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What should your liver enzyme levels be: High, Low & Normal Results, Symptoms & Causes


5 Ways to Lower ALT Levels Naturally

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

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

What is ALT? 

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

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

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

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

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

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

1. Drink more coffee

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

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


Is coffee bad for you? It can have many health benefits — as long as you drink it in moderation

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

2. Improve your diet 

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

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

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

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

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

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

3. Get more folic acid 

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

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

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

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

4. Lower your cholesterol 

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


5 ways to lower your cholesterol naturally

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

“Patients who have fatty liver disease frequently have comorbid medical conditions like

high cholesterol
, and we certainly want good control of those conditions because of the increased risk of heart disease,” Henry says. 

5. Avoid alcohol and smoking 

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

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


All of the amazing ways your body heals itself when you quit smoking: A timeline from 20 minutes to 15 years after your last cigarette shows your dramatic decrease in risk of premature death

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


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

Abnormal Liver Function Tests – Gastroenterologist in Flemington & Hillsborough, NJ

Abnormal Liver Function Tests (or LFT’s) 

Where is the liver located?

The liver is located in the right upper quadrant of your abdomen, just beneath your diaphragm, above your stomach, right kidney, and intestines. It weighs about 3 pounds and holds about 13% of your body’s blood supply at any given moment. 

The liver is made up of 2 main lobes: a right and a left lobe, which are divided into smaller lobes called lobules. These different areas are connected by ducts, which eventually join to form the common hepatic duct. This duct transports bile made by the liver to the gallbladder and small intestine. Bile helps to digest and absorb fats and fat-soluble vitamins (Vitamins A, D, E and K).

The liver is the largest solid organ in your body. It carries out over 500 functions and is a part of your digestive system. Its main function is to filter blood coming from your digestive tract, before it passes to the rest of your body. The liver detoxifies chemicals and breaks down drugs into simpler and less toxic forms. 

What are the functions of the liver?

The liver has 100’s of vital functions. Some of these include:

  • Regulating most chemical levels in your blood.
  • Producing and excreting bile
  • Processing and “cleaning” your blood 
  • Converting excess glucose (or sugar) into glycogen (for storage and later use). This helps to regulate our blood sugar levels.
  • Breaking down or metabolizing drugs into simpler forms that are easier for our bodies to use and that are nontoxic. 
  • Producing proteins such as albumins and globulins. These proteins help with fluid balance, fighting infection, and they carry various substances throughout our bodies, like hormones, vitamins, and other enzymes. 
  • Producing cholesterol and proteins that help carry fats throughout our bodies.
  • It plays a major role in red blood cell production by breaking down and recycling hemoglobin, a component of our red blood cells that carries oxygen to our cells. 
  • It stores iron as ferritin for later use to make new red blood cells. 
  • It processes and converts poisonous ammonia (a byproduct of protein metabolism) into urea, which is excreted in our urine. 
  • It plays a major role in blood clotting 
  • It disposes of bilirubin, made during the normal break down of red blood cells. 
  • It makes immune factors and removes bacteria from your blood

What are “Liver Function Tests”?

Liver function tests are blood tests that measure different enzymes, proteins, and other substances made in the liver. These substances are often tested together on a single blood sample, and may include:

  • ALT (alanine aminotransferase) and AST (aspartate aminotransferase): These tests measure enzymes your liver releases in response to damage or disease.
    • These enzymes normally live inside your liver cells, but when cells are damaged these enzymes can leak out and cause blood levels to increase. 
    • ALT is an enzyme specifically found in the liver. It helps convert proteins into energy for your liver cells. 
    • ALT is more specific to liver cells than AST, as AST can also be found in your heart, skeletal muscles, and red blood cells. 
    • AST is an enzyme that helps metabolize amino acids from proteins. 
  • Albumin is one of several proteins produced by the liver. This test measures how well your liver produces albumin. 
    • Albumin helps to maintain fluid balance in your body, and helps to keep fluid from leaking out of your blood vessels. It also carries things like hormones and vitamins throughout your body.
  • Total Protein is a measure of the total amount of protein (both albumins and globulins) present in your blood.
    • Proteins are important building blocks for all of your cells and tissues. 
  • Albumin to Globulin (or A/G) ratio: This is the ratio of albumin to globulin in your blood.
    • Globulins are proteins that play an important role in your immune health.
  • Alkaline phosphatase is an enzyme found in your liver and bones. It is important in breaking down proteins. 
    • This test is especially useful in diagnosing diseases of the bile duct system; however, it can be elevated in conditions unrelated to the liver so we may need to order “isoenzymes” to help differentiate the source of your abnormal labs: liver vs. bone. 
    • *Alk Phos is also normally elevated during adolescence and in the third trimester of pregnancy. This is largely due to bone growth during adolescence. Additionally, the placenta produces Alk phos during the 3rd trimester of pregnancy normally. 
  • GGT or gamma-glutamyl transpeptidase is an enzyme found in many organs throughout the body, with its highest concentrations in the liver. It is elevated in most diseases of the liver or bile ducts. 
  • Bilirubin is a test that measures how well your liver disposes of bilirubin. 
    • Bilirubin is a substance produced by the liver during the normal breakdown of red blood cells.  
  • L-lactate dehydrogenase (LD) is another enzyme found in your liver. Elevated levels may indicate liver damage but LD can be elevated in other disorders too.
  • Prothrombin Time (or PT) is the time it takes your blood to clot. 
    • Increased PT levels may indicate liver damage but can also be seen if you’re taking certain blood-thinning drugs, such as warfarin, or have other conditions.
    • PT is often ordered in conjunction with INR, another test that assesses how well your blood clots. Your liver plays a major role in your body’s ability to clot blood by producing a number of clotting factors necessary for proper blood clotting.  

What are some of the symptoms of liver disease? 
Symptoms can be vague but may include:

  • Weakness, fatigue, or lack of energy
  • Weight loss or gain
  • Shortness of breath
  • New anemia
  • Jaundice or yellowing of the skin or eyes
  • Fluid collection in the abdomen or lower extremities
  • Very dark urine 
  • Light colored, clay-colored, or white stools
  • Nausea
  • Vomiting
  • Diarrhea
  • Change in bowel habits
  • Abdominal pain
  • Abnormal bruising 
  • Easy or excessive bleeding
  • Itchy skin and other skin changes

Why are LFTs ordered? 
LFTs are ordered for any variety of reasons. They may be ordered as a part of your routine annual physical exam with your family physician to screen for disease, or they may be ordered if certain diseases are suspected, or to monitor a known disease state.  

What can liver function tests tell you?
Liver function tests can be used to:

  • Screen for liver infections, such as hepatitis A, B, or C. 
  • They can help to monitor the progression and severity of certain diseases, such as viral or alcoholic hepatitis, fatty liver, NASH (Nonalcoholic steatohepatitis), NAFLD (Nonalcoholic Fatty Liver Disease), and cirrhosis of the liver, 
  • They can help to evaluate how effective your current treatment approach is.
  • They can help to monitor for possible medication side effects. Many medications are metabolized (or broken down) via the liver and can affect how your liver is functioning. 
  • They can also measure how well your liver is performing its normal functions.

What are some of the causes of Abnormal Liver Function Tests? 
LFT’s may be elevated for a variety of reasons. 

  • Infections like Acute Hepatitis A, Acute or Chronic Hepatitis B and C, infectious mononucleosis, cytomegalovirus (CMV), parvovirus, and even the novel coronavirus (COVID-19) can all causes elevated LFT’s. 
  • Alcohol (both long-term use, and acute alcoholic hepatitis)
  • Certain prescription, herbal, and OTC medications. Tylenol, antidepressants, birth control pills, certain antibiotics, and certain anti-hypertensive’s are common culprits. 
  • Fatty liver disease, NAFLD (Nonalcoholic Fatty Liver Disease) and NASH (Nonalcoholic steatohepatitis) 
  • Certain autoimmune diseases 
  • Celiac disease
  • Certain types of cancers, both primary and secondary neoplasms 
  • Genetic disorders such as Wilson’s Disease, Gilbert’s Disease, Alpha-1-Antitrypsin Deficiency, Hemochromatosis, and other metabolic glycogen storage disorders 
  • Cirrhosis of the liver
  • Gallstones and other disease of the gallbladder and biliary ducts
  • Tumors of the pancreas 
  • Heart failure 
  • Primary sclerosis cholangitis 
  • Paget’s disease 
  • Bone fractures 
  • Osteomalacia
  • Multiple myeloma, and
  • Ischemic liver injury as seen in severely low blood pressure or shock

Diseases of the liver, pancreas, gallbladder, infections, autoimmune diseases, and blood diseases can ALL cause abnormal liver function tests. Just because your liver function tests are abnormal doesn’t necessarily mean you have liver disease. There are many reasons why your tests might be abnormal. 

Liver disease is frequently asymptomatic, so ALL abnormal LFT’s should be investigated thoroughly, promptly, and properly by a trained medical professional like Dr. Sinha to avoid missed diagnoses and/or delayed diagnoses and delayed care. We interpret abnormal LFT’s and diagnose underlying liver disease every day in our practice.

The pattern of your test abnormality will help us determine the origin of your issue. A comprehensive clinical history, including family history and medication history, and the presence of any current or recent symptoms, will help us determine why your LFT’s are elevated and allow us to help create a treatment plan specific to your needs.  

What are the risk factors for having elevated LFT’s?

  • Having a known history of Hepatitis.  
  • Having a Family History of inherited liver disease or certain autoimmune conditions.
  • Having a personal history of certain autoimmune conditions. 
  • Taking certain medications metabolized by the liver.
  • Having certain infections like mono or Epstein-Barr Virus. 
  • Having a history of gallbladder disease.
  • Having a history of cancer. 
  • Drinking alcohol.
  • Being overweight. 
  • Having a history of diabetes, pre-diabetes, or high cholesterol. 

I’m being worked up for elevated LFT’s. What can I expect?
When basic LFT’s are abnormal, we will conduct a comprehensive history and physical exam to help us understand what might be causing your abnormal lab results. This history may include questions about your: 

  • Personal Medical History, including history of Diabetes, Obesity, High Cholesterol, High Blood Pressure and Heart Disease.
  • Family History and any known history of inherited genetic disorders
  • Travel history
  • History of blood transfusions
  • Medication history
  • Substance abuse history
  • Alcohol use history 
  • Social history including your occupation and upbringing (where you were born)

A full Physical Exam will be conducted to evaluate for signs and symptoms of liver disease.

We’ll recheck your labs tests, order additional lab tests if appropriate, and consider imaging studies. These additional tests may include:

  • Viral panels for hepatitis A, B, and C, cytomegalovirus (CMV), Epstein-Barr Virus (EBV), parvovirus, and possibly HIV.
  • An autoantibody screen including antimitochondrial antibody, anti-smooth muscle antibody, and antinuclear antibody to assess for certain autoimmune disorders.
  • A complete blood count and iron studies to assess for anemia and other disorders or iron absorption and storage. 
    • Elevated ferritin levels can be seen in Hemochromatosis, a genetic disorder of iron overload. 
  • Alpha-fetoprotein (AFP): a protein produced by certain cancers, such as liver cancer. 
    • It is often used as a tumor marker to evaluate for cancer concern or risk.
  • Copper/ceruloplasmin to evaluate for Wilson’s disease, a genetic disorder of copper overload.
  • Alpha-1 antitrypsin (A1AT) to evaluate for Alpha 1 antitrypsin deficiency. 
    • A1AT is a protein the liver produces that protects the lungs. In this disorder the liver doesn’t produce this protein. The result can be lung and liver disease. 
  • Fibroscore. A blood test that helps measure the level of scarring or hardening in your liver and helps to evaluate for fibrosis and cirrhosis.
  • Imaging studies such as ultrasound or MRI to help detect structural abnormalities, fatty liver, fibrosis and cirrhosis.

Increase in liver enzymes often linked to fatty liver disease

Dear Doctor: I recently had blood work done, and now my doctor says my liver enzymes are too high. How can I lower them? I have no symptoms, so I was surprised. I have never consumed alcoholic beverages, nor smoked. I am trying to lose some weight. I do frequently take ibuprofen for arthritis.

Dear Reader: I am not certain which of your liver enzymes are elevated, but the ones most often tested are AST (aspartate aminotransferase) and ALT (alanine aminotransferase). These enzymes are important for enzymatic reactions in the liver, but they are also a marker for liver inflammation and injury. We’ll start with those.

An obvious cause for liver enzyme elevation is alcohol, which directly damages the cells of the liver. In such circumstances, AST is more elevated than ALT. But, as you said, you don’t drink. Other possible causes include chronic infection with hepatitis B or C, or a genetic disorder called hemochromatosis, which leads to iron deposits in the liver. Tests for hepatitis infection and for iron and ferritin (a protein containing iron) levels can help diagnose or rule out these conditions.

Many medications can inflame the liver, such as statins for lowering cholesterol. Stopping the statin is often necessary to see if the liver enzymes come back down to normal. As for ibuprofen, it and other nonsteroidal anti-inflammatory drugs, or NSAIDs, rarely cause liver inflammation, but acetaminophen (Tylenol) does, especially at high doses (more than 4,000 milligrams per day). But again, the only way to determine a connection is to stop the medication and see if the enzymes return to normal.

Heart failure can be linked to liver enzyme elevation, as can cancers of the liver and cancers that metastasize to the liver. These conditions can be diagnosed through imaging procedures such as ultrasound and CT. Autoimmune conditions are a possibility, as well; these are better diagnosed with specific blood tests.

But after ruling out these conditions, the most likely cause of liver enzyme elevation is nonalcoholic fatty liver disease, the most common liver disorder in the United States. A 2017 study of 6,000 adult men and women estimated the prevalence of fatty liver in the United States about 30 percent. The rise of this disease correlates with the rise of obesity and diabetes.

To diagnose fatty liver, you must rule out other causes for liver disease, with the first being alcohol consumption. After that, an ultrasound of the liver is a sensitive and simple way to diagnose the condition. An MRI, although costlier, is also a good test to diagnose the disease. Rarely, a liver biopsy is necessary to diagnose and evaluate the extent of fatty liver.

The best treatment for this condition is weight loss. Studies have shown significant improvements because of weight loss among those with fatty liver. To decrease both blood sugar and the storage of fat, choose a diet that is low in sugars and simple carbohydrates.

90,000 ALT and AST (biochemical blood test)

ALT and AST – these abbreviations can often be seen in a blood biochemistry test. What do they mean? What can they tell the doctor about? Our questions are answered by a gastroenterologist “Clinic Expert” Kursk Vasilisa Vladimirovna Ishchenko.

– Vasilisa Vladimirovna, what do the abbreviations ALT and AST mean?

– ALT, or alanine aminotransferase, is an endogenous enzyme produced by liver cells – hepatocytes.Its content in blood serum is insignificant. The highest concentration of ALT is found in the liver, therefore this enzyme is a specific marker of diseases of this organ. In addition, ALT can be found in small amounts in the kidneys, heart muscle, skeletal muscles, and pancreas.

AST, or aspartate aminotransferase, is also an enzyme from the group of transaminases that is involved in the exchange of amino acids. It is found mainly in the liver, myocardium, nervous tissue, skeletal muscles, in a smaller amount – in the kidneys, pancreas, spleen, lung tissue.

When cells are damaged under the influence of infectious or toxic factors, energy metabolism in cells changes. Due to a violation of the permeability of cell membranes, components of the cytoplasm and disintegrated intracellular structures, including enzymes, enter the blood serum. As a result, the level of ALT and AST in the blood rises. This complex of disorders is called cytolytic syndrome.

– What will the ALT and AST indices in the biochemical blood test tell us about?

– Normally, the concentration of transaminases and their ratio to each other in the blood plasma are constant values.They reflect the balance between the formation and release of these enzymes. In addition, this balance indicates the normal course of physiological destruction of aged cells (apoptosis). A deviation from the norm in the level of ALT and AST and a change in their ratio is observed in pathological processes.

The degree of increase in the activity of these enzymes allows us to judge the severity of the cytolytic syndrome. However, these indicators do not always indicate the severity of organ damage and do not allow the doctor to judge the prospects for the development of the disease.Therefore, along with the analysis of ALT and AST, specialists usually prescribe a set of laboratory and instrumental examination methods, and also monitor the level of enzymes over time.

– When are these tests recommended?

– ALT and AST data can be important for non-specific symptoms such as general weakness, decreased performance, lack of appetite, nausea, vomiting, abdominal pain, flatulence, yellowing of the skin and mucous membranes.These indicators are necessarily determined to diagnose diseases and assess the functioning of the liver.

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Mom, my stomach hurts! What is behind a child’s abdominal pain?
How not to become a balloon? Getting rid of flatulence in the intestines
Why do people turn yellow?

– What are the reasons for the increase in ALT and AST in the blood?

– Acute and chronic viral, toxic hepatitis, autoimmune diseases, fermentopathies, liver cirrhosis, tumor processes and liver metastases, infectious mononucleosis, pulmonary embolism, poliomyelitis, malaria, leptospirosis – in many pathological conditions, we observe an increase in the level of these enzymes in the blood.Also, ALT and AST indicators increase with myocardial infarction. Small short-term changes in their level can be observed during heavy physical exertion.

I would like to note that the ratio between ALT and AST (the so-called de Ritis coefficient) is also an important diagnostic indicator. This coefficient helps us to distinguish, for example, viral hepatitis from alcoholic liver damage, myocardial infarction from liver disease.

Read related materials:

How to protect yourself from Botkin’s disease?
Hepatitis C shield and sword.How to protect yourself and your loved ones?
“Silent killer” of contemporaries
Invisible disease: fatty liver disease
What can you get infected on vacation? Caution Malaria!
Is polio coming back?
How to prevent myocardial infarction?

– What could be the reason for the decrease in ALT and AST in the blood?

– With a lack of vitamin B6, a severe form of liver cirrhosis, pathologies of the pancreas, with renal failure (especially in patients on hemodialysis).

– How does the level of ALT and AST in the blood change during pregnancy?

– Since the liver during this period detoxifies the body of not only the mother, but also the fetus, an increase in the level of these enzymes can be observed.

– Vasilisa Vladimirovna, is preparation required for testing for ALT and AST? If so, which one?

– Definitely required. Blood from a vein must be taken in the morning on an empty stomach (last meal 12 hours before the study).On the eve of the test, one should avoid heavy physical exertion, changes in the diet, and the use of alcoholic beverages. For half an hour before blood sampling, you must refrain from smoking.

I want to emphasize that determining only the level of ALT and AST is not always informative enough, therefore, most often doctors prescribe them in combination with other biochemical indicators.

Would you like to read about other analyzes? You can find articles about them in our heading on laboratory diagnostics

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Interviewed by Sevilya Ibraimova

The editors recommend:

Blood Biochemistry: Frequently Asked Questions
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For information:

Ishchenko Vasilisa Vladimirovna

Graduate of the Faculty of General Medicine of Kursk State Medical University in 2015.

In 2016, she completed an internship in the direction of “Therapy” and underwent retraining in gastroenterology.

Currently he is a gastroenterologist at the “Expert Clinic” Kursk.Reception is conducted at the address: st. Karl Liebknecht, 7.

norm in the 1st, 2nd and 3rd trimester

Why is research important?

The body of a pregnant woman undergoes severe stress and significant restructuring. This often leads to exacerbation of chronic diseases and the emergence of new pathologies.

A biochemical blood test is an important element of screening during pregnancy. The analysis allows:

  • to evaluate the functions of internal organs;
  • to determine violations of water-salt metabolism;
  • to reveal the lack of microelements;
  • to diagnose diseases in the early stages.

What are the indications for a pregnant woman to be tested?

The doctor does not need any reason to order a study. The analysis is mandatory and during pregnancy is carried out several times: in the first trimester when registering, as well as in the second and third trimesters. For certain indications, the study can be assigned additionally.

Preparatory phase

Blood sampling is performed from a vein, in the morning and on an empty stomach.Proper preparation for research is as follows:

  • the interval between the last dinner and analysis must be at least 12 hours;
  • only water may be consumed immediately prior to analysis. Juices, coffee, tea and other drinks are prohibited;
  • 48 hours before the study, you should stop physical activity and try to avoid stress.

Indicators of biochemical blood test

A biochemical blood test is a complex study consisting of many tests.

Total protein and albumin

Total protein shows the content of all types of proteins in the blood serum. Proteins are responsible for the transport of nutrients, protect the body from infections, serve as building blocks for cells, tissues and organs, maintain hormonal balance in the female body.

Protein levels may decrease during pregnancy. This is due to the consumption of substances for the construction of fetal cells.

Pathological reasons for a decrease in protein can be:

  • diseases of the liver, kidneys;
  • malfunction of the thyroid gland;
  • internal bleeding.

Protein concentration increases in inflammatory processes, systemic pathologies, autoimmune diseases, acute intestinal infections.

Albumins are proteins with a low molecular weight. The concentration of these substances affects the osmotic pressure of the blood, which regulates the water exchange between tissues and blood.

Albumin is optional. It is mainly determined in pregnant women in the following situations:

  • with the appearance of edema;
  • with gestosis;
  • when the level of total protein is increased.

Urea and creatinine

Urea and creatinine are chemical compounds that are formed as a result of the breakdown of proteins and are excreted from the body by the kidneys. The concentration of these substances allows you to assess the work of the urinary system. For example, with kidney dysfunction, the products of protein metabolism accumulate in the blood, causing intoxication of the body. High levels of urea and creatinine can cause pathologies that are dangerous for the pregnant woman and the fetus.

During pregnancy, the risk of kidney disease increases dramatically.This happens for the following reasons:

  • due to hormonal changes, immunity decreases and the body becomes susceptible to viruses and bacteria. As a result, the likelihood of developing pyelonephritis and other inflammatory kidney diseases increases;
  • The enlarged uterus compresses the ureters, which leads to stagnation of urine in the kidneys.

High urea and creatinine can be observed in pregnant women with urolithiasis, renal failure, diabetic nephropathy, inflammation of the urinary tract.

In addition, the concentration of urea and creatinine allows you to track the condition of other organs. For example, a low urea content is observed in liver pathologies.


In human blood, cholesterol is contained in the form of complex compounds with special proteins. Depending on the density of complex compounds, cholesterol can be divided into several types:

  • HDL – “good cholesterol”, which provides strength and elasticity to cell membranes, promotes the production of vitamin D in the body, takes part in the synthesis of sex and steroid hormones;
  • LDL – “bad cholesterol”.An excess of the substance reduces the functionality of HDL and leads to the formation of atherosclerotic plaques on the walls of blood vessels. A high level of LDL is observed in hypothyroidism, diabetes mellitus, systemic connective tissue diseases, and obesity.

During the period of gestation, the cholesterol level rises. This is due to changes in hormonal levels and metabolism in the female body. Therefore, special norms have been developed for pregnant women, which should be taken into account when decoding the analysis.


In a healthy pregnant woman, blood glucose (glycemia) is within certain physiological limits. Higher values ​​may indicate type I or type II diabetes, or gestational diabetes (GDM).

GDM is the most common metabolic disorder in pregnant women encountered by endocrinologists and obstetricians-gynecologists. The main cause of the disease is a change in hormonal levels.Most often, with GDM, there is no pronounced symptomatology, which makes diagnosis difficult. Determination of glucose in biochemical analysis is one of the ways to identify pathology. GDM requires immediate treatment, as it can cause miscarriage, affect the health of the unborn child and the woman herself.


ALT and AST are enzymes of the transaminase subgroup, which are considered the main markers of liver disease. In case of damage to the parenchyma of an organ, substances in large quantities enter the blood, which indicates the presence of pathology.

In addition, the level of enzymes allows you to track the work of the cardiovascular system, the state of skeletal muscles.

The synthesis of substances is associated with the content of vitamin B6 in the body. Accordingly, with a lack of this vitamin, the ALT and AST values ​​will be lowered.


Bilirubin is a substance that is formed when erythrocytes are destroyed. Mostly this process takes place in the liver, therefore, first of all, the value of bilirubin reflects the work of this organ.

The results of biochemical analysis indicate the values ​​of three types of bilirubin:

  • general;
  • direct;
  • indirect.

Indirect bilirubin is very dangerous: its high content in the blood causes intoxication of the body. Direct bilirubin is water soluble and less toxic.

If the pregnancy proceeds without complications, then the indicators of the three types of bilirubin do not deviate from the reference values. Acute and chronic hepatitis, liver tumors can cause increased results. Also, high numbers are observed with severe toxicosis.


Alpha-amylase is an enzyme that breaks down starch into simpler saccharides and participates in the digestion process. Without this substance, the body would not be able to assimilate carbohydrates as the main source of energy.

An increase in the enzyme during pregnancy can indicate the following problems:

  • diabetes mellitus;
  • pancreatitis – inflammation of the pancreas;
  • cholecystitis – inflammation of the walls of the gallbladder;
  • renal failure – impairment of all renal function;
  • Ectopic pregnancy – the attachment of a fertilized egg outside the uterine cavity.

Alkaline phosphatase (ALP)

It is the most abundant enzyme in the body and is present in all tissues and organs. The substance takes part in the transport of phosphorus and accelerates the decomposition of complex compounds of phosphoric acid. Determination of the amount of the enzyme is necessary to assess the state of the liver, kidneys, gallbladder, bone tissue and other organs and structures.

In the second trimester of pregnancy, fetal placental alkaline phosphatase begins to enter the maternal bloodstream.A woman’s ALP level rises and reaches its maximum in the third trimester.

The physiological increase in the concentration of the substance is not dangerous and is not considered a pathology. But if the result of the analysis significantly exceeds the reference values, then this may indicate the presence of diseases:

  • gestational diabetes mellitus;
  • gestational dermatosis;
  • inflammatory processes of the liver, kidneys, gallbladder.


Microelements are substances that ensure the full functioning of the body.A lack of trace elements in a pregnant woman can adversely affect the endocrine, nervous, digestive system, and also lead to fetal abnormalities. Therefore, it is so important during pregnancy to check the content of these nutrients in the body.

Biochemical analysis determines the level of calcium, iron, sodium and other trace elements. When prescribing an analysis, the doctor determines the number of positions studied, taking into account the individual characteristics of the patient. With a deficiency of any substance, a correction of the diet or the intake of vitamin-mineral complexes is required.

Online consultation of a gynecologist

Online consultation

As part of the consultation, you will be able to voice your problem, the doctor will clarify the situation, decipher the analyzes, answer your questions and give the necessary recommendations.

Table: reference values ​​of the biochemical blood test during pregnancy by trimester



1 trimester

2 trimester

3 trimester

Total protein level

g / l



g / l





mmol / l



Total cholesterol

mmol / l


Blood glucose

mmol / l



unit / l

up to 32

up to 31

up to 31


unit / l

up to 31

up to 30

up to 30


μmol / l




Total bilirubin

μmol / l


Direct bilirubin

μmol / l

Up to 7.9

Indirect bilirubin

μmol / l


Alpha amylase

unit / l


Alkaline phosphatase

unit / l




Iron level

μmol / l



Sodium level

mmol / l




Chlorine level

mmol / l


Potassium level

mmol / l




Phosphorus level

mmol / l




Magnesium level

mmol / l





A biochemical blood test during pregnancy is an important test that is mandatory.The results of the study make it possible to assess the state of the female body, to predict the course of pregnancy and childbirth.

Lactate dehydrogenase (LDH) – what is it? Properties and indications

Analysis number in the “Science” database: 126.

LDH is a zinc-containing enzyme that catalyzes the reduction of pyruvic acid to lactic acid, and vice versa, pyruvic acid to lactic acid. It is an intracellular enzyme found in all tissues of the body: kidneys, liver, heart, skeletal muscles, erythrocytes.


LDH, lactate dehydrogenase, LDH, EC

Research Method:

UV kinetic test. The method is based on the difference between the absorption spectra of the oxidized and reduced forms of NAD at 340 nm.

Biomaterial for analysis:

Blood serum.


Blood sampling should be done in the morning on an empty stomach. After the last meal, at least 12 hours should pass. Physical and emotional stress should be avoided 30 minutes before blood sampling.Eliminate alcohol.


Lactate dehydrogenase (LDH) exists in body tissues in the form of a tetramer: two monomers, H and M, can combine in different ratios to form five known LDH isozymes. The enzyme catalyzes the conversion of pyruvic acid to lactic acid with the participation of NADH, as well as the reverse reaction. This reaction is the final stage of the anaerobic glucose oxidation mechanism:

pyruvate + NADH + H + ↔ L-lactate + NAD +

In some pathological conditions, an increase in LDH activity is observed, for example, in acute liver damage, in skeletal muscle and kidney damage, in megaloblastic and hemolytic anemias.In lymphoma, high plasma LDH activity is a harbinger of a poor prognosis. There is a relationship between enzyme activity and tumor volume; therefore, successive measurements of the level of LDH activity make it possible to evaluate the effectiveness of therapy.

Both in the heart muscle and in erythrocytes, LDH is represented mainly by LDH isoenzymes (H4). The isoenzyme exhibits much greater catalytic activity towards α-hydroxybutyrate than lactate (in comparison with other isoenzymes), therefore, when measuring the LDH activity, it is this substrate that is used.The second name of the LDH isoenzyme is α-hydroxybutyrate dehydrogenase (HBB).

Determination of the activity level of LDH isoenzymes is important for suspected myocardial infarction and in the diagnosis of hemolytic crisis in sickle cell anemia.

What is analysis used for?

To determine the serum LDH activity.

When is it appointed?

Suspected of:

  • myocardial infarction,
  • sickle cell anemia,
  • liver damage,
  • pathology of the pancreas.

Reference values ​​(norm)

The normal level of LDH activity in the serum of an adult is 225–550 U / L.

Result values ​​

Under physiological conditions, increased activity is observed in pregnant women, newborns and after intense physical exertion. An increase in LDH is observed in myocardial infarction, leukemia, thrombocytopenia, liver damage of a viral, toxic and traumatic nature, tumors of various localization, kidney disease, erythrocyte hemolysis.

Exceeding the upper limit of the norm by more than 10 times:

  • cholestasis,
  • alcoholic liver damage.

Exceeding the upper limit of the norm by 5 – 10 times:

  • hepatitis (acute and chronic),
  • cirrhosis (without cholestasis),
  • other liver diseases,
  • pancreatitis.

Exceeding the upper limit of the norm by less than 10 times:

  • alcohol abuse,
  • drugs causing enzyme induction;
  • congestive heart failure.

The decrease in LDH activity has no clinical significance.

90,000 Hepatitis C: risk groups, symptoms, treatment

Hepatitis C is an infectious liver disease resulting from infection with the hepatitis C virus (HCV), which spreads primarily through contact with the blood of an infected person. Hepatitis C can be acute or chronic.

Acute hepatitis is an inflammatory process in the liver that occurs during the first 6 months after infection with the hepatitis C virus. For most people, acute hepatitis C leads to a chronic infection.
Chronic hepatitis C is a long-term illness that occurs when the hepatitis C virus remains in the body. The chronic form can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.
According to various estimates, up to 5 million people in Russia are carriers of this viral infection.Most people do not know they are infected because they do not feel sick.
Approximately 75% -85% of people who are infected with hepatitis C virus develop chronic infection
Chronic hepatitis C virus (CVHC) is a serious illness that can lead to long-term health problems, including cirrhosis of the liver, hepatic failure, liver cancer, or death. CVHC today is one of the main causes of cirrhosis and hepatocellular carcinoma (HCC) – liver cancer.

How is hepatitis spread?

Hepatitis C develops after the blood of an infected person enters the body of a healthy person. Today, most people are infected with the hepatitis C virus by sharing needles and other drugs to inject drugs. Until 1992, when blood screening began, hepatitis C was also widely spread through blood transfusions and organ transplants. People can also be infected with the hepatitis C virus through medical intervention, with untreated instruments, at birth from a mother infected with hepatitis C.You are less likely to get the hepatitis C virus through personal care products that can contain blood particles, such as razors and toothbrushes. It is also possible to become infected after sexual contact with a person infected with the hepatitis C virus.
Transmission of hepatitis C (and other infectious diseases) is possible during tattooing or piercing, if all hygiene rules and norms are not observed. This often happens in prisons or in non-specialized institutions.
The risk of sexual transmission is considered low. The risk is higher for those who have multiple partners, have comorbid sexually transmitted diseases, or are infected with HIV.
Hepatitis C has not spread through cutlery, hugging, kissing, shaking hands, by airborne droplets, food or water. The hepatitis C virus is not transmitted from mosquito and pet bites.

Who is at risk?

Some people are at increased risk of infection:

  • injecting drug users;
  • patients who have received donated blood, blood products or organs;
  • 90,128 persons receiving hemodialysis;

  • people who have piercings or tattoos with non-sterile instruments;
  • healthcare workers with hepatitis C virus positive patients;
  • HIV-infected persons;
  • children born to mothers infected with the hepatitis C virus.

Less at risk:

  • persons who have had sexual contact with a person infected with the hepatitis C virus;
  • people using personal hygiene items such as razors and toothbrushes, which may contain blood particles from an infected person.

What is the risk of passing the hepatitis C virus from a pregnant woman to her child?

Hepatitis C and pregnancy is one of the most pressing issues. Hepatitis C is rarely passed from a pregnant woman to a child.About 4 out of 100 babies born to mothers with hepatitis C become infected with the virus. However, the risk is greater if the mother has HIV infection or high levels of the virus in her blood.

What are the symptoms of acute hepatitis C?

Approximately 70% -80% of patients with acute hepatitis C do not have any symptoms. Some people, however, may experience mild to severe illness sometime after infection, including: 90,035 fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, lighter stools, joint pain, jaundice (yellow skin color or sclera of the eyes).
If symptoms occur, on average, 6-7 weeks after infection, although the duration can vary from 2 weeks to 6 months. However, many people who are infected with the hepatitis C virus do not have any symptoms. Even if the carrier of hepatitis C does not notice any symptoms of the disease, then he can be the spread of the virus to other people. Many people who are infected with the hepatitis C virus do not know they are infected because they do not feel sick.

What are the symptoms of chronic hepatitis C?

Most people with chronic hepatitis C do not have any symptoms.However, if a person has been infected for many years, their liver may be damaged. In many cases, the symptoms of this disease do not appear until the liver problems develop. Hepatitis C is often diagnosed in asymptomatic individuals by routine blood tests to assess liver function or liver enzymes (involved in protein synthesis).
As a rule, people with chronic hepatitis C are characterized by wavelike changes in the level of liver enzymes, and they can periodically return to normal or be almost normal.Some people who are infected have normal liver enzyme levels for more than one year, even if they have liver damage. If the liver enzymes are normal, it should be checked several times over a period of 6-12 months. If your enzymes are consistently normal, your doctor may recommend testing them less frequently, such as once a year.

Who should get tested for hepatitis C?

Talk to your doctor about testing for hepatitis C if:

  • you have used drugs in the past;
  • you had surgery before 1989;
  • you had a blood transfusion or organ transplant before 1989;
  • you received hemodialysis;
  • there are abnormalities in liver function tests;
  • you are a healthcare professional and have had contact with patients’ blood;
  • you are infected with HIV;
  • If you are pregnant, you need to get tested for hepatitis C.

Diagnosis of hepatitis C involves several different blood tests. The doctor may order one or more of these tests. As a rule, first of all, a screening test is done, which shows the presence of antibodies to the hepatitis C virus (antibodies to hepatitis C are proteins contained in the blood that are produced by the body in response to the virus). A positive antibody test means the body has been exposed to the virus. If the antibody test is positive, the doctor will most likely order a test for the virus itself.


The goal of CVHC treatment is sustained virological response (SVR). This term means the prolonged absence of signs of liver inflammation with an undetectable level of the virus in the blood. Some patients with SVR completely get rid of the virus, while others achieve long-term remission of the disease. Unfortunately, there are currently no available diagnostic methods that guarantee the complete removal of the virus from the body, so all cured patients must undergo PCR tests annually and cannot become blood and organ donors.Each person should discuss treatment options with an infectious disease specialist. People with chronic hepatitis C should be screened regularly to assess liver health and are considered candidates for antiviral therapy. In the treatment of hepatitis C, a combination of two drugs, interferon and ribavirin, is used. However, not every person with chronic hepatitis C infection requires treatment. In addition, the drugs can cause serious side effects in some people.
People with chronic hepatitis C should be supervised by an experienced healthcare professional.They should avoid alcohol as it can cause additional liver damage. Be sure to check with a healthcare professional before taking any over-the-counter medications, dietary supplements, or other medications, as they can harm the liver. Ask your doctor about vaccinations against hepatitis A and hepatitis B.
People infected with hepatitis C cannot be fired for this reason unless their job involves exposure to blood or blood products.

Are there vaccines that can prevent hepatitis C?

While there are only vaccines for hepatitis, A and hepatitis B.Although scientific research in this area is underway.

If markers of hepatitis are found, you need to contact an infectious disease doctor at the local polyclinic. If necessary, you can get a referral to the diagnostic and treatment department of the GBUZ “SKIB”. You can sign up for a consultation by calling (861) 255-11-12, or online. You should have an extract from the hospital (if you have been hospitalized), a passport and an insurance policy.

Biochemical blood test ALT, when it is prescribed to children

Usually, the concentration of ALT in the blood is insignificant, but when the cells of the corresponding organs are destroyed, transferase enters the bloodstream, and its level rises.Therefore, in clinical practice, the determination of the level of ALT in the blood serum is used to diagnose diseases of the liver and some other organs.

When is an ALT blood test prescribed?

As a rule, a simultaneous test for ALT and AST (alanine aminotransferase and aspartate aminotransferase) is prescribed. Typically, this test is needed to diagnose heart disease, liver disease, abdominal or chest injuries, and to monitor liver function during serious treatment (for example, antiretroviral therapy for HIV).A blood test for ALT and AST is indicated for intoxication, autoimmune and endocrine pathologies, and allergies. Analysis for ALT and AST is included in a comprehensive biochemical blood test during pregnancy.

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-treatment! Only a doctor in consultation can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan!

How to prepare for the analysis?

A week before the analysis, do not abuse salty, fatty, spicy, starchy and sweet.Blood for ALT and AST should be taken on an empty stomach, and you should also not smoke before testing. Before the analysis for ALT and AST, X-rays and ultrasound are not prescribed.

If ALT is increased

The ALT rate differs by age. The ALT rate in men and women is different.

  • An increase in ALT up to 3 times is considered small.
  • ALT is considered moderately elevated, increased 3-19 times against the norm.
  • If ALT is increased more than 20 times, this increase is considered significant.
  • In hepatitis, ALT can be increased 20-50 times, since liver cells are actively destroyed.For example, in hepatitis A, there is a moderate increase in ALT several weeks before the onset of characteristic symptoms. This enables doctors to stop the development of the disease in a timely manner.
    Cirrhosis of the liver, in which hepatocytes die, and connective tissues appear in their place, also causes a sharp increase in ALT.
  • Elevated ALT in cancer may indicate liver metastases, but this is not necessary.
  • Increases in ALT in myocardial infarction, since alanine aminotransferase is found not only in the liver, but also in the heart.When the myocardium is damaged, part of the muscle dies off, and transaminases enter the bloodstream.
  • ALT may also be increased in other diseases such as pancreatitis, muscular dystrophy, burns and shock conditions, etc.

If ALT is lowered

A sharp decrease in ALT may mean vitamin B6 deficiency or extensive necrosis of liver tissue.

Make an appointment with our nephrologists to consult on the test results or before they are taken.

What is the normal value of alt and ast should be in women

For the diagnosis of a number of diseases, an ALT blood test is prescribed, what is it? Alanine aminotransferase (ALT, ALT) is an enzyme involved in the transport of the amino acid alatin.ALT is found everywhere in all cells of the body, it can be found in large quantities:

  • in the muscles, including the heart;
  • in the cells of the pancreas, liver and kidneys.

For an adult, normal blood ALT is

  • for men – 39-40 U / l;
  • for women – 29-30 U / l.

In inflammatory processes, necrosis and other destruction of internal organs, the ALT index rises.Therefore, if the blood contains more ALT than it should be according to the standard, this allows you to determine the stage to which the organ damage has reached.

Analysis for ALT is often prescribed in conjunction with another biochemical study, for AST. Simultaneous testing of blood for AST and ALT allows for a more accurate diagnosis. AST is an enzyme that transports the amino acid aspartate.

Most AST detected:

  • in the liver;
  • in skeletal muscle and heart;
  • in the kidneys.

Analyzes for AST and ALT are prescribed as additional diagnostic measures in combination with other studies.

The ALT enzyme is found in greater amounts in liver cells; when these cells are damaged, it is released into the circulatory system, which makes it possible to diagnose cirrhosis, hepatitis and other diseases in which the liver mainly suffers. The AST enzyme is present in a greater volume in the muscle tissue of the myocardium, therefore, in ischemia, myocardial infarction, myocarditis and other heart diseases, an increased content of AST in the blood can detect pathology.

Analyzes for AST and ALT are prescribed as additional diagnostic measures in combination with other studies.

1Which doctor will prescribe an analysis

Most often, a biochemical blood test for AST and ALT is prescribed by a cardiologist or gastroenterologist. What other doctors can refer to this study?

  • gynecologist;
  • endocrinologist;
  • orthopedist;
  • Nephrologist.

A blood test for AST and ALT can be taken in any clinic.It is better to order a survey together with a transcript.

A blood test for AST and ALT can be taken in any state clinic and in almost every private laboratory. It is better to order an examination together with a transcript, since laboratory research data may be presented in different ways in the conclusion, depending on the standards of a particular institution.

2How to take the analysis of ALT and AST

The level of enzymes is influenced by stress, alcohol and drug intoxication.Therefore, in order for the test data to reflect the real situation, the patient needs special training:

  • stop using alcoholic beverages and drugs in 7 days;
  • Refrain from intense excitement and stress;
  • 10 hours before the tests, refrain from food, do not drink anything other than plain water.

If the patient is taking any medications, the attending physician must be informed. Many medications (especially steroids and enzymes) can interfere with the test results.

In men, the enzyme composition of the blood quickly reacts to intense physical activity (lifting weights, running, sports training), therefore, before the tests, you should refrain from going to the gym and other strenuous muscle work. In men and women, the enzyme composition of the blood is sensitive to nervous tension and stress.

To get results that are consistent with the real situation, you should get a good sleep before donating blood and limit conflict situations.

3Which diseases require AST and ALT tests 90 160

ALT and AST analyzes are used to diagnose the following diseases:

  1. Viral hepatitis, liver cirrhosis, liver tumors, including cancer, mononucleosis.
  2. Pancreatic diseases, pancreatitis.
  3. Heart failure, ischemic heart disease, myocardial infarction, inflammation of the heart muscle (myocarditis, pericarditis).
  4. Diseases of skeletal muscles, inflammatory processes in muscles, myositis, myopathy.
  5. Lung infarction.
  6. Hypothyroidism.
  7. Hemolytic anemia.
  8. Injuries, shock, burns, hypoxia.

An increase in ALT and AST shows necrotic changes, therefore it is widely used to quickly determine the severity of the disease. The interpretation of the analysis results is carried out by the attending physician. The AST and ALT scores are influenced by many factors that the doctor takes into account when interpreting the results:

  • pregnancy;
  • obesity;
  • sex, age;
  • chronic diseases;
  • taking medications, for example, hormonal contraceptives, non-steroidal anti-inflammatory drugs.

Due to the destruction of muscle tissue and liver cells, ALT is increased due to severe mental shocks, extensive burns, pain shock and trauma.

In conditions that threaten the patient’s life, a biochemical blood test for ALT and AST is not used, but is universally carried out to diagnose diseases of the heart muscle and liver.

4 Interpretation of results 90 160

AST and ALT indicators are measured in conventional units per liter (U / l). Some laboratories use different units of measurement, so when analyzing data, it is necessary to clarify how to translate results from one system to another.How does the amount of these enzymes change with age?

  • the optimal indicator for a newborn child up to 5 days of life is 49 U / l;
  • norm for children under 6 months – 56 U / l;
  • from 6 months to 1 year – 54 U / l;
  • from 1 year to 3 years – 33 U / l;
  • from 3 to 6 years old – 29 U / l;
  • from 6 to 12 years old – 39 U / l.

Fluctuations in AST and ALT are associated with a person’s height. For each age, a person is characterized by a certain hormonal background and biochemical composition of the blood.

A slight increase in enzymes in children does not necessarily indicate any serious illness.

In adolescents from 12 to 14 years old, AST and ALT indicators gradually reach values ​​characteristic of adults. The norm of ALT and AST in the blood for adults:

  • for men, the optimal performance is up to 40 U / l;
  • for women – up to 30 U / l.

For diagnostics, it is not the ALT (ALT in Latin abbreviation) and AST (AST) indicators per se that matter, but their ratio.This ratio is named after Dr. de Ritis (DRr). To calculate it, the AST indicator must be divided by ALT. You will get a number by which you can make a conclusion about the presence or absence of pathology. For men and women, the de Ritis coefficient is estimated in the same way.

Fluctuations in AST and ALT are associated with a person’s height. For each age, a person is characterized by a certain hormonal background and biochemical composition of the blood.

In hepatitis, the DRr coefficient is less than one, in dystrophic processes in the liver, it is greater than or equal to one.For a more accurate clinical picture, an albumin test is used.

If the DRr coefficient is greater than 2, and the albumin index is less than 35 g / l, this indicates liver necrosis. AST and ALT blood tests can detect viral hepatitis A 2 weeks before the onset of jaundice, and viral hepatitis B – 2-10 weeks before obvious changes.

The diagnosis is never made only on the basis of the DRr coefficient, the attending physician prescribes other tests.

5 Changes in indicators for various diseases 90 160

As an additional diagnostic measure, a biochemical blood test for AST and ALT is used to monitor the state of the liver and heart, less often the pancreas.How do the enzyme indices change relative to the norm in pathological processes in the heart and liver?

  1. Gestosis. If in the first trimester of pregnancy the normal level of AST and ALT increases, what does this mean? Most often, the reason is not any serious illness, but a lack of vitamin B6. For the normal development of the fetus, a large amount of vitamin B6 is required, which is involved in the synthesis of the enzymes AST and ALT. When vitamin B6 deficiency is compensated, liver and muscle tissue homeostasis is restored.In the 2-3 trimesters, the level stabilizes, which indicates that the woman’s liver and kidneys are coping with the increased load. If the indicators are significantly higher than normal, this indicates gestosis.
  2. Hepatitis. Acute viral hepatitis leads to an increase in ALT up to 500-3000 U / L. The indicator reaches its peak values ​​2-3 weeks after infection, then a decrease begins. A repeated increase in ALT levels indicates liver cirrhosis. With alcoholic hepatitis, ALT and AST indicators are 500-600 U / l.A biochemical blood test can detect diseases that do not have symptoms in the early stages, for example, viral hepatitis B.
  3. Hyperfermentation. Moderate hyperfermentation of the liver gives an increase in ALT and AST by 1.5-5 times, moderate hyperfermentation – by 6-10 times, severe – an increase of more than 10 times compared with the norm. A change in the volume of enzymes circulating in the circulatory system allows us to conclude that there is a serious disturbance in the liver. If these enzymes enter the bloodstream in large volumes, what does this mean? Liver cells are damaged and destroyed by a pathological process.Other studies specify which pathology is being discussed. If the increase in AST is greater than ALT, hyperfermentation may indicate cirrhosis, metastases of a malignant tumor in the liver, intrahepatic cholestasis, and infectious mononucleosis.
  4. Heart disease. In myocardial infarction, the increase in enzyme indices does not occur synchronously. AST increases 8-10 times, and ALT – 1.5-2 times. After an attack, an increase in AST and ALT occurs within 6-8 hours, the maximum value is reached after 16-48, the indicators return to normal values ​​after 3-6 days.

In myocardial infarction, the increase in enzyme parameters does not occur synchronously. AST increases 8-10 times, and ALT – 1.5-2 times.

In order for the test data to be reliable, the doctor evaluates not only AST and ALT, but also other liver enzymes:

  • bilirubin;
  • creatine kinase;
  • alkaline phosphatase;
  • gamma glutamyl transferase;
  • lactate dehydrogenase.

An increase in liver enzymes by 5-10% in the first trimester of pregnancy is the norm in women.The examination is usually carried out 1 time per pregnancy, most often in 2-3 trimesters, if there is no indication for urgent analysis. If heart disease is suspected, in addition to AST and ALT, the biochemical blood test includes:

  • myoglobin;
  • C-reactive protein;
  • troponins;
  • Creatine kinase MB fraction.

A biochemical blood test is used not only for diagnosis, but also for disease control.

The half-life of AST and ALT is from 12 to 24 hours, therefore, when monitoring the patient’s condition, studies are carried out no more often than once every 2 days.

In adult men and women, indicators can fluctuate during the day within 10-30% of the norm.

AST in women increases naturally during gestation; within 2-3 months after conception, the level of enzymes normalizes.

AST in women rises naturally during gestation; within 2-3 months after conception, the level of enzymes normalizes.

6 Indicator below the norm 90 160

Reduced AST and ALT indices are determined in analyzes due to two violations:

  • lack of vitamin B6, which is involved in the synthesis of these enzymes;
  • Severe cirrhosis of the liver, in which the organ can no longer produce enough enzymes.

Vitamin B6 does not accumulate in cells, therefore, for the effective synthesis of AST and ALT, its constant intake with food is necessary. What are the signs of vitamin B6 deficiency?

  • from the immune system: decreased immunity, vulnerability to infectious diseases;
  • from the heart: surges in blood pressure, dizziness, fainting, insufficient blood supply;
  • diseases of the nervous system and psyche: depression, anxiety, insomnia, decreased concentration;
  • from the side of the muscles: convulsions, myalgia;
  • on the part of the skin: a decrease in the rate of tissue regeneration;
  • from the liver: lack of liver enzymes, which leads to indigestion.

B6 deficiency negatively affects the work of all organs and body systems without exception. B6 – pyridoxine is a substance that is indispensable in a variety of chemical reactions. Therefore, if you suspect vitamin B6 deficiency, it is useful to take a biochemical blood test.

Find out the norms of ALT and AST in the blood

All cells of living organisms contain aminotransferases, each of which has its own function of transferring amino acids . AST is responsible for the transfer of aspartic acid, ALT is responsible for the transfer of alanine molecules.

Both components are proteins and are involved in the transport of amino acids. Their entry into the blood occurs only when organs are damaged. An increase or decrease in the level of these components is used to study the biochemical composition of the blood.

These indicators help to identify the absence or presence of trauma, hepatitis, heart attack and other diseases in a patient.

What can negatively affect the results of the study of these proteins? The analysis is negatively affected by taking certain types of medicines .It can be hormonal contraceptives, drugs with niacin, immunosuppressants.

The analyzes are also distorted by excess weight, the presence of pregnancy in the patient.

And also, before the analysis, you must not load the body with physical activity, otherwise, a laboratory study may give an unreliable result.

Analysis transcript

To do this, stop taking medications 7 days before blood sampling .Blood is donated only on an empty stomach. Sports and intense physical activity should not be performed 24 hours before the analysis. Before the study, you can not smoke tobacco and take alcohol, eat fatty fried.

When diagnosing diseases, the doctor should take into account that AST is responsible for the functioning of the liver, muscle tissue, kidneys, heart, while ALT reflects the work of the liver and kidneys.

Decoding by de Ritis coefficient

It is generally accepted in medical practice to diagnose diseases using the de Ritis coefficient.

This ratio is the ratio of ALT protein to AST protein. Normally, it should vary from 0.91 to 1.75 units.

It is necessary to calculate the ratio if, when taking blood for biochemistry and subsequent studies, the laboratory assistant reveals deviations of indicators 10 times higher than the norm. For example, in a patient with hepatitis, ALT can increase up to 10 times the normal value.

If AST is sharply increased, then this indicates a necrotic process in liver cells.

  • If AST is much higher than ALT, then this often means the presence of chronic hepatitis and irreversible changes.
  • Doctors observe similar indicators in persons suffering from chronic alcoholism .
  • In cases where the patient’s de Ritis coefficient is less than one, this indicates the presence of viral hepatitis.
  • If the coefficient varies from 1 to 2, then this is a sign of chronic liver pathologies.

A ratio above 2 units usually reflects whether a patient has a myocardial infarction or alcohol-related cirrhosis.

What values ​​are considered the norm?

For women, the boundaries of indicators from 20 to 40 are characteristic, and in male patients this indicator is lower and is from 15 to 31 units.

In a newly born child, the indicator varies from 25 to 75 and gradually decreases.

From one year to 18 years, the protein norm is from 15 to 60 .

In pregnant patients, this indicator varies slightly.During the first three months of pregnancy, it can deviate by 5-10% and can be either increased or decreased.

In this case, this does not mean any serious illness.

ALT level

In patients aged 18 years and older, it should be about 32 units, and in male patients of this age it reaches 41 .

In a newborn child, the ALT level is increased and is 48 units, by the age of six months it rises to 55 , and then gradually decreases again.

By the age of 11, it reaches 38 units.

A slight increase is a 2–3 fold change, a moderate increase in a component is a 6 to 10 fold increase. A very high level of increase – 10 times or more.

Read also: Causes and treatment of increased ALT and AST in the blood

In people with recorded obesity and a large number of extra pounds, these indicators can be increased by up to 50%.

Reasons for increasing

Alanine aminotransferase may increase due to medication , for example, cytostatics, narcotics, oral contraceptives.

And also its changes are observed during prolonged stress, if the patient constantly eats fatty or fried foods, drinks alcoholic beverages. Such changes are also recorded with active growth or heavy physical exertion, injuries.

Often, its increase indicates a problem with the liver, usually after that bilirubin in the blood begins to rise.

Doctors note that a 5–10-fold excess of the level is observed in acute phases of diseases.

In addition, if it does not decrease, then this may indicate necrotic processes in the liver.The reasons for the increase in ALT can be hepatitis, cancer in the liver, cirrhosis, jaundice, trauma with a large number of damaged muscle fibers, myocardial infarction.

Clinical picture ALT

The clinical manifestations of elevated ALT depend on the underlying cause of the disease. But there are a number of common symptoms, for example, feces and urine become much lighter, painful sensations appear in the right side of the abdomen, limbs and chest ache. A person quickly gets tired, he does not want to eat, he is often sick and may even vomit.

Yellow spots appear on the skin.

Reasons for increasing AST

  1. This indicator deviates from the normal level upwards, if the patient had injuries , a dystrophic or inflammatory process is going on in the body.
  2. And it can also cause severe intoxication, stress, significant physical activity and cancer.
  3. The most common cause of its increase is heart disease, for example, with myocardial infarction, the indicator increases up to 20 times.
  4. And its increase is also observed in angina pectoris, coronary insufficiency, hepatitis of various etiologies, stagnation of bile, inflammatory process in the gallbladder.

In addition, an increase in AST causes pancreatitis in the chronic stage, the presence of purulent inflammation in the abdomen.

Treatment of elevated AST and ALT

Power supply

In order to reduce the level of these indicators, it is necessary to eat properly , eat meat products, fish, seasonal vegetables and fruits.Meals should be fractional at least 5 times a day.

It is recommended to eat only freshly prepared foods with reduced fat and carbohydrate content. Food is thoroughly worried, it is not recommended to eat dry food. Dinner should be no later than 2 hours before bedtime.

The use of foods fortified with vitamin B6 is also important.

It can be meat, bananas, spinach.

For the treatment of the disease, doctors prescribe hepatoprotectors. It can be Galstena, Gepabene, Carsil, Essentiale forte N and other drugs.

Read also: Causes and treatment of increased ALT and AST in the blood

Reduced values ​​

ALT can go down with cancer , pathologies of the genitourinary system, vitamin B6 deficiency, necrotic processes in the liver.

The AST index may fall due to damage to liver cells or a lack of vitamin B6.

This condition is more rare than elevated component levels. But you can’t self-medicate.Treatment of concomitant diseases can only be carried out by a doctor.

In these cases, the therapist refers the patient to a surgeon, gastroenterologist, endocrinologist or other doctor.

The specialist prescribes individual medication treatment for the patient, which depends on the underlying cause.


To maintain these indicators in the norm, you should include more vitamin D in your menu, remove an abundance of fatty and salty foods from the diet. This will help relieve the patient’s liver.

Doctors strongly recommend to stop drinking alcoholic beverages and smoking.

The patient should be careful about his health and not expose the body to toxic agents that destroy liver cells.

In addition, patients are not recommended to self-medicate and take antibiotics on their own.

Long-term use of this group of drugs contributes to the destruction of the liver.

Watch the video on this topic


Abnormal ALT and AST levels per se is not a disease , but indicates a serious malfunction in the body, for example, in muscle tissue, heart, urinary tract or liver.

Detection of high or low values ​​using a blood test indicates the presence of a serious illness.

The patient is recommended to undergo additional examination in order to find the root cause of the disease.

The doctor, on the basis of the tests carried out, based on the course of the disease and its stage, he prescribes an effective therapy for a person. The patient’s nutrition also plays an important role in this process.

When changing indicators, it is recommended to minimize the use of fatty, salty, fried foods.

Separately deserve attention and preventive measures, which consist in maintaining a healthy lifestyle, maximizing the toxic effects on the body of alcohol and tobacco, and other measures.

Norm of ALT and AST in the blood, analyzes and decoding

Before prescribing a treatment for any disease, you must first conduct a complete examination of the body in order to make the correct diagnosis. A general and biochemical blood test, which includes tests for ALT and AST, will help to do this.

Currently, medicine has such an indicator as the rate of ALT and AST in the blood. If it is increased, it means that the person is sick with a certain disease.

But before looking for the reasons why the level of ALT and AST is elevated, or one indicator out of two, as well as looking for ways of treatment, you need to find out in more detail what it is.

What are AST and ALT?

Many cells of living organisms contain aminotransferases, which used to be called transaminases.They can be found both in the simplest unicellular organisms and in multicellular organisms.

Each such aminotransferase has its own inherent functions that cells are able to carry (this also applies to amino acids, which each has its own).

The following groups of aminotransferases exist:

  • Aspartate aminotransferase (AST, ASAT) is a specific enzyme capable of transporting aspartate amino acids from biomolecules.
  • Alanine aminotransferase (ALT, ALT) is an enzyme that carries the amino acid alanine of biomolecules.

The maximum activity of ALT and AST is observed in the human body in the kidneys, muscle tissue, heart and liver. The greatest activity of ALT can be noted in the pancreas. Important: since each group of aminotransferases is located in a specific organ, if it is damaged, it easily enters the blood stream.

Thanks to this property of the enzyme ALAT and AST, it is possible to determine the presence of diseases that are latent in the body. If after taking blood in the biochemical analysis, the ALT and AST values ​​are increased, this means that the patient suffers from hepatitis, pancreatitis, myocardial infarction, or any injuries have occurred in the body.

What does an increase in performance mean?

Since the level of AST and ALT in each internal organ is different, increased indicators indicate its disease.

The main part of the ALAT enzyme is found in the liver, heart muscle, kidneys and pancreas. With pathologies of these organs, ALT enters the bloodstream, which causes a strong increase in this enzyme during the analysis.

Most of the AST enzyme is found in the myocardium, nerve and muscle tissues, and the liver.Damage to any of the above organs leads to an increase in the level of AST in the blood.

The norm of ALT and AST in the blood directly depends on the functioning of the liver, which is responsible for the following functions:

  • Synthesis of protein in the body;
  • Removal of toxic substances and poison in case of poisoning;
  • Creation of biochemical substances;
  • Storage of glycogen, which is responsible for the vital activity and normal functioning of the body;
  • Regulation of biochemical reactions.

What indicators are considered the norm of AST and ALT?

A biochemical blood test helps to identify dangerous diseases latent in the body at an early stage.

Often, an increase in ALT means and indicates a violation of liver functions, while an increased rate of AST reflects a malfunction of the heart.

But which indicators are considered normal and which are abnormalities, so that it can be argued that high or low levels of ALT and AST are a sign of a dangerous progressive disease.

Normal and acceptable levels of ALT and AST depend on gender, so it will differ significantly in men, women and children.

  • In adult women, the level of ALT and AST should be less than 31 U / L.
  • In adult men, the AST rate in the blood should be less than 47 U / L, and the ALT rate should not be higher than 45 U / L.
  • As children are constantly growing, their ALT and AST readings change. At the same time, the ALT level in children should be below 50 U / L, while the AST indicator in children in the first 5 days of life reaches 140 U / L.After 5 days and until the age of nine, the AST level in children should be below 55 U / L.

For the convenience of determining the level of ALT and AST, a table was developed, which reflects all indicators depending on the gender of the patient:

ALT and ASAT levels in children, men and women

Since the level of AST and ALT can be different depending on the modernity of the equipment used for the biochemical analysis, a table was developed, which reflects the normal values ​​and degrees of deviation of enzymes present in the blood:

If the parameters of AST and ALT during biochemical analysis are strongly increased, the patient can be diagnosed with liver pathologies.Often this phenomenon is observed with latent hepatitis and other dangerous diseases.

If the biochemical analysis showed that the AST level is increased several times, this means the presence of myocardial infarction in the body. If the AST was first increased, and after 4 days it decreased, then there was no heart attack.

Reasons for changing the level of indicators

After deciphering the analysis of biochemistry, it was noticed that certain diseases affect the decrease in ALT, but this has nothing to do with the functionality of the liver.A decrease in ALT can be caused by infectious genitourinary systems, alcoholic hepatitis, tumor neoplasms, frequent alcohol consumption, and a lack of vitamin B6 due to an improper diet.

The main reasons that the analysis rates in men, children and women are increased are:

  • Myocardial infarction;
  • Hepatitis;
  • Forms of pancreatitis;
  • Liver pathologies caused by drug, alcohol or viral infection;
  • Taking steroids;
  • Reaction of the body to drugs;
  • Liver metastases;
  • Fatty hepatosis;
  • Burns and injuries where muscle and muscle tissue damage has occurred.

It is worth knowing that a decrease in the level of these enzymes occurs on their own after the underlying disease is cured.

The first symptoms showing an increase in AST and ALT:

  • Nervousness and depression;
  • Itching;
  • Bad sleep;
  • Decreased appetite that causes weight loss;
  • General weakness of the body.

Late symptoms of elevated enzyme levels include:

  • Changed color of urine, which becomes darker;
  • Discolored stool;
  • Whites of eyes and skin become yellowish;
  • Nausea and feeling unwell;
  • Swelling of the extremities.

Additional diagnostic measures to determine the presence of latent diseases:

  • Blood test for hepatitis B and C;
  • Ultrasound of the abdominal organs;
  • Clinical blood test;
  • Liver biopsy;
  • Blood donation for thyroid hormones.


If the level of AST and ALT in children, men and women is increased, it means that there is some disease in the body. To lower the indicators of these enzymes, you first need to get rid of the focus of the disease, which caused their increase.

First of all, you need to properly organize your food, which must be of high quality and healthy:

  • Eat plenty of fresh fruits and vegetables as they contain fiber. This also includes brown rice, which has the same properties.
  • Green and medicinal teas containing burdock, dandelion or milk thistle will help cleanse the liver and restore the body’s water balance.
  • Eating foods high in vitamin C is important.For example, revit vitamins contain a whole range of useful substances.
  • Drinking regime should be observed.
  • A cool shower must be taken.
  • Respiratory gymnastics, as well as morning exercises or sports activities – all this helps to defeat the disease, and therefore to reduce the level of AST and ALAT in the blood.

Since ALT levels are often elevated in liver pathologies, the doctor must also prescribe medications that will help protect hepatocytes from other harmful factors.These drugs are collectively called hematoprotectors.

Also, the doctor will note that the liver during illness in children, men and women is severely weakened, which means that it should not be exposed to unnecessary risk, as the organ will be damaged even more.

Ast and alt increased: what does it mean and how to treat it?

Why, at the first visit to the hospital, to any doctor, from a general practitioner to a narrow-profile specialist, the patient is immediately sent for a blood test? Because it is through the biochemical study of blood that you can find out about the presence of pathologies in the body.

Even if there are no other obvious signs of the disease, arising and developing in the patient, even if the disease has not yet had a serious impact on the organs and systems, certain indicators will already be changed in the “biochemistry”. And this will lead the doctor to suspect the presence of pathology.

And if necessary, the doctor will send the patient for further examination in order to prescribe the required treatment.

One of the main indicators of a biochemical blood test is ALT (or ALAT) and AST (or ASAT).Any increase or decrease in these indices indicates that something is going wrong in the human body. What exactly can be evidenced by the fact that ALT and AST are elevated, and what treatment is prescribed for such indications?

One of the main indicators of the biochemical blood test – ALT and AST

What is ALT and AST

First, you need to answer the main question: what are alt and ast? The full medical name for these indicators is aspartate aminotransferase (ASAT) and ALAT, called alanine aminotransferase.

As doctors say, the enzymes AST and ALT (also sometimes referred to as transaminase) are active participants in the metabolism in the human body.

In simple terms, what is it? ALT “lives” in hepatocytes (liver cells) and, together with other participants in the process, breaks down the amino acid alanine. Liver enzymes – this is the name of this substance.

AST is responsible for what? This enzyme also “works” on the breakdown of amino acids, but only aspartic.And it is mainly found in the tissues of the heart muscle.

What does the deviation of the level of these enzymes from normal values ​​indicate during the measurement?

The ALT index rises if there are any malfunctions in the liver or some pathology of this gland occurs. Also in medicine, there are cases when an increase in the level of this enzyme in the blood indicated developing diseases of the kidneys, skeletal muscles and tissues of the nervous system.

AST is considered a marker of myocardial destruction.If this indicator in the blood test deviated in the positive direction, then it is urgently necessary to monitor the work of the heart.

Preparation for analyzes

ALT and AST blood tests are taken, like the rest of “biochemistry”, on an empty stomach

As doctors say, special preparation for donating blood for these indicators is not required. ALT and AST blood tests are taken, like the rest of “biochemistry”, on an empty stomach. It is imperative that the patient does not eat for at least 12 hours prior to blood donation.

Also, at least two days before the analysis, you must not drink alcohol, smoke for 10-12 hours. In addition, doctors recommend that on the eve of donating blood for research, protect yourself from emotional and physical overload. And you shouldn’t go for an analysis immediately after any even the most minimal surgical interventions or after dental treatment.

It should be noted that ALT in hepatitis C is always increased by . And, if the patient is aware that he has been diagnosed with this disease, it is worth warning the doctor and the laboratory assistant who takes the blood.You also need to know that the ALT rate in women is slightly lower than that of the stronger sex.

Norm of ALT and AST in blood

Of course, there is an established ALT and AST norm – indicators in numbers that are characteristic of an average healthy person. There is a special table in which the norms for age and sex are entered.

The level of this enzyme is measured in different ways: there are units of measurement of indicators in mol, but many laboratories issue research results, where the data are indicated in units / l.

We give the norm indicators that can be seen in adults in the table in these units.

In men, the normal levels of these enzymes in the blood test throughout life, if the person is healthy, do not change. In representatives of the stronger sex, biochemistry, in the case of order in the body, gives ALT a maximum of 18 U / L, and AST – a maximum of 22 18 U / L.

But women have different norms at different stages of life. So a biochemical blood test in a healthy woman shows ALT not higher than 15, and AST – not higher than 17 U / L.Blood from a vein in women who are expecting a baby will give the level of these enzymes slightly lower (by 5-10%) than usual.

The numbers in the transcript of the study in nursing mothers and young ladies who have menstrual bleeding at the time of the test are gradually returning to normal values. Although, there may be minor deviations, for example, in nursing mothers, the level of substances may increase slightly.

But the norm in the blood after 50 years in both men and women remains at the same level as at a young age.

As for children, the highest levels of AST and ALT are recorded in infants. In newborns under one month of age, ALT at 38 U / L is common, and AST – up to 32. In children under one year of age, the maximum AST and ALT thresholds are fixed at 36 and 27 units (respectively), in children up to 16 years – 31 and 22 (respectively).

What does the deviation of the level of these enzymes in the body from the norm indicate? As already mentioned, this suggests one thing: something went wrong with some of the internal organs and their functions.To understand what kind of failure occurred and to pinpoint the problem, doctors look at other indicators of a biochemical blood test, and also prescribe additional examinations.

Reasons for the increase

So, what exactly can the increase in ALT and AST in the blood be evidence of? It has already been noted that if ALT and AST are elevated, then this clearly indicates pathologies of the heart and liver and indirectly indicates problems with the kidneys, muscles, blood vessels, and the nervous system.

Reasons why ALT enzyme levels are elevated:

High rates for this substance are given by a blood test for cirrhosis of the liver of various etiologies

  • High values ​​for this substance are given by a blood test for liver cirrhosis of various etiologies (alcoholic, toxic, arising as a result of other hepatic pathologies), with prolonged and regular use of alcohol, as well as with alcoholic liver damage.
  • A high level of ALT indicates the development of acute pancreatitis in the patient.
  • Increased figures relative to the norm will be in the conclusion of the analysis in acute hepatitis or chronic development of this disease.
  • Elevated ALT in the analysis may indicate that cancer is progressing in the liver and / or biliary tract. And also that metastases of a tumor “living” in another organ began to spread to these organs.
  • An increase in the concentration of a substance is observed with fatty hepatosis.
  • The level of this enzyme also increases if the patient develops cholestasis or cholestatic jaundice.
  • Such a development of events is also possible: ALT increases with normal bilirubin. This, as a rule, indicates that the patient is taking various drugs – oral contraceptives, drugs that prevent the development of tumors, chemotherapy and psychotropic drugs.
  • ALT levels are also increased in severe burns.

In this case, the doctor will also pay attention to such a line in the conclusion about the study of the patient’s blood as gamma-glutamyltransferase (GGT). Information about the level of this substance can confirm or deny the presence of one or another hepatic pathology.

Why can there be a high content of ast-enzyme in the blood:

  • A patient has acute myocarditis or myocardial infarction.
  • Increased AST indicators can be in case of serious muscle injuries – sprains, ruptures.
  • There may be increased asthma in hepatitis C and other hepatic pathologies.
  • The indicator for the enzyme changes to “plus” if the patient is diagnosed with myopathy, myositis, myodystrophy.
  • Unstable angina, as well as pulmonary embolism, may also give rise to a substance.

An increase in the level of both enzymes at once can be caused by severe physical fatigue or prolonged stress in the patient.

It is especially dangerous when these indicators were about to be normal, and suddenly increased sharply at two times 2 times. This suggests that some kind of negative scenario is developing with dysfunctions of internal organs, and at the same time there is a lack of substances vital for a person.

Reasons for decline

Low values ​​for these enzymes in the test results should also alert the patient and the doctor. ALT and AST indicators may be below normal in hepatitis, and when the disease is started, when it has not been diagnosed and treated for a long time, and the organ tissues have already undergone necrosis.

Also a decrease in ALT and AST means in a biochemical blood test that a person does not have enough vitamin B6-peroxin. Usually this condition provokes long-term use of antibiotics.

Indicators in pregnant women and children

As already mentioned, the analysis of ALT, AST, bilirubin in pregnant women may differ from the conclusion of a blood test of a woman who is not expecting a baby.

The level of these enzymes in the first trimester of pregnancy, due to changes in hormonal levels, usually slightly increases, and later, in the second and third trimester, is slightly below normal.

As a rule, this does not lead to anything bad, but is simply caused by the current state of the expectant mother.

But if suddenly the situation gets out of control, and the enzyme numbers decrease significantly or, conversely, catastrophically increase, the gynecologist leading the pregnancy prescribes additional tests and examinations.

This is necessary to exclude the presence of a serious pathology in a mother or an unborn baby.

For example, an increase in ALT and AST may indicate the development of gestosis, which negatively affects the condition of the mother and the fetus.

Interpretation of results by De Ritis coefficient

There is another very important indicator in the biochemical study of a patient’s blood – the De Ritis coefficient. This is the ratio of AST to ALT, the quantitative ratio of enzymes to each other.

The ALT and AST reference values ​​are 1.33 units. If the patient’s indicators are less than these values, then he probably develops some kind of serious hepatic pathology.

In the case when the De Ritis coefficient is higher than normal, then the patient has problems with the myocardium.

What to do if ALT and AST are above the norm

Of course, in a situation where the level of enzymes is above or below normal, it is necessary to take action.

As a rule, with such test results, doctors, if they do not immediately diagnose, then send the patient for an additional examination, after which adequate treatment is prescribed.

Usually, when eliminating pathologies that result in an increase in the level of substances, it is possible to automatically lower the indicators.How quickly this happens depends on the correctness of the prescribed therapy and on the response of the patient’s body to it.

What to do, if you cannot reduce the numbers in the lines with the words “ALT” and “AST” in the conclusion of the blood test? This may be due to an incorrect diagnosis and / or incorrect treatment. Most likely, in this case, an adjustment of the appointments and / or a new examination will be required.


Hepatoprotectors will help restore liver cells

How to reduce the level of enzymes with drugs if they are still high, and the patient has been treated as required, and the patient has absolutely no pathologies at this stage.

There are a number of medications for lowering ALT and AST levels.

How to effectively lower the level of these enzymes? In this case, hepatoprotectors will help, “working” on the restoration of liver tissues and cells, normalizing its functions; enzymes that “put in order” the stomach and pancreas; heart medications; and pain relievers to relieve spasms.

Of course, self-medication is not worth doing in this case either. And all drugs must be taken exclusively as directed by the attending physician.

A child under the age of 16 has physiologically increased indicators for these substances. A decrease, if everything is in order in the body, occurs as the little patient grows up.

Folk remedies

It is believed that you can normalize the level of these enzymes by folk remedies. To do this, it is recommended to take various hepatic fees, milk thistle decoction, dandelion flower tincture, as well as corn silk infusion. To maintain the heart, you can drink the adonis infusion.

Of course, folk remedies are good. But with serious pathologies and serious deviations from the norm with their help, the result cannot be achieved. They can be used, but only in conjunction with drugs. And only then can you achieve a good result from the therapy.

Diet and prevention

What is the prevention of such abnormalities in blood test results? Of course, first of all, it is necessary to prevent the occurrence of pathologies and diseases that provoke an increase or decrease in the level of enzymes in the human body.

Of course, there must be a rejection of bad habits, the use of alcoholic beverages, some potent and / or illegal drugs, smoking.

It is also necessary to lead a correct and healthy lifestyle, which consists in rational and timely nutrition and the organization of moderate and adequate physical activity.

When it is necessary to reduce the level of enzymes in the blood, along with the intake of medications prescribed by the doctor and ancillary folk remedies, a reasonable diet should also be applied.

In case of pathologies associated with the liver, a complete rejection of alcohol, fried in oil and fatty, smoked and overly salty, sweet, is recommended. The patient’s diet should consist of the correct combination of proteins, fats and carbohydrates, poultry and lean meat, as well as fish, vegetables and cereals, can be eaten. And everything must be steamed or stewed without adding oil.


About blood tests AST and ALT.

Alt and ast the norm in women

AST and ALT research is used in the diagnosis of liver diseases.The rate of AST and ALT in women can increase during pregnancy, steatosis and cirrhosis of the liver, damage to it, after taking medications or exercising.

Table of contents:

Decreased values ​​are observed, for example, with urinary tract infections.

Alanine aminotransferase (ALT) is an enzyme that acts mainly in the cytoplasm of the parenchymal cells of the liver, epithelial cells of the renal glomeruli, and in smaller amounts in the heart and skeletal muscles.

ALT is involved in protein metabolism. Vitamin B6 is needed for its synthesis. It occurs in the body in some organs, but the overwhelming amount is found in liver cells. When the cells of the above organs are destroyed, the ALT level increases in the blood. A small amount of enzyme activity is present in the blood of healthy people, and in the case of illness, growth depends on the severity of organ damage.

Determination of ALT level in biochemical blood test is carried out most often:

  • when performing diagnostics, differentiation and control of inflammatory processes in the liver, mainly associated with the hepatitis B and C virus;
  • for alcoholism;
  • for toxic effects of drugs;
  • for inflammation of the biliary tract.

An increase in the level of alanine aminotransferase in the blood serum is the most important indicator of liver cell necrosis. Often, an increase in ALT is observed for no apparent reason.

An increase in ALT activity precedes the onset of jaundice by 7-14 days in the case of viral hepatitis. Alanine aminotransferase values ​​may vary depending on the time of day.

Its high concentrations in the blood serum are observed during the day, and lower – early in the morning.

Aspartate aminotransferase (AST) is an enzyme that is present in the form of the cytoplasmic membrane and mitochondrial inclusions in many tissues of the body.AST is mainly present in the liver, heart and skeletal muscles, in smaller amounts in the kidneys, pancreas and erythrocytes.

AST was the first enzyme whose designation was used to determine necrotic changes in the myocardium during a heart attack.

Currently, the determination of AST activity is used in the diagnosis of acute and chronic liver inflammation. It is one of the most important indicators of liver cell necrosis.

An increase in the activity of ALT and AST in the blood always indicates damage to liver cells.AST is less sensitive to ALT in liver disease.

  • The indication for determination is the recognition, differentiation and control of the course of diseases of the liver and biliary tract and (to a lesser extent) diseases of skeletal muscles and pancreas.
  • The material for the study is blood serum and plasma, a blood test is performed.
  • A blood sample should be taken for analysis in the morning on an empty stomach.

The study does not require special training.However, strenuous physical effort should be avoided before taking the test. Due to the fact that the results of the study can be influenced by the medications taken and current diseases, it is necessary to inform the doctor in advance about them.

It is important to inform the doctor and personnel responsible for blood collection about existing blood clotting disorders and the presence of pathogens transmitted through the blood (for example, HIV, hepatitis B, C) in order to take the necessary safety measures.

To obtain material for research, an injection is made into a vein (usually in the area of ​​the lower part of the elbow) using a disposable sterile needle and blood is collected into a test tube.The blood sample is examined in a special device. After removing the needle, you need to press on the injection site for a few minutes to prevent bleeding.

Standard values ​​of the norm of ALT and AST in adults and children:

  • ALT in women –

Rules for the management of patients taking lipid-lowering therapy

How often should cholesterol levels be monitored?

Before starting lipid-lowering therapy, the analysis should be performed at least twice with an interval of 1-2 weeks, except for conditions requiring immediate prescription of drugs, for example, the development of ACS

How often should the cholesterol level be determined after starting treatment?

– 8 (± 4) weeks after starting medication

– 8 (± 4) weeks after changing therapy before reaching target control values ​​

How often to check cholesterol or lipid levels after patient reaches target or optimal cholesterol levels?

Once a year (unless there are problems with adherence to the doctor’s instructions or there are other specific reasons for more frequent tests)

How often the level of liver enzymes (ALT, AST) should be monitored in patients taking hypolipidemic drugs?

– Before starting treatment

– 8 weeks after the start of drug therapy or after any increase in the dose of drugs

– After that, once a year if the level of liver enzymes is <3 VHN *

What to do in in the case of an increase in the level of liver enzymes in patients taking lipid-lowering drugs?

If the enzyme level does not exceed 3 ULN:

– Continue treatment

– Recheck the enzyme level after 4-6 weeks

If the enzyme level exceeds 3 ULN:

– Statins should be discontinued or the dose of drugs should be reduced, re checking the level of enzymes after 4-6 weeks

– After the level of ALT returns to normal, you should try with caution to return to the previous treatment regimen

How often should the level of CPK be monitored in patients taking lipid-lowering drugs?

Before starting treatment:

– Before prescribing the drug

– If the CPK level is> 5 VGN, treatment should not be started, the analysis should be repeated


– There is no need for routine control of CPK level

– Level CPK should be checked when the patient develops myalgia

Special care should be taken about the possibility of myopathy and an increase in CPK levels when treating high-risk patients: elderly people taking concomitant medications, with liver or kidney disease

What to do in the case of an increase in the CPK level in patients taking lipid-lowering drugs?

If the CPK level> 5 VGN:

– Stop treatment, check kidney function and conduct an analysis every 2 weeks until the CPK level normalizes

– Assess the likelihood of a transient increase in the CPK level due to other reasons, for example, muscle tension

– Assess the likelihood of other causes while maintaining a high CPK level

If CPK level ≤5 VGN:

– In the absence of any muscle symptoms, treatment should be continued (patients should be warned about the need to immediately report any symptoms ; CPK level should be determined regularly)

– If symptoms of myalgia (myopathy) are present, CPK level should be checked regularly

– Advice to the doctor to improve patient adherence to treatment

– Establish a good relationship with the patient

– Make sure that that the patient understands how to change lifestyle changes affect the course of cardiovascular disease, and use this to reach agreement on the need for lifestyle changes

– Potential barriers to achieving these changes should be ascertained

– A lifestyle change plan should be developed with the patient, which should be real and optimistic

– The patient’s effort to comply with prescribed prescriptions should be encouraged in every possible way

– If necessary, other specialists should be involved in the treatment

– A long-term visit program should be developed

– Tips for improving patient adherence to the treatment regimen with multiple drugs

– If possible, the regimen of taking medications should be simplified by reducing the frequency of administration and other ineffective drugs should be canceled

– Cheaper (at a price) medications should be preferred

– Appointments should be accompanied by clear oral and written instructions

– The patient should be discussed about the importance of adhering to medical recommendations

– The therapy should be adapted to the patient’s lifestyle as much as possible

– The patient should be involved as a partner when discussing the plan treatment

– It is useful to use modern information technologies (reminder systems, notes, self-control diary, feedback, encouragement)

* VGN – the upper limit of the norm

Author: EOK / EOA

Source: medspecial.