP levels are very rare but can be a sign that you’re not absorbing food properly — for example, if you have inflammatory bowel disease (IBD) or coeliac disease.

What are the most common symptoms of high ALP?

If your ALP levels are high as a result of liver damage, common symptoms include: 

• jaundice — yellow skin and eyes
• nausea and vomiting
• abdominal pain

High ALP might also indicate bone problems — symptoms might include bone pain and an increased risk of fractures.

What is gamma-glutamyl transpeptidase (GGT)

Gamma-glutamyl transpeptidase (GGT) is an enzyme found mainly in your liver, but also in your kidney, gallbladder, and pancreas. 

What is the function of GGT?

Like other liver enzymes, GGT also helps to break down protein. But its main function is moving other molecules around your body — playing a key role in helping your liver break down drugs and toxins.

What can cause your GGT levels to change?

High GGT levels can be a sign of liver damage or disease. If you drink too much alcohol, your GGT levels usually increase. Some drugs, including antibiotics and NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen, can also increase your levels.

What are the most common symptoms of high GGT?

If your GGT levels are high as a result of liver damage, common symptoms include: 

• jaundice — yellow skin and eyes 
• itching 
• nausea and vomiting
• tiredness
• unexplained weight loss 
• swelling around your eyes, stomach, or legs

How to test liver enzymes

You can test your liver enzymes with a liver blood test (previously known as a liver function blood test or LFT).

This test can’t formally diagnose or rule out any liver disease without further investigation from your GP or full medical context.

This means that the blood count for any of your liver enzymes measured might be normal even if you have liver disease. But an abnormal count can still occur in a normally functioning liver. 

A liver blood test might be helpful if you:

• have symptoms of fatigue and nausea
• have an eating disorder — like anorexia
• drink more than 14 units of alcohol a week
• are worried about fatty liver disease

When doing this blood test, one of our reporting GPs will review your:

• previous liver blood test results (if you have any)
• health profile 
• body mass index (BMI)
• alcohol consumption
• diet

These factors will give an understanding of how likely you are to develop liver disease .

What if you have abnormal liver enzyme results?

Mild to moderate abnormalities in liver enzymes are commonly associated with: 

• non-alcoholic fatty liver disease
• alcohol-related liver disease — for example, you might have elevated gamma-glutamyl transpeptidase (GGT) levels
• certain medication — like some antibiotics, anti-epileptic drugs, and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, to name a few
• infections like hepatitis B and C

If your liver blood test results are abnormal, we recommend following them up with a healthcare professional. They will investigate your results further to help rule out or diagnose liver disease. 

The National Institute for Health and Care Excellence (NICE) recommend a FibroScan if you drink more than 50 units of alcohol a week for men, or 35 units or more a week for women. 

How to lower liver enzyme levels

A healthy lifestyle can help to lower raised liver enzymes levels caused by liver damage. This includes avoiding too much:

• saturated and trans fats — like fried foods, red meat, cakes, pastries, and cream 
• refined carbohydrates — like white bread and white pasta 
• added sugars — like fruit juices, fizzy drinks, and sweets 
• salt — like frozen foods, salted nuts, and smoked or cured meats 
• alcohol — limit to 14 units a week (equivalent to about 6 pints or 7 medium-sized glasses of wine)

price, take an analysis in Moscow and Moscow Region – SmartLab MEDSI

A blood test with ALT (alanine aminotransferase) is performed to assess acute and chronic liver pathologies. In blood serum, the indicator is detected using a UV kinetic test.

Biological material : blood (venous).

ALT is an enzyme found in all cells of the human body. Most of its concentration is observed in the liver and kidneys. Normal enzymatic activity of ALT
reduced. The indicator can increase even before the manifestation of an obvious clinical picture of the disease (including jaundice).

Important! Regular examinations are necessary for patients who are treated for hepatitis and other liver diseases.

What can influence the result?

The level of ALT in the body can increase with:

• intense physical activity
• intramuscular administration of drugs
• taking dietary supplements
• fast food abuse

Important! The interpretation of the analysis is carried out only by a doctor. If necessary, the patient is referred for other examinations (including instrumental and functional).

We recommend that you consult a doctor and have a checkup.

Important! ALT and AST are often compared with each other.
(aspartate aminotransferase). In most liver pathologies, the activity of the first exceeds the activity of the second.

Additional tests

Additionally, the patient may be referred for testing to determine indicators such as:

• AST
• Total alkaline phosphatase
• Serum albumin
• Gamma GT

Which doctors refer for ALT analysis?

A referral for an examination is usually issued by an internist or general practitioner, hematologist, gastroenterologist, infectious disease specialist, endocrinologist or surgeon.

MEDSI takes care of its patients

• Experienced specialists. They conduct research professionally
  biological material, which guarantees the accuracy of diagnostics.
• Comfortable conditions for testing. You can take the test throughout the day.
  The results will be available in your personal account.
• Modern laboratory equipment. It corresponds to a high European and global level. Equipment used in the laboratory
  such leading manufacturers as Beckman Coulter, Siemens, Ortho Clinical
  Diagnostics, Thermo Fisher, Sysmex, BD. In all areas of testing and
  assessment of biomaterial are the latest devices to ensure
  high-level/high-precision diagnostics.
• Regular maintenance of equipment and automation of research processes. All analytical units are serviced and meet quality standards. All processes are automated as much as possible and
  built in accordance with LEAN-management. This allows the laboratory to control processes, minimize time and errors in the production of analyzes.
• Automation of the sorting process of biomaterials. Preliminary
  identification of the biomaterial is carried out with the patient. Eliminate the probability
  lost test tubes.
• The shortest processing times for materials. They are provided with modern equipment and experienced specialists.
• It is possible to undergo a comprehensive examination. This provides a fast, accurate diagnosis.

To make an appointment with a doctor and clarify the conditions for taking an analysis (including
cost) call +7 (495) 7 800 500. Our specialist will answer
questions and suggest the best time to visit the clinic. Also, registration and payment for services is possible through the SmartMed application.

• On an empty stomach (not earlier than 8 hours after the last meal).
• You can drink water.

Testing is recommended :

• in order to diagnose liver damage in viral and toxic hepatitis
• to assess the condition of patients with hepatitis
• for the control of patients who take hepatotoxic drugs for a long time
• to evaluate the effectiveness of the treatment of liver diseases

ALT analysis is important in the following cases :

• Liver disease or symptoms that include: yellowing of the whites of the eyes
  and skin, weakness and fatigue, abdominal pain and bloating,
  nausea and vomiting, loss of appetite, itchy skin.
• When changing the color of urine (darkening) and lightening the feces.
• At increased risk of liver disease due to: abuse
  alcohol, previous hepatitis, contact with an infected person,
  hereditary predisposition, diabetes, overweight, regular
  taking medications that damage the liver.

Age (in years)	Floor	Reference values ​​(in U/L)
0-1	any	to 56
over 1	men	to 50
over 1	women	to 35

Important! ALT and AST (aspartate aminotransferase) are often compared with each other. In most liver pathologies, the activity of the first exceeds the activity of the second.

Service: Alanine aminotransferase (ALT)

Price: 370

Biochemical blood tests – ALT (ALT, alanine aminotransferase) near the house

Paracelsus Medical Center

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Alanine aminotransferase (ALT) is an enzyme found mainly in liver and kidney cells and in markedly smaller amounts in heart and muscle cells. In healthy people, activity in the blood is low, the ALT norm has low values. When cells in the liver tissue are damaged, ALT is released into the bloodstream, usually before symptoms such as jaundice appear. In this regard, the activity of this enzyme is used as an indicator of liver damage. Together with other studies that perform the same tasks, the analysis for ALT is part of the so-called liver tests.

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

A number of diseases lead to damage to liver cells, which contributes to an increase in ALT activity.

The most common test for ALT is to check if the liver is damaged by hepatitis and taking drugs or other substances that are toxic to this organ. However, ALT does not always reflect only liver damage; the activity of this enzyme can also increase in diseases of other organs.

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 identify the causes of liver damage.

For an examination in our multidisciplinary clinic “Paracelsus” in Yekaterinburg at an affordable price, you can make an appointment with us online or by phone +7 (343) 272-03-03.

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Dear patients!
Multidisciplinary Clinic and Maternity Hospital “Paracelsus” informs you, according to the Letter of the Ministry of Finance of the Russian Federation to the Federal Tax Service dated March 25, 2022. N BS-4-11 / 3605, that subparagraph 3 of paragraph 1 of Article 219 of the Tax Code of the Russian Federation provides for the taxpayer’s right to receive a social tax deduction in the amount paid by him in the tax period for medical services provided by medical organizations engaged in medical activities , him, his spouse, parents, children (including adopted children) under the age of 18, wards under the age of 18 (in accordance with the list of medical services approved by the Government of the Russian Federation).

Joint order of the Ministry of Taxation of Russia and the Ministry of Health of Russia of July 25, 2001 N 289 / BG-3-04 / 256 (hereinafter – the order of July 25, 2001) approved the form of the Certificate of payment for medical services for submission to the tax authorities of the Russian Federation (hereinafter – the Certificate payment for medical services).

This certificate certifies the fact of receiving a medical service and its payment through the cash desk of a healthcare institution at the expense of the taxpayer.