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Normal alt blood levels: Types of Liver Problems & Their Causes

Types of Liver Problems & Their Causes

Written by Steven Brown

  • Infections
  • Immune System Problems
  • Cancer and Tumors
  • Conditions You Inherit
  • Other Causes of Liver Disease

Your liver does a lot of things that keep you healthy. It turns nutrients into chemicals your body needs. It filters out poisons. It helps turn food into energy. So when your liver doesn’t work well, that can affect your whole body.

Different things can cause serious liver conditions. You’ll want to know about the top causes.

Sometimes, the problem is that you have an infection that inflames your liver. Viral hepatitis is the most common cause, including:

  • Hepatitis A. Most people get it by eating or drinking something that’s tainted by fecal matter. You might not have any symptoms. It usually goes away by itself within 6 months without any long-term harm.
  • Hepatitis B. You get it from somebody else, such as through unprotected sex or taking drugs with shared needles. If it lasts longer than 6 months, it makes you more likely to get liver cancer or other diseases.
  • Hepatitis C comes from infected blood that gets into your blood. You might get it if you take drugs with shared needles or in connection with HIV. If you’re a health-care worker, you might get it from an infected needle that accidentally sticks you. Symptoms may not show up for many years. For reasons that aren’t quite clear, baby boomers are at risk for hepatitis C and should be tested for it.

Your immune system fights off invaders including bacteria and viruses. But it might go wrong and attack one or more parts of your body, such as your liver.

  • Autoimmune hepatitis inflames your liver. It can lead to other disorders and even liver failure. It strikes girls and women more often than boys or men.
  • Primary biliary cholangitis attacks tiny tubes in your liver called bile ducts. They carry bile, a chemical that helps you digest food. When the ducts are injured, the bile backs up inside your liver and scars it. Women come down with this more often than men.
  • Primary sclerosing cholangitis scars your bile ducts, and it can eventually block them. The bile builds up inside your liver, and that makes it harder for your liver to work. It may lead to liver cancer, and you might someday need a liver transplant. Men are more likely than women to get it.

If cancer shows up in your liver, that’s most likely because it has spread from another part of your body, like your lungs, colon, or breasts. But a few cancers can start in the liver.

  • Liver cancer affects women more often than men, and African-Americans more often than whites. Your doctor might call it hepatocellular carcinoma. It’s more likely if you have hepatitis or drink too much.
  • Bile duct cancer strikes the tubes that run from your liver to your small intestine to carry bile, a fluid that helps you digest food. This kind of cancer mainly affects people over age 50, but it’s uncommon.
  • Liver cell adenoma is a tumor that doesn’t have cancer. It’s uncommon, but women who take birth control pills for a long time are more prone than other people to develop it. There’s a small chance the tumor could eventually turn into cancer.

Some inherited liver disorders only happen if they run in your family.

  • Hemochromatosis makes your body store up too much of the iron from your food. The extra iron builds up in your liver, heart, or other organs. It can lead to life-threatening conditions such as liver diseases, heart disease, or diabetes.
  • Hyperoxaluria hits when your urine has too much of a chemical called oxalate. In this condition, your liver makes too much oxalate due to a genetic mutation. This can cause kidney stones and kidney failure. If your kidneys do fail, that can give you oxalosis, where the oxalate collects in other organs and causes more trouble.
  • Wilson’s disease makes copper build up in your liver and other organs. Its first symptoms usually show up when you’re between the ages of 6 and 35, most often in your teens. It not only affects your liver, but it can cause nerve and psychiatric problems.
  • Alpha-1 antitrypsin deficiency involves a chemical that helps your lungs resist infections. Your liver makes it. But when your liver gets the recipe wrong, the faulty chemical can build up and cause liver disease.
  • Alcohol abuse can lead to cirrhosis. So can nonalcoholic fatty liver disease and long-term cases of hepatitis B and C.
  • Drug overdoses. Taking too much acetaminophen or other medications can harm your liver. Make sure you follow the dosing instructions on the label, and be aware that acetaminophen might be in more than one medicine you take.
  • Nonalcoholic fatty liver disease (NAFLD) is when too much fat has built up inside your liver. The extra fat can inflame your liver. One type of NAFLD is nonalcoholic steatohepatitis (NASH). It means you have inflammation and cell damage in your liver, as well as fat. It can scar your liver and lead to other disorders, like cirrhosis.

Dire complications of liver disease include:

  • Acute liver failure. This happens when you don’t have a long-term liver disease but your liver quits working within a very short time — days or weeks. That may happen because of an overdose of acetaminophen, infections, or because of prescription drugs.
  • Cirrhosisis a buildup of scars in your liver. The more scars replace the healthy parts of your liver, the harder it is for your liver to do its job. Over time, it may not work like it should.

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A Visual Guide to Hepatitis A, B, C

Medically Reviewed by Gabriela Pichardo, MD on September 05, 2021

Hepatitis is an inflammation of the liver. It may be caused by drugs, alcohol use, or certain medical conditions. But in most cases, it’s caused by a virus. This is known as viral hepatitis, and the most common forms are hepatitis A, B, and C.

Sometimes there are no symptoms of hepatitis in the first weeks after infection — the acute phase. But when they happen, the symptoms of types A, B, and C may include fatigue, nausea, poor appetite, belly pain, a mild fever, or yellow skin or eyes (jaundice). When hepatitis B and C become chronic, they may cause no symptoms for years. By the time there are any warning signs, the liver may already be damaged.

Hepatitis A is highly contagious and can spread from person to person in many different settings. It typically causes only a mild illness, and many people who are infected may never realize they’re sick at all. The virus almost always goes away on its own and does not cause long-term liver damage.

It usually spreads through food or water. Food can be tainted when it’s touched by a person with hepatitis who did not wash their hands after using the bathroom. This transfers tiny amounts of infected stool to the food. Raw shellfish, fruits, vegetables, and undercooked foods are common culprits in hepatitis A outbreaks. The virus can also spread in daycare centers if employees aren’t careful about washing hands after changing diapers.

A prime risk factor for hepatitis A is traveling to or living in a country with high infection rates. You can check the CDC’s travel advisories to learn about recent outbreaks. Eating raw foods or drinking tap water can raise your risk while traveling. Children who attend daycare centers also have a higher risk of getting hepatitis A.

Many adults who get hepatitis B have mild symptoms for a short time and then get better on their own. But some people are not able to clear the virus from the body, which causes a long-term infection. Nearly 90% of infants who get the virus will carry it for life. Over time, hepatitis B can lead to serious problems, such as liver damage, liver failure, and liver cancer.

You can get it through contact with the blood or body fluids of an infected person. In the U.S., it’s most often spread through unprotected sex. It’s also possible to get hepatitis B by sharing an infected person’s needles, razors, or toothbrush. And an infected mother can pass the virus to their baby during childbirth. Hepatitis B is not spread by hugging, sharing food, or coughing.

Anyone can get hepatitis B, but people who have multiple sex partners or inject illegal drugs have a higher risk. Other risk factors include being a health care worker who is exposed to blood, or living with someone who has chronic hepatitis B.

About 25% of people who get hepatitis C defeat the virus after a short-term infection. The rest will carry the virus in their body for the long term. Chronic hepatitis C can cause very serious complications, including liver failure and liver cancer. There are effective treatments for the virus, though. 

It spreads through infected blood. In the U. S., sharing needles or other items used to inject drugs is the most common cause of infection. Getting a tattoo or body piercing with an infected needle is another means of exposure. A mother may pass the virus to their child at birth. In rare cases, unprotected sex spreads hepatitis C, but the risk appears small. Having multiple sex partners, HIV, or rough sex seems to raise risk for spreading hepatitis C.

People who have injected illegal drugs at any time, even one time, many years ago, could be walking around with chronic hepatitis C. Because there are often no symptoms, many former drug users may not realize they have the infection. People who received a blood transfusion before 1992 also have a higher risk. Before that year, donated blood was not screened for the hepatitis C virus.

Chronic hepatitis can quietly attack the liver for years without causing any symptoms. Unless the infection is diagnosed, monitored, and treated, many of these people will eventually have serious liver damage. Fortunately, blood tests can determine whether you have viral hepatitis, and if so, which kind.

Testing is important for anyone with the risk factors we’ve mentioned, particularly injected drug users and people who have had multiple sex partners. Health advocates are also urging people of Asian heritage to get tested. Stanford University’s Asian Liver Center estimates that 1 in 10 Asians living in the U.S. has chronic hepatitis B. Many of them have probably had the virus since birth.

Also, the U.S. Preventive Services Task Force recommends that health care providers offer a one-time hepatitis C screening for anyone born between 1945 and 1965.   

If a test says you have viral hepatitis, you can take steps to protect the ones you love. For hepatitis A, wash hands frequently. For hepatitis B and C, avoid sharing nail clippers, razors, or toothbrushes. Hepatitis B, and sometimes hepatitis C, can be passed through sexual contact. Make sure everyone in your household gets the hepatitis B vaccine. An important step is to see a specialist to discuss treatment options.

Hepatitis A almost always goes away on its own, and no medication is needed. If nausea is a problem, try eating several small meals throughout the day instead of three large ones. Drink water, juice, or sports drinks to stay hydrated. And avoid hard exercise until you’re feeling better.

The goal of treating chronic hepatitis B is to control the virus and keep it from damaging the liver. This begins with regular monitoring for signs of liver disease. Antiviral medications may help, but not everyone can take them or needs to be on medication. Be sure to discuss the risks and benefits of antiviral therapy with your doctor.

The latest drug to be approved by the FDA is glecaprevir and pibrentasvir (Mavyret). This medication offers a shorter treatment cycle of 8 weeks for adult patients with all types of HCV who don’t have cirrhosis and who have not been previously treated. The length of treatment is longer for those who are in a different disease stage. The prescribed dosage for this medicine is 3 tablets daily.

There are several other combination drugs available, as well as some single drugs that may be used in combination. Your doctor will choose the right one for you depending on the type of hepatitis C you have, how well your liver is functioning and any other medical problems you may have. Also be sure to discuss your insurance coverage since these medications are expensive.

To manage chronic hepatitis B or C, your doctor will order regular blood tests to check how well your liver is working. Ultrasounds and CT scans can also reveal signs of damage. If the virus is not causing any liver problems, you may not need treatment. But it’s important to have regular tests to watch for changes. Complications are easiest to treat when found early.

One of the most common complications of chronic hepatitis is cirrhosis. This is a scarring of the liver that can be found with a biopsy. Cirrhosis makes it difficult for the liver to do its job and can lead to liver failure, a life-threatening condition. Symptoms include fatigue, nausea, weight loss, and swelling in the belly and legs. In severe cases, patients may experience jaundice and confusion.

Viral hepatitis is the top cause of liver cancer, so people with chronic hepatitis B or C need monitoring even if they feel healthy. Blood tests can detect proteins that suggest the presence of liver cancer. Ultrasounds, CT scans, and MRIs can reveal abnormal lesions in the liver (seen here in green). A biopsy is needed to determine if these areas are cancerous. Tumors that are found early may be surgically removed. But most liver cancers are difficult to treat.

The liver is a vital organ that aids in metabolism, digestion, detoxifying, and the production of many proteins needed by the body. If a large part of the liver is damaged beyond repair, it will no longer be able to perform these important jobs. People cannot live without a working liver. In this case, a liver transplant may be the best hope. This option provides the patient with a healthy liver from a donor.

There are vaccines to protect against hepatitis A and B. The CDC recommends hepatitis A vaccination for all children ages 12 to 23 months and for adults who plan to travel or work in areas with hepatitis A outbreaks or who have other risk factors. People with chronic hepatitis B or C should also get the hepatitis A vaccine if they don’t already have immunity to the disease. The hepatitis B vaccine is recommended for all infants at birth and for adults who have any of the risk factors we discussed earlier. There is no vaccine for hepatitis C.

If you have chronic hepatitis, there are steps you can take to keep your liver resilient. Avoid alcohol, which can cause additional liver damage. Check with your doctor before taking any medications or supplements, because some are tough on the liver or may not be safe in people with liver disease. Most importantly, keep your appointments for regular monitoring. By watching for any changes in your liver, you and your health care provider can stay one step ahead of the virus.

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Allegheny General Hospital Liver Cancer Network.
American Cancer Society web site.
American Liver Foundation web site.
Centers for Disease Control and Prevention web site.
Hepatitis Foundation web site.
John W. Ward, MD, director, division of viral hepatitis, CDC, Atlanta.
Melissa Palmer, MD, clinical professor of medicine, New York University School of Medicine, New York City.
National Digestive Diseases Information Clearinghouse.
Pediatrics, published online Feb. 1, 2011.
The Nemours Foundation.
World Health Organization web site.
FDA. “FDA approves Mavyret for Hepatitis C.” “Mavyret Prescribing Information.”
Hepatitis C Online. “Hepatitis C Treatments.”


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Elevated Blood ALT: Causes and Diagnosis


  • 1 Elevated Blood ALT: Causes, Symptoms, and Treatment
    • 1.1 Elevated Blood ALT
    • 1.2 ALT: What It Is and How It Works 900 08
    • 1.3 Functions of ALT in the body
    • 1.4 Causes of elevated levels of ALT
    • 1.5 Diseases that cause elevated levels of ALT in the blood
      • 1. 5.1 Hepatitis
      • 1.5.2 Cirrhosis of the liver
      • 1.5. 3 Gallstone disease
      • 1.5.4 Aminotransferase dystrophy (ATD)
      • 1.5.5 Other diseases
    • 1.6 Symptoms of elevated blood levels of ALT
    • 1.7 Diagnosis of elevated levels of ALT
    • 9 0005 1.8 ALT tests: preparation and procedure

    • 1.9 Norm blood ALT levels
    • 1.10 Treatment of elevated ALT levels
    • 1.11 Related videos:
    • 1.12 Q&A:
        • What is ALT and what is its blood level?
        • What diseases can cause elevated blood levels of ALT?
        • Can elevated ALT be due to medication?
        • What test should be taken to determine the level of ALT in the blood?
        • Is it possible to determine the level of ALT in the blood?
        • What should be done if ALT is elevated in the blood?

Wondering what an elevated ALT level in a blood test means? Find out what causes this, what are the symptoms, and how you can lower your ALT levels through diet and treatment.

Alanine aminotransferase (ALT) is one of the indicators of a biochemical blood test that can signal liver damage. Elevated ALT levels can be indicative of a variety of diseases and conditions. The main thing is not to ignore this symptom and consult a doctor immediately.

Elevated blood levels of ALT can be caused by a variety of causes, including viral hepatitis, alcoholic and non-alcoholic fatty liver disease, drug poisoning, biliary obstruction, infectious diseases, and others. This indicator can also increase with prolonged physical exertion on the body, as well as during pregnancy.

In order to establish an accurate diagnosis, a comprehensive examination is required. In addition to a biochemical blood test for ALT, ultrasound and X-ray examinations of the abdominal organs, blood tests for other indicators, etc. can also be performed.

It is important to remember that spontaneous treatment can cause great harm to health. Be sure to contact only qualified doctors and follow all doctor’s prescriptions.

Elevated blood ALT

ALT (alanine aminotransferase) is an enzyme found in liver cells. When liver cells are damaged or destroyed, ALT is released into the bloodstream, causing an increase in blood levels of the enzyme.

To diagnose an elevated ALT level in the blood, it is necessary to conduct a blood test for biochemical analysis. In addition, additional tests, such as liver ultrasound or computed tomography, may be needed to determine the cause of elevated ALT levels.

  • To reduce the level of ALT, you need to see a doctor and determine the cause of the change in level.
  • Certain measures, such as avoiding alcohol, eating healthy, and exercising, can help lower your ALT levels.
  • Treatment of liver diseases is based on the cause of the disease.

ALT: what it is and how it works

ALT is an enzyme that converts alanine to pyroglutamate. ALT is found within liver cells, and to a lesser extent in the heart, muscles, and other organs.

It is important to understand that ALT cannot cross cell membranes. If the level of ALT is elevated, this may indicate the destruction of the cells that contain this enzyme.

ALT is used in medical diagnostics as an indicator of damage to the liver and other organs. Elevated blood levels of ALT can indicate various diseases such as viral hepatitis, liver cirrhosis, liver cancer, as well as drug toxicity and other health conditions.

  1. ALT is an important indicator of the health of the liver and other organs
  2. Elevated levels of ALT can indicate various diseases
  3. It is important to identify the cause of elevated levels of ALT in the blood for proper diagnosis and treatment

ALT functions in the body

ALT (alanine aminotransfer aza) is an enzyme found in body tissues, especially in the liver and heart. There are several functions of ALT in the body. One of its main functions is participation in the metabolism of protein compounds, including amino acids.

In addition, ALT plays a key role in animal metabolism. It helps to remove excess ammonia, which is toxic to the body.

Changes in the level of ALT in the blood may indicate abnormalities in the functioning of the liver, heart and other organs.

Causes of elevated ALT levels

Alanine aminotransferase (ALT) is an enzyme found in the cells of the liver, heart, muscles and other organs. Its level in the blood is an indisputable marker of diseases of certain organs and tissues. Consider the main reasons for the increase in the level of ALT in the blood.

  • Liver diseases . Elevated ALT levels can be associated with various liver diseases such as hepatitis, cirrhosis, jaundice, and others. In these cases, an increase in ALT levels may be one of the first signs of the disease.
  • Alcoholism . Heavy drinking can lead to liver damage and elevated ALT levels.
  • Muscle injury . Muscle injury can lead to elevated ALT levels. Also, exercises that cause intense stress on the muscles can lead to an increase in ALT levels for a short time.
  • Medicines . Certain medications, such as aspirin, antibiotics, steroids, and others, can raise blood levels of ALT.

Remember that elevated ALT is not a disease in itself, but only a marker. Diagnosis and identification of the causes of elevated levels of ALT in the blood requires a visit to a doctor and further examination.

Diseases that cause elevated levels of ALT in the blood


An increase in the level of ALT in the blood is often associated with hepatitis – viral or alcoholic. Hepatitis is an inflammatory reaction of the liver that can lead to elevated levels of ALT in the blood. With viral hepatitis, ALT can increase by several tens of times.

Cirrhosis of the liver

Cirrhosis of the liver is a chronic disease in which healthy liver tissue is replaced by scarring, which can lead to decreased liver function. A high level of ALT in the blood can be one of the signs of cirrhosis of the liver.


In gallstone disease, stones form in the gallbladder or bile ducts, which can lead to inflammation of the liver. ALT levels may be elevated in acute or chronic inflammation of the liver associated with gallstone disease.

Aminotransferase dystrophy (ATD)

Aminotransferase dystrophy is a genetic disease that causes an increase in the level of ALT in the blood. This is due to a violation of the transfer of the amino acid alanine between cells.

Other diseases

Elevated levels of ALT may also be associated with other liver diseases, such as hepatosis (changes in the structure of the liver), liver cancer, or even heart failure.

Some diseases associated with elevated levels of ALT Disease Description

Hepatitis Inflammation of the liver, causing an increase in the level of ALT in the blood
Cirrhosis of the liver Chron a medical disease that results in the replacement of healthy liver tissue with scarring and elevated levels of ALT
Gallstone disease Formation of stones in the gallbladder or bile ducts causing inflammation of the liver and elevation of ALT
ATD Genetic disease that causes an increase in the level of ALT in the blood
Hepatosis Change in the structure of the liver that causes an increase in the level of ALT in the blood
Liver cancers Liver cancer or metastases causing elevated ALT in the blood
Heart failure Decreased heart function causing an increase in the level of ALT in the blood

Symptoms of elevated blood levels of ALT

Elevated levels of ALT in the blood can be a symptom of various diseases and organ dysfunctions.

An increased amount of ALT may indicate the presence of viral hepatitis, liver cirrhosis, liver cancer, alcohol and drug intoxication, diseases of the liver, bile ducts and biliary tract. Elevated ALT levels can also be observed in people with diabetes and obesity.

If you have symptoms of elevated ALT levels in the blood, it is important to immediately consult a doctor and undergo a comprehensive examination in order to identify the cause of this condition and begin timely treatment.

Diagnosis of elevated ALT levels

Diagnosis of elevated blood ALT levels begins with a complete blood count, which is often performed during routine check-ups. If the ALT level exceeds the norm, then the doctor may prescribe additional studies.

To confirm the diagnosis and determine the cause of elevated ALT levels, more accurate tests, such as biochemical tests of blood, urine and feces, as well as ultrasound of the liver and gallbladder, may be prescribed.

  • Blood chemistry tests can help determine specific ALT levels as well as other indicators associated with liver disease;
  • Ultrasound examination of the liver and gallbladder allows you to determine possible changes in these organs and study their structure;
  • Urine and feces analysis helps to find out which metabolic products are excreted from the body;

Depending on symptoms and other factors, your doctor may order additional tests and procedures to identify the cause of your high ALT levels. The results of all these studies will help to make an accurate diagnosis and prescribe the right treatment.

ALT Tests: Preparation and Procedure

ALT testing requires preparation. Within 12 hours before blood sampling, it is recommended not to eat, and also to exclude the intake of alcohol, fatty and fried foods, and smoking. This will help avoid distorting the analysis results.

ALT results are usually available 1-2 days after blood sampling. With elevated ALT levels, additional diagnostics may be required to identify the cause of this phenomenon, but only a doctor can determine the need for such a study.

Normal blood ALT levels

ALT (alanine aminotransferase) is an enzyme produced in liver cells and other body tissues. The normal level of ALT in the blood in adult men does not exceed 45 units per liter, in women – no more than 34 units per liter.

In children and adolescents, normal ALT levels may vary by age. So, in children under the age of 9 years, the normal level of ALT is no more than 50 units per liter, in adolescents aged 9 to 12 years – no more than 45 units per liter, and in boys and girls aged 12 to 18 years – no more than 55 units per liter.

It is important to note that ALT levels may vary depending on the assay methods used in the laboratory. When interpreting the results, it is necessary to take into account the specific methods and norms adopted in this laboratory.

Treatment of elevated ALT levels

If elevated ALT levels are detected, consult a physician and follow treatment recommendations. Changes in diet and a healthy lifestyle can help reduce ALT levels, but in most cases, medication will be needed.

Depending on the cause of the elevated ALT levels, different medications are used. If the cause is viral, then antiviral drugs are needed, in the case of hepatitis, the establishment of timely diagnosis, the choice of appropriate therapy and its strict implementation.

In diseases of the biliary tract, choleretic, cholelithic preparations are recommended. In the presence of tumor processes, only surgical treatment can normalize the level of ALT. Additional recommendations for treatment should be prescribed by the attending physician.

It is not recommended to stop taking medications without your doctor’s consent.

  • Drug treatment should be carried out under medical supervision.
  • Do not mix drugs with alcohol to avoid additional damage to the liver.
  • It is important to take care of your health and have regular medical check-ups.

If you experience pain in the right hypochondrium, weakness, fever, swelling and jaundice, you should immediately consult a doctor.

Video on the topic:


What is ALT and what is its norm in the blood?

ALT (alanine aminotransferase) is an enzyme that is found inside the liver cells and is responsible for the metabolism of amino acids in the body. The norm of ALT in the blood in men is 10-40 U / l, and in women – 7-35 U / l. However, with various diseases, the norm may deviate upwards.

What diseases can cause elevated blood levels of ALT?

Elevated ALT levels may be associated with liver disease (hepatitis, cirrhosis, fatty degeneration), heart disease (heart attack, arrhythmia), problems with the external bile duct, and other diseases associated with impaired amino acid metabolism (eg, diabetes).

Can elevated ALT levels be related to medication?

Yes, some medications can increase ALT levels in the blood, such as anti-tuberculosis drugs, antivirals, steroids, anti-cancer drugs, antibiotics, etc. Therefore, you should tell your doctor that you are taking any medications before testing.

What test should be taken to determine the level of ALT in the blood?

A blood chemistry test is required to determine the level of ALT in the blood. Usually, this test is prescribed in combination with other tests, such as a complete blood count, bilirubin level, AST, etc.

Can I determine the level of ALT in the blood myself?

No, the determination of the level of ALT in the blood is possible only when donating blood in a medical institution and conducting an appropriate analysis. It is impossible to independently determine the level of ALT in the blood.

What should be done if ALT is elevated in the blood?

If ALT levels are elevated, you should see a doctor to diagnose the disease that caused this deviation. Depending on the cause of the elevated ALT level, your doctor will prescribe the appropriate treatment.

ALT (ALT, Alanine aminotransferase, alanine transaminase, SGPT, Alanine aminotransferase)

Alanine aminotransferase (AlAT, ALT) is an intracellular enzyme, the content of which in the blood of healthy people is low. It is mainly found in the cells of the liver, myocardium, skeletal muscles, pancreas. When cells containing ALT are damaged or destroyed, the enzyme is released into the bloodstream, and its concentration in the blood increases.

Determination of the level of alanine aminotransferase is carried out for the diagnosis of liver diseases and dynamic monitoring of their treatment. The analysis is performed for suspected acute or chronic hepatitis of viral or toxic etiology, cirrhosis of the liver, primary tumors, or metastatic liver disease.

The growth of alanine aminotransferase in the blood in hepatitis is noted much earlier than the onset of the icteric stage, which makes it possible to identify the pathology at the initial stage.

As part of a screening examination (preventive examination of persons who do not have complaints) to assess the state of the liver, before planned hospitalization and surgical treatment, an analysis for ALT is prescribed together with another enzyme – AsAT (aspartate aminotransferase).

The level of ALT along with other enzymes is evaluated in diseases of the pancreas and gallbladder – pancreatitis, cholecystitis, cholelithiasis; if there are complaints of unexplained general weakness, fatigue, yellowness of the skin and sclera, abdominal pain, including a feeling of heaviness in the right hypochondrium, nausea, vomiting.

In addition, the ALT level is taken into account in myocardial infarction and myocarditis, although in cases of heart damage it is only of secondary importance. The study is prescribed for suspected myositis, myodystrophy, when complaints of muscle pain cannot be explained by injuries or excessive physical activity.

Donation is a mandatory reason for testing for ALT.

ALT values ​​are assessed in any chronic disease, before prescribing drug therapy, for example, antitumor, anti-tuberculosis drugs, to assess the initial state of the liver and over time to assess drug tolerance.

Preparation for the procedure

It is better to take the test in the morning on an empty stomach (after an 8-14 hour break after the last meal).

Drinking water is allowed.

If necessary, it is permissible to donate blood 4-6 hours after a light meal.

On the eve it is desirable to avoid physical and emotional overload, overeating.

Avoid alcohol intake 5-6 days before the test.

Avoid smoking 30 minutes before blood sampling.


The survey is completed within one business day.

What can affect the results

Intense physical activity the day before and even a few days before the test can lead to damage to muscle tissue (the so-called tear of muscle fibers) and, accordingly, an increase in the level of ALT. For the same reason, the analysis given after the injury is not informative.

Taking alcohol, certain drugs (antibiotics, non-steroidal anti-inflammatory drugs, anticancer drugs, oral contraceptives, etc.) often distort the result of the study. The list of medications taken should be discussed with the doctor who ordered the analysis, cancel those that are possible – without risk to health.

ALT (ALT, Alanine aminotransferase, alanine transaminase)

For research, blood is taken from a vein. Usually, ASAT (AST, Aspartate aminotransferase) is determined simultaneously and the ratio of ASAT / AlAT (de Ritis coefficient) is estimated.

You can take a blood test for ALT (ALT, Alanine aminotransferase, alanine transaminase) at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the “Addresses” section.

The interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.


Units of measure: U/l.

Reference values ​​

Floor Age AlAT level, U/l
Both < 5 days < 49
5 days – 6 months < 56
6 – 12 months < 54
1 – 3 years < 33
3 years – 6 years < 29
6 – 12 years old < 39
Male 12 – 17 years old < 27
> 17 years old < 41
Female 12 – 17 years old < 24
> 17 years old < 31

Explanation of indicators

The level of ALT depends on the age and sex of the patient. Minor deviations from the norm, as a rule, do not require drug therapy, and the recommendations associated with them, such as rational nutrition, avoidance of alcohol, etc. should be discussed with your doctor.

The AST/ALAT ratio (de Ritis ratio) is normally between 0.91 and 1.75.

What do low readings mean

A significant decrease in the level of ALT can be detected in severe liver damage, for example, in the terminal stage of liver cirrhosis, when the number of liver cells is significantly reduced.

What do elevated values ​​mean

First of all, with an increase in ALT, liver problems should be suspected: fatty hepatosis, hepatitis of viral or toxic etiology, cirrhosis of the liver, liver cancer – primary or metastatic.

The degree of increase in ALT is usually associated with the extent or severity of liver damage, but cannot be considered as a determining factor for the prognosis of the disease. The maximum levels of ALT (and AST) – more than a hundred times higher than the norm, are observed in patients with acute viral and drug-induced hepatitis.

A significant increase in alanine aminotransferase can be observed in acute cholecystitis, cholelithiasis, and acute destructive pancreatitis. Another reason may be the use of hepatotoxic drugs that damage liver cells.

An increase in the level of ALT is detected with extensive injuries of the skeletal muscles, severe myositis and myodystrophy, frequent intramuscular injections.

A less significant increase in ALT is recorded in acute myocardial infarction and myocarditis.

Additional examination in case of deviation of the indicator from the norm

If a change (often an increase) in the level of ALT is detected, patients are consulted

general practitioners



, hepatologists, infectious disease specialists.

To clarify the diagnosis, in addition to ALT, other liver enzymes (AST, gamma-HT, alkaline phosphatase, bilirubin), clinical blood counts, and markers of viral hepatitis, primarily hepatitis B and hepatitis C, are usually examined.

An ultrasound examination of the abdominal organs is performed, according to indications – computed tomography (CT) with contrast.

If damage to the skeletal muscles is suspected, the CPK enzyme is additionally examined and a rheumatologist is consulted.

If there is a suspicion of damage to the heart muscle, a consultation with a cardiologist is required. Usually, the doctor prescribes additional electrocardiography (ECG), echocardiography, blood test for CF-CPK, troponin I.

O.P. The role of new reference values ​​of alanine aminotransferase in the diagnosis of various forms of non-alcoholic fatty liver disease in patients with metabolic syndrome. Journal of Biomedical Technologies № 1. 2015. P. 9-15.

  • Clinical guidelines “Cirrhosis and fibrosis of the liver”. Developed by: Russian Society for the Study of the Liver, Russian Gastroenterological Association. – 2021.
  • Clinical guidelines “Liver cancer (hepatocellular)”. Developed by: Association of Oncologists of Russia, Russian Society of Clinical Oncology, Russian Society of Radiologists and Radiologists.