What are AST and ALT. How are these liver enzymes measured. What do high or low levels indicate. When should you get tested for AST and ALT. How can you maintain healthy liver enzyme levels.

The Importance of AST and ALT in Liver Health Assessment

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are crucial enzymes primarily found in the liver. These enzymes play a significant role in amino acid metabolism and are key indicators of liver health. When liver cells are damaged, AST and ALT are released into the bloodstream, making them valuable markers for detecting liver disease and injury.

AST is present in various tissues throughout the body, including the heart, muscles, and kidneys, while ALT is more specific to the liver. Together, these enzymes provide a comprehensive picture of liver function and can help healthcare providers diagnose and monitor a wide range of liver conditions.

Why are AST and ALT tests performed?

Healthcare providers order AST and ALT tests for several reasons:

• To screen for liver disease in patients with risk factors
• To diagnose the cause of symptoms suggestive of liver problems
• To monitor the progression of known liver conditions
• To assess the effectiveness of treatments for liver diseases
• To check for potential liver damage from medications

These tests are often part of a comprehensive metabolic panel (CMP) or liver function panel, which provides a broader overview of metabolic and liver health.

Understanding AST and ALT Test Results

Interpreting AST and ALT test results requires considering the normal ranges, which can vary slightly between laboratories. Generally, normal ALT levels range from 7 to 55 units per liter (U/L) for adults, while normal AST levels typically fall between 8 and 48 U/L. However, it’s crucial to note that these ranges may differ based on age, gender, and individual factors.

What do elevated AST and ALT levels indicate?

Elevated levels of AST and ALT can signify various liver conditions and other health issues:

1. Hepatitis (viral, alcoholic, or autoimmune)
2. Cirrhosis
3. Nonalcoholic fatty liver disease (NAFLD)
4. Drug-induced liver injury
5. Liver cancer
6. Heart problems (particularly for AST)
7. Muscle disorders or injuries (especially for AST)

It’s important to understand that mildly elevated levels don’t always indicate serious liver disease. Factors such as strenuous exercise, certain medications, and even rapid growth in children can cause temporary increases in these enzymes.

Factors Affecting AST and ALT Levels

Several factors can influence AST and ALT levels, making it essential for healthcare providers to consider a patient’s complete medical history when interpreting results. Some of these factors include:

• Age and gender
• Body mass index (BMI)
• Alcohol consumption
• Medication use
• Recent physical activity
• Presence of other medical conditions

For instance, men typically have slightly higher ALT levels than women, and older adults may have lower baseline levels of both enzymes. Understanding these factors helps in providing a more accurate interpretation of test results.

The AST/ALT Ratio: A Valuable Diagnostic Tool

The ratio of AST to ALT can provide additional insights into the nature and severity of liver damage. This ratio is particularly useful in distinguishing between different types of liver diseases and assessing the likelihood of certain conditions.

How is the AST/ALT ratio interpreted?

The AST/ALT ratio is interpreted as follows:

• A ratio less than 1 is considered normal and is often seen in viral hepatitis and nonalcoholic fatty liver disease.
• A ratio greater than 2 may indicate alcoholic liver disease or advanced liver cirrhosis.
• A ratio between 1 and 2 can be seen in various liver conditions and requires further investigation.

While the AST/ALT ratio is a valuable tool, it should always be considered alongside other clinical findings and diagnostic tests for a comprehensive evaluation of liver health.

Preparing for AST and ALT Tests

Proper preparation is crucial for obtaining accurate AST and ALT test results. While these tests don’t typically require extensive preparation, there are a few important considerations:

What should you do before an AST/ALT test?

• Inform your healthcare provider about all medications and supplements you’re taking, as some may affect test results.
• Avoid strenuous exercise for 24-48 hours before the test, as intense physical activity can temporarily elevate enzyme levels.
• Follow any fasting instructions provided by your healthcare provider. Some tests may require fasting for 8-12 hours before the blood draw.
• Stay well-hydrated, unless instructed otherwise, to make the blood draw easier.

By following these guidelines, you can help ensure that your test results accurately reflect your liver health status.

Beyond AST and ALT: Other Important Liver Function Tests

While AST and ALT are crucial indicators of liver health, they are often part of a broader panel of tests that provide a more comprehensive assessment of liver function. Other important liver function tests include:

• Alkaline phosphatase (ALP)
• Gamma-glutamyl transferase (GGT)
• Bilirubin
• Albumin
• Prothrombin time (PT)

These tests, when interpreted together, offer a more complete picture of liver health and can help differentiate between various liver conditions. For example, elevated ALP and GGT levels may indicate bile duct problems, while abnormal bilirubin levels can signal issues with bile production or flow.

How do these tests complement AST and ALT?

Each of these tests provides unique insights into different aspects of liver function:

• ALP and GGT can help identify cholestatic liver diseases
• Bilirubin levels can indicate problems with bile production or excretion
• Albumin and PT assess the liver’s synthetic function

By combining these tests with AST and ALT measurements, healthcare providers can gain a more comprehensive understanding of liver health and function, leading to more accurate diagnoses and treatment plans.

Lifestyle Factors Affecting Liver Enzyme Levels

Various lifestyle factors can significantly impact liver enzyme levels, including AST and ALT. Understanding and managing these factors can help maintain optimal liver health and prevent liver damage.

Which lifestyle choices influence AST and ALT levels?

1. Alcohol consumption: Excessive alcohol intake is a major contributor to elevated liver enzymes and can lead to alcoholic liver disease.
2. Diet: A diet high in processed foods, saturated fats, and added sugars can contribute to nonalcoholic fatty liver disease and elevated enzyme levels.
3. Physical activity: Regular exercise can help maintain healthy liver enzyme levels, while lack of physical activity may contribute to fatty liver disease.
4. Weight management: Obesity is strongly associated with nonalcoholic fatty liver disease and elevated liver enzymes.
5. Smoking: Tobacco use can exacerbate liver damage and contribute to elevated enzyme levels.

By addressing these lifestyle factors, individuals can take proactive steps to maintain healthy liver enzyme levels and overall liver health.

When to Seek Medical Attention for Abnormal AST and ALT Levels

While mildly elevated AST and ALT levels may not always indicate a serious problem, there are situations where medical attention is warranted. Understanding when to consult a healthcare provider is crucial for early detection and management of potential liver issues.

In which cases should you consult a doctor about AST and ALT levels?

• Persistently elevated levels: If AST and ALT levels remain elevated over multiple tests, it’s important to investigate the underlying cause.
• Significantly high levels: AST or ALT levels more than three times the upper limit of normal may indicate acute liver injury and require immediate medical attention.
• Accompanying symptoms: If elevated enzyme levels are accompanied by symptoms such as jaundice, abdominal pain, fatigue, or unexplained weight loss, medical evaluation is necessary.
• Risk factors: Individuals with risk factors for liver disease, such as a history of alcohol abuse, obesity, or exposure to hepatitis, should be particularly vigilant about abnormal test results.
• Medication use: If you’re taking medications known to affect liver function, any elevation in AST or ALT should be discussed with your healthcare provider.

Early detection and management of liver problems can significantly improve outcomes and prevent the progression of liver disease.

Natural Ways to Support Liver Health and Enzyme Levels

Maintaining healthy liver enzyme levels and overall liver health can often be achieved through natural means. While it’s important to consult with a healthcare provider for personalized advice, several lifestyle changes and natural remedies may help support liver function and keep AST and ALT levels within normal ranges.

What natural methods can help maintain healthy liver enzyme levels?

1. Maintain a balanced diet: Focus on whole foods, fruits, vegetables, lean proteins, and healthy fats. Limit processed foods, saturated fats, and added sugars.
2. Stay hydrated: Adequate water intake helps flush toxins from the liver and supports overall liver function.
3. Exercise regularly: Moderate exercise can help reduce liver fat and improve liver enzyme levels.
4. Limit alcohol consumption: If you drink alcohol, do so in moderation or consider abstaining completely for optimal liver health.
5. Manage stress: Chronic stress can negatively impact liver function. Practice stress-reduction techniques like meditation, yoga, or deep breathing exercises.
6. Consider liver-supporting herbs: Some herbs, such as milk thistle, dandelion root, and turmeric, have shown potential benefits for liver health. However, always consult with a healthcare provider before starting any herbal supplements.
7. Maintain a healthy weight: Losing excess weight can significantly improve liver enzyme levels and overall liver health.
8. Get enough sleep: Adequate sleep is crucial for liver health and overall well-being.

By incorporating these natural strategies into your daily routine, you can support your liver’s health and potentially improve AST and ALT levels. However, it’s important to remember that these methods should complement, not replace, medical advice and treatment when necessary.

The Role of AST and ALT in Monitoring Liver Disease Progression

AST and ALT levels play a crucial role in monitoring the progression of liver diseases and assessing the effectiveness of treatments. Regular testing of these enzymes provides valuable insights into the state of liver health over time and helps healthcare providers make informed decisions about patient care.

How are AST and ALT used to track liver disease?

• Disease progression: Tracking changes in AST and ALT levels over time can indicate whether a liver condition is improving, stable, or worsening.
• Treatment efficacy: These enzymes can help assess how well a particular treatment is working. For example, in viral hepatitis, a decrease in enzyme levels may indicate that antiviral therapy is effective.
• Medication monitoring: For patients on potentially hepatotoxic medications, regular AST and ALT testing can help detect early signs of liver damage.
• Recovery assessment: After acute liver injury, monitoring these enzymes can help track the liver’s recovery process.
• Cirrhosis evaluation: In advanced liver disease, AST and ALT levels may actually decrease as the liver loses its ability to produce these enzymes, providing important prognostic information.

By closely monitoring AST and ALT levels, healthcare providers can make timely adjustments to treatment plans and interventions, potentially improving outcomes for patients with liver diseases.

Future Directions in Liver Enzyme Testing

As medical science advances, new approaches to liver enzyme testing and interpretation are emerging. These developments promise to enhance our understanding of liver health and improve the accuracy of liver disease diagnosis and monitoring.

What innovations are on the horizon for AST and ALT testing?

1. Non-invasive imaging techniques: Advanced imaging methods like FibroScan are being developed to complement enzyme tests, providing a more comprehensive assessment of liver health without the need for biopsy.
2. Genetic markers: Research is ongoing to identify genetic variations that may influence AST and ALT levels, potentially leading to more personalized interpretation of test results.
3. Artificial intelligence: Machine learning algorithms are being developed to analyze patterns in liver enzyme levels and other clinical data, potentially improving early detection of liver diseases.
4. Point-of-care testing: Rapid, portable devices for measuring AST and ALT are being developed, which could make liver enzyme testing more accessible in various healthcare settings.
5. Novel biomarkers: Scientists are investigating new biomarkers that, when combined with AST and ALT, may provide more specific information about liver health and disease progression.

These advancements hold the promise of more accurate, timely, and personalized liver health assessments, potentially leading to improved patient outcomes and more effective management of liver diseases.

As our understanding of liver function and disease continues to evolve, the role of AST and ALT testing remains central to liver health assessment. By staying informed about these important enzymes and emerging developments in liver testing, individuals can take a more active role in maintaining their liver health and overall well-being.

Alanine Aminotransferase (ALT) Test | Kaiser Permanente

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Test Overview

An alanine aminotransferase (ALT) test measures the amount of this enzyme in the blood. ALT is found mainly in the liver, but also in smaller amounts in the kidneys, heart, muscles, and pancreas. ALT was formerly called serum glutamic pyruvic transaminase (SGPT).

ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood. But when the liver is damaged or diseased, it releases ALT into the bloodstream, which makes ALT levels go up. Most increases in ALT levels are caused by liver damage.

The ALT test is often done along with other tests that check for liver damage, including aspartate aminotransferase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin. Both ALT and AST levels are reliable tests for liver damage.

Why It Is Done

The ALT test is done to:

• Identify liver disease, such as cirrhosis and hepatitis, caused by alcohol, drugs, or viruses.
• Help check for liver damage.
• Find out whether jaundice was caused by a blood disorder or liver disease.
• Keep track of the effects of medicines that can damage the liver.

How To Prepare

Avoid strenuous exercise just before having an ALT test.

How It Is Done

A health professional uses a needle to take a blood sample, usually from the arm.

How long the test takes

The test will take a few minutes.

Watch

• Learning About Your Blood Test
• Learning About Blood Tests for Children

How It Feels

When a blood sample is taken, you may feel nothing at all from the needle. Or you might feel a quick sting or pinch.

Risks

There is very little chance of having a problem from this test. When a blood sample is taken, a small bruise may form at the site.

Results

Each lab has a different range for what’s normal. Your lab report should show the range that your lab uses for each test. The normal range is just a guide. Your doctor will also look at your results based on your age, health, and other factors. A value that isn’t in the normal range may still be normal for you.

Results are usually available within 12 hours.

High values

High levels of ALT may be caused by:

• Liver damage from conditions such as hepatitis or cirrhosis.
• Lead poisoning.
• Very strenuous exercise or severe injury to a muscle.
• Exposure to carbon tetrachloride.
• Decay of a large tumor (necrosis).
• Many medicines, such as statins, antibiotics, chemotherapy, aspirin, opioids, and barbiturates.
• Mononucleosis.
• Growth spurts, especially in young children. Rapid growth can cause mildly elevated levels of ALT.

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  Why It Is Done

Aspartate Aminotransferase (AST) Test – Testing.com

Test Quick Guide

Aspartate aminotransferase (AST) is an enzyme, a type of protein that enables most bodily processes. AST exists mostly in the liver, but it is found in numerous tissues in the body.

When cells become damaged, AST can be released into the bloodstream. For this reason, abnormal levels of AST in a blood sample can indicate an underlying problem.

Although AST can be measured alone, it is usually included with other enzymes as part of broader tests, such as a liver panel or comprehensive metabolic panel (CMP). When interpreted alongside other enzymes, an AST measurement can help identify liver disease and other health issues.

About the Test

Purpose of the test

A blood test measuring AST is used to detect damage to cells. Most often, it helps assess the condition of the liver, but it can provide insight into other health concerns as well.

Depending on the situation, AST testing, usually combined with other measurements in a panel test, can be used as a form of medical screening, diagnosis, or monitoring:

• Screening is the medical term for testing when you don’t have any symptoms of a condition. A screening that includes AST may be prescribed if you have risk factors for liver disease such as obesity, diabetes, significant alcohol use, or a family history of liver problems. During routine health checkups, AST may also be tested on a CMP.
• Diagnosis takes place after symptoms have occurred and is the process of finding the cause. For example, AST may be measured if you have had jaundice, fatigue, swelling, unexplained weight loss, itching, nausea and vomiting, or other symptoms associated with liver problems.
• Monitoring describes the steps taken to see how your health situation evolves. Sometimes, you may have repeated tests that include AST at frequent intervals to track your liver health. AST can be measured to help determine how well treatment for liver problems works. A panel test with AST can also check for signs of liver damage if you start taking a medication that could potentially affect your liver.

What does the test measure?

This test measures the level of AST in your blood. AST is an enzyme normally present in the liver, heart, brain, pancreas, kidneys, and many other muscles and tissues in the body. Enzymes like AST help facilitate fundamental biological processes in these organs and tissues.

It is common for AST to be measured as part of a panel of other enzymes and proteins in the blood because it may give your doctor a better view of your overall condition compared to only evaluating the AST test result.

When should I get this test?

A measurement of AST in your blood may be beneficial in several different medical situations. If you have symptoms of liver disease, a panel test that includes AST can help assess the cause and determine the severity of the problem.

Tests that measure AST like the liver panel and the CMP are often used as diagnostic tests if you have to go to the emergency room or have general symptoms that could cause many health problems.

Testing your levels of AST can be appropriate as a form of screening, especially if you are at high risk of liver problems. Some doctors prescribe AST testing during normal checkups even if you don’t have risk factors for liver disease. Despite this, there is no clear medical evidence showing that this broad approach to screening generates more benefits than drawbacks, which can include increased costs and unnecessary follow-up tests.

An AST test may be utilized for monitoring if you have previously had an abnormal test result or a diagnosed liver disease. If you begin taking a new medication that can affect the liver, your doctor may prescribe a lipid panel with an AST measurement to monitor for possible side effects.

Finding an Aspartate Aminotransferase Test

How can I get an aspartate aminotransferase test?

Tests for AST are usually prescribed by a doctor and conducted in a doctor’s office, hospital, or laboratory, where blood is drawn from a vein in your arm. Results are determined through laboratory analysis of your blood sample.

Can I take the test at home?

While most AST testing is done with a blood draw in a medical setting, somas little as $29e at-home tests include a measurement of AST in a panel along with other enzymes and proteins. After taking a blood sample at home, you mail it to a laboratory. You then receive results by mail, with a smartphone app, or through an online portal.

How much does the test cost?

The cost of an AST test can vary depending on where the test sample is taken, whether other measurements are included, whether you have medical insurance, and whether your insurance covers the test.

Several charges may be associated with an AST test or a panel test that includes AST. For example, separate fees may be charged by the technician who draws your blood, the lab that does the analysis, and the doctor’s office which prescribes the test or reviews the results with you.

If your doctor recommends the test, many of these charges are partially paid for by insurance. But check with your doctor and insurance company to find out if your test will be covered and if you are responsible for any copayment or deductible.

At-home tests that include AST can vary in price based on how many different measurements are taken. Tests are often available for around $100, which includes the test kit, shipping, laboratory analysis, and results.

Taking an Aspartate Aminotransferase Test

Testing AST requires a sample of blood. Blood is obtained through a venipuncture procedure using a needle inserted into a vein in your arm.

At-home tests for AST also rely on a blood sample; however, they utilize a fingerstick instead of venipuncture. This means that you prick your finger to obtain a drop of blood. This sample is then mailed to a laboratory where it can be tested for its level of AST.

Before the test

Because AST is usually measured with other enzymes and compounds, you typically need to fast before your blood is drawn. This means that you consume no food and no beverages other than water. You may need to fast up to 12 hours before the test, but check with your doctor’s office for specific instructions.

If you are being tested for only AST, you usually do not need to fast or take other special precautions before the test.

Various types of medications can influence levels of AST and other liver enzymes, so talk with your doctor before the test about any prescription drugs, over-the-counter medications, or dietary supplements you take regularly.

During the test

When you go for a blood draw, you will be seated, and a stretchy band will be tied tightly around the upper part of one arm so that there is greater blood flow in that arm. The technician will use an antiseptic to clean the puncture site and then insert a needle into your vein to withdraw a vial of blood.

Once the necessary amount of blood is drawn, the needle is removed. The whole process is usually over within a few minutes. You may experience a sting or other pain from the needle puncture.

You will need to read and follow the instructions in your test kit for an at-home test. In most cases, you will use an antiseptic to clean your fingertip and then use a small needle included in the kit to lightly prick your finger. A drop of blood is placed on a special test paper, which you then seal and put in the mail.

After the test

After a blood draw, a small bandage will be placed on your arm to apply pressure and stop further bleeding. You may have some bruising or discomfort, but it is rare for there to be any serious side effects.

If you were instructed to fast before the test, you may want to bring a snack to eat once the test is over. After the test, you can return to most normal activities, including driving.

Side effects are also uncommon after an at-home test. If needed, you can use a bandage to stop continued bleeding from your fingertip.

Aspartate Aminotransferase Test Results

Receiving test results

You should receive results with your AST levels within a few business days after your blood draw. A test report may be available to access electronically or sent to you by mail. Your doctor’s office may also call you to provide results.

And if you take an at-home AST test, the kit must be sent by mail to a laboratory to analyze it. As a result, it may take an extra few days to get results, which are usually provided electronically.

Interpreting test results

AST levels are usually listed on your test report in units per liter (U/L) or international units per liter (IU/L). Next to the level found in your blood, the test report should list the laboratory’s reference range.

It is important to look closely at the range for the specific lab that analyzed your sample because there is no universal reference range for AST. Ranges can vary because not all labs use the same methods, and studies have not demonstrated a precise healthy range.

In addition, no AST level is normal for all people. Instead, a healthy AST level can change depending on your age, sex, race, weight, and other factors that your doctor can consider when interpreting your test result.

To understand the significance of your results, your doctor often looks at AST and the levels of other enzymes included in a liver panel test. Patterns in which enzymes are normal or abnormal can offer meaningful clues about an underlying problem.

Because AST levels in the blood can rise when cells are damaged, elevated AST can reflect health conditions, including liver diseases like cirrhosis or hepatitis. To determine the cause of an abnormal result, the doctor may consider how high the AST level is and how it compares to the levels of other liver enzymes.

Very high levels of AST often reflect short-term liver damage, while smaller but persistent elevations in AST over time can be tied to chronic conditions. However, because AST is found in other body parts, it can be elevated in the blood due to cell damage outside the liver.

For this reason, the doctor may look at the levels of both AST and the enzyme alanine aminotransferase (ALT) side by side. ALT is more concentrated in the liver, so if AST is high while ALT is normal, it can indicate a problem outside the liver. In other cases, though, having a much higher level of AST than ALT can be a sign of alcohol-induced damage to the liver.

It is also important to note that having elevated AST is not proof of a medical problem. If you are healthy with proper liver function, you may still have an AST level outside the normal range, which can occur based on individual factors like age, sex, race, diet, exercise, or having taken medications that can affect AST.

Because of the complexity of interpreting AST levels, including their relationship to other measurements on a panel test, always discuss your test result with a doctor who can explain what the test means and how it reflects your overall health.

To best understand the meaning and interpretation of your AST test, you can ask some of the following questions when discussing your test with your doctor:

• What is the reference range for AST for the laboratory that did my test?
• Were my AST levels normal or abnormal?
• Did the test measure anything in addition to AST? Were any of those levels abnormal?
• What is the most likely explanation for my AST level?
• Should I repeat this test or take other tests as a follow-up?

• ALT Blood Test (Alanine Aminotransferase)
• Alkaline Phosphatase (ALP Blood Test)
• CMP Blood Test (Comprehensive Metabolic Panel)
• Liver Panel Test
• A/G Ratio Blood Test (Total Protein, Albumin-Globulin Ratio)

Resources

• American Liver Foundation: Diagnosing Liver Disease
  Learn More
• National Institute of Diabetes and Digestive and Kidney Diseases: Liver Disease
  Learn More
• National Library of Medicine: Liver Diseases
  Learn More

Sources

A. D.A.M. Medical Encyclopedia. ALP – Blood Test. Updated May 1, 2021. Accessed November 24, 2022. https://medlineplus.gov/ency/article/003470.htm

A.D.A.M. Medical Encyclopedia. Aspartate Aminotransferase (AST) Blood Test. Updated January 24, 2021. Accessed November 24, 2022. https://medlineplus.gov/ency/article/003472.htm

A.D.A.M. Medical Encyclopedia. Basic Metabolic Panel. Updated May 1, 2021. Accessed November 24, 2022. https://medlineplus.gov/ency/article/003462.htm

A.D.A.M. Medical Encyclopedia. Enzyme. Updated January 16, 2021. Accessed November 24, 2022. https://medlineplus.gov/ency/article/002353.htm

American Board of Internal Medicine. ABIM Laboratory Test Reference Ranges. Updated January 2022. Accessed November 24, 2022. https://www.abim.org/Media/bfijryql/laboratory-reference-ranges.pdf

American Gastroenterological Association. American Gastroenterological Association Medical Position Statement: Evaluation of Liver Chemistry Tests. Gastroenterology. 2002;123(4):1364-1366. doi:10.1053/gast.2002.36060

ARUP Consult. Evaluation of Liver Function. Updated October 2022. Accessed November 24, 2022. https://arupconsult.com/content/liver-disease-evaluation

Friedman LS. Approach to the Patient With Abnormal Liver Biochemical and Function Tests. In: Chopra S, ed. UpToDate. Updated April 5, 2022. Accessed November 24, 2022. https://www.uptodate.com/contents/approach-to-the-patient-with-abnormal-liver-biochemical-and-function-tests

Friedman LS. Enzymatic Measures of Cholestasis (e.g., Alkaline Phosphatase, 5′-Nucleotidase, Gamma-glutamyl Transpeptidase). In: Chopra S, ed. UpToDate. Updated July 28, 2022. Accessed November 24, 2022. https://www.uptodate.com/contents/enzymatic-measures-of-cholestasis-eg-alkaline-phosphatase-5-nucleotidase-gamma-glutamyl-transpeptidase

Friedman LS. Liver Biochemical Tests That Detect Injury to Hepatocytes. In: Chopra S, ed. UpToDate. Updated March 4, 2021. Accessed November 24, 2022. https://www. uptodate.com/contents/liver-biochemical-tests-that-detect-injury-to-hepatocytes

Givler DN, Givler A. Health Screening. In: StatPearls. Updated August 24, 2022. Accessed November 24, 2022. https://www.ncbi.nlm.nih.gov/books/NBK436014/

Green RM, Flamm S. AGA Technical Review on the Evaluation of Liver Chemistry Tests. Gastroenterology. 2002;123(4):1367-1384. doi:10.1053/gast.2002.36061

Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. 2017;112(1):18-35. doi:10.1038/ajg.2016.517

Lala V, Zubair M, Minter DA. Liver Function Tests. In: StatPearls. Updated October 5, 2022. Accessed November 24, 2022. https://www.ncbi.nlm.nih.gov/books/NBK482489/

Lindenmeyer CC. Laboratory Tests of the Liver and Gallbladder. MSD Manual Professional Edition. Updated September 2022. Accessed November 24, 2022. https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/testing-for-hepatic-and-biliary-disorders/laboratory-tests-of-the-liver-and-gallbladder

Lindenmeyer CC. Liver Blood Tests. Merck Manual Consumer Edition. Updated September 2022. Accessed November 24, 2022. https://www.merckmanuals.com/en-ca/home/liver-and-gallbladder-disorders/diagnosis-of-liver,-gallbladder,-and-biliary-disorders/liver-blood-tests

MedlinePlus: National Library of Medicine. Alkaline Phosphatase. Updated August 3, 2022. Accessed November 24, 2022. https://medlineplus.gov/lab-tests/alkaline-phosphatase/

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The norm of ALT and AST in the blood test in women: what you need to know

Contents

• 1 The norm of ALT and AST in the blood of women: what indicators are the norm and what do the deviations say?
  • 1.1 Blood test norm for women: ALT and AST
  • 1.2 What is a blood test?
  • 1.3 What do ALT and AST mean?
  • 1.4 Why is it important to know the norms of ALT and AST?
  • 1.5 How are ALT and AST analyzed?
  • 1.6 How do I prepare for an ALT and AST test?
  • 1.7 Norm of ALT and AST in women: age characteristics
  • 1.8 What diseases can affect the level of ALT and AST in the blood of women?
  • 1. 9 What should I do if my ALT and AST levels are elevated?
  • 1.10 What factors can increase blood levels of ALT and AST?
  • 1.11 Can I decode the results of ALT and AST analysis myself?
  • 1.12 Related videos:
  • 1.13 Q&A:
    • • 1.13.0.1 What are ALT and AST in a blood test?
      • 1.13.0.2 What causes ALT and AST levels to rise?
      • 1.13.0.3 What are the norms for ALT and AST in women?
      • 1.13.0.4 Can elevated levels of ALT and AST in women be associated with medication?
      • 1.13.0.5 Can elevated levels of ALT and AST in women indicate cancer?
      • 1.13.0.6 What should be done if the level of ALT and AST in the blood of a woman is elevated?

Find out what the norm of alt and ast means in a blood test for women. Which values ​​are normal, and which may indicate diseases. The importance of timely and correct decoding of a blood test for maintaining health.

The results of a biochemical blood test are one of the key indicators of the health of the body. It is especially important to correctly interpret the level of AST (aspartate aminotransferase) and ALT (alanine aminotransferase), as they are a reflection of the work of the liver. Blood tests for AST and ALT are often prescribed in combination with other indicators to assess liver function, determine the nature of the disease and monitor the progress of treatment.

For women, normal levels of AST and ALT may differ slightly from those for men, in addition, during pregnancy and some other conditions, there may be significant changes in enzyme levels. Therefore, it is important to know the features of the interpretation of the results and the possible causes of deviations from the norm.

In this article we will tell you what are the norms of the levels of AST and ALT in the blood in women, what means their increase or decrease, as well as what factors can affect the result of the tests. If you find deviations from the norm, do not panic, perhaps this is a temporary phenomenon, but additional consultation with a doctor and diagnosis of the condition of the liver is necessary.

Blood test norm for women: ALT and AST

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes that are found in the cells of the liver, heart, muscles and other tissues of the body. Their level in the blood can be increased in diseases of these organs, as well as in other pathologies.

The norm of AST in women is from 7 to 31 units per liter of blood. An increase in AST levels can be associated with diseases of the liver, cardiovascular system, as well as muscle injuries.

It is important to remember that ALT and AST limits may differ depending on the laboratory where the blood was tested. Therefore, the doctor should interpret the results, taking into account all the factors affecting the level of these enzymes.

What is a blood test?

A blood test is a laboratory study of a biological fluid that circulates through a person’s blood vessels. This analysis is one of the most common methods for diagnosing many diseases, as well as monitoring the state of the body, both in case of deterioration and improvement of its health.

A blood test goes through many stages, from taking blood to interpreting the results. The analysis should take into account various factors, such as age, gender, physical condition, the presence of chronic diseases and the use of drugs.

Various blood tests, such as hemoglobin, leukocytes, platelets, ALT, AST and many others, may indicate various diseases or abnormalities in the body.

What do ALT and AST mean?

ALT and AST are enzymes found in liver cells. ALT (alanine aminotransferase) and AST (aspartate aminotransferase) can be used as indicators of liver damage. These enzymes are released from liver cells into the bloodstream when an organ is damaged or diseased, and their levels can indicate how severe the damage is.

High levels of ALT and AST in the blood of women may indicate the presence of liver disease or other diseases such as hepatitis, cirrhosis or liver tumors. However, elevated levels of ALT and AST may also be indicative of other non-liver related conditions, such as heart failure.

Why is it important to know the norms of ALT and AST?

Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) are enzymes found in liver and heart cells. If their level in the blood is elevated, this may indicate damage to the cells of these organs.

Measurement of ALT and AST levels in the blood is an important blood test that provides information about the condition of the liver and heart in women. Elevated levels of ALT and AST may indicate various diseases, such as hepatitis, cirrhosis, heart failure, and others.

ALT and AST values ​​are indicative and may vary depending on the woman’s age, sex and lifestyle. Therefore, it is important to know the norm of ALT and AST for women in order to make it easier to determine the presence of any diseases.

If ALT and AST are elevated, see a doctor who can diagnose and suggest treatment. Treatment may be aimed at eliminating the causes of increased enzyme levels, as well as restoring liver and heart function.

How is ALT and AST analyzed?

The ALT and AST test is a common blood test. Usually, blood is taken from a vein in the elbow for analysis. Before passing the analysis, you must follow the rules of preparation.

After the blood has been collected, it is sent to a laboratory where it is analyzed for ALT and AST levels. The results of the analysis are usually ready in a few days.

When analyzing ALT and AST, be aware that the results may vary depending on age, sex, physical activity and the use of certain medications. Therefore, before the analysis, it is necessary to consult a doctor and follow the recommendations for preparation.

How to prepare for ALT and AST analysis?

The analysis of ALT and AST requires some preparation in order for the results to be accurate and reliable. Here are some tips to help you properly prepare for this analysis.

• Refusal of food 8-12 hours before the test. It is best to take the test in the morning on an empty stomach so as not to affect the results. This means that 8-12 hours before blood collection, you need to refuse food.
• Medication withdrawal. Be sure to tell your doctor if you are taking any medications. Some medicines may interfere with the results of the test. If your doctor thinks you need to stop taking your medication, it’s best to follow their advice.
• Refusal of alcohol one day before the analysis. Alcohol can interfere with test results, so alcohol should be avoided the day before the test.
• Maintaining rest and avoiding exercise. Physical activity can also affect the results of the test, so the day before it is taken, physical activity should be avoided and rest should be observed.
• Blood collection compliance. To obtain accurate and reliable results, you must follow the rules for collecting blood. The blood collection process itself should not take more than 5-7 minutes and take place in a sterile environment.

By following these guidelines, you can be confident that your ALT and AST results will be reliable and will help your doctor make the right diagnosis and treatment.

The norm of ALT and AST in women: age characteristics

ALT and AST are important indicators of the functional state of the liver, determined in the blood.

It is possible to establish the norm of ALT and AST in the blood of women only taking into account age characteristics.

So, for example, in women under the age of 50, the ALT norm is up to 31 units per liter of blood, and in women over 50 years old – up to 35 units.

The norm of AST for women under the age of 50 is up to 31 units per liter of blood, after 50 years – up to 35 units.

It should also be noted that during pregnancy, women may experience changes in ALT and AST levels, which usually return to normal after childbirth.

In any case, if you find abnormalities in ALT and AST, you should contact a specialist for further diagnosis and treatment.

What diseases can affect the blood levels of ALT and AST in women?

Blood levels of ALT and AST in women can increase as a result of various diseases. For example, hepatitis is one of the main causes of elevated levels of ALT and AST. This is due to the fact that these enzymes are found in high concentration in the liver, and in hepatitis, the liver tissue can be damaged, which leads to the release of large amounts of ALT and AST into the blood.

In addition, diseases that affect the biliary tract, such as gallstones and cholangitis, can also increase ALT and AST levels. The levels of these enzymes may also increase in women with cardiovascular disease such as myocardial infarction or arrhythmias.

1. Hepatitis;
2. Cirrhosis of the liver;
3. Oncological diseases;
4. Muscular diseases;
5. Gallstone disease;
6. Cholangitis;
7. Cardiovascular diseases;

What if ALT and AST levels are high?

If ALT and AST levels are elevated in a woman’s blood test, a doctor should be consulted for diagnosis and possible causes. Perhaps an increase in the level of these indicators may indicate diseases of the liver or other organs.

Your doctor may order additional tests, such as an ultrasound of the liver, a CT scan, or a liver biopsy, for diagnosis. In addition, it is necessary to analyze urine and blood for the presence of infections, viruses and other pathological processes.

If the reason for the increase in ALT and AST levels is related to the disease, it is necessary to undergo treatment prescribed by a doctor. This may include medication, diet, and other measures, depending on the specific disease and its stage.

In addition, women who have high ALT and AST levels should lead a healthy lifestyle, give up addictions and watch their diet. It is recommended to increase the amount of vegetables and fruits consumed, reduce the intake of fatty and fried foods, and also pay attention to the quantitative and qualitative composition of food.

• see a doctor for diagnosis;
• complete the required tests;
• get treated by a doctor;
• lead a healthy lifestyle and watch your diet.

What factors can increase blood levels of ALT and AST?

Preparations. In addition to drugs that fight liver disease, many drugs can increase blood levels of ALT and AST, such as antiviral drugs, anabolic steroids, anticancer drugs, and others.

Alcohol. Regular alcohol consumption can lead to liver damage and possible increase in blood levels of ALT and AST.

Wrong diet. Excessive consumption of fatty and fried foods can lead to impaired liver function and increased levels of ALT and AST in the blood.

Inflammatory diseases of the liver. Viral, alcoholic or autoimmune hepatitis, cirrhosis of the liver, fatty degeneration cause liver inflammation, which increases the level of ALT and AST in the blood.

Examples of drugs that can increase ALT and AST in the blood Drug Group

Can I decode the results of ALT and AST analysis myself?

Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) are enzymes that are found in liver cells without penetrating into the blood. They are released into the blood only under pathological conditions of the organ. Changes in the levels of these enzymes indicate damage to liver and/or heart cells.

ALT and AST analysis results may only be decoded by qualified medical personnel after examining the patient and performing other investigations.

Although regular analysis of ALT and AST levels helps to identify possible diseases in the very early stages, you should not try to diagnose yourself. The best solution is to consult with your doctor.

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Q&A:

What is ALT and AST in a blood test?

ALT and AST are enzymes found in the cells of the liver, heart, muscles and other organs. If their blood levels are elevated, this may indicate damage to the cells of these organs.

What causes ALT and AST levels to rise?

Elevated levels of ALT and AST in the blood may be associated with diseases of the liver (hepatitis, cirrhosis), cardiovascular system (heart attack, cardiomyopathy), muscles (muscular dystrophy) and other organs. It can also be caused by taking certain medications, alcohol, or toxic substances.

What are the norms for ALT and AST in women?

Guideline values ​​for ALT and AST may vary slightly depending on the laboratory and the age of the woman. Typically, the ALT level should not exceed 31 U/L, and the AST level should not exceed 30 U/L.

Can high levels of ALT and AST in women be related to medication?

Yes, some medicines can increase blood levels of ALT and AST, such as antibiotics, antiparkinsonian drugs, some antiviral drugs. Therefore, if you are taking any medications, tell your doctor before taking a blood test.

Can elevated levels of ALT and AST in women indicate cancer?

No, elevated levels of ALT and AST are not specific to cancer and are not the main sign of cancer.

What should be done if the level of ALT and AST in the blood of a woman is elevated?

The first step is to see a doctor who will conduct additional tests and determine the cause of the increased values. Depending on the diagnosis, appropriate treatments and recommendations for lifestyle and diet changes will be prescribed.

ALT, take a blood test for ALT (AlAT, alanine aminotransferase)

Method of determination
Kinetic UV method (optimized DGKC method), 37°C.

Test material
Blood serum

Alanine aminotransferase is an intracellular enzyme involved in the metabolism of amino acids. The test is used in the diagnosis of lesions of the liver, cardiac and skeletal muscles.

Synonyms: Glutamate pyruvate transaminase; Serum glutamate pyruvate transaminase; SGPT.

Alanine aminotransferase; Serum glutamic-pyruvic transaminase; SGPT; Alanine transaminase.

Brief characteristics of the analyte ALT

Alanine aminotransferase belongs to the group of enzymes that catalyze the reversible conversion of a-keto acids into amino acids by transferring amino groups. The highest activity of ALT is detected in the liver and kidneys, the lower one – in the heart, skeletal muscles, pancreas, spleen, lungs, erythrocytes. ALT is a cytoplasmic enzyme. When cells are damaged or destroyed, the enzyme is released, which leads to an increase in its activity in the blood.

Under what conditions can elevated levels of ALT in the blood serum

Increased activity of ALT in serum is usually considered as an indicator of damage to the liver parenchyma.

Despite the combined increase in the level of transaminases (ALT and AST) with liver cell damage, in most types of liver pathology, the increase in serum ALT activity is more significant, this enzyme is a more specific marker of liver diseases than AST (see test No. 9).

ALT values ​​greater than 50 times the upper limit of normal values ​​are mainly due to viral hepatitis, acute hepatic perfusion disorder, or exotoxin-induced acute hepatic necrosis. In viral hepatitis, an increase in enzyme activity occurs very early, before the onset of clinical signs and symptoms of the disease in the prodromal period. In dynamics, with a favorable course of the process, ALT activity slowly decreases to its original values ​​within a few weeks. Persistence of elevated alanine aminotransferase activity for more than 6 months after an episode of acute hepatitis is used to diagnose chronic hepatitis. In most patients with chronic hepatitis, the maximum activity of ALT is seven times higher than the norm by no more than 7 times. In chronic hepatitis C, ALT levels in a significant number of patients may be normal for a long time or only marginally elevated.

Toxic hepatitis gives a picture similar to infectious hepatitis, with very high ALT and AST values ​​in severe cases. A more moderate increase in ALT activity is observed in alcoholic hepatitis.

The levels of ALT and AST in liver cirrhosis vary, depending on the stage of the cirrhotic process, often ranging from the upper limit of the norm to a 4-5-fold increase (the level of AST in this case may become higher than ALT, which is associated with a decrease in ALT production damaged liver). In myocardial infarction, ALT in blood serum increases to a lesser extent than AST, since the activity of alanine aminotransferase in cardiomyocytes is 15 times lower than the activity of AST. In uncomplicated myocardial infarctions, ALT levels may be only slightly increased or remain within reference values. In clinical practice, the AST / ALT ratio (de Ritis ratio) is used for diagnosis. With fermentemia of hepatic origin (acute viral and toxic hepatitis), the de Ritis coefficient can decrease to 0.2-0.5, with myocardial infarction and damage to skeletal muscles – it is more than 1.5.

What is the purpose of determining the level of ALT in the blood serum?

Determination of the level of ALT in the blood serum is used mainly in the diagnosis and control of the course of liver diseases, as well as in complex panels of screening biochemical studies.

What can affect the result of the study of ALT in the blood serum

A slight or moderate increase in the activity of AST and ALT was observed after taking various drugs, such as non-steroidal anti-inflammatory drugs, antibiotics, antiepileptic drugs.