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?

Tags:

supernatural

Mysticism and psychics

unsplash.com

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.

ADVERTISING – CONTINUED BELOW

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.

“Thin” human bodies. – Quasar NEWS — LiveJournal

Among the many theories about biofields, the most common theory is the existence of a single human energy field, which includes seven energy layers (or bodies) schematically resembling a nesting doll. These include: physical, ethereal, astral, mental, karmic (casual), intuitive (buddhic), atmic (keter, celestial or nirvana body). But unlike nesting dolls, the subtle bodies of a person penetrate each other, and we can conditionally imagine the aura as a homogeneous energy structure. The own radiation of each body adds its own nuances to the general human field.

Etheric body.

It resembles the physical in form and also includes all parts of the body and organs. It contains chakras and meridians, through which vital energies are transmitted. If the etheric body is harmed, then after some time the organ on the physical body will also become ill. The etheric body is an intermediary and transmits information perceived by our senses to more subtle levels, and vice versa, transfers energy and information coming from our subtle bodies to the physical body.

Any changes first occur on the etheric level. It is very interesting to observe in early spring, when a greenish haze appears above the trees – a prototype of future leaves, every day it becomes brighter and more distinct, growing leaves fill an already existing form. In healing, this is noticeable when working with a burn or wound: you “tighten” on the etheric body – healing on the physical body is accelerated. The etheric body has weight, in an ordinary person it is painted in a bluish-lead hue and its borders can be easily seen, they are 1-2 cm apart from the physical body. The size and saturation of the etheric body indicates the amount of vitality. Sensations – physical pain and pleasure.

Astral body.

Has a more subtle structure – it is often called emotional. It is associated with feelings and emotions, it is seen as clouds of colored spots – from bright, light and saturated to dark and muddy. When a person is angry, they say about him – “throws thunder and lightning.” Such lightning is seen as flying off clots of red and steel colors. When a person is in love, ranges of pastel shades, often pink or blue, sad – greenish-gray, envy has dark tones. Thus, this body radiates the whole range of colors and changes its colors depending on the emotional state of the person. Responsible for our desires and creativity. It is the astral body that people usually try to capture on film, these pictures are known to many as “aura photos”.

Also, in the astral body, the emotions, fears and experiences that we suppress can accumulate and remain. If we radiate negative emotions, then we attract unpleasant events and similar situations from the world around us, which is a mirror image of what we are.

There is such a thing as astral flights. General anesthesia has the effect of separating the astral body from the physical body, and some drugs also have this property. During the operation, many people see their physical body from somewhere above, hear the conversation of doctors. When the astral body is separated from the physical body, it nevertheless maintains a connection with it with a thin energy thread. The defeat of the astral body is much more dangerous than the defeat of the physical, it leads to a serious illness and death of the latter. The boundaries of the astral body can reach several tens of centimeters.

Mental body.

All patterns of our thinking are contained here. We react to events happening to us in accordance with these schemes, and this reaction may be erroneous. Painted in golden-blue colors, it consists of images and thought forms that have different brightness and configuration. When the mental body is poorly developed, its colors will be relatively monotonous and dull. Each thought form has its own color and is connected to an emotion, which is why our thoughts have such a strong influence on our emotional state. Any mental images are easily read, emotions are felt on vibrations or seen in colors. They thought about something past – they were sad, they remembered something pleasant – they were delighted. They say – “immersed in their thoughts” or “thoughts in my head are moving.”

Our habitual thoughts are a powerful force that influences our lives and actively governs our actions. First, a thought is born, then desire and emotions arise, and only after that the mechanism of manifestation is turned on.

Karmic body.

This body contains the causes of all our actions and events happening to us, information about previous incarnations. The karmic body forms the fate of a person, which manifests itself in the conditions of life. It is responsible for our unconscious aspirations, all “congenital” diseases, the place of birth and the family in which we were born, it is a kind of feedback mechanism that attracts objects and events into our lives.

Here are clots of our spiritual distortions that pass from one life to another until they are cleared and do not agree with our higher reality. Having a certain experience, one can look into these clots and see some past event in which the balance was disturbed. In our lives, we are faced with a certain kind of situations, events or people, getting another opportunity to realize our mistakes and correct them.

Buddhic body.

It contains all the images and forms that exist on the physical plane, and is the information matrix of the human etheric body. Also, this body contains data on the main direction of the development of life and regulates communication with energy formations, or egregors – tribal, family, religious, professional.

It is believed that people living an intense spiritual life or Initiates have a developed buddhic body. Such people are able to correct a person’s life attitudes and have a significant impact on his worldview. A person with an undeveloped buddhic body lives in the absence of a common goal of existence and does not have a clear life position.

Atmic body.

Merging with the Spirit. The body of very subtle and high vibrations, dissolves in the cosmic consciousness and carries it in itself. Contains information about the main (main) task of a particular person. As this body develops, a person develops a strong sense of the reality of the existence of a Higher Power, the unity of all mankind and the world. There are not so many people who realize and use their atmic body, in many traditions they are called saints.