What is the most common cause of high ALT?
Chronic alcohol consumption, drugs, non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis are common causes associated with raised ALT and AST. In chronic viral hepatitis, the elevation of liver enzyme may not correlate well with the degree of liver damage.
- Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
- Certain prescription medications, including statin drugs used to control cholesterol.
- Drinking alcohol.
- Heart failure.
- Hepatitis A.
- Hepatitis B.
- Hepatitis C.
- Nonalcoholic fatty liver disease.
ALT is most commonly increased in response to liver disease or liver damage, caused by alcohol, drugs, supplements, or toxins. Other causes of high ALT include obesity, anorexia, biliary disease, muscle damage and disease, heart attack, hypothyroidism, and infections and diseases that can impair liver function.
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Very high ALT levels can be caused by:
- Acute viral hepatitis.
- An overdose of drugs such as acetaminophen (Tylenol)
- Liver cancer.
- Sepsis.
What ALT level is considered high? The upper limit of normal for ALT is 55 IU/L. When an ALT level is double to triple the upper limit of normal, it is considered mildly elevated. Severely elevated ALT levels found in liver disease are often 50 times the upper limit of normal.
Can Stress Cause Elevated Liver Enzymes? Stress and anxiety are proven to contribute to high liver enzyme levels since they can reduce blood flow to the liver.
In healthy individuals, ALT levels can vary 10 to 30% from one day to the next. ALT levels can fluctuate 45% during a single day, with highest levels occurring in the afternoon and lowest levels at night. A high body mass index can increase ALT levels by 40 to 50%. Reference range is 14 - 63 IU/L.
High levels of ALT in your blood can be due to damage or injury to the cells in your liver. An increased ALT level may indicate the following conditions: Alcohol-induced liver injury. Fatty liver disease (too much fat in your liver). Hepatitis (liver inflammation).
- The antibiotics synthetic penicillin, ciprofloxacin and tetracycline.
- The anti-seizure drugs carbamazepine and phenytoin and valproic acid.
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- The diabetes drugs sulfonylureas and glipizide.
- The tuberculosis drugs isoniazid, pyrazinamide and rifampin.
Treatment, if any, depends on what's causing the increase. Of the 10 percent of people in the United States estimated to have high ALT, less than 5 percent have serious liver disease.
What ALT level indicates liver damage?
A normal AST:ALT ratio should be <1. In patients with alcoholic liver disease, the AST:ALT ratio is >1 in 92% of patients, and >2 in 70%. AST:ALT scores >2 are, therefore, strongly suggestive of alcoholic liver disease and scores <1 more suggestive of NAFLD/NASH.
People can lower their ALT levels by making lifestyle changes, such as taking regular exercise and changing their diet. Increasing fiber intake, reducing saturated fats and processed foods, as well as consuming a range of nutrients from fruits and vegetables may all help to lower levels.
ALT is measured in units per liter of blood or U/L. The normal range is around 7-35 U/L in women and 7-40 U/L in men.
Typically, ALT levels in these conditions can be two-to-five times the upper limit of normal, which is around 40 IU/l in most hospitals. Occasionally ALT levels can rise to levels of >1,000 IU/l.
The alanine aminotransferase (ALT) is a specific marker for liver inflammation and is typically elevated in individuals with a fatty liver. If your ALT test results are elevated, your doctor may order additional blood tests to check for other conditions including viral hepatitis.
Elevated liver enzymes might be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated.
Usually, the upper limit of ALT is 35 - 40 U/L. Moderate increase in ALT (such as 70 U/L) is seen in chronic hepatitis, chronic obstruction of bile ducts, heart damage, alcohol abuse, liver tumor, skeletal muscle damage. In any acute liver conditions, ALT is much more elevated.
- Reducing daily alcohol intake: ...
- Consuming more caffeine: ...
- Switching to natural and organic foods: ...
- Consuming more fruits and vegetables: ...
- Increasing intake of dietary fiber: ...
- Exercising regularly: ...
- Weight reduction: ...
- Quitting smoking:
Medical treatment
For most causes of high ALT, treatment involves lifestyle changes, such as exercise, a modified diet, and reducing alcohol intake. Depending on the results of your liver panel and your medical history, your healthcare professional may recommend checking them again at a later date.
Marker | Time to return to normal limits |
---|---|
Aspartate aminotransferase | 7 days, but considerable variability in declines with abstinence |
Alanine aminotransferase | Unknown |
Macrocytic volume | Unknown but half–life ∼ 40 days |
Carbohydrate–deficient transferrin | 2–4 weeks of abstinence |
Can ALT levels go up and down?
In healthy individuals, ALT levels can vary 10 to 30% from one day to the next. ALT levels can fluctuate 45% during a single day, with highest levels occurring in the afternoon and lowest levels at night. A high body mass index can increase ALT levels by 40 to 50%. Reference range is 14 - 63 IU/L.
Normal Results
The normal range is 4 to 36 U/L. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your health care provider about the meaning of your specific test results.
Normally, levels of ALT in the blood are low. Very high levels of ALT (more than 10 times normal) are usually due to acute hepatitis, sometimes due to a viral infection. In acute hepatitis, ALT levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal.
In many cases, liver enzyme levels return to normal on their own within about a month. You might need to switch medications, stop taking a supplement, or cut back on drinking if you drink, but you will not need a treatment plan.
- Beetroot Juice. Beetroot juice is rich in potassium, Vitamin C, and antioxidants. ...
- Orange Juice. Orange juice is another healthy drink that you can include in your diet to detoxify your liver. ...
- Lemon Juice. ...
- Carrot Juice. ...
- Green Juice.
References
- https://www.ucsfhealth.org/medical-tests/alanine-transaminase-(alt)-blood-test
- https://www.personalabs.com/blog/what-does-it-mean-when-your-alt-is-high/
- http://www.clinlabnavigator.com/alanine-aminotransferase-alt.html
- https://www.theraleighhouse.com/addiction-blog/will-liver-heal-stop-drinking
- https://www.apollo247.com/health-queries/70-high-alt-level_hqu
- https://www.kent.co.in/blog/detox-your-liver-with-these-nutritious-and-tasty-cold-pressed-juices/
- https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/sym-20050830
- https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02215-x
- https://www.priorygroup.com/blog/how-long-does-alcohol-stay-in-your-system
- https://cura4u.com/blog/elevated-liver-enzymes-causes-symptoms-and-tests
- https://pubs.niaaa.nih.gov/publications/assessingalcohol/biomarkers.htm
- https://www.healthline.com/health/can-liver-enzymes-fluctuate
- https://www.nuffieldhealth.com/fasting-blood-test
- https://www.healthline.com/health/how-to-lower-alt
- https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.22109
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267040/
- https://labs.selfdecode.com/blog/alanine-aminotransferase/
- https://www.aafp.org/pubs/afp/issues/1999/0415/p2223.html
- https://www.frontiersin.org/articles/10.3389/fnut.2021.709683/full
- https://www.getlivesmart.com/alanine-transferase
- https://labs.selfdecode.com/blog/high-alt/
- https://www.verywellhealth.com/liver-enzymes-1759916
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289828/
- https://kidshealth.org/en/teens/test-liver-function.html
- https://www.aafp.org/pubs/afp/issues/2017/1201/p709.html
- https://www.drugs.com/medical-answers/medications-liver-enzymes-elevated-3566419/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841735/
- https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/common-liver-tests
- https://my.clevelandclinic.org/health/diagnostics/22028-alanine-transaminase-alt
- https://perks.optum.com/blog/most-common-causes-high-liver-enzymes/
- https://www.medicalnewstoday.com/articles/319080
- https://my.clevelandclinic.org/health/symptoms/17679-elevated-liver-enzymes
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609680/
- https://www.ucsf.edu/news/2017/01/405561/binge-drinking-may-quickly-lead-liver-damage
- https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/definition/sym-20050830
- https://nutritionj.biomedcentral.com/articles/10.1186/s12937-016-0180-y
- https://academic.oup.com/alcalc/article/39/4/336/139692
- https://www.medicalnewstoday.com/articles/326425
- https://www.sutterhealth.org/health/south-asian/risks/fatty-liver
- https://emedicine.medscape.com/article/285913-workup
- https://www.webmd.com/digestive-disorders/alanine-aminotransferase-test
- https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/alanine-aminotransferase
- https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/alcohol-related-liver-disease
- https://www.medicinenet.com/how_can_i_lower_my_alt_levels_quickly/article.htm
- https://medlineplus.gov/lab-tests/alt-blood-test/
- https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/alcohol-related-liver-disease
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4953107/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321494/