What are normal AST levels in blood tests. How do high AST levels impact liver health. What causes elevated AST levels in the bloodstream. When should doctors order AST blood tests. How do AST and ALT tests work together to assess liver function.

The Significance of AST in Blood Tests

Aspartate aminotransferase (AST) is an enzyme primarily found in the liver, but also present in other organs such as the kidneys, heart, and muscles. An AST blood test measures the levels of this enzyme in the bloodstream, serving as a crucial indicator of liver function. When liver cells are damaged, AST is released into the blood, resulting in elevated levels that can signal potential liver problems.

Understanding AST test results is essential for assessing liver health, but it’s important to note that normal ranges can vary depending on factors such as age, sex, weight, and race. Additionally, different laboratories may use varying testing methods, so it’s crucial to consider the specific reference range provided with your test results.

What are the typical AST level ranges?

While exact ranges may differ, general guidelines for AST levels are as follows:

• Adults: Normal range is typically 10-40 IU/L
• Children: Normal range is generally below 40 IU/L
• High levels: Above 36 U/L for adults, or above 40 IU/L for children
• Very high levels: Above 1,000 U/L, which may indicate severe liver injury or hepatitis

It’s important to remember that these ranges are general guidelines, and individual results should always be interpreted by a healthcare professional in the context of a person’s overall health and other test results.

Interpreting Elevated AST Levels

High AST levels in blood tests can be indicative of various health issues, primarily related to liver function. However, it’s crucial to understand that elevated AST alone doesn’t necessarily confirm a liver problem. Healthcare providers often consider AST results in conjunction with other liver enzyme tests and clinical symptoms to make accurate diagnoses.

What health conditions can cause high AST levels?

Elevated AST levels may be associated with several conditions, including:

• Chronic hepatitis
• Alcohol-induced liver damage
• Cholestasis (decreased bile flow)
• Heart, kidney, bone, or muscle damage
• Liver cancer
• Liver cirrhosis (scarring)
• Acute hepatitis (very high AST levels)

It’s important to note that high AST levels can sometimes occur in individuals with normal liver function due to factors such as age, sex, race, or certain medications. Always consult with a healthcare provider to interpret your specific test results accurately.

The Relationship Between AST and ALT

When assessing liver health, doctors often consider AST levels in conjunction with another liver enzyme called alanine aminotransferase (ALT). Understanding the relationship between these two enzymes can provide valuable insights into the nature and extent of potential liver issues.

How do AST and ALT levels compare in liver function assessment?

ALT is more specific to the liver than AST, which is also found in other organs. When comparing AST and ALT levels:

• If ALT levels are normal but AST levels are high, it may indicate a health problem outside the liver or alcohol-induced liver damage.
• If both AST and ALT levels are elevated, it often suggests a liver-specific issue.
• The ratio of AST to ALT can sometimes help differentiate between various liver conditions.

Healthcare providers use these enzyme levels, along with other clinical information, to form a comprehensive picture of liver health and function.

Low AST Levels: What They Mean

While much attention is given to high AST levels, low levels of this enzyme can also be significant. Although less common, low AST levels may indicate certain health conditions that warrant further investigation.

Which conditions can lead to low AST levels?

Low AST levels in blood tests may be associated with:

• Vitamin B6 deficiency
• Kidney disease
• Advanced liver disease or cirrhosis
• Certain types of cancer
• Autoimmune conditions
• Genetic conditions affecting enzyme production

It’s important to note that low AST levels alone are not typically a cause for immediate concern. Healthcare providers will consider these results in the context of other tests and clinical symptoms to determine if further investigation is necessary.

When to Undergo an AST Blood Test

AST blood tests play a crucial role in screening, diagnosis, and monitoring of liver health. Understanding when these tests are recommended can help individuals take proactive steps in managing their overall health.

In which situations do doctors typically order AST blood tests?

Healthcare providers may recommend an AST test in the following scenarios:

1. Screening for liver disease in individuals with risk factors such as:
   • Family history of liver problems
   • Obesity
   • Diabetes
2. Investigating symptoms that may indicate liver issues, including:
   • Jaundice (yellowing of skin or eyes)
   • Unexplained fatigue
   • Unexplained weight loss
3. Monitoring the effectiveness of treatment for existing liver conditions
4. Assessing overall liver health as part of a comprehensive health check-up

Regular AST testing can help detect liver problems early, allowing for timely intervention and potentially better health outcomes.

The AST Blood Test Procedure

Understanding what to expect during an AST blood test can help alleviate any anxiety associated with the procedure. The test is generally straightforward and similar to other routine blood tests.

What steps are involved in an AST blood test?

The typical procedure for an AST blood test includes the following steps:

1. The patient is seated comfortably, and a healthcare professional ties an elastic band around the upper arm to increase blood flow.
2. The site of the blood draw is cleaned with an antiseptic wipe to prevent infection.
3. A needle is carefully inserted into a vein in the arm. Patients may feel a mild prick or slight pain during this step.
4. Once the required amount of blood is collected, the needle is removed, and pressure is applied to the site to stop any bleeding.
5. The blood sample is then sent to a laboratory for analysis.

The entire process usually takes only a few minutes, and most people experience minimal discomfort. After the test, patients can typically resume their normal activities immediately.

Factors Influencing AST Levels

While AST levels are primarily used to assess liver health, it’s important to understand that various factors can influence these enzyme levels. Being aware of these factors can help in the accurate interpretation of test results and prevent unnecessary concern.

Which factors can affect AST levels besides liver health?

Several factors can impact AST levels in the blood, including:

• Age: AST levels can naturally increase with age
• Sex: Men typically have slightly higher AST levels than women
• Body mass: Obesity can lead to increased AST levels
• Exercise: Intense physical activity can temporarily elevate AST levels
• Medications: Certain drugs, including some antibiotics and statins, can affect AST levels
• Alcohol consumption: Regular or excessive alcohol intake can increase AST levels
• Muscle injuries: Damage to muscle tissue can release AST into the bloodstream
• Diet: Some studies suggest that dietary factors may influence AST levels

Healthcare providers take these factors into account when interpreting AST test results, often considering them alongside other liver function tests and clinical information to form a comprehensive assessment of liver health.

Beyond Liver Health: Other Uses of AST Tests

While AST tests are primarily associated with liver function, their utility extends beyond hepatic health assessment. Understanding the broader applications of AST testing can provide insights into its importance in overall health evaluation.

How are AST tests used to assess non-liver conditions?

AST tests can be valuable in evaluating various non-liver conditions, including:

• Heart health: Elevated AST levels can indicate heart muscle damage, such as in myocardial infarction (heart attack)
• Muscle disorders: Conditions affecting skeletal muscles, like muscular dystrophy, can lead to increased AST levels
• Kidney function: In some cases, kidney problems may be associated with changes in AST levels
• Pancreatitis: Inflammation of the pancreas can sometimes cause elevated AST levels
• Celiac disease: This autoimmune condition can occasionally lead to increased AST levels
• Hemolytic anemia: The breakdown of red blood cells in this condition can release AST into the bloodstream

In these cases, AST levels are typically considered alongside other specific tests and clinical symptoms to reach accurate diagnoses and guide treatment decisions.

As we delve deeper into the complexities of AST blood tests, it becomes clear that these enzyme measurements play a crucial role in assessing not just liver health, but overall bodily function. The interpretation of AST levels requires a nuanced understanding of various factors and should always be done in conjunction with other clinical data. Regular monitoring of AST levels, especially for individuals with risk factors for liver disease, can be an essential part of maintaining long-term health and catching potential issues early. As medical science continues to advance, our understanding of AST and its implications in various health conditions is likely to expand, further enhancing its value as a diagnostic and monitoring tool.

High and low levels, and what do results mean

An AST blood test measures levels of aspartate aminotransferase (AST) and helps determine liver function. Too much of this enzyme can indicate a problem, such as liver damage.

Aspartate aminotransferase (AST) is an enzyme mostly found in the liver. AST is also present in other parts of the body, including the:

• kidneys
• heart
• muscles

Another name for the AST enzyme is serum glutamic-oxaloacetic transaminase (SGOT).

Most people have low levels of the AST enzyme. Damage to liver cells can cause the release of extra AST into the blood though, leading to higher levels of the enzyme.

After taking a blood test, doctors will classify AST ranges as normal, high, or low. Laboratories may use different testing methods for analyzing samples, so normal ranges can vary between each laboratory.

There is not an exact range for AST levels, as levels can vary among people and still be normal. AST levels can vary depending on factors such as:

• age
• sex
• weight
• race

The measurements for AST levels are typically in units per liter (U/L) or international units per liter (IU/L). On a test result, the laboratory will usually list their specific reference range.

People will need to look at this reference range and discuss with their doctor what their test results mean for them. To understand the results of an AST blood test, a doctor will also look at other enzymes that can indicate a liver problem.

The following table indicates general AST blood test ranges. However, reference ranges can vary slightly among different laboratories.

Results from an AST blood test can help indicate liver health.

If AST levels are high, it may also be a sign of:

• chronic hepatitis
• damage from alcohol
• cholestasis, a decrease in bile flow
• heart, kidney, bone, or muscle damage
• liver cancers
• liver scarring, known as liver cirrhosis

Very high AST levels are usually a sign of progressing liver damage, often due to acute hepatitis.

Low AST levels may indicate:

• vitamin B6 deficiency
• kidney disease
• liver disease
• cirrhosis
• cancer
• autoimmune conditions
• genetic conditions

A doctor may also test levels of alanine aminotransferase (ALT), another liver enzyme. ALT levels occur in higher concentrations in the liver.

If ALT levels are normal but AST levels are high, it could indicate a health problem outside of the liver, or it may be a sign of alcohol-induced liver damage.

Having high levels of AST and no other signs of a problem is not necessarily a cause for concern. People with normal liver function can have high AST levels, which may be due to:

• age
• sex
• race
• certain medications

A person should always discuss any medications or health products they take with a doctor.

Doctors primarily use the AST blood test to check for and assess liver problems, usually alongside other liver tests. The AST protein mainly occurs in the liver and heart. With liver damage, AST can leak from the liver into the bloodstream. When this happens, AST levels in the blood will be higher than normal.

AST also occurs in the brain, heart, kidneys, and muscles. If there is damage in any of these areas, AST levels may also increase.

To rule out issues affecting areas outside the liver, doctors may order a check of the second liver enzyme, ALT, at the same time. If both levels are high, it may indicate a problem with a person’s liver. If only AST levels are high, this may indicate a problem with another organ or system.

People may have an AST test for screening, diagnosis, or monitoring purposes. A doctor may recommend this test if a person:

• has risk factors for liver disease, such as family history, obesity, or diabetes
• has symptoms of a liver problem, such as jaundice, fatigue, or unexplained weight loss
• is undergoing treatment for a liver condition, as an AST blood test can help show how well treatment is working

Alanine aminotransferase (ALT) is an enzyme that mostly occurs in the liver. If there is damage to liver cells, ALT levels in the bloodstream can increase. An ALT test can help indicate liver health, along with other liver enzyme tests.

Healthcare professionals may use both ALT and AST tests to check for the presence of liver enzymes in the blood, as this can give them a clearer idea of overall liver function and health.

Learn more about the ALT test here.

The AST blood test is straightforward and similar to any other blood test. A healthcare professional may take the following steps:

• sit the person down and tie a stretchy band around the upper arm to increase blood flow to that area
• clean the site of the blood draw with an antiseptic wipe
• insert a needle into a vein in the arm to take a blood sample, which may cause people to feel a mild prick or pain
• remove the needle once they have drawn enough blood
• send the blood sample to a laboratory for testing

An AST blood test will usually only take a few minutes in total.

In some cases, people may be able to take an AST test at home. Using an at-home test kit, people will take a blood sample from their fingertip and send the sample to a laboratory. People may receive AST blood test results through the mail, an app, or an online system.

Learn how long it might take to receive blood test results here.

Preparation

People may need to fast for several hours if they are having a combination of liver enzyme tests.

If people are only having an AST blood test, they may not need to fast or prepare in any way.

People will need to let their doctor know if they are taking any medications or supplements, as some may interfere with liver enzyme levels.

As a healthcare professional will be taking blood from the arm, it may be helpful to wear short sleeves during the test.

As with any blood test, an AST blood test has very few risks. It is rare to experience any severe side effects, but people may have some mild bruising or discomfort in the area at the site of the blood draw.

A healthcare professional will place a Band-Aid or bandage on the arm to stop any bleeding.

People may want to have something to eat after the test, particularly if they were fasting beforehand. It is safe for people to drive and continue their usual activities after an AST blood test, unless they experience any unusual symptoms.

A doctor may order tests along with an AST blood test or follow-up tests. This is to help ensure proper diagnosis and determine the best course of treatment. These tests may include:

• ALT test: A doctor may order an ALT test alongside an AST test.
• Platelet count: Low platelet levels may indicate HELLP syndrome during pregnancy.
• Coagulation panel: This measures the functioning of clotting-related proteins that the liver produces.
• Complete metabolic panel: This assesses how well the kidneys and liver are working and shows levels of electrolytes.
• Bilirubin test: A bilirubin test checks levels of a byproduct created when the liver breaks down red blood cells.
• Glucose test: High or low blood glucose levels may indicate a liver problem.
• Viral testing: This can help doctors check for hepatitis.
• Imaging: A doctor may order images of the liver via ultrasound.

The extent of follow-up testing will depend on a person’s results. A doctor may also take additional blood tests, imaging tests, or a biopsy to identify or rule out any potential conditions relating to abnormal AST levels.

Learn about different types of blood tests here.

An AST blood test, or SGOT test, checks how much AST, a liver enzyme, is present in the blood. High levels of AST in the bloodstream could be a sign of liver damage, or cell damage in another organ such as the heart or kidneys.

Doctors may also take additional tests to check other liver enzymes, such as ALT, to get more information on the health of the liver.

Elevated Liver Enzymes in Children: Symptoms, Diagnosis and Treatment

Nationwide Children’s Hospital

Overview

Causes

Symptoms

Diagnosis

Treatment

Next Steps

What Are Elevated Liver Enzymes in Children?

Enzymes are substances that help speed up chemical reactions. Thousands of enzymes are found in the human body. Every day, these enzymes carry out many jobs that are vital to life.

Two of these enzymes are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). These are also called transaminases. It is normal for children to have small amounts of ALT and AST in the blood. ALT is mostly found in the liver. AST is found in many organs, including the liver, pancreas, muscles, heart and brain. This is important because it means that although we call ALT and AST “liver enzymes”, they usually, but not always come from the liver.

There are other liver enzymes that your doctor may test in the blood, such as alkaline phosphatase (AP) or gamma-glutamyltransferase (GGT), but as tests for liver disease in children, ALT and AST are used most commonly.

Elevated (too high) levels of liver enzymes are a warning sign that something might be harming the liver. This may happen for a variety of reasons. Further tests may be needed to find the exact cause.

What Causes Elevated Liver Enzymes in Children?

Most of the time, elevated liver enzymes are due to conditions that are not dangerous, are easily treatable, or go away on their own. Some common causes include:

• Non-alcoholic fatty liver disease (NAFLD). This is probably the main reason for elevated liver enzymes in children in the U.S. today. Mild forms of this disease are very common; the more serious form that over many years can lead to cirrhosis (scarring) and liver failure is called non-alcoholic steatohepatitis (NASH).
• Certain medicines. Drug-induced liver injury (DILI) is another possibility. Medications that can affect the liver include those for attention-deficit/hyperactivity disorder, such as atomoxetine; antibiotics, such as erythromycin or minocycline; anticonvulsants, such as valproic acid; or products containing acetaminophen. Drug-induced liver injury is often mild, but sometimes it can be severe.
• Viral infections. Many viruses can temporarily increase liver enzyme levels. These include rhinovirus (common cold) or Epstein-Barr virus (EBV), the virus that causes mononucleosis (“Mono”).

Rarely are elevated liver enzymes due to a serious or even life-threatening condition. Some of these less common causes include:

• Autoimmune hepatitis (AIH)
• Hepatitis B and C
• Diseases of the bile ducts, such as biliary atresia, choledochal cyst, or bile duct blockage from a gallstone or from pancreatitis 
• Diseases of other organs, such as celiac disease, a disorder of the intestine (gut) 
• Genetic (inherited) conditions, such as alpha-1 antitrypsin (AAT) deficiency (where a protein gets produced incorrectly and “gets stuck” in the liver), hemochromatosis (too much iron) or Wilson disease (too much copper)

What Are the Symptoms of Elevated Liver Enzymes in a Child?

Many times, childhood liver diseases do not cause obvious symptoms, especially in the early stages. Elevated liver enzymes are often the first sign of liver trouble in children. When symptoms do appear, they may include:

• Jaundice (yellowish skin and eyes)
• Swollen abdomen
• Swelling of arms or legs
• Vomiting or diarrhea
• Black or bloody stools
• Easy bleeding or bruising, or bleeding for longer than usual 
• Pain or swelling in joints
• Unexplained fever 
• Unusual or unexplained rash 

How Are Elevated Liver Enzymes Diagnosed in a Child?

High liver enzymes may show up on a routine blood test during a child’s yearly checkup. A health care provider may also test for elevated liver enzymes when a child is feeling unwell. This is especially true if a child has abdominal pain, vomiting, diarrhea, or jaundice (yellowish color of the eyes or skin).

What Does a Diagnosis of Elevated Liver Enzymes in a Child Mean?

Liver enzyme levels alone are not enough to tell exactly what is wrong with the liver. This is why it is very important to follow up with a child’s health care provider. If high levels of liver enzymes are found, more tests can help determine the cause.

The reason for elevated liver enzymes sometimes appears to be fairly clear. For example, your child’s health care provider may decide that the elevated liver enzymes are probably due to a virus. In these cases, your child’s health care provider may want to wait and see what happens. As the illness clears up, elevated liver enzymes should return to normal levels. 

Seeing a Specialist

It is rare for a primary health care provider to not be able to explain why liver enzymes are elevated. However, occasionally your child’s health care provider may suspect something more serious. If so, a doctor who specializes in liver diseases (hepatologist) can help.

Specialized care starts with taking a careful history, and then a physical exam to check for outward signs of liver disease. Such signs may include jaundice or an enlarged liver or spleen.  

If liver trouble seems likely, additional tests may include:

• Other liver tests to compare levels of ALT and AST with alkaline phosphatase (AP), gamma-glutamyl transpeptidase (GGT), bilirubin, albumin, prothrombin time etc.
• Specialized lab tests to look for specific diseases, such as celiac disease, autoimmune hepatitis, alpha-1 antitrypsin deficiency, Wilson disease, and viruses such as hepatitis B, hepatitis C, EBV or cytomegalovirus (CMV)
• Imaging tests, such as ultrasound, computerized tomography (CT) or magnetic resonance imaging (MRI), to examine the liver, blood vessels, and nearby organs – especially the spleen.
• Liver biopsy (under anesthesia) to remove a tiny piece of the liver that will be examined under a microscope

Once complete, all of these tests help paint a more complete picture of a child’s liver. This can point the way to the correct diagnosis.

How Are Elevated Liver Enzymes Treated in a Child?

Treatment for elevated liver enzymes depends on the cause. Often, elevated liver enzymes will get better without treatment. For example, if a child has a viral infection, liver enzyme levels may go up for a week or two. When the virus goes away, enzyme levels typically return to normal.

In other cases, simple treatments can help. For instance, NAFLD is a common cause of elevated liver enzymes. Weight loss is the main treatment. As the child loses weight, liver enzyme levels and other symptoms of NAFLD improve.

If elevated liver enzymes are due to something more serious, treatment may include medicines, surgery or other medical procedures. 

What Are the Complications of Elevated Liver Enzymes in a Child?

Possible complications of elevated liver enzymes depend on the cause. Most children with elevated liver enzymes do not develop complications. Rarely, children with a serious liver disease may have complications including:

• Cirrhosis (scar tissue in the liver)
• Fluid buildup and swelling in the belly (ascites)
• Severe jaundice 
• Liver failure

Should I Call My Child’s Health Care Provider?

Elevated liver enzymes in children must not be ignored. Liver disease in childhood can be very serious or even life-threatening if not properly treated. Call your child’s health care provider right away if your child’s symptoms get worse or new symptoms show up.

Key Points about Elevated Liver Enzymes in Children

• ALT and AST (liver enzymes or transaminases) are normally present in the body and in the blood.
• Elevated liver enzymes in children are often found during a routine blood test.
• Elevated liver enzymes are a warning sign of possible liver damage, irritation or inflammation.
• Elevated liver enzymes are usually due to common conditions that are easily treated or resolve on their own. 
• Rarely, they may be due to a serious or even life-threatening disease.
• Liver enzyme levels alone are not enough to tell exactly what is wrong with the liver.
• More tests may be needed to find the reason for elevated liver enzymes. 
• Sometimes, no cause for the elevated liver enzymes is found at all; in those cases, the liver enzymes may return to normal on their own.  
• Treatment options vary depending on the cause.

Next Steps

If you have been told your child has elevated liver enzymes, your best source of information is your child’s health care provider. He or she will work with you to give your child the best chance of recovery. Some things you can do to help include:

• Learn all you can about recommended treatments. Ask about the benefits and the downsides.
• Keep all follow-up appointments with your child’s health care provider. 
• Ask if your child should see a liver disease specialist. 
• Ask your child’s health care provider before trying any home remedies or over-the counter medications. 
• If there is any concern about liver disease, we do not recommend any supplements or herbal drugs to “help the liver.” No such thing exists, and some products sold for that purpose can be dangerous and may actually harm the liver.

You Might Also Be Interested In

Condition

Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in American children. NAFLD occurs when too much fat builds up in the liver. Excess fat in the liver and elsewhere in the body makes it harder for the liver to work well. Over time, NAFLD can cause other health issues.

Condition

Liver Failure in Children

Liver failure happens when the liver becomes so sick and damaged that it stops working, either partly or completely. Although this is rare, liver failure can happen even in children. Many of them recover well, but others become extremely ill, and some may need a liver transplant to survive.

Condition

Autoimmune Hepatitis

Autoimmune hepatitis in children is a rare and serious disease of the liver. It happens when something goes wrong with the body’s immune system. In autoimmune hepatitis, the immune system attacks normal liver cells. This causes damage that makes it hard for the liver to work properly.

When the liver goes wrong: a gastroenterologist named 4 common reasons why ALT and AST are elevated in the blood

• Health

However, the growth of these main “liver” markers in the blood test does not always indicate problems.

April 25, 2022

Source:

Getty Images

A biochemical blood test is considered one of the main ways to find out if the liver copes with the load of “wrong” nutrition, alcohol, and medication. This will be told by such indicators in the analysis as ALT (alanine aminotransferase) and AST (aspartate aminotransferase) – these liver enzymes are among the first to respond to malfunctions of the organ.

– If there is an increase in both ALT and AST, this means that the liver cells are destroyed and the enzymes from them enter the blood. (…) An increase in AST and ALT means that an inflammatory process is taking place in the liver and its cells are being destroyed. If the indicators are above the norm, you need to contact a gastroenterologist, – gastroenterologist Maria Lopatina wrote in her telegram channel, adding that the upper limits of the norm may differ in different laboratories and one must focus on those established where the analysis was taken.

The doctor named the 4 most common causes of increased liver values.

Chronic viral hepatitis

With an increase in ALT and AST in the blood, viral hepatitis B and C are always excluded first. This is very important, as they can be asymptomatic, while destroying the liver. Mandatory tests: HBsAg – hepatitis B and Anti-HCV – hepatitis C.

Non-alcoholic fatty liver disease

When fatty liver cells destroy them, ALT and AST in the blood rise and steatohepatitis develops.

Fatty liver disease is suspected if:

• Waist circumference ≥94/≥80 cm in men/women;

• Blood pressure 130/85 mmHg And more, or the person is taking antihypertensive drugs;

• Fasting glucose level of 5.6 mmol/l or more, or the person is taking hypoglycemic drugs;

• Serum triglycerides more than 1.7 mmol/l;

• High-density lipoprotein (HDL) level less than 1.0/1.3 mmol/l in men/women.

Drug-induced liver injury

All drugs that we take by mouth pass through the liver. The more drugs we take, the more likely it is to be damaged. This group includes both herbal preparations and dietary supplements. Liver damage can occur immediately or after several weeks.

Alcohol

According to Russian clinical guidelines, a safe dose for the liver in women is 20 grams of ethanol per day, for men – 40 grams. Regular excess of this dose leads to the development of alcoholic hepatitis and an increase in ALT and AST.

Determining the ethanol content in 100 ml of a drink is very simple: the percentage of alcohol in the drink must be multiplied by 0.8. Thus, 100 ml of 40% vodka contains 40×0.8=32 grams of ethanol, and 100 ml of 12% wine contains 12×0.8=9.6 grams of ethanol.

The doctor specifies that there are other reasons for the increase in ALT and AST in the blood, but these four are the most common.

Read also

When an increase in the indicator is not a cause for alarm

It happens that an increase in the level of “liver” indicators may not be associated with a problem in the work of our main “filter”. According to gastroenterologist Maria Lopatina, this may be the case if only the AST index is elevated.

– AST is found not only in the liver, but also in the heart, muscles, kidneys, brain and pancreas. If AST levels are elevated and ALT is normal, causes that are not related to damage to liver cells should be ruled out. For example, active training for all muscle groups, the doctor clarifies.

But if the liver values ​​are below normal in the blood test, in most cases this is not a cause for serious concern. According to the gastroenterologist, a decrease in their level can occur during pregnancy, starvation and a reduced content of vitamin B6.

What other indicators of a blood test can be used to understand that something is wrong with the liver, read HERE.

Signs of liver problems that can be seen in the mirror

According to doctors, the liver does not hurt in the usual sense of the word, especially at first – specific symptoms of the disease appear when things have gone too far. As the head of the MIBS outpatient department, gastroenterologist Iyri Alaya said, liver diseases are often accompanied by various digestive disorders:

• Increased flatulence;

• Feeling of fullness in the stomach;

• Rapid satiety after eating;

• Loss of appetite;

• Dryness and bitterness in the mouth;

• Attacks of nausea and vomiting;

• Constipation or diarrhoea.

And the most famous sign of liver problems is yellowness of the skin, mucous membranes and sclera, which indicates an increase in the level of bilirubin (bile pigment) in the blood.

Text author: Anastasia Romanova

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Aspartate aminotransferase (AST)

Aspartate aminotransferase (AST) is an enzyme 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-oxaloacetate 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.
• Avoid physical and emotional stress for 30 minutes prior to examination.
• 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

• AST activity may decrease during pregnancy.