5 ways to lower ALT levels naturally

• To lower ALT levels, you can drink coffee, improve your diet, get more folic acid or folate, lower your cholesterol, and avoid alcohol or smoking.
• High ALT levels can indicate a liver problem, as these liver enzymes do not function properly and leak into the bloodstream.
• This article was medically reviewed by Rudolph Bedford, MD, gastroenterologist at Providence Saint John’s Health Center in Santa Monica, CA.

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If you have high ALT levels — a liver enzyme known as alanine aminotransferase — it may be due to a liver problem. Here’s what you need to know about these liver enzymes and how to lower your ALT levels naturally.

What is ALT?

ALT is an enzyme in your liver cells that helps convert proteins from the foods you eat into energy. If your liver cells are inflamed or injured, they may leak higher amounts of these enzymes, which causes them to be released into your bloodstream.

Your ALT level can be measured through an ALT blood test. For males, the normal amount ranges from 29 to 33 units per liter (IU/L) of blood. For females, the range is 19 to 25 IU/L.

Some of the common causes of a high ALT level include:

• Nonalcoholic fatty liver disease, an accumulation of extra fat in your liver cells that isn’t caused by drinking alcohol
• Drinking excessive amounts of alcohol, such as more than three drinks a day
• Being obese
• Side effects of over-the-counter pain medications (like Tylenol) or cholesterol-lowering medications (like statins)
• Hepatitis A, B, or C
• Heart failure

Fortunately, an elevated ALT level is usually temporary and doesn’t indicate a serious liver problem.

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“If you have an elevated liver enzyme test, step one is to give it some time and repeat it,” says hepatologist Zachary Henry, MD, an associate professor in the Division of Gastroenterology and Hepatology at the University of Virginia. “Sometimes these levels go up and down, and it may have just been a red herring.”

But, if you do have persistently high ALT levels, the following lifestyle changes may help lower them and improve your liver health overall.

1. Drink more coffee

“Coffee is a fascinating drink for the liver,” Henry says. In fact, drinking up to four cups a day can help lower your ALT levels, according to a 2017 review.

A large 2014 study found that both caffeinated and decaffeinated coffee lowered levels of abnormal liver enzymes. Of the 27,793 adult participants, those who drank at least three cups of coffee a day had lower ALT levels than participants who didn’t drink coffee.

One caveat is that you should drink coffee without sugar and cream since these can have a detrimental effect on your liver. “It’s best to drink it black,” Henry says.

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2. Improve your diet

Studies have found that eating a healthy, well-balanced diet can help lower your ALT level. After 10 men in Japan ate low-calorie lunches for a month that were high in vegetables and low in animal-based proteins, their ALT levels were lowered by 20.3%, according to the results of a small 2013 study.

There are no specific foods or beverages that will lower your ALT level, Henry says. But a healthy diet is important, especially if the cause of an elevated ALT level is nonalcoholic fatty liver disease.

The American Liver Foundation recommends that you eat more of these foods for a healthier liver:

• Fruits and vegetables
• Lean meats
• Fish containing omega-3 fatty acids, such as salmon and trout
• High-fiber foods like whole-grain breads, rice, and cereal
• Fat-free or low-fat milk and other dairy products

On the other hand, you should avoid eating the following:

• Foods high in sugar, fat, or salt
• Fried foods
• Raw or undercooked shellfish like clams or oysters
• Foods containing partially hydrogenated vegetable oils

3. Get more folic acid

Folic acid is a form of vitamin B-9 found in supplements and in its natural form as folate in some foods. It’s essential for the production, growth, and function of red blood cells.

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A folic acid deficiency may lead to a higher ALT level. A 2011 study of 480 participants with mild hypertension found that a daily dose of 800 milligrams of folic acid may help lower ALT levels, especially for men and people with elevated ALT levels.

However, Henry warns that you should always consult with your doctor before taking folic acid or other supplements to make sure there are no perceived health risks. Instead of taking folic acid supplements, he recommends eating foods that are high in folate. These include:

• Leafy, dark green vegetables like spinach, kale, and brussels sprouts
• Beans
• Peanuts
• Sunflower seeds
• Whole grains
• Liver

4. Lower your cholesterol

A large 2018 study suggests that high cholesterol levels are associated with elevated ALT levels.

While lowering your cholesterol level may not necessarily also lower your ALT level, making lifestyle improvements like eating a healthy diet and exercising regularly are still important.

“Patients who have fatty liver disease frequently have comorbid medical conditions like high cholesterol, and we certainly want good control of those conditions because of the increased risk of heart disease,” Henry says.

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5. Avoid alcohol and smoking

It’s a well-known fact that drinking alcohol can damage your liver, leading to serious health issues like cirrhosis.

A large 2010 study found that normal ALT levels were elevated by 6% for those who drank about two alcoholic drinks each day, and 10.4% for those who had four drinks daily.

Smoking cigarettes should also be avoided since it can harm your liver in several ways. For example, it produces potentially toxic chemicals that could cause liver inflammation and scarring of your liver tissue. Researchers have found that for people who don’t drink alcohol, smoking may be a significant risk factor for developing nonalcoholic fatty liver disease.

Takeaways

While making these lifestyle changes may help lower your elevated ALT level and improve your health overall, it’s important to see a doctor if the level continues to be high after follow-up ALT tests. Your doctor may recommend additional bloodwork and an ultrasound of your liver, or may refer you to a specialist, to determine why your liver is injured or inflamed.

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About asat and alat in the blood test and the reasons for their increase

Cells of the liver, heart and some other organs produce special enzymes involved in metabolic processes. Normally, they practically do not enter the bloodstream, and are not detected during the analysis or are contained in very small quantities. However, diseases that cause destruction of the cellular structure of tissues contribute to the release of these enzymes into the bloodstream. The most significant in the diagnosis of pathological processes are substances abbreviated as AlAt and AsAt.

Alat in a blood test – what is it?

This is the abbreviation for one of the main enzymes involved in the metabolism of amino acids – alanine aminotransferase. It is produced mainly by hepatocytes – liver cells. In smaller quantities, it is synthesized in skeletal and cardiac muscle tissue, the pancreas. Usually, in the blood of a healthy person, in a laboratory biochemical study, alanine aminotransferase is not detected or is detected in very small quantities. At the same time, ALT is increased in men due to accelerated amino acid metabolism (in women, it is carried out less intensively).

Most often, a complex laboratory analysis is carried out with the determination of the concentration of another substance – aspartate aminotransferase (abbreviated AsAt). It is produced by the same cells and also participates in amino acid metabolism. The content of the enzyme in the blood plasma also changes with certain diseases of the liver and muscles of the heart, indicating necrotic processes.

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But the main diagnostic value is the ratio of these two enzymes, the value of which is called the de Ritis coefficient and allows you to reliably establish the localization of the pathological process. If the reference (permissible) indicators are exceeded, and the coefficient value is less than 0.91 or more than 1.75, one can assume liver problems in the first case or heart pathology in the second.

Norm of AsAt and AlAt in the biochemical analysis of blood

The concentrations of these enzymes change over time, which is the norm in childhood. For example, in infants, the level is higher than in adults due to the characteristics of the period of childbirth. Due to the massive release of erythrocytes into the blood and their subsequent transformation into bilirubin, jaundice characteristic of newborns develops and, accordingly, an increase in the amount of ALT.

For ASAT and ALT, the norms for children of different ages and adults can be found in the table:

As can be seen from the table, normal values ​​constantly fluctuate in childhood and adolescence, and from the age of 12 they also differ according to the sex of the subject. In addition, a slight increase in the level of Alat is the norm in women in the blood during early pregnancy. However, in the last trimester, an increase in the concentration of the enzyme indicates gestosis, which threatens the health of the mother and fetus.

Aspartate aminotransferase is also determined in different quantities according to sex and age. In adult men, the upper limit of the norm is 37 units per liter, in women – 31. The highest level is observed in children of the first days of life (up to 97 units / l), decreasing to 82 by the year, and to 36 by six. For adolescents, 12 -17 years old, values ​​​​not exceeding 29 and 25 IU / l for boys and girls, respectively, are considered normal.

AlAt and AsAt are elevated in the blood test – what does this mean, what are the reasons?

An increase indicates a pathological destruction of hepatocytes, heart cells, and pancreas. Normally, they enter the blood in a minimal amount, as a result of natural tissue renewal and the death of old cells. Extensive organ damage and massive cell death lead to a sharp increase in their volume in the bloodstream. Thus, the growth of ALT indices in the blood serum is typical for the following diseases and conditions:

• hepatitis, liver cirrhosis, fatty degeneration;
• acute pancreatitis;
• extensive burns, shock;
• viral infections;
• lymphoblastic leukemias;
• shocks of various etiologies;
• disorders of hematopoiesis;
• muscular dystrophy;
• mononucleosis.

Elevated blood AST or aspartate aminotransferase appears in blood plasma in large quantities during necrotic processes in the body. Exceeding the maximum allowable values ​​by several times (from 2 to 20) is a sign of diseases of the following organs:

• Heart – coronary insufficiency, myocardial infarction, pulmonary thrombosis, angina attacks, postoperative condition, rheumatic heart disease.
• Gall bladder and liver – cholestasis, cholangitis, amoebiasis, liver cancer, hepatitis, cirrhosis.
• Pancreas – acute inflammation or phlegmon.
• Skeletal muscles – damage or dystrophy;

The plasma concentration of the amount of the enzyme also increases with such systemic and infectious pathologies as vasculitis, mononucleosis, hemolytic syndrome.

Can an increase in the content of alanine aminotransferase and aspartate aminotransferase be caused by other causes, not related to diseases? Yes, enzyme levels rise in women early in pregnancy, which is normal. The same phenomenon can be observed with the use of certain drugs: antibiotics, antitumor and sedative drugs, barbiturates, oral contraceptives, and others. The level of physical activity, the intake of sports nutrition, and alcoholic beverages also affect the growth of indicators.

Read more: Deciphering the norms of blood biochemistry in the table for adults

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Who needs a study

Referral for biochemical blood analysis of AsAt and AlAt is mandatory given to all donors before the blood sampling procedure, as well as to persons with identified pathologies of the liver, heart, pancreas.

The results of this study are also used in hepatitis, cirrhosis, as they allow to determine the degree of damage to the organ. In addition, it is necessary to control the amount of enzymes during treatment with certain antibiotics, as well as after ingestion of toxic compounds.

The basis for a biochemical blood test is also a deterioration in general well-being in the form of constant weakness, fatigue, loss of appetite. Common symptoms such as abdominal pain, nausea and vomiting, yellowing of the whites of the eyes, dark urine, and digestive problems are reasons to see a doctor for a referral for an examination immediately.

How to prepare for an analysis for ALT, ASAT

You need to take blood from a vein for testing, which is done in state clinics by referral or on a paid basis in private laboratories. A sample for AlAt and AsAt in the blood is taken in the morning and strictly on an empty stomach: at least 12 hours must pass after the last meal. On the day of the visit to the laboratory, you should not smoke, drink any liquids other than water. All week before the test, it is strictly forbidden to drink alcoholic beverages.

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In addition, the result may distort the intake of any drugs – antimicrobial, contraceptive, choleretic, sedative and others. So the question of their cancellation or temporary suspension of treatment should be discussed with your doctor in advance. The term for the analysis is a day, that is, the very next day you can go for the results. For an additional fee, the process can be accelerated: an express test is done in just 2 hours.

Analysis transcript

The test results must be given to your doctor. The specialist draws attention to the quantitative indicators of the content of both enzymes, the degree of excess of the maximum allowable value and their ratio. For example, the concentration of Alat allows us to draw conclusions about the nature of liver diseases. Thus, hepatitis A, B, C cause a 20-fold excess of the norm, and alcoholic – 6 times. With fatty degeneration, an increase of 2 or 3 times is observed.

As for oncological diseases (liver cancer, in particular), then attention should be paid to aspartate aminotransferase and its concentration.

With carcinoma, it increases several times, and progresses over time. At the same time, the values ​​of alanine aminotransferase increase slightly. In the late, inoperable stages of cirrhosis, the opposite phenomenon is observed.

Of particular importance is the so-called de Ritis coefficient – the numerical ratio of elevated ALT and ASAT values, especially if the localization of the pathological process has not yet been accurately established. With liver damage, elevated ALT in the blood is usually observed, and the content of aspartate aminotransferase decreases. If the myocardium is damaged, the inverse proportion is obtained. Normally, the de Ritis coefficient has a value of 0. 91 to 1.75, that is, with the destruction of hepatocytes, it is much less than 1, and with a heart attack – more than 2.

In addition, the concentration of enzymes is reduced. For AlAt and AsAt in the blood test, this is typical in the case of repeated sessions of hemodialysis, liver rupture, necrosis or cirrhosis, as well as with a pronounced lack of B-group vitamins in the body or taking anticoagulants. In any case, a specialist should deal with the decoding, taking into account external factors that could affect the final result of the study, since it is not always determined by pathological causes. It is unacceptable to draw conclusions and make diagnoses without having a special education.

How to lower blood ALT?

If quantitative deviations of indicators from the norm were revealed, first of all it is necessary to exclude the influence of such factors as the intake of dietary supplements and alcohol, excessive physical activity. A diet that includes too many fatty and “heavy” foods also needs to be adjusted. Often it is food that provokes inflammation of the pancreas, and diet promotes recovery.

When drug therapy becomes the cause, the doctor should adjust the course or change the drug to a less toxic one. However, the effectiveness of such a measure should be continuously monitored through regular reviews. If the concentration of enzymes has changed due to liver disease or other pathological process, it must be identified and cured. For this, a complete examination with hospitalization is usually prescribed.

Read more: ESR in oncology, normal blood counts, relationship with cancer

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Obesity and liver

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Obesity and liver

The liver is a vital organ that guards our body.
Recently, gastroenterologists have noted a bleak trend: during diagnostic examinations, situations are increasingly encountered when a patient’s blood test reveals an increase in the level of liver enzymes (transaminases – AST and ALT). This increase indicates a violation of the normal functioning of liver cells.
At the same time, the person does not abuse alcohol, does not suffer from viral liver diseases.

What is the reason for this phenomenon?

Obesity is at the root of the problem. It is represented by both a visible increase in body weight (in numbers, this reflects BMI – body mass index), and invisible obesity of internal organs. In this case, part of the mass of cells of the internal organs is replaced by adipose tissue, which, of course, is benign, although it does not fulfill its functions. All this is true for the liver.
Obesity of the internal organs is caused by a decrease in the sensitivity of the insulin-receiving receptors of the cells of the internal organs to insulin (the cells stop absorbing glucose, which disrupts their normal functioning), i. e. developing insulin resistance. It is believed that in most cases, the hereditary factor plays a role in the development of insulin resistance, but according to modern research, the influence of external risk factors has also turned out to be just as important: a high-calorie diet, low physical activity, and a violation of the intestinal microflora. With a disturbed microflora, the growth of bacteria in the small intestine increases several times, along with this, the activity of bacterial antigens entering the liver with the bloodstream increases. Antigens activate complex mechanisms of action on the liver cell, which contribute to the blocking of insulin-perceiving receptors. A decrease in the sensitivity of the cells of the internal organs to insulin leads to a lack of absorption of glucose by the cells, which disrupts their normal functioning. And, ultimately, leads to the death of liver cells (hepatocytes).

How to detect the disease?

With regard to liver cells, the described phenomenon clearly reflects the biochemical analysis of blood. The higher the level of transaminases (AST, ALT), the more pronounced the destruction of liver cells – cytolysis. With obesity, cytolysis proceeds slowly in the liver, for years. To eliminate the risk of developing cytolysis in the absence of visible signs, it is necessary to periodically (once every six months) undergo a scheduled medical examination. A biochemical blood test will reveal existing disorders even in the early stages of diseases. Extended tests will be carried out as needed.
Remember, the earlier violations are detected, the more chances to cope with the disease. Do not neglect the recommendations of doctors to undergo timely medical examination.

In order to prevent

It is necessary to exclude, first of all, factors that damage the liver, including alcohol, to treat or prevent obesity, disorders of carbohydrate fat metabolism, high cholesterol (high cholesterol also dramatically increases the risk of developing cardiovascular diseases).