What causes high AST and ALT levels in asymptomatic individuals. How should primary care doctors approach patients with elevated liver enzymes. When is further testing necessary for abnormal AST and ALT results.

The Significance of AST and ALT in Liver Health Assessment

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are crucial enzymes that play a vital role in assessing liver health. These enzymes, often referred to as liver enzymes, are typically found inside liver cells. When liver cells are damaged or die, AST and ALT are released into the bloodstream, causing their levels to rise. This makes them valuable markers for detecting liver injury or disease.

AST is present in various tissues, including the liver, heart, and muscles, while ALT is primarily found in the liver. Due to its specificity, elevated ALT levels are generally considered more indicative of liver damage than increased AST levels. Understanding the nuances of these enzymes is crucial for primary care physicians in diagnosing and managing liver-related conditions.

Normal Ranges and Variations

The normal range for ALT is typically between 14 and 63 IU/L, though this can vary slightly between laboratories. It’s important to note that ALT levels can fluctuate naturally:

• Daily variations of 10-30% are common
• Levels can fluctuate up to 45% within a single day, peaking in the afternoon and reaching their lowest at night
• A high body mass index can increase ALT levels by 40-50%

These natural variations underscore the importance of considering multiple factors when interpreting ALT results.

Common Causes of Elevated AST and ALT Levels

Several conditions can lead to increased AST and ALT levels. Understanding these causes is crucial for accurate diagnosis and appropriate management. Some common causes include:

1. Viral hepatitis (e.g., hepatitis A, B, C)
2. Alcoholic liver disease
3. Non-alcoholic fatty liver disease (NAFLD)
4. Drug-induced liver injury
5. Autoimmune hepatitis
6. Hemochromatosis
7. Wilson’s disease
8. Cirrhosis
9. Ischemic liver injury

Each of these conditions has distinct patterns of enzyme elevation and associated symptoms, which can guide diagnosis and treatment.

Viral Hepatitis

In cases of viral hepatitis, ALT levels typically increase before the onset of jaundice and peak near its onset. The elevation can be significant, often 10-40 times the upper limit of normal (ULN). ALT levels usually decrease slowly, at an average rate of about 10% per day, and may remain elevated for 27 ± 16 days.

Alcoholic Liver Disease

Alcoholic liver disease presents a unique pattern. In uncomplicated alcoholic hepatitis, ALT values are almost never more than 10 times the upper reference limit. The AST to ALT ratio is often greater than 2, which can be a helpful diagnostic clue.

Drug-Induced Liver Injury

Certain medications can cause elevations in liver enzymes. The most common culprits include:

• Sulfonamides
• Statins
• Isoniazid

Primary care physicians should always consider a patient’s medication history when evaluating elevated liver enzymes.

Interpreting AST and ALT Ratios

The ratio of AST to ALT can provide valuable insights into the underlying liver condition. In most liver diseases, ALT elevation is greater than AST due to ALT’s longer half-life in circulation (47 ± 10 hours). However, there are notable exceptions:

• Alcoholic hepatitis
• Cirrhosis
• Wilson’s disease
• Very early stages of liver damage

In these conditions, the AST to ALT ratio is generally greater than 2. This ratio can be a useful diagnostic tool, especially when differentiating between alcoholic and non-alcoholic liver disease.

Diagnostic Approach for Primary Care Physicians

When faced with elevated AST and ALT levels in an asymptomatic patient, primary care physicians should follow a systematic approach:

1. Confirm the elevation: Repeat the test to rule out transient or lab error-related increases.
2. Assess the degree of elevation: Mild elevations (less than 5 times ULN) may warrant watchful waiting, while significant elevations (more than 15 times ULN) often require immediate evaluation.
3. Review the patient’s history: Consider factors such as alcohol consumption, medication use, and risk factors for viral hepatitis.
4. Perform a thorough physical examination: Look for signs of chronic liver disease or other systemic conditions.
5. Order additional tests: Based on the initial assessment, consider tests for viral hepatitis, autoimmune markers, iron studies, or imaging studies.

This structured approach helps ensure that no important diagnoses are missed while avoiding unnecessary testing.

When to Refer to a Specialist

While many cases of mildly elevated liver enzymes can be managed in primary care, certain situations warrant referral to a hepatologist or gastroenterologist. Consider specialist referral in the following scenarios:

• Persistent elevation of AST or ALT more than 3 times ULN for over 6 months
• Signs of advanced liver disease (e.g., ascites, jaundice, coagulopathy)
• Suspected autoimmune hepatitis or genetic liver diseases
• Concurrent elevation of alkaline phosphatase or bilirubin
• Inconclusive initial workup

Early referral in complex cases can lead to more timely diagnosis and treatment, potentially preventing progression of liver disease.

Management Strategies for Elevated Liver Enzymes

The management of elevated AST and ALT levels depends on the underlying cause. However, some general strategies can be beneficial:

1. Lifestyle modifications: Encourage weight loss in overweight patients, as even modest weight reduction can improve liver enzyme levels in NAFLD.
2. Alcohol cessation: For patients with alcohol-related liver disease, complete abstinence is crucial.
3. Medication review: Discontinue or modify any medications that may be contributing to liver enzyme elevation.
4. Treatment of underlying conditions: Address specific causes such as viral hepatitis or autoimmune hepatitis with appropriate therapies.
5. Regular monitoring: Schedule follow-up tests to track enzyme levels and assess response to interventions.

These strategies should be tailored to each patient’s specific situation and underlying diagnosis.

Emerging Research and Future Directions

The field of hepatology is rapidly evolving, with new insights into liver disease pathogenesis and novel diagnostic tools emerging. Some areas of current research include:

• Non-invasive biomarkers for liver fibrosis assessment
• The role of the gut microbiome in liver health
• Gene therapies for hereditary liver diseases
• Advanced imaging techniques for early detection of liver tumors

Primary care physicians should stay informed about these developments, as they may soon impact clinical practice and patient management strategies.

The Promise of FibroScan Technology

FibroScan, a non-invasive technique using transient elastography, is gaining popularity for assessing liver fibrosis and steatosis. This technology could potentially reduce the need for liver biopsies in some patients. Primary care physicians should be aware of this tool and consider its use in appropriate clinical scenarios.

Patient Education and Follow-up

Effective management of elevated liver enzymes extends beyond medical interventions. Patient education plays a crucial role in ensuring adherence to treatment plans and lifestyle modifications. Primary care physicians should:

• Explain the significance of elevated liver enzymes in lay terms
• Discuss the importance of follow-up testing and appointments
• Provide resources on liver health and disease prevention
• Address any patient concerns or misconceptions

Regular follow-up is essential to monitor progress and adjust management strategies as needed. The frequency of follow-up will depend on the severity of enzyme elevation and the underlying cause.

Long-term Monitoring Considerations

For patients with chronic liver conditions, long-term monitoring is crucial. This may involve:

1. Periodic liver enzyme tests
2. Regular ultrasound examinations for patients at risk of hepatocellular carcinoma
3. Ongoing assessment of liver function through tests like albumin and prothrombin time
4. Monitoring for complications of advanced liver disease

A well-structured monitoring plan can help detect disease progression early and guide timely interventions.

Special Considerations in Pediatric and Geriatric Populations

The interpretation and management of elevated liver enzymes can differ in pediatric and geriatric populations. In children, the normal ranges for AST and ALT vary with age and sex. In elderly patients, factors such as polypharmacy and age-related changes in liver function can complicate the assessment.

Pediatric Considerations

In children:

• ALT levels are typically lower than AST until 15-20 years of age
• Causes of elevation may include genetic disorders, obesity-related fatty liver, and autoimmune hepatitis
• Growth and development must be considered in management plans

Pediatric patients with persistently elevated liver enzymes should be referred to a pediatric gastroenterologist for specialized care.

Geriatric Considerations

In elderly patients:

• Mild elevations in liver enzymes are common and may not always indicate significant liver disease
• Drug-induced liver injury is more common due to polypharmacy
• Comorbidities can complicate diagnosis and management

Careful medication review and consideration of age-related changes are crucial in managing elevated liver enzymes in this population.

Understanding these age-specific nuances is essential for primary care physicians to provide appropriate care across all age groups.

The Role of Nutrition in Liver Health

Nutrition plays a significant role in maintaining liver health and can be a key factor in managing elevated liver enzymes. Primary care physicians should be prepared to offer dietary advice as part of a comprehensive management plan.

Dietary Recommendations

General dietary recommendations for liver health include:

• Reducing saturated fat intake
• Increasing consumption of fruits, vegetables, and whole grains
• Limiting sugar and refined carbohydrates
• Avoiding excessive salt intake
• Maintaining adequate hydration

For patients with specific liver conditions, such as NAFLD or hemochromatosis, more targeted dietary interventions may be necessary.

The Mediterranean Diet

The Mediterranean diet has shown promise in improving liver health. This diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, has been associated with reduced liver fat and improved insulin sensitivity. Encouraging patients to adopt elements of this diet can be beneficial, especially for those with NAFLD.

Supplements and Liver Health

While a balanced diet is generally sufficient, certain supplements may be beneficial for liver health:

• Vitamin E has shown potential benefits in non-alcoholic steatohepatitis (NASH)
• Milk thistle is a popular herbal remedy, though its efficacy remains controversial
• Omega-3 fatty acids may help reduce liver fat in NAFLD

However, it’s crucial to advise patients to consult with their healthcare provider before starting any supplements, as some can interact with medications or have adverse effects on the liver.

By incorporating nutritional advice into their management plans, primary care physicians can empower patients to take an active role in improving their liver health.

Alanine Aminotransferase or ALT is increased in liver disease

Alanine Aminotransferase (ALT)

Alanine aminotransferase is an enzyme involved in the transfer of an amino group from the amino acid, alanine, to alpha-ketoglutaric acid to produce glutamate and pyruvate. ALT is located primarily in liver and kidney, with lesser amounts in heart and skeletal muscle. Increased ALT activity is more specific for liver damage than increased aspartate aminotransferase (AST) activity. ALT is seldom increased in patients with heart or muscle disease in the absence of liver involvement. In healthy children, plasma ALT activity is lower than AST until 15 to 20 years of age. Thereafter, plasma ALT activity tends to be higher than AST activity until age 60, when the activities become roughly equal. The half-life of ALT in the circulation is 47 +/- 10 hours.

ALT activity in the liver is 3000 fold higher than in serum. Measurement of serum ALT activity is a good indicator of hepatocyte injury.

X ULN = times upper limit of normal, Protime prolongation is number of seconds above ULN

• The best ALT discriminant value for recognizing acute hepatic injury is 300 U/L.
• ALT increases before & peak near onset of jaundice in viral hepatitis. Activity falls slowly, an avery of 10% per day. ALT remains elevated 27 +/- 16 days.
• ALT levels fluctuate between normal and abnormal in hepatitis C. 15 to 50% of patients with chronic hepatitis C have persistently normal ALT.
• In uncomplicated alcoholic hepatitis, ALT values are almost never >10 times the upper reference limit.
• Extremely elevated ALT levels are common in toxic hepatitis and hepatic ischemia secondary to circulatory collapse and heatstroke. 90% of cases with ALT >3000 U/L are due to toxic or ischemic injury. AST is usually higher than ALT and both enzymes peak in the first 24 hours after admission. After peaking, both levels fall rapidly; AST faster than ALT.
• Peak ALT levels bear no relationship to prognosis and may fall with worsening of the patients condition. In fulminant hepatic necrosis, decreasing ALT may signify a paucity of viable hepatocytes rather than recovery.

Patients with cirrhosis, non-alcoholic steatohepatitis, cholestatic liver disease, fatty liver and hepatic neoplasm typically have slightly raised serum ALT levels (<120 IU/L). Patients with cirrhosis seldom have ALT levels higher than two times normal. Cirrhotic patients without ongoing liver injury the values may have normal values.

Other causes of elevated ALT include hemochromatosis, Wilson disease, autoimmune hepatitis, primary biliary cirrhosis, sclerosing cholangitis and alpha-1 antitrypsin deficiency. The medications most commonly associated with elevated ALT are sulfonamides, statins and isoniazid.

The ratio of AST to ALT in plasma may help in the diagnosis of some liver diseases. Most liver diseases are associated with greater elevation of ALT than AST because of the longer circulating half-life of ALT. Exceptions include alcoholic hepatitis, cirrhosis, Wilson disease and very early liver damage. In these disorders the AST to ALT ratio is generally greater than 2.

Both AST and ALT require vitamin B6 (pyridoxal-5′-phosphate, P5P) as a catalytic cofactor. Pyridoxal-5’-phosphate deficiency is common in alcoholic liver disease and renal failure.  In an attempt to standardize aminotransferase assays, the International Federation of Clinical Chemistry (IFCC) recommended that laboratories add excess P5P to their enzyme reagents so that these assay accurately measure enzyme activity independently of vitamin B6 status. Unfortunately, less than 50% of ALT assays incorporate exogenous 5P5.

In healthy individuals, ALT levels can vary 10 to 30% from one day to the next.  ALT levels can fluctuate 45% during a single day, with highest levels occurring in the afternoon and lowest levels at night.  A high body mass index can increase ALT levels by 40 to 50%. 

Reference range is 14 – 63 IU/L.

Specimen requirement is one SST tube of blood.  ALT is stable at room temperature for 3 days and refrigerated for 3 weeks.  Hemolysis causes moderate increases in ALT levels.  

Abnormal liver enzymes | Christian Healthcare Ministries

Health & Wellness

By Dr. Jacobson, D.O.

A member wrote:

I’ve been doctoring a sharp, knife-like pain and burning in my sternum area for five months. My blood work shows high liver enzymes: AST [aspartate transaminase] of 561 and ALT [alanine transaminase] of 469. I’ve never consumed alcohol, smoked or taken drugs of any sort. In the last few days, my stools have been soft and a yellowish-orange color. All other tests—CT [computed tomography], MRI [magnetic resonance imaging], MRCP [magnetic resonance cholangiopancreatography], and ultrasound of my abdomen—showed nothing. Additional blood work results were good. Can you help me please?

Dr. Jacobson’s response: I summarize the history you’ve provided as follows: mid-chest pain; recent stool changes, soft and light in color; elevated liver (hepatic) enzymes with AST slightly higher than ALT; additional normal lab work; and no unusual radiology reports.

The first concern would be to address the chest pain and to rule out the most serious and immediate threats to your health. The pain’s duration—five months—and the sharp, stabbing character as a practical matter rule out a cardiac (heart) cause. It may, or may not, be related to the bowel and liver problems you describe. Most likely, it’s coming from the rib cage and sternum area; it’s called atypical chest pain, though it’s the most common type.

The changes in stool are characteristic of someone who has a biliary system issue. Bile—which assists in the breakdown of fats—is dark green and gives the stool its brown color. Manufactured in the liver, bile is normally stored in the gallbladder. Released in response to a meal containing long-chain fats, bile moves in a duct that travels through the pancreas into the small intestines. Blockage of the bile ducts anywhere in this system can result in light-colored stools similar to your description.

Abnormal liver enzyme levels may also provide a clue as to the cause. ALT, AST and alkaline phosphatase are three of the most commonly-tested enzymes, but there are others, including bilirubin levels. The latter two are typically elevated when something outside the liver is blocking the bile system. However, if all other lab tests are normal, it’s most advantageous to look at the AST and ALT values.

You report that AST and ALT are only mildly elevated, and AST is slightly higher than ALT. In this scenario, causes that should be considered include:

• acetaminophen (generic for Tylenol) or other drug toxicity,
• autoimmune hepatitis, especially in females 30-50 years old
• non-alcoholic fatty liver disease, especially in presence of obesity, diabetes, elevated cholesterol and hypertension
• iron overload (genetic hemochromatosis)
• viral hepatitis—usually higher levels of ALT and AST in the acute stage
• ischemia (lack of blood supply to the liver)
• cirrhosis of the liver—usually from chronic alcoholism
• rhabdomyolysis (a by-product of massive muscle breakdown)
• hemolysis (breakdown of blood cells)
• Budd-Chiari syndrome (The liver veins can become blocked, preventing drainage. This syndrome can vary from extremely severe to no symptoms at all.)
• Wilson’s disease (A rare inherited disorder in which copper accumulates in the liver, brain and other organs. It may be accompanied by a brown ring, or copper deposits, along the edge of the cornea and may require a liver biopsy to diagnose).
• Other conditions outside the liver such as thyroid disease or celiac

The list of possible causes for elevated liver enzymes is long, and it can be difficult to ascertain the cause. The likely diagnosis usually becomes more apparent after standard lab tests and imaging such as you described.

As your diagnosis is still elusive, however, I would make sure that your physician(s) has taken a thorough look into possible auto-immune disorders and has considered performing a liver biopsy. The best route might be to take all of your records to a university-based hepatologist—a gastroenterologist who has sub-specialized in the study of disorders of the liver, pancreas, gallbladder and biliary tree.

References

DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 – . Record No. T316452, Abnormal Liver Function Tests – Approach to the Patient; [updated 2018 Dec 02, cited West Chester, OH, May 21, 2020]. Available here. Registration and login required.

Vagvala, S.H. and O’Connor, S.D. (2018), Imaging of abnormal liver function tests. Clinical Liver Disease, 11: 128-134. doi:10.1002/cld.704

What is astral projection? Facts and theories

Astral projection is the supposed act of going out of the body during sleep, but is it real?

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supernatural

Mysticism and psychics

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What is astral projection? This phenomenon was shown in the 2016 blockbuster “Doctor Strange” and the sequel “Doctor Strange in the Multiverse of Madness”, where the superhero has the ability to separate the physical body from the spiritual one and participate in battles. But still, astral projection is not just another trick invented by filmmakers, but a spiritual practice with a long history.

Surveys show that between 8 and 20 percent of people say they have experienced something like an out-of-body experience at some point in their lives—the feeling that the consciousness, spirit, or “astral body” is leaving the physical body. While most experiences occur during sleep or under hypnosis, some claim they can experience it simply by relaxing.

Background

The idea that people can leave their body during sleep is ancient. Countless people, from New Ageers to shamans around the world, believe that it is possible to communicate with the cosmic mind through visions and vivid dreams experienced during astral projection, also known as out-of-body experiences.

The idea of ​​astral projection comes from a 19th century mystical system called Theosophy, which states that we have seven bodies, from the lowest physical to the highest spiritual and mental bodies.

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The Theosophical Society was founded in New York in 1875 by Helena Blavatsky, who claimed to have traveled the world, studied with Tibetan gurus, contacted the dead, and learned to reach higher planes from Hindus and Buddhists.

Theosophy teaches that there are seven human bodies, the third of which is the astral. The astral body can leave the physical and etheric bodies and travel through the astral planes. Theosophy had a profound influence on artists and scientists in the 19th and early 20th centuries.

Although originally a private, quasi-religious meditation practice, like many New Age beliefs, it has become commercialized. Astral travel can become big business, and there are many books, seminars, and other materials that promise to teach people to leave their physical body and access other dimensions. But does astral projection work?

Is astral projection real?

If astral projection is real, why couldn’t science prove it?

Astral travel practitioners insist that the experience must be real because it seems so vivid and some of the experiences are similar even for people from different cultures. But it is not surprising that many people who try to experience an astral projection experience similar experiences, as they are told in advance what to expect from an astral projection.

This may be a profound experience, but the fundamental problem is that there is really no way to scientifically measure whether a person’s spirit “leaves” or “enters” the body. The simplest and best explanation for out-of-body experiences is that the person is simply fantasizing and daydreaming. Since there is no scientific evidence that consciousness can exist outside the brain, scientists reject astral projection.

Why hasn’t astral projection been scientifically proven?

Some argue that leading scientists are limited in their view of the world and refuse to even look at evidence that does not fit their narrow world view. However, in science, those who refute the prevailing theories are rewarded, not punished. Evidence of the existence of psychic powers, astral projection, or alternate dimensions would earn dissenting scientists a place in the history books, if not a Nobel Prize.

The scientific verification of astral travel should be fairly simple. For example, you can hide ten unknown objects in different places, and then ask the person to project their consciousness into each place and describe exactly what is there. Either the descriptions match or they don’t.

According to researcher Susan Blackmore, author of Out of the Body: A Study in Out-of-Body Experiences, people who claimed to have had astral experiences scored higher on measures of hypnotizability and, in several surveys, on absorption rates, a measure of a person’s ability to turn on something full attention and immerse yourself in it. People who have an out-of-body experience are more imaginative, suggestible, and fantasizing than others, although they have low levels of drug and alcohol use and no overt signs of psychopathology or mental illness.

There are other possible causes of OBEs and astral projections. In 2017, a study published by The Atlantic analyzed about 210 patients with vestibular disorders. The vestibular system in the inner ear is responsible for providing the body with a sense of balance, and problems associated with this system can lead to feelings of dizziness and disorientation. In a survey of patients, it was found that about 14% reported out-of-body experiences compared to 5% of those surveyed without any form of vestibular problems.

Although practitioners of astral projection insist that their experiences are real, all their evidence is anecdotal—in the same way, a person who takes psychostimulant substances may be sincerely convinced that he interacted with God, dead people, or angels while in changed state. Astral projection is a fun and harmless pastime that can feel profound and, in some cases, even life-changing. But there is no evidence that out-of-body experiences occur outside the body and not inside the brain.

Read online “Keepers about the astral worlds and their possibilities”, keeper without title – Litres

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ISBN 978-5-4493-1157-3

Created by Ridero intellectual publishing system

Guardians about the astral, parallel and sleeping worlds, and how to interact with it in the second attention, in places of power, through imagination, through dreams, through free thoughts of the form, through the mental, emotional and physical bodies.

During this training, we will speak on behalf of the One Soul, the Creator, from all Its parts, the Awakened (Conscious) representatives of one or another Level of Consciousness, the Ray of Creation. By the Awakened and Conscious We mean the Higher Spiritual and Human Aspects who have embarked on the expansion of the Path, the Game of searching for oneself (the Higher Self, God in oneself) and who have begun or wish to begin to fulfill their Divine Purpose in the universal Game of Creation

Astral plane article one

What are the astral worlds, how are they related to physical reality and how do they affect people’s lives.

Guardians: The Astral Plane is a virtual reality consisting of many parallel worlds that exist at the level of emotional energy and are created for the sake of realizing some goal in the physical world.

As you already understand, the astral world is a field, a plan created by the Creator, from a human thought. What people invented, out of their prejudices, thoughts out of fear, about hell and heaven, was supported and developed by the same created thoughts, projections, ideas about it. And in the future it began to be called the highest and lowest astral.

The creator of each of the astral worlds is some being who has a direct connection with material reality or wants to establish it. For example, the astral world can be created by a person during sleep or dreams, when he puts his emotional energy into certain images observed in his imagination. These thought forms become the information basis for the new astral world, and through them the creator of this world can connect to it again and again, remembering what he saw at the level of imagination. Each time he can supplement this world with new details by visualizing them, thanks to which this world begins to develop and the events in it begin to contribute to the realization of the purpose for which it was created. If the astral world arose as a result of dreams, then it will contain a specific image of the incarnation, and a person visualizing it will more and more clearly represent the ultimate goal for himself. Thanks to such a clear idea of ​​​​his goal, a person will act more accurately and make fewer mistakes, while the astral reality will help its creator to keep in mind all the necessary nuances.

The astral world created by man is able to help him achieve his goal not only at the level of information, but also energetically. When a person visualizes his desire, he transfers his energy to the corresponding astral world, on which he exists and makes changes within himself. The more a person pays attention to his dream, the more colorful and detailed the process of its realization, the more energy goes to the astral reality. Then this energy, concentrating in the image of the final result, begins to broadcast the vibration of the final goal into the physical world. This vibration primarily supports the creator of the astral reality, since it is with him that this world has the greatest connection. Since this energy contains the vibration of the successful realization of the goal, it inspires a person to complete what he has begun and helps him choose among the many steps those that will lead him along the shortest path. With its radiation, the astral world gives a person a very precise tuning and, like a beacon, helps not to go astray.

Just as the astral world energizes a person, it can also energize the processes surrounding him, making them support for the realization of the goal. This is expressed in the fact that a person falls into a fortunate combination of circumstances that can significantly speed up the realization of a dream. These fortunate events can be in the actions of other people, be any social or natural phenomena that react to the energy of the astral world. Moreover, the surrounding people may not be interested in the implementation of such a goal, however, the vibration of the corresponding astral world turns out to be useful for some of their personal tasks. For example, help may come from a person who does not know about the ultimate goal, but is ready to cooperate in a specific step. The support of the astral reality associated with this desire lies in the fact that lucky accidents come in very handy and become an amazing acceleration in the realization of the desire. The more energy is contained in the astral world, the more successful coincidences occur, and the faster the path of achievement turns out to be. This energy seems to attract surrounding events, allowing them to turn around in a suitable direction to a person so that he can use them for his own purpose. Ideally, the astral world needs only a slight change in the course of some process in order to make it favorable. For example, if a person needs to find a knowledgeable and friendly seller to buy some product, then the astral world attracts just such a specialist from among the many possible ones, helping its creator to pay attention to him. At the same time, the astral world will take into account the necessary details – it will help you choose a seller who will be free and in a good mood, since such requests are embedded in the energy that fills this world. The astral world does not need to expend energy to free the seller from other business or to improve his mood, everything happens due to the best choice of sellers from the many possible, making this decision obvious to the person. In the same way, social or natural phenomena can become favorable, and for example, a person will start crossing the road a minute before the moment when a drunk driver rushes by, or he comes to work before the start of a thunderstorm.

Thus, it is most convenient for the astral world to act through the consciousness of the person with whom it is connected, directing his attention to the most successful options, as if highlighting them in the person’s perception and making them more noticeable than the rest. This is done by the slightest energy impulses transmitted to a person, filling with energy a separate act of perception or thought. This happens due to the similarity of vibrations, some kind of impression and the energy contained in the astral world, due to which a resonance is created and the corresponding human thought is strengthened. In the same way, if necessary, the astral world can influence other people or surrounding phenomena, if the vibrations in which they are located correspond to the energy of the final goal. For example, a person who was next to the creator of the astral reality was ready to help, and the astral world only needed to direct his attention. Such help is often provided unconsciously, for example, it can be random words spoken by someone and prompted another to a unique solution.

If required, the astral reality can even change the course of global processes, influencing their course at turning points, so that at the moment of contact with a person their action would be favorable. However, any social process brings together the efforts of many people, and therefore changing its course is much more costly than pointwise changing the perception of an individual. Therefore, if an astral reality is created by some one person, then usually it acts very locally, most often transmitting impulses to its creator, less often to other people or entities, and finally, in exceptional cases, to whole phenomena.

There are also astral worlds created not by a single person, but by a whole group of people or entities. An example is any idea or dream shared by many people, each of whom, through a given thought-form, is connected to the corresponding astral world. Initially, such an astral reality could be created by one person who was the author of the idea, then he connected other people to it, involving them in his dream. Since such a world is fed by the emotions of all people who want to implement an idea, it has much more energy than worlds accessible to one person. Due to this, they can significantly accelerate the achievement of the desired, and this can be seen in the success of many projects implemented by people together. Such worlds have the ability to influence not individual people, but entire phenomena, thereby literally building the surrounding reality to achieve the goal. In general, the more people who work together, the more structured their path becomes. This is due not only to the unification of the capabilities of each participant, but also due to the powerful attracting energy that they create on the subtle plane by emotional inclusion in their goal.

The question may arise – where do the astral worlds exist, and how do they influence what happens in people’s lives?

Every astral world is created in a 4D reality that is inextricably linked to the 3D space in which you exist. Four-dimensional reality is a space of information where everything exists at the level of emotional energy. In this space, there are all thoughts and images born by the consciousness of beings living in the physical world. That is, at the moment when a person acts at the level of his imagination, his attention turns out to be in a four-dimensional reality.

In this space, the attention of any other entity, with its body or energy located on another level or in another parallel world, can be. Such a being, who has no direct connection with your physical world, only needs to think about your world or imagine what he wants to implement in it, and with part of his energy he will fall into the astral reality associated with the achievement of such a goal. And although a being cannot act directly in your world, feeding the astral reality with its energy, it can contribute to the actions of people, with its thoughts and emotions also included in it. In this case, the astral plane becomes a link between your world and many other realities, helping their inhabitants to participate in the events of your life. At the same time, the astral plane is only a part of the four-dimensional space, in which, in addition to the astral worlds, there are many other processes.

A distinctive feature of astral realities is that they are created in relation to a specific physical world in order to make some changes in it. Therefore, the details that fill each of the astral worlds describe what is happening in physical reality or is just about to happen. At the same time, the images that fill the astral plane are usually not an absolute copy of what is happening physically, most often they describe it allegorically. The reason is that these images are created by the imagination of people, through their creative perception, and although behind them there is a true feeling leading to the goal, individual details can be quite fantastic. Such embellishments that people use to incite their emotions do not always distort the result, because the energy behind the images is of the greatest importance, and if it is chosen correctly, it will contribute to a favorable set of circumstances. The unusual filling of the astral worlds is also due to the fact that most of the images are created by beings living in other worlds or spiritual beings located at higher levels of reality, and it is difficult for all of them to understand the features of the world in which you exist. They can connect with a person at the level of feelings and emotionally share his idea, and therefore are able to create those astral images that will contribute to the goal. All such images and thought forms created by people or other beings in a four-dimensional reality are called astral projections.

Astral projections do not have a direct connection with the physical world, but they are able to manifest themselves in the minds of people, acting at the expense of the emotional energy that fills them. There are many thoughts in the human mind, but they are all emotionally colored in different ways, and this coloring creates the direction of the flow of thinking. A person transfers his attention to that thought, which in its vibrations is close to the previous one and follows logically from it, or turns out to be especially saturated energetically. Therefore, in order to draw attention to itself, an astral projection can wait its turn during the thought process, or speed up this moment by transferring an energy impulse to a person, thereby strengthening the corresponding thought and literally requiring a person to turn attention to himself. Such distractions are felt by a person as unexpected thoughts, literally wedged into the mental process.

Astral projections can affect not only the process of thinking, but also the creative act or the flow of emotions felt by a person, but for this they need to create a stronger energy impulse. The mental process is less energy-consuming and takes place more at the level of information, by sorting thought forms or creating new ones, but the observed images are not filled with emotions. It is very easy for astral projections to influence such a process, because for this they just need to change the order in which they contact human consciousness. In order to influence the emotional flow launched by a person, an astral projection needs to create a similar flow, which will merge into the already created one and change the nature of its flow.

Since most of the astral realities exist solely due to the emotions of people, they do not have a significant supply of energy and they are not inclined to waste it for no reason. Therefore, they carry out most of the influences on the mental level, and very rarely are included in the flow of feelings experienced by a person. The exception is those astral worlds that are supported by a large number of beings, both people and representatives of other worlds. Astral projections of such worlds exist in abundance of energy and can affect human emotions. In addition, if necessary, they can transfer their energy to social or natural processes that also operate at the level of emotional energy. Due to this, the astral reality gets the opportunity to influence what is happening in the physical world, acting in addition to the consciousness of people. However, for this, the astral world needs some kind of intermediary, which is included in the astral reality by its perception and contributes to the process taking place in the physical reality by its actions. In the case of social processes, such intermediaries are usually the Lyrans, and in natural phenomena, the spirits of nature. These energy beings, like people, are one of the main participants in the events taking place in the astral worlds and build them with their attention. If people create astral projections at the expense of their personal energy, then Lyrans or nature spirits use someone else’s energy, most often transmitted from the forces of those who want to realize some goal in the human world. At the same time, the Lyrans create those astral worlds that are related to social processes, and the spirits of nature – to natural phenomena. In particular, any social phenomenon has its own astral reality that contributes to its implementation, and it is called an egregore. Any natural phenomenon has such an egregor, and the only difference is that its flow is supported by the forces of nature, and not by representatives of the social system.

Although each astral world is created by the imagination of people or other beings, the astral projections that fill it can act independently, using the emotional energy that is transmitted to them. From this point of view, they can be considered living beings that exist in their own separate space and are able to contact other worlds on a mental or energy level. Some astral projections are exact replicas of beings or processes in your physical world, and are most often created through visualization. Due to this, some creature can literally go to the astral plane and exist in it, moving its attention there. Thanks to this, people can travel through the astral worlds, for example, in dreams or in special practices.

At such a moment in the four-dimensional reality, an energy projection of a person is created, inextricably linked with some of the astral worlds, and through his subtle perception, a person can travel in it. At the same time, the human energy body is not transferred to this astral reality and remains in contact with the material shell, however, all the human attention goes beyond the body. At this moment, the person completely associates himself with the astral reality, and such a powerful transfer of attention can be useful for immersing yourself in the desired experiences or for accurately remembering those images that exist on the astral plane. However, you should be attentive to the sensations that you experience while connecting to the astral world, as some astral projections tend to take away energy from a person.

Astral projections seek to replenish their energy in order to have a greater influence on physical processes. If they do not have a sufficient number of energy sponsors in the form of other parallel worlds or spiritual entities, then practically the only way to remain active is to feed on the energy of people. At the same time, some astral projections can act quite harmoniously and cooperate, while others will seek to manipulate. Much depends on the purity of the intentions of the creator of such a projection, and the corresponding thought forms become a kind of template according to which the astral entity operates.

Usually an astral entity behaves in a straightforward manner, because its need is very simple – to receive energy for the realization of the goal laid down in it. While communicating with others, she uses the principles that her creator put into her when he thought over the steps to realize his goal. These principles are often very rigid programs that the astral entity cannot bypass, since it does not contain other tools. Changes in the nature of her behavior will occur only when her creator reconnects to this astral reality and supplements the already created thought forms with new details. However, it often happens that the astral reality was created a very long time ago and was literally abandoned by its creator, for example, when a person forgets about his idea or dream. Astral projections created by him continue to live on their own and strive to achieve their goal. If they do not find a response in their creator, then they begin to act through others, trying to find support in them. Since their creator no longer feeds them with emotions, they consider other beings as a source of energy, for which they can begin to manipulate them.

This situation is very common on the astral plane, and therefore it is worth interacting with those astral realities in which you are directly interested. Then your energy contribution will be justified, and interaction with astral entities can be based on mutually beneficial cooperation. But it often happens that the astral world attracts a person with vivid images and unusual impressions, but at the level of sensations they will be disappointed. At the level of vibrations, such a reality remains cold for a person, and staying in it can even be painful. The reason lies in the energy withdrawal that is carried out by astral projections, and any person can easily feel it. For example, the considered thought form turns out to be very difficult to perceive or even unpleasant, due to which an energy outflow occurs. Initially, a person can be attracted to this astral reality due to the colorfulness and unusualness of the first sensations, but then the experiences are replaced by others, while the plot of flashing images can be very dynamic, forcing a person to keep his attention on these projections. This is often felt in moments of unpleasant dreams or nightmares, which captivate with their swiftness, but energetically devastate. In the same way, some kind of social egregor can act to manipulate people, using a colorful idea as a bait, but forcing them to take actions that take energy. In order not to be at the mercy of such an astral reality, one should be attentive not only to the informational component of the thought forms that come during thinking or to the plot of a dream, but also to the sensations they cause. If such an imaginary contact is uncomfortable, then it is better to break it, that is, get out of an uncomfortable sleep or temporarily stop thinking that plunges you into low vibrations.