Liver enzymes: No trivial elevations, even if asymptomatic

Review

Brian Agganis, MD, David Lee, MD and Thomas Sepe, MD

Cleveland Clinic Journal of Medicine August 2018, 85 (8) 612-617; DOI: https://doi.org/10.3949/ccjm.85a.17103

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• Liver enzymes, August 2018 – October 01, 2018

ABSTRACT

Primary care physicians are at the forefront in screening for abnormal levels of liver enzymes and investigating the likely causes by obtaining a detailed history and physical examination, followed by appropriate laboratory and diagnostic workup. This review outlines common causes for the two main mechanisms of liver injury—cholestasis and hepatocellular insult—and explores the associated risk factors, methods of diagnosis, and management, with a focus on nonalcoholic fatty liver disease, one of the most often encountered causes of abnormal liver enzyme levels.

KEY POINTS

• Disorders of hepatocellular injury tend to elevate levels of aminotransferases, whereas cholestatic disorders cause elevations of alkaline phosphatase and bilirubin.

• The three most common causes of liver enzyme elevation are alcohol toxicity, medication overdose, and fatty liver disease.

• Other disorders of liver dysfunction include hereditary hemochromatosis, viral hepatitis, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and alpha-1 antitrypsin disease.

• Nonhepatic causes of elevated “liver enzymes” also need to be considered. For instance, rhabdomyolysis causes elevations in aminotransferase levels.

Elevated levels of circulating enzymes that are frequently of hepatic origin (aminotransferases and alkaline phosphatase) and bilirubin in the absence of symptoms are common in clinical practice. A dogmatic but true statement holds that there are no trivial elevations in these substances. All persistent elevations of liver enzymes need a methodical evaluation and an appropriate working diagnosis.¹

Here, we outline a framework for the workup and treatment of common causes of liver enzyme elevations.

PATTERN OF ELEVATION: CHOLESTATIC OR HEPATOCELLULAR

Based on the pattern of elevation, causes of elevated liver enzymes can be sorted into disorders of cholestasis and disorders of hepatocellular injury (Table 1).¹

TABLE 1

Liver disease and associated liver enzyme elevations

Cholestatic disorders tend to cause elevations in alkaline phosphatase, bilirubin, and gamma-glutamyl transferase (GGT).

Hepatocellular injury raises levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

HOW SHOULD ABNORMAL RESULTS BE EVALUATED?

When approaching liver enzyme elevations, the clinician should develop a working differential diagnosis based on the medical and social history and physical examination.

Think about alcohol, drugs, and fat

The most common causes of liver enzyme elevation are alcohol toxicity, medication over dose, and fatty liver disease.

Alcohol intake should be ascertained. “Significant” consumption is defined as more than 21 drinks per week in men or more than 14 drinks per week in women, over a period of at least 2 years.²

The exact pathogenesis of alcoholic hepatitis is incompletely understood, but alcohol is primarily metabolized by the liver, and damage likely occurs during metabolism of the ingested alcohol. AST elevations tend to be higher than ALT elevations; the reason is ascribed to hepatic deficiency of pyridoxal 5‱-phosphate, a cofactor of the enzymatic activity of ALT, which leads to a lesser increase in ALT than in AST.

Alcoholic liver disease can be difficult to diagnose, as many people are initially reluctant to fully disclose how much they drink, but it should be suspected when the ratio of AST to ALT is 2 or greater.

In a classic study, a ratio greater than 2 was found in 70% of patients with alcoholic hepatitis and cirrhosis, compared with 26% of patients with postnecrotic cirrhosis, 8% with chronic hepatitis, 4% with viral hepatitis, and none with obstructive jaundice.³ Importantly, the disorder is often correctable if the patient is able to remain abstinent from alcohol over time.

A detailed medication history is important and should focus especially on recently added medications, dosage changes, medication overuse, and use of nonprescription drugs and herbal supplements. Common medications that affect liver enzyme levels include statins, which cause hepatic dysfunction primarily during the first 3 months of therapy, nonsteroidal anti-inflammatory drugs, antiepileptic drugs, antibiotics, anabolic steroids, and acetaminophen (Table 2).¹ Use of illicit drugs and herbal remedies should be discussed, as they may cause toxin-mediated hepatitis.

TABLE 2

Hepatotoxicity of selected drugs

Although inflammation from drug toxicity will resolve if the offending agent is discontinued, complete recovery may take weeks to months. ⁴

A pertinent social history includes exposure to environmental hepatotoxins such as amatoxin (contained in some wild mushrooms) and occupational hazards (eg, vinyl chloride). Risk factors for viral hepatitis should be evaluated, including intravenous drug use, blood transfusions, unprotected sexual contact, organ transplant, perinatal transmission, and a history of work in healthcare facilities or travel to regions in which hepatitis A or E is endemic.

The medical and family history should include details of associated conditions, such as:

• Right heart failure (a cause of congestive hepatopathy)

• Metabolic syndrome (associated with fatty liver disease)

• Inflammatory bowel disease and primary sclerosing cholangitis

• Early-onset emphysema and alpha-1 anti-trypsin deficiency.

The physical examination should be thorough, with emphasis on the abdomen, and search for stigmata of advanced liver disease such as hepatomegaly, splenomegaly, ascites, edema, spider angiomata, jaundice, and asterixis. Any patient with evidence of chronic liver disease should be referred to a subspecialist for further evaluation.

Further diagnostic workup

Abnormal liver enzyme findings or physical examination findings should direct the subsequent diagnostic workup with laboratory testing and imaging.⁵

For cholestasis. If laboratory data are consistent with cholestasis or abnormal bile flow, it should be further characterized as extrahepatic or intrahepatic. Common causes of extrahepatic cholestasis include biliary tree obstruction due to stones or malignancy, often visualized as intraductal biliary dilation on ultrasonography of the right upper quadrant. Common causes of intrahepatic cholestasis include viral and alcoholic hepatitis, nonalcoholic steatohepatitis, certain drugs and toxins such as alkylated steroids and herbal medications, infiltrative diseases such as amyloid, sarcoid, lymphoma, and tuberculosis, and primary biliary cholangitis.

Abnormal findings on ultrasonography should be further pursued with advanced imaging, ie, computed tomography or magnetic resonance cholangiopancreatography (MRCP). The confirmation of a lesion on imaging is often followed by endoscopic retrograde cholangiopancreatography (ERCP) in an attempt to obtain biopsy samples, remove obstructions, and place therapeutic stents. In instances when endoscopic attempts fail to relieve the obstruction, surgical referral may be appropriate.

For nonhepatobiliary problems. Depending on clinical presentation, it may also be important to consider nonhepatobiliary causes of elevated liver enzymes.

Alkaline phosphatase is found in many other tissue types, including bone, kidney, and the placenta, and can be elevated during pregnancy, adolescence, and even after fatty meals due to intestinal release.⁶ After screening for the aforementioned physiologic conditions, isolated elevated alkaline phosphatase should be further evaluated by obtaining GGT or 5-nucleotidase levels, which are more specifically of hepatic origin. If these levels are within normal limits, further evaluation for conditions of bone growth and cellular turnover such as Paget disease, hyperparathyroidism, and malignancy should be considered. Specifically, Stauffer syndrome should be considered when there is a paraneoplastic rise in the alkaline phosphatase level in the setting of renal cell carcinoma without liver metastases.

AST and ALT levels may also be elevated in clinical situations and syndromes unrelated to liver disease. Rhabdomyolysis, for instance, may be associated with elevations of AST in more than 90% of cases, and ALT in more than 75%.⁷ Markers of muscle injury including serum creatine kinase should be obtained in the setting of heat stroke, muscle weakness, strenuous activity, or seizures, as related elevations in AST and ALT may not always be clinically indicative of liver injury.

Given the many conditions that may cause elevated liver enzymes, evaluation and treatment should focus on identifying and removing offending agents and targeting the underlying process with appropriate medical therapy.

FATTY LIVER

With rates of obesity and type 2 diabetes on the rise in the general population, identifying and treating nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) require increased awareness and close coordination between primary care providers and subspecialists.

According to current estimates, up to one-third of the US population (100 million people) may have NAFLD, and 1% to 3% of the population (4–6 million people) likely have NASH, defined as steatosis with inflammation. Development of NASH places patients at a significantly higher risk of fibrosis, hepatocellular injury, and cancer.⁸

NAFLD is more common in men than in women. It is present in around 80% to 90% of obese adults, two-thirds of adults with type 2 diabetes, and many people with hyperlipidemia. It is also becoming more common in children, with 40% to 70% of obese children likely having some element of NAFLD.

Diagnosis of fatty liver

Although liver enzymes are more likely to be abnormal in individuals with NAFLD, many individuals with underlying NAFLD may have normal laboratory evaluations. ALT may be elevated in only up to 20% of cases and does not likely correlate with the level of underlying liver damage, although increasing GGT may serve as a marker of fibrosis over time. ^9–11 In contrast to alcohol injury, however, the AST-ALT ratio is usually less than 1.0.

Noninvasive tools for diagnosing NAFLD include the NAFLD fibrosis score, which incorporates age, hyperglycemia, body mass index, platelet count, albumin level, and AST-ALT ratio. This and related scoring algorithms may be useful in differentiating patients with minimal fibrosis from those with advanced fibrosis.^12,13

Ultrasonography is a first-line diagnostic test for steatosis, although it may demonstrate fatty infiltration only around 60% of the time. Computed tomography and magnetic resonance imaging are more sensitive, but costlier. Transient elastography (FibroScan; Echosens, Paris, France) has become more popular and has been shown to correlate with findings on liver biopsy in diagnosing or excluding advanced liver fibrosis.^14,15

The gold standard for diagnosing NAFLD and NASH is identifying fat-laden hepatocytes or portal inflammation on biopsy; however, biopsy is generally reserved for cases in which the diagnosis remains uncertain.

Behavioral treatment

The primary treatment for NAFLD consists of behavioral modification including weight loss, exercise, and adherence to a low-fat diet, in addition to tight glycemic control and treatment of any underlying lipid abnormalities. Studies have shown that a reduction of 7% to 10% of body weight is associated with a decrease in the inflammation of NAFLD, though no strict guidelines have been established.¹⁶

Given the prevalence of NAFLD and the need for longitudinal treatment, primary care physicians will play a significant role in long-term monitoring and management of patients with fatty liver disease.

OTHER DISORDERS OF LIVER FUNCTION

Hereditary hemochromatosis

Hereditary hemochromatosis is the most common inherited liver disorder in adults of European descent,¹⁷ and can be effectively treated if discovered early. But its clinical diagnosis can be challenging, as many patients have no symptoms at presentation despite abnormal liver enzyme levels. Early symptoms may include severe fatigue, arthralgias, and, in men, impotence, before the appearance of the classic triad of “bronze diabetes” with cirrhosis, diabetes, and darkening of the skin.¹⁸

If hemochromatosis is suspected, laboratory tests should include a calculation of percent transferrin saturation, with saturation greater than 45% warranting serum ferritin measurement to evaluate for iron overload (ferritin > 200–300 ng/mL in men, > 150–200 ng/mL in women).¹⁹ If iron overload is confirmed, referral to a gastroenterologist is recommended.

Genetic evaluation is often pursued, but patients may ultimately require liver biopsy regardless of the findings, as some patients homozygous for the HFE mutation C282Y may not have clinical hemochromatosis, whereas others with hereditary hemochromatosis may not have the HFE mutation.

Therapeutic phlebotomy is the treatment of choice, and most patients tolerate it well.

Chronic hepatitis B virus and hepatitis C virus infections

Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common in the United States, with HBV affecting more than 1 million people and HCV affecting an estimated 3. 5 million.

Chronic HCV infection. Direct-acting antiviral drugs have revolutionized HCV treatment and have led to a sustained viral response and presumed cure at 12 weeks in more than 95% of cases across all HCV genotypes.²⁰ Given the recent development of effective and well-tolerated treatments, primary care physicians have assumed a pivotal role in screening for HCV.

The American Association for the Study of Liver Diseases and the Infectious Diseases Society of America²¹ recommend screening for HCV in people who have risk factors for it, ie:

If HCV antibody screening is positive, HCV RNA should be obtained to quantify the viral load and confirm active infection, and genotype testing should be performed to guide treatment. Among the 6 most common HCV genotypes, genotype 1 is the most common in North America, accounting for over 70% of cases in the United States.

Although recommendations and therapies are constantly evolving, the selection of a treatment regimen and the duration of therapy are determined by viral genotype, history of prior treatment, stage of liver fibrosis, potential drug interactions, and frequently, medication cost and insurance coverage.

HBV infection. The treatment for acute HBV infection is generally supportive, though viral suppression with tenofovir or entecavir may be required for those who develop coagulopathy, bilirubinemia, or liver failure. Treatment of chronic HBV infection may not be required and is generally considered for those with elevated ALT, high viral load, or evidence of liver fibrosis on noninvasive measurements such as transient elastography.

Autoimmune hepatitis

Autoimmune causes of liver enzyme elevations should also be considered during initial screening. Positive antinuclear antibody and positive antismooth muscle antibody tests are common in cases of autoimmune hepatitis.²² Autoimmune hepatitis affects women more often than men, with a ratio of 4:1. The peaks of incidence occur during adolescence and between ages 30 and 45.²³

Primary biliary cholangitis

Additionally, an elevated alkaline phosphatase level should raise concern for underlying primary biliary cholangitis (formerly called primary biliary cirrhosis), an autoimmune disorder that affects the small and medium intra-hepatic bile ducts. Diagnosis of primary biliary cholangitis can be assisted by a positive test for antimitochondrial antibody, present in almost 90% of patients.²⁴

Primary sclerosing cholangitis

Elevated alkaline phosphatase is also the hallmark of primary sclerosing cholangitis, which is associated with inflammatory bowel disease.²⁵ Primary sclerosing cholangitis is characterized by inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts, which are visualized on MRCP and confirmed by biopsy if needed.

REFERRAL

Subspecialty referral should be considered if the cause remains ambiguous or unknown, if there is concern for a rare hepatic disorder such as an autoimmune condition, Wilson disease, or alpha-1 antitrypsin deficiency, or if there is evidence of advanced or chronic liver disease.

Primary care physicians are at the forefront of detecting and diagnosing liver disease, and close coordination with subspecialists will remain crucial in delivering patient care.

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What High ALT Levels Mean and How to Lower Them

High levels a liver enzyme known as ALT in the blood can indicate liver issues. Implementing these strategies may help lower ALT levels.

Alanine aminotransferase (ALT) is an enzyme found inside liver cells. Liver enzymes, including ALT, help your liver break down proteins to make them easier for your body to absorb.

When your liver is damaged or inflamed, it can release ALT into your bloodstream. This causes your ALT levels to rise. A high ALT level can indicate a liver problem, which is why doctors often use an ALT test when diagnosing liver conditions.

Several things can cause high ALT levels, including:

• nonalcoholic fatty liver disease (NAFLD)
• over-the-counter pain medications, especially acetaminophen
• prescription medications used to manage cholesterol
• alcohol consumption
• obesity
• hepatitis A, B, or C
• heart failure
• hereditary hemochromatosis, an inherited condition that can lead to liver disease due to iron overload
• thyroid disorders
• some muscle disorders
• celiac disease

Rare causes

Other causes of high ALT levels that are rare include:

• autoimmune hepatitis
• alpha-1 antitrypsin deficiency, an inherited condition that can lead to lung and liver disease
• Wilson’s disease, an inherited condition that can cause a buildup of copper in the body

Regardless of what’s causing your elevated ALT levels, it’s important to work with your doctor to find and address the underlying cause. But in the meantime, there are a few things you can try that may help lower your ALT levels.

Drink coffee

Several studies have found that coffee may have a protective effect on the liver and that drinking it can lower liver enzymes.

A 2017 review found that drinking anywhere from 1 to 4 cups of coffee per day can help lower ALT levels and reduce the risk of liver disease and cancer.

More recently, the results of a 2021 meta-analysis of 19 observational studies involving 222,067 people also suggested that coffee consumption was associated with lower ALT.

Another recent study into the benefits of coffee on liver health found that all types of coffee appeared to lower the risk of liver disease.

Here are 9 other science-backed benefits of drinking coffee.

Consume more folate or take folic acid

Consuming more folate-rich foods and adding a folic acid supplement to your diet are both linked to lower ALT levels.

While the terms “folate” and “folic acid” are often used interchangeably, they aren’t quite the same. They’re two different forms of vitamin B9.

Folate is a naturally occurring form of B9 found in certain foods. Folic acid is a synthetic form of B9 used in supplements and added to some processed foods. Your body processes them in different ways, too.

While they aren’t quite identical, both folate and folic acid have benefits when it comes to liver health and lowering ALT.

Studies have linked folate deficiency to increased ALT levels and liver damage and found that folic acid appears to reduce ALT in people with liver damage.

A 2017 study found that folic acid appeared to be just as effective as, if not more than, silymarin treatment in lowering liver enzymes in children with drug-induced liver injuries from antiepileptic therapy.

To help lower ALT levels, consider adding more folate-rich foods to your diet, such as:

• leafy greens, including kale and spinach
• asparagus
• legumes
• Brussels sprouts
• beets
• bananas
• papaya

You can also try taking a folic acid supplement. Most folic acid supplements contain doses of either 400 or 800 micrograms. Aim for a daily dose of 800 micrograms, which is the equivalent of 0.8 milligrams.

This is the dose involved in many studies looking at the link between folic acid and ALT levels.

Make changes to your diet

Adopting a healthier diet can help lower ALT levels and reduce your risk of liver disease.

A 2019 clinical trial compared the effects of a low sugar diet and a typical diet in adolescent boys with NAFLD. Sugar in the diet intervention group was limited to less than 3 percent of the total daily caloric intake.

After 8 weeks, those in the diet group had lower liver enzymes and a greater reduction in liver fat.

Reducing the amount of fat and carbohydrates can also help treat and prevent NAFLD, a common cause of high ALT.

To improve liver health and help lower ALT, you don’t necessarily need to make drastic changes to your diet. Start by trying to eat at least five servings of fresh fruits and vegetables per day.

You can also try incorporating these tips into your weekly meal planning:

• Limit fruits and vegetables served with high calorie sauces or added sugar and salt.
• Eat fish at least twice a week, ideally those high in omega-3 fatty acids, such as salmon or trout.
• Opt for fat free or low fat milk and dairy products.
• Replace saturated and trans fats with monounsaturated and polyunsaturated fats.
• Choose fiber-rich whole grains.
• Opt for lean animal proteins, such as skinless chicken or fish.
• Swap fried foods for baked or roasted ones.
• Snack on nuts, which have various health benefits and have been shown to lower liver enzymes in people with NAFLD.

Learn more about treating fatty liver disease with food.

There is no specific medical treatment for high ALT. Treatment, if any, depends on what’s causing the increase.

Of the 10 percent of people in the United States estimated to have high ALT, less than 5 percent have serious liver disease.

For most causes of high ALT, treatment involves lifestyle changes, such as exercise, a modified diet, and reducing alcohol intake.

Depending on the results of your liver panel and your medical history, your healthcare professional may recommend checking them again at a later date.

If they’re very high or if you have risk factors for liver disease or other symptoms, your doctor may recommend further testing or an appointment with a liver specialist to help diagnose the underlying cause of your high ALT.

Depending on what your healthcare professional suspects, they may recommend any of the following:

• blood tests to check for other conditions, such as hepatitis B and C as well as diabetes
• liver ultrasound
• abdominal CT scan
• biopsy
• thyroid stimulating hormone (TSH) test
• creatine kinase (CK) test
• lipid panel
• iron studies to rule out hereditary hemochromatosis

Contact a doctor if a blood test shows you have high ALT. Based on the results of your liver panel, the doctor will advise you on the next steps.

A high ALT level is usually a sign of some type of liver issue. It’s important to work with your doctor to find the underlying cause of your elevated ALT, even if you don’t have any symptoms.

Lowering your ALT will require treating the cause, but certain dietary changes can help.

causes and treatment of liver enzymes

Content

• 1 ALT and AST elevation in children: causes, symptoms and treatment
  • 1.1 ALT and AST elevation in children
  • 1.2 ALT and AST – what is it?
  • 1.3 How does ALT and AST increase?
  • 1.4 Why can children have elevated ALT and AST levels?
  • 1.5 How to diagnose elevated ALT and AST levels in children?
  • 1.6 Treatment of elevated ALT and AST
    • 1.6.1 Diet
    • 1.6.2 Drug therapy
    • 1.6.3 Removing the cause
    • 1.6.4 Daily routine
  • 1.7 Prevention of elevated ALT and AST levels in children 9000 8
  • 1. 8 Predicted duration of treatment for elevated ALT and AST levels in children
  • 1.9 For which symptoms should I see a doctor?
  • 1.10 What types of therapy can be used to treat elevated levels of ALT and AST?
  • 1.11 Nutrition for elevated ALT and AST levels in children
    • 1.11.1 Basic nutritional advice:
    • 1.11.2 What to include in your diet if you have elevated ALT and AST levels:
    • 1.11.3 What to avoid in your diet if you have elevated ALT and AST levels:
  • 1. 12 Possible side effects in the treatment of elevated ALT and AST
  • 1.13 Vitamins and minerals in the treatment of elevated ALT and AST
    • 1.13.1 The role of vitamins in the treatment of elevated ALT and AST
    • 1.13.2 The role of minerals in the treatment of elevated ALT and AST
    • 1.13.3 How do I get the vitamins and minerals I need?
    • 1.13.4 Important to remember
  • 1.14 Question: Can high levels of ALT and AST be completely cured?
  • 1. 15 How to prevent the recurrence of elevated levels of ALT and AST?
  • 1.16 Questions for the doctor in the diagnosis and treatment of elevated levels of ALT and AST
  • 1.17 Complications of elevated levels of ALT and AST in children
  • 1.18 Question and answer:
    • • 1.18.0.1 What do the abbreviations ALT and AST mean?
      • 1.18.0.2 What could be the causes of elevated ALT and AST levels in children?
      • 1.18.0.3 What symptoms indicate elevated levels of ALT and AST in a child?
      • 1.18.0.4 How are children tested for ALT and AST levels?
      • 1.18.0.5 Can the increase in ALT or AST be due to drugs?
      • 1.18.0.6 How can ALT and AST levels be lowered?
      • 1.18.0.7 Are there any restrictions after testing for ALT and AST levels?
      • 1.18.0.8 How can ALT and AST increase in children be prevented?
  • 1.19 Findings
  • 1.20 Related videos:

Find out what elevated alt and ast levels mean in children, why changes in liver enzymes occur, and how diagnose and treat this condition. Details on our website.

Increasing ALT and AST levels in children is now a common problem. This problem is revealed when a general blood test is performed in children. The cause of increased levels of liver enzymes may be the different nature of the diseases. Therefore, it is important to know what factors can lead to elevated levels of liver enzymes and how to treat this condition.

ALT and AST are enzymes produced by the liver that are involved in protein metabolism. Elevated levels of these enzymes are a marker of damage to liver cells. Therefore, an increase in ALT and AST levels in children may indicate the presence of diseases of the liver or other organs.

There are many reasons why ALT and AST levels may increase in children. These can be viral hepatitis, alcohol, drug or drug exposure, as well as a violation of the diet or hereditary factors. Therefore, it is important to identify the cause of elevated liver enzyme levels in order to properly prescribe treatment and prevent possible complications.

Increased ALT and AST levels in children

Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) are enzymes found in a child’s liver. If the levels of these enzymes are elevated, it may indicate problems with the liver or other organs.

Leading causes of elevated ALT and AST levels in children may include liver disorders such as viruses, alcohol, certain drugs, poisoning, and gallstones. Also, certain diseases, such as Wilson-Konovalov disease, can increase the level of these enzymes.

Treatment for elevated ALT and AST levels depends on the cause. Treatment may include stopping the medication or changing the diet, as well as treating the disorder causing the elevated enzyme levels. In some cases, hospitalization may be required for observation and treatment.

• • Ultimately, prevention of liver problems can help prevent increased ALT and AST levels in children. Preventive measures may include the following:
    1. Avoid alcohol if the child is under the legal age to do so.
    2. Make sure your child eats a healthy and balanced diet that includes fruits and vegetables.
    3. Check that medications, if taken, do not cause side effects on the liver.
    4. Be alert for signs of any disease that could affect your child’s liver and seek immediate medical attention if needed.

ALT and AST – what is it?

ALT and AST are enzymes found in liver cells that are involved in various chemical reactions in the body. They are very important for health, as they help to evaluate the functioning of the liver and identify possible diseases.

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are present in different organs, but the greatest amount of them is found in the liver. If the levels of these enzymes are elevated, this may indicate a problem with the liver.

Note: ALT and AST levels are usually significantly lower in children than in adults.

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How does ALT and AST increase?

ALT and AST are enzymes produced in liver cells. An excessive increase in their levels may indicate that the liver cells have been damaged or destroyed.

Increased ALT and AST levels can be caused by several causes such as hepatitis, liver cirrhosis, liver cancer, alcohol disorder, viral infections, and other factors.

When liver cells are damaged, ALT and AST are released from the cells into the bloodstream, which leads to their increase in the blood. For example, if a child has hepatitis, they may experience elevated blood levels of ALT and AST.

Treatment for elevated ALT and AST levels depends on the cause. If the increase is caused by a disease, then treatment will be aimed at eliminating the underlying disease and restoring liver function. In some cases, the child may need to be hospitalized to ensure optimal treatment and liver monitoring.

In general, elevated ALT and AST levels in children can be a serious symptom requiring immediate medical attention. If elevated levels of these enzymes are suspected, a physician should be consulted to diagnose and treat the underlying cause.

Why can children have elevated ALT and AST levels?

AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are liver enzymes that are responsible for amino acid metabolism. Elevated levels of these enzymes may indicate the presence of liver disease. In children, the reasons for the increase in ALT and AST can be:

• • • Hepatitis. Viral, autoimmune, or cryptogenic hepatitis may cause elevations in ALT and AST levels.
    • Cholelithiasis. In the presence of gallstones, bile stasis in the liver can occur, which can lead to an increase in ALT and AST levels.
    • Cirrhosis of the liver. In the presence of cirrhosis of the liver, there may be an increase in AST and ALT due to the destruction of liver cells.
    • Toxic effect. Liver exposure to toxic substances, such as long-term use of drugs, can lead to increased levels of AST and ALT.

A number of diseases can also cause an increase in ALT and AST levels in children. In the event that the blood contains an increased amount of these enzymes, a doctor’s consultation is necessary to find out the cause of this condition and prescribe the appropriate treatment.

How to diagnose elevated ALT and AST levels in children?

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are liver enzymes that are normally present in the blood in small amounts. If ALT and AST levels are higher than normal, this may indicate problems with the liver or other organs.

ALT and AST blood tests are used to diagnose elevated liver enzymes in children. Blood is usually taken from a vein and analyzed in a laboratory. It is important to consider possible physical activities and medications before the test, as they can affect the results.

Elevated ALT and AST levels are not a diagnosis and may require additional investigations such as liver ultrasound, computed tomography, or magnetic resonance imaging.

If ALT and AST levels remain elevated for a long time, it is necessary to consult a doctor for further advice and treatment tactics.

Treatment for elevated ALT and AST

Diet

If ALT and AST levels are elevated, a special diet is suggested. It is recommended to exclude fatty, spicy, salty and canned foods from the diet. Instead, you should eat more fresh fruits and vegetables, greens and protein foods.

Drug therapy

In some cases, drug treatment may be given to lower ALT and AST levels. Your doctor may prescribe anticholinergics, hepatoprotectors, and other medications, depending on the cause of the elevated liver enzymes.

Removing the cause

If the increase in ALT and AST levels is caused by some disease, then it must first be eliminated. For example, with hepatitis, you need to treat hepatitis, with fatty degeneration of the liver, you need to change your lifestyle and start losing weight.

Daily routine

It is important to monitor your daily routine and get enough hours of sleep. Irregular work schedules and lack of rest can cause elevated ALT and AST levels.

Prevention of rising ALT and AST levels in children

Studies show that elevated ALT and AST levels in children can be caused by a variety of reasons, from poor diet to various diseases of the liver and other organs.

However, there are several ways that can help prevent the increase in ALT and AST levels in children. First of all, it is important to monitor the proper nutrition of the child and provide him with all the necessary healthy food.

Avoid contact with toxic chemicals that can affect liver function. Another way to prevent the increase in ALT and AST levels in children is to regularly take medications prescribed by a doctor.

Important: If a child has elevated levels of ALT and AST, do not try to diagnose and treat yourself. It is necessary to consult a doctor who will determine the cause and prescribe treatment depending on the results of tests and examinations.

Predicted duration of treatment for elevated ALT and AST levels in children

The duration of treatment aimed at lowering ALT and AST levels in a child depends on many factors. One of the main factors is the cause of the increase in liver enzymes. If the cause was alpha thalassemia, treatment may not be required as this condition does not require treatment. However, if the increase in enzymes is due to a viral infection, an autoimmune disease, or strong hepatotoxic drugs, in other words, more serious liver diseases, it takes a long time to restore health.

The cause of elevated ALT and AST levels determines the duration of treatment, which can vary from several months to several years. In addition, the effect of treatment on the child may depend on the presence of comorbidities and the general health of the child.

To reduce treatment time and achieve better health outcomes for children, the causes of elevated liver enzymes must be identified and treated as early as possible. To do this, it is necessary to conduct regular medical examinations in order to identify possible problems and solve them in a timely manner.

Finally, it is important to remember that the time required for ALT and AST blood levels to return to normal in children varies from child to child. Some children may seek help late in the disease, while others may receive treatment early. In this case, predicting the duration of treatment becomes even more difficult, and it all depends on many factors. The main thing is not to delay the visit to the doctor and take measures to improve the health of your child as early as possible.

What symptoms should I see a doctor for?

Elevated levels of AST and ALT in the blood is not an independent disease, but only a sign of liver dysfunction. The symptoms of this disorder may not be obvious and minor in the initial stage, so regular blood tests can reveal changes in enzyme levels.

However, when the level of liver enzymes is significantly elevated, symptoms appear that may indicate the need to see a doctor. These include: jaundice, that is, staining of the skin and mucous membranes in yellow; pain in the abdomen, the area of ​​the right hypochondrium; severe fatigue, weakness and depression; palpitations and swelling.

If a child complains of these symptoms, parents should immediately contact a doctor to start treatment. You also need to visit a doctor if an increase in the level of AST and ALT is detected on routine tests or during a medical examination.

Treatment of elevated AST and ALT levels in children depends on the cause and degree of liver dysfunction. You may need to change your diet, increase physical activity, stop medications, or use special medications. In any case, don’t delay seeing your doctor, because early detection and timely treatment of elevated AST and ALT levels can prevent the development of more serious liver disease.

What types of therapy can be used to treat elevated levels of ALT and AST?

Treatment for elevated ALT and AST depends on the cause of the abnormality. If elevated levels are associated with another disease, then the underlying disease must be treated first.

When elevated levels of ALT and AST are associated with liver pathology, the treatment is aimed at restoring the function of the liver and its cells. The therapy may contain drugs such as hepatoprotectors that help renew and repair damaged liver cells. It is important to remember that in all children an individual approach to treatment and the dosage of drugs should be prescribed only by a doctor.

In addition to medicines, it is also recommended to regulate the child’s diet in order to reduce the load on the liver. The diet should include foods rich in vitamins and minerals, such as: fresh fruits and vegetables, green leaves, protein foods such as chicken or fish. Fatty, fried, fried and canned foods should be avoided.

In some cases, hospitalization may be required for closer medical observation. This is especially true for children with painful symptoms or high levels of ALT and AST.

In general, the treatment of elevated ALT and AST levels in children is not only aimed at lowering liver enzymes, but also at restoring and maintaining overall liver health. This can be a lengthy process that requires patience and commitment from doctors and parents.

Nutrition for Elevated ALT and AST in Children

Basic Dietary Recommendations:

Elevated ALT and AST in children is important to follow a proper and balanced diet, which can help reduce the load on the liver and improve its functional activity.

What to include in the diet with elevated levels of ALT and AST:

• • • Vegetables and fruits (especially rich in antioxidants, such as beets, carrots, apples, grapefruit).
    • Low fat protein products (fish, chicken, turkey, seafood).
    • Healthy fats (olive oil, nuts, avocado).
    • Healthy cereals and legumes (buckwheat, bran, beans).
    • Low-fat fermented milk products (kefir, yogurt).

What should be excluded from the diet at increased levels of ALT and AST:

• • • Fat and fried products (Kovbas, sausage, fast food).
    • Sweets (chocolate, sweets, cakes).
    • Carbonated drinks and juices with added sugar.
    • Canned and salted foods (fish, meat, vegetables).
    • White bread and foods high in sugar.

Nutrition with elevated levels of ALT and AST is an important component of complex therapy. Be sure to consult with a specialist and follow the doctor’s recommendations.

Possible side effects when treating elevated ALT and AST levels

Treatment of elevated ALT and AST levels in children may have some side effects. One of the most common side effects is nausea, which can occur with drugs used to lower blood levels of ALT and AST.

In addition, the treatment may lead to decreased appetite and stomach upset. In some cases, symptoms of an allergic reaction may appear, such as skin rash and itching.

Certain drugs can cause potassium and magnesium to be flushed out of the body, which can lead to physical weakness and muscle cramps. In addition, the treatment can have a negative effect on the liver, and therefore children need to regularly monitor the level of ALT and AST in the blood.

In general, side effects in the treatment of elevated ALT and AST levels in children are rare and careful monitoring by a doctor helps to minimize the risks and prevent possible negative consequences.

• • • Nausea is one of the most common side effects;
    • In rare cases, allergic reactions may occur ;
    • Treatment may lead to loss of appetite and gastric disturbances;
    • Certain drugs can cause a potassium and magnesium flush, which can lead to muscle cramps and weakness;
    • Treatment may have adverse effects on the liver.

Vitamins and minerals in the treatment of elevated levels of ALT and AST

The role of vitamins in the treatment of elevated levels of ALT and AST

B vitamins (B6, B9 and B12) play an important role in the body’s metabolism, including processes associated with liver function. Vitamin B6 helps break down proteins, which helps lower ALT and AST levels. Vitamin B9 is involved in the formation of new cells, and B12 helps to improve the functioning of the nervous system.

The role of minerals in the treatment of elevated levels of ALT and AST

Magnesium plays an important role in the processes associated with the functioning of the liver. With a lack of magnesium, an increase in the level of ALT and AST can be observed. Zinc helps reduce levels of inflammation in the liver and lowers ALT levels. Selenium helps reduce oxidative stress, which can lead to elevated ALT and AST levels.

How do I get the vitamins and minerals I need?

• • • Vitamin B6: beans, nuts, bananas, potatoes, chicken;
    • Vitamin B9: green vegetables, fruits, nuts, chicken, fish;
    • Vitamin B12: dairy products, meat, fish, eggs;
    • Magnesium: nuts, cereals, green vegetables, buckwheat, dark chocolate;
    • Zinc: nuts, chicken, legumes, milk, walnuts;
    • Selenium: nuts, fish, meat, eggs, spinach.

Important to remember

Consult your doctor before taking any vitamins and minerals. Do not exceed the recommended dose, as this can lead to negative health effects.

Question: Is it possible to completely recover from elevated levels of ALT and AST?

Elevated levels of ALT and AST may indicate a child with liver problems. Although elevated levels of ALT and AST can be a sign of various diseases, these levels can also be elevated due to other causes, such as the use of toxic substances, drugs, or injury.

In most cases where elevated levels of ALT and AST are caused by liver disease, it is possible to achieve a complete or partial cure. However, it is not always possible to be completely cured, especially in cases of severe liver disease or when the problem was not identified and treated early enough.

Treatment for elevated ALT and AST levels associated with liver problems may include medications, diet, lifestyle changes, and possibly other treatments such as hepatoprotectors and physical therapy. In some cases, more serious treatment, such as a liver transplant, may be needed.

Therefore, the possibility of complete recovery from elevated ALT and AST levels depends on the cause and severity of liver disease. However, timely contact with doctors and early treatment can increase the chances of a complete cure for elevated levels of ALT and AST.

How to prevent recurrence of elevated ALT and AST levels?

Prevention of recurrence of elevated ALT and AST levels in children can be achieved by making certain changes in their lifestyle and diet, as well as by regular medical examination.

To prevent ALT and AST levels from rising, children’s diets should be monitored to include more fruits, vegetables, and grains. It is also necessary to limit the consumption of fatty and fried foods, alcohol and other harmful substances.

Regular exercise and play can also help reduce ALT and AST levels in a child’s body. It can be running, jumping, swimming or playing outside.

In addition, it is important to monitor the general health of the child and conduct an annual medical check-up. If elevated levels of ALT and AST are detected, it is urgent to consult a pediatrician and conduct an additional examination to determine the reasons for the increase.

In general, by following simple dietary and lifestyle recommendations and regular health check-ups, elevated ALT and AST levels can be prevented from recurring in a child, contributing to their health and well-being.

Questions for the doctor when diagnosing and treating elevated levels of ALT and AST

If a child has an elevated level of ALT and AST, it is necessary to consult a doctor and conduct a diagnosis. For correct diagnosis and treatment, it is important to ask the following questions:

• • • What are the child’s symptoms or complaints?
    • What were the levels of ALT and AST on previous test results?
    • Was there any therapy?
    • Does the child have a genetic predisposition to liver disease?
    • What medications has the child taken in recent months?
    • What is the child’s diet and does he drink alcohol?

After identifying the cause of the elevated ALT and AST levels, the doctor will prescribe the appropriate treatment. Depending on the cause, medication may be prescribed, diet changes, or a specific lifestyle recommended.

It is important to remember that each child may have unique factors that affect liver enzyme levels, so follow your doctor’s instructions and do follow-up tests.

Complications of elevated ALT and AST levels in children

High levels of ALT and AST can indicate problems in the liver, which can lead to various complications in children. The most common complications are:

• • • Hepatitis: elevated levels of ALT and AST may indicate the presence of hepatitis, which can lead to inflammation of the liver and various violations of its functions. Hepatitis can be caused by viruses, autoimmune disorders, or toxic substances.
    • Cirrhosis: Chronic hepatitis can lead to cirrhosis of the liver, which is a serious complication that can lead to liver dysfunction and, in severe cases, death.
    • Liver necrosis: high levels of ALT and AST may indicate the presence of liver necrosis, which is a serious complication and can lead to death.
    • Liver tumors: high levels of ALT and AST can indicate the presence of tumors in the liver, which can lead to various disorders of its functions and even liver cancer.

Elevated levels of ALT and AST in children require mandatory examination and treatment. Early detection and treatment of liver pathology can prevent the development of serious complications and save the life of the child.

Q&A:

What do the abbreviations ALT and AST mean?

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes found primarily in the liver. They are actively involved in the process of amino acid metabolism, catalyzing the transfer of amino acid groups from one molecule to another.

What could be the reasons for the increase in ALT and AST levels in children?

There may be several causes: inflammatory liver disease (hepatitis), liver damage (trauma), medications, metabolic disorders, the presence of a tumor, etc.

What symptoms indicate elevated levels of ALT and AST in a child?

Elevated enzyme levels may occur without any symptoms. But jaundice, appetite disorders, diarrhea, nausea and vomiting, fatigue, fever, pain and malaise in the abdomen are also possible.

How are children tested for ALT and AST levels?

The sample is taken using a normal vein. The patient usually does not have to fast, but it is preferable to donate blood in the morning on an empty stomach. The blood is placed in a test tube and tested in a laboratory to determine the levels of ALT and AST.

Can the increase in ALT or AST be due to drugs?

Yes, medications can cause elevated enzyme levels. For example, antibiotics, anti-inflammatory drugs, and antidepressants can increase ALT and AST levels, but this varies by drug and dosage.

How can ALT and AST levels be lowered?

The decrease in ALT and AST levels depends on the specific cause of the elevated enzymes. Treatment may include special diets, medications, and lifestyle changes. Ultimately, treatment is directed at treating the underlying disorder causing elevated enzyme levels.

Are there any restrictions after testing for ALT and AST levels?

Usually there are no restrictions after testing for liver enzyme levels. The patient can continue their normal activities regardless of the test result.

How can ALT and AST levels be prevented in children?

Usually, elevated levels of ALT and AST are the result of some disease or one or more risk factors. To prevent levels from rising, it is essential to follow a healthy lifestyle, travel to medical checkups, and talk to your doctor if you have risk factors for liver disease (eg, abdominal pain, jaundice, etc.).

Conclusions

As a result of the study, the following conclusions can be drawn:

• • • Elevated levels of ALT and AST in children are a sign of impaired liver function.
    • Increased ALT and AST levels can be caused by various liver diseases such as hepatitis, cirrhosis or fatty degeneration.
    • Increases in ALT and AST levels may also be associated with certain medications, alcohol, strenuous exercise, stress, and poor diet.
    • To treat elevated ALT and AST levels in children, the underlying cause must be identified and appropriate therapy prescribed, which may include medication, diet, or lifestyle changes.
    • Gastroenterologists recommend regular examinations in order to timely detect and treat liver problems.

Related videos:

what does this mean and what to do?

Increased levels of ALT and AST in the blood may indicate various diseases of the liver, heart or muscles. It is important to consult a doctor and undergo a comprehensive examination to determine the cause of the increased rates.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes found inside the cells of the liver and other organs. When cells become damaged or die, ALT and AST enter the bloodstream and blood levels of these enzymes rise.

Elevated levels of ALT and AST may indicate various diseases related to the liver, heart or muscles. For example, it can be a sign of hepatitis, cirrhosis of the liver, liver cancer, myocardial infarction, myositis, and other diseases.

If you have elevated ALT and AST levels, you should see a doctor for advice and diagnosis. Depending on the cause of the elevated readings, treatment may include medication, lifestyle changes, diet, or surgery.

Elevated ALT and AST

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes found in liver and heart cells that perform important functions in the body. If the level of these enzymes is elevated, this may indicate the presence of diseases.

Elevated levels of ALT and AST are often indicative of liver disease such as hepatitis, cirrhosis, or liver cancer. However, in addition to liver disease, elevated levels of these enzymes may be associated with other causes such as myocarditis, myocardial infarction, myopathies, alcoholic liver disease, and other diseases.

Determination of ALT and AST levels is carried out in the blood by analyzing biochemical parameters. The results of the analysis can be used along with other tests and examinations to diagnose and evaluate the condition of the liver and other organs.

If you find elevated levels of ALT and AST in a blood test, don’t panic. It is recommended that you see your doctor for further diagnosis and to determine the cause of the elevated levels. Depending on the cause, medications, diets, or lifestyle changes may be prescribed.

Important to remember:

• Elevated levels of ALT and AST are not an accurate indicator of the presence of the disease, but are only an indicator;
• Never attempt to make a diagnosis on your own based on test results – this should be done by a qualified physician;
• Follow your doctor’s instructions and don’t forget your check-ups.

What does this mean?

ALT and AST are enzymes found in liver cells.

The normal level of ALT and AST depends on the sex and age of the person, as well as on the methods of analysis and the units used. If ALT or AST values ​​are elevated, this may indicate damage to the liver cells. Also, ALT levels can be elevated in a number of other diseases, including diseases of the heart, pancreas, and muscles.

Elevated ALT and AST levels are most commonly associated with liver disease . Some of these may be caused by viruses such as hepatitis B and C, alcoholic cirrhosis, or fatty liver.

If you have elevated ALT and/or AST levels, you should contact your doctor immediately for further testing and determination of the cause of liver cell damage.

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What level is normal?

Normal levels of ALT and AST may vary slightly depending on the age and sex of the person. Usually, in men, AST is from 8 to 40 U / l, ALT – from 10 to 50 U / l. In women, the indicators may be slightly lower: AST – from 7 to 35 U / l, and ALT – from 5 to 35 U / l.

However, if the levels of liver enzymes are higher than normal, this may indicate the presence of a disease. In this case, it is important to consult a doctor and undergo an additional examination. It must be understood that it is possible to increase ALT and AST in other diseases, for example, urolithiasis, myocarditis, etc.

Also, be aware that AST and ALT levels may rise due to physical activity, medication, alcohol, poor quality food or stressful situations. Therefore, if the level of liver enzymes is elevated, it is worth re-analyzing after some time to exclude temporary factors and track the dynamics of the change.

What can lead to an increase in ALT and AST?

AST and ALT are enzymes produced in liver cells. Elevated levels may indicate problems with the liver or other parts of the body, such as the cardiovascular system or muscles. The following are some of the causes of elevated AST and ALT levels:

1. Hepatitis: is an inflammatory disease that can damage liver cells and increase blood levels of AST and ALT.
2. Alcohol: Excessive alcohol consumption can damage liver cells and increase liver function.
3. Drugs: Some drugs can increase AST and ALT levels, such as some antibiotics, antivirals, and cancer drugs.
4. Cirrhosis: This chronic and progressive liver disease can lead to impaired liver function and elevated enzyme levels.
5. Fatty Liver: is a condition in which fat accumulates in the liver, which can lead to liver damage and increased levels of AST and ALT.

If you have elevated levels of AST and ALT, but do not know what may be the cause, contact your doctor for medical advice and further examination.

What symptoms can accompany elevated values?

Feeling tired and weak is a common symptom that can accompany elevated ALT and AST levels. Fatigue can be aggravated by physical exertion and the body’s need for regeneration.

Liver dysfunction – the liver may increase in size, pain in the right hypochondrium, icteric color of the skin and mucous membranes. Dyspepsia (digestion disorders) may also occur.

Muscle pain and cramps – elevated levels of ALT and AST may be accompanied by pain and cramps in the muscles. Often these symptoms indicate metabolic disorders and a lack of certain vitamins and minerals.

Decreased appetite – Metabolic disorders may occur, resulting in a lack of energy in the body. Decreased appetite can also be associated with problems in the digestive system.

Cardiovascular disorders – Elevated levels of AST may indicate disorders of the cardiovascular system. This can occur with heart disease and increased pressure in the pulmonary artery.

What illnesses usually cause high rates?

Elevated values ​​of ALT and AST can indicate various diseases and conditions of the body. Below are the most common ones:

• Hepatitis . One of the most common causes of elevated ALT and AST levels. Hepatitis can be caused by a virus or other factors (alcohol disorder, toxic effects, etc.).
• Cirrhosis of the liver . With this disease, there is a gradual replacement of healthy liver tissues with connective tissue, which leads to a decrease in its functional activity.
• Oncological diseases . Elevated values ​​of ALT and AST may indicate the presence of cancer cells in the body.
• Pancreas . In diseases of the pancreas, an increase in the level of ALT and AST can also occur.
• Cardiovascular diseases . Elevated levels can be caused by heart disease, such as myocardial infarction or arrhythmia.

It is very important to remember that only a doctor can accurately determine the cause of elevated ALT and AST levels and prescribe the necessary treatment.

How to diagnose ALT and AST levels?

ALT and AST levels require blood tests at a clinic or laboratory. Usually, along with the level of ALT and AST, other blood parameters are also determined, which can provide additional information about the work of the liver and other organs.

Blood for ALT and AST is taken from a vein on an empty stomach. Prior to the analysis, you must refrain from food and alcohol for at least 8 hours. It is also preferable to avoid physical exertion and stress for 24 hours before analysis.

These rates may be elevated in cases such as alcohol abuse, certain medications, liver infections, fatty liver disease, tumor diseases, heart disease, and many others. Therefore, if the results of the analysis showed an increased level of ALT and AST, it is necessary to consult a doctor who will help determine the cause of the change in indicators and suggest the necessary treatment.

It is important to remember that elevated levels of ALT and AST are not an independent disease, but only a signal of possible disorders in the liver and other organs. Therefore, you should not self-medicate and take any medications that can worsen the situation without consulting a doctor.

What treatments are used for elevated values?

Treatment of elevated ALT and AST begins with identifying the cause of the increase. In some cases, for example, in the presence of infectious diseases or taking certain medications, the indicators may return to normal after the cause is eliminated.

If elevated levels are a sign of liver disease, then the main task is to treat the disease itself. In this case, the main methods are conservative therapy and surgical intervention, depending on the severity of the disease.

If elevated levels of ALT and AST are associated with cardiac diseases, then treatment is aimed at improving the functioning of the heart and blood vessels, lowering cholesterol levels and normalizing blood pressure. In such cases, treatment may include medication, lifestyle and dietary changes, and regular exercise.

Some lifestyle changes can also help reduce ALT and AST levels. These include eating healthy, exercising regularly, not smoking, and drinking in moderation.

In any case, in case of elevated ALT and AST levels, it is necessary to consult a doctor who will prescribe the necessary treatment.

Can drugs cause an increase in performance?

Yes, medicines can increase blood levels of ALT and AST. This is especially true of drugs that affect the liver and metabolism of substances.

Some antibiotics, for example, can cause an increase in ALT and AST levels. Taking aspirin and other anti-inflammatory drugs can also increase the levels of these enzymes.

Hormonal medications such as steroids and contraceptives may also increase ALT and AST levels.

If you notice changes in your ALT and AST levels while taking any medication, be sure to contact your doctor. He will conduct an additional examination and adjust the treatment, if necessary.

Also, before taking any medications, including vitamins and dietary supplements, be sure to talk to your doctor about any medical conditions or health problems you may have.

Avoid self-medication and do not take drugs without a doctor’s prescription. This can lead to serious complications and an increase in ALT and AST levels in the blood.

What lifestyle changes can help lower ALT and AST levels?

1. Keeping a healthy lifestyle.

You need to watch your lifestyle, because it can increase ALT and AST. To do this, you should give up bad habits, such as smoking or drinking alcohol. You also need to watch your diet, avoiding fatty, spicy and fried foods, and increasing the consumption of fruits and vegetables. It is recommended to consume more protein (meat, fish, eggs, legumes).

2. Moderate physical labor.

Moderate stress on properly functioning organs helps to reduce ALT and AST levels, as they stimulate metabolic processes in cells. It is worth doing sports: choose the type of physical activity that suits you – running, swimming, yoga and other types of activities.

3. Weight normalization.

Excess weight is one of the reasons for the increase in ALT and AST levels, having a negative effect on the liver. In order to have a therapeutic effect in reducing the level of ALT and AST, a person can lose weight by 10-15% of the current weight for the following certain periods of time

4. Reducing stress.

Stress has an adverse effect on the functioning of organs and systems of the body, including the liver. In order to reduce ALT and AST levels, it is recommended to reduce stress levels in your life, for example, by including meditation, yoga or aromatherapy in your daily routine.

5. Carrying out regular medical examinations.

Examination should be carried out procedurally from certain periods of time to identify upcoming diseases and control liver parameters.

What else can be done to improve liver health?

If you have elevated ALT and AST levels, you should pay attention to your lifestyle and diet. For liver disease, a diet that includes vegetables, fruits, protein, and healthy fats is recommended.

In addition, it is beneficial to consume foods rich in vitamins and minerals such as folic acid, vitamin A, C, E, D and B group, as well as selenium, zinc and magnesium.

Avoid carbohydrate foods, fatty and fried foods, as well as alcohol and tobacco, which can damage the liver. Instead, you should consume green tea, which has antioxidant properties, as well as water, which helps to remove toxins from the body.

For those who work with toxic substances, protective clothing and masks should be worn to avoid contamination. It is also important to take regular wellness treatments such as yoga, meditation, or massage to help relieve stress and improve overall well-being.

What measures should be taken to avoid elevated ALT and AST levels?

Nutrition: You need to eat right, eat protein-rich foods such as mugherka, chicken (without skin) and others. Also, do not abuse fatty foods, eat less processed foods, fast carbohydrates, strong alcohol and hepatitis-causing drinks (for example, viral hepatitis C can lead to liver disease).

Physical activity: It is necessary to exercise the liver, regularly do physical exercises suitable for your age and physical condition. Moderate exercise can be helpful in strengthening the body.

Cessation of bad habits: Smokers need to stop smoking to avoid increased stress on the liver, which often leads to increased levels of ALT and AST. You also need to limit your alcohol intake.

Prevention of viral hepatitis: Precautions must be taken to protect against viral hepatitis (A, B, C, D, E). This includes vaccination against hepatitis A and B, avoiding consumption of consumer goods that can be contaminated with hepatitis viruses (for example, blood and its components, tattoo instruments, non-sterile medical instruments), and good hygiene (frequent change of bed linen, towels).

Medical check-ups: Regular medical check-ups will detect elevated levels of ALT and AST at the very beginning, which will help prevent serious illness.

Can I drink alcohol if I have elevated ALT and AST?

Elevated levels of ALT (alanine aminotransferase) and AST (aspartate aminotransferase) may indicate the presence of liver disease such as hepatitis, cirrhosis or fatty degeneration. At the same time, alcohol consumption can aggravate the situation and increase the destruction of liver cells, which contributes to a further increase in ALT and AST levels.

Therefore, with elevated levels of ALT and AST in the blood, it is recommended to refrain from drinking alcohol. It is important to understand that even small doses of alcohol can harm the body and worsen health.

In addition, a treatment plan and a liver CT or ultrasound scan to determine the cause of elevated ALT and AST levels are recommended. It is possible that these indicators can be managed through changes in diet and other ways to lead a healthy lifestyle.

What foods should be included in the diet with elevated levels of ALT and AST?

With elevated ALT and AST, it is important to choose the right diet that includes the following foods:

• Vegetables and fruits – these contain vitamins and minerals that are essential for liver health. They also contain antioxidants that help the liver defend against stress and regenerate.
• Protein foods – Include meat, fish and eggs in your diet as they contain amino acids that help the liver recover and regenerate.
• Nuts and seeds – they contain magnesium, which helps reduce inflammation in the liver and improve blood flow.
• Cereals – buckwheat, oatmeal, sprouted rice – they are rich in fiber and beneficial substances that reduce inflammation in the liver and help it fight toxins.

At the same time, you should limit the intake of fatty foods, salt, sugar and alcoholic beverages, as they can impair the functioning of the liver.

Foods to avoid Foods to include in the diet

What if the indicators do not decrease even with treatment?

If ALT and AST levels do not decrease with treatment, a doctor should be consulted to adjust therapy. In addition, additional examinations may be required to identify the cause of the increased rates.

The following causes of therapy failure are possible:

• Incorrectly selected medicine;
• Insufficient amount of medicine;
• Medication disorder;
• Concomitant diseases not previously detected;
• Toxic damage, such as that caused by the use of alcohol or drugs.

Your doctor may decide to change your medication or change your dose. Additional examinations may also be required, for example, ultrasound examination of the liver or hepatobiliary system, computed tomography, etc.

In any case, treatment should not be stopped without consultation with the doctor, even if ALT and AST levels remain elevated. The ineffectiveness of therapy can be caused by various reasons, and only a qualified doctor can prescribe the correct treatment.

How often should ALT and AST be monitored?

The frequency of monitoring of ALT and AST levels may vary depending on the cause of the increase in these levels and the general health of the patient. Usually, the first study is carried out by doctors immediately when there is a suspicion of diseases that can lead to an increase in ALT and AST.

Further, if the indicators remain high for a long time, they must be monitored monthly. In the presence of disease progression or worsening of symptoms, the frequency of control may change.

However, if the ALT and AST levels return to normal after treatment of the disease, further control can be carried out in at least half a year or even a year.

ALT and AST control frequency determination should be ordered by a specialist who diagnoses and treats the disease.

In any case, with a repeated increase in indicators, it is necessary to immediately consult a doctor for additional examination and adjustment of therapy.

What are the consequences of a prolonged increase in performance?

If the level of ALT and AST is increased for a long time, this can lead to serious consequences:

• Liver damage. This could be disease, slow liver damage, drug overdose, or alcohol abuse. With a prolonged increase in ALT and AST levels, there may be yellowing of the skin and mucous membranes, hepatitis, abdominal pain, hepatosis, cirrhosis, and liver metastases.
• Cardiovascular diseases. Elevated AST levels, even for a short time, may indicate heart problems. Fatigue, shortness of breath, or chest discomfort may be a warning sign. With a prolonged increase in indicators, myocardial infarction, peripheral arterial disease, thrombosis, arterial hypertension may occur.
• Problems with the muscular system. In many cases, elevated levels of ALT and AST are indicative of problems with muscle tissue. Prolonged elevations can lead to myopathy, target injury, and neuropathies.

A prolonged increase in ALT and AST levels requires a doctor’s consultation and further examination. The doctor may prescribe treatment depending on the problems found. It is important to monitor the level of ALT and AST in order to identify problems in a timely manner and prevent serious diseases.

Q&A:

What are ALT and AST?

ALT (alanine aminotransferase) and AST (aspartate aminotransferase) are enzymes found inside liver cells. When liver cells are damaged, these enzymes enter the bloodstream, increasing their levels in the blood.

Can elevated levels of ALT and AST cause liver disease?

Yes, elevated levels of ALT and AST can be a sign of liver disease such as hepatitis, cirrhosis, or fatty liver disease.

What other factors can affect blood levels of ALT and AST?

In addition to liver disease, elevated levels of ALT and AST can be caused by other factors such as myocardial infarction, diabetes, drugs such as aspirin, and other factors.

How can I lower my ALT and AST levels?

If elevated levels of ALT and AST are caused by a liver disease, then the level can only be reduced by treating this disease. If the level is elevated due to other factors, then they must be eliminated. It is also important to follow a healthy lifestyle, proper nutrition and physical activity.

Can elevated levels of ALT and AST affect pregnancy planning?

Yes, elevated levels of ALT and AST may be associated with impaired liver function, and this may affect pregnancy planning and pregnancy in general. If the level of ALT and AST is elevated, it is necessary to undergo an examination and consult a doctor.

What symptoms can accompany elevated levels of ALT and AST?

Elevated levels of ALT and AST may be accompanied by various symptoms such as jaundice, fatigue, nausea, vomiting, abdominal pain, and others.

How often should ALT and AST blood levels be checked?

If the ALT and AST levels are normal, then it is enough to check them once a year at the doctor’s examination. If the level is elevated, then it is necessary to undergo an examination and consultation with a doctor, and then follow the recommendations for the frequency of studies and treatment that the doctor will prescribe.

How to help the liver recover after past illnesses?

Past illnesses can adversely affect liver function and lead to elevated levels of ALT and AST in the blood. But there are ways to help the body restore its work and reduce enzyme levels to normal.

First, you need to give up bad habits, especially alcohol, which is one of the most common causes of liver dysfunction. It is also desirable to remove fatty, fried and spicy foods from the diet, which will reduce the load on the organ.

Secondly, you need to pay attention to the levels of vitamins and minerals necessary for liver health.