An increase in ALAT can occur in different cases. But most often this happens with liver diseases. This is the largest gland, which plays an important role in the functioning of the entire body. An increase in ALT in the blood may indicate other diseases. This test can be prescribed both for prevention and in the presence of a number of symptoms.

Alanine aminotransferase - what is it?

Alanine aminotransferase is an enzyme produced by the liver. A small amount of it is also present in the kidneys, pancreas, heart muscle, and skeleton. This substance is involved in amino acid metabolism.

Under normal conditions, this enzyme can be found in the blood in small quantities. But if the organs in which it is included are damaged as a result of injury or disease, then the analysis will show that the level of ALAT is increased.

An enzyme level test allows you to quickly make a diagnosis for problems with the liver, gall bladder, pancreas, myocardium and skeleton. The ALT blood test is also prescribed to monitor the condition of the liver during hepatitis, during treatment with medications, or to assess damage from contact with toxic substances. Blood donors must also undergo this procedure.

You can find out what level of ALT is in the blood if you experience symptoms such as:

• poor appetite;
• discomfort in the abdominal area and flatulence;
• change in the color of urine and feces;
• yellow color of the skin and whites of the eyes;
• constant weakness and decreased performance.

ALT is often determined together with aspartate aminotransferase (AST) levels. This substance (the level in the blood is also elevated) makes it possible to diagnose problems with the liver and heart.

1. Blood must be donated in the morning. Before this, you cannot eat anything for eight hours.
2. You are allowed to drink some clean water.
3. Two or three days before the test, you must give up alcohol, smoking, fatty foods, and limit physical and emotional stress.
4. If you use any medications, you must inform your specialist.

Norm and deviations

Normal alanine aminotransferase levels should be low. The amount of this enzyme in the body changes throughout life.

Children and adults should have the following ALT levels in their blood:

• in the body of newborns and up to one year there should be no more than 55 units/l;
• from one to three years - 34 units/l;
• for children from three to six years old, 30 units/l is considered normal;

• up to the age of twelve, the normal ALT level should not exceed 39 U/L;
• for men, 45 units of ALT per liter of blood is considered normal;
• in women's blood should be up to 35 units/l.

These standards are not exact. These are just approximate values. Depending on the quality of equipment and reagents used, results may vary slightly in different laboratories.

If the ALT blood level is elevated, then to make a diagnosis it is also necessary to take into account the degree of increase. There are mild, moderate and pronounced increases. The first two degrees indicate the development of the disease, and the last - that the organ begins to collapse. Therefore, it is very important to determine the causes of increased ALT in the early stages of the disease.

Why is ALT elevated in the blood?

The cells of parenchymal organs, and especially the liver, are filled with transaminases. It is by this indicator that one can judge the condition of the organ. An increased ALT value can be detected with the slightest damage to an organ, in which cells begin to break down and the enzyme enters the blood plasma.

If alanine aminotransferase is elevated, then the reasons for this phenomenon may lie in the following diseases:

• ALAT may increase with hepatitis. There are several forms of this disease. If hepatitis is viral or chronic, then the level of alanine aminotransferase is slightly increased. In acute hepatitis, an increase of several tens of times can be observed.
• An increased rate can be observed with obstructive jaundice, but in rare cases.
• Liver cirrhosis can be detected by elevated enzyme levels. This disease may not manifest itself in the early stages of development, which poses a serious danger.

• Liver cancer. Alanic acid may increase in cancer. Most often, this type of cancer develops in people suffering from hepatitis.
• With fatty liver disease - steatosis - you can observe an increase in ALT several times.
• An exacerbation of pancreatitis can be diagnosed if the level of aspartate aminotransferase in the blood is high.
• Damage to the heart muscle. This condition is called myocarditis. It can be noticed by shortness of breath, weakness and elevated ALT levels.
• Myocardial infarction. With this problem, the tissue of the heart muscle dies due to impaired blood flow. If the enzyme concentration increases tenfold or more, it means that after the attack the patient’s condition worsens.

ALT is higher than normal not only in cases of illness.

The following factors can also affect the enzyme content:

• use of hormonal drugs - oral contraceptives, steroids, fluoroquinolones, cephalosporins, aminoglycosides;
• excessive physical activity;
• the use of dietary supplements that contain substances that negatively affect the condition of the liver;
• alcoholic drinks increase the enzyme content, so you should avoid alcohol for a week or two before donating blood;

• Stress and emotional overstrain lead to disruption of the nervous system and the entire body;
• consumption of fatty foods, harmful additives, fast food, soda and other unhealthy foods.

Due to these reasons, the biochemistry result may show a slight increase in ALT.

A lower figure also does not mean anything good. This can occur with liver rupture, organ necrosis, or vitamin B6 deficiency. This condition can occur when using Aspirin, Interferon.

How to lower ALT

If the ALT level is elevated, only a specialist can explain what this means. Having received such results, you cannot ignore them. It is necessary to conduct a comprehensive examination and find out the cause of the deviation.

You can lower ALT in the blood only by diagnosing and treating the underlying disease. Only a doctor knows what to do in such a situation.

Typically, hepatoprotectors, choleretic drugs, and agents to improve the digestion process are prescribed for the treatment of liver diseases. The patient must also follow a special diet. This allows you to improve organ function and reduce ALT.

In addition, the following measures must be taken:

1. If the increase in enzyme levels was caused by medications, then it is advisable to discontinue them and select alternative remedies.
2. It is also necessary to introduce more foods containing vitamin D into the diet. These foods include milk, eggs, fish, and green vegetables.
3. It is very important to lead a healthy lifestyle. Quit alcoholic drinks and smoking. Spend more time outdoors.
4. During the treatment process, it is necessary to periodically donate blood to determine the level of the enzyme to find out whether the prescribed therapy is effective or not.

Medicines used in these cases can have serious side effects, so the course of treatment should only be determined by a specialist.

Elevated ALT levels in the blood - the main causes

ALT – alanine aminotransferase. It is a specific enzyme involved in the production and breakdown of proteins. It is synthesized by cells of various organs: liver, spleen, kidneys, lungs, heart muscles. Normally, a small amount enters the blood. Blood ALT testing is a common diagnostic test.

Diagnosis based on ALT analysis

The level of alanine aminotransferase is detected as part of a general biochemical blood test. Complaints for which a blood test for ALT is prescribed are:

• Increased fatigue;
• Decreased appetite;
• The appearance of weakness in the body;
• Pain on the right side of the abdomen;
• Change in urine color;
• Yellowness of the skin;
• Pain in the heart area;
• Urge to feel sick.

Possible diseases with elevated ALT levels

It is mandatory to detect aminotransferase levels in patients suffering from obesity, diabetes mellitus, and liver disease.

Important! Blood donation is carried out in the morning on an empty stomach. It is not recommended to drink alcohol or fatty foods the day before the test.

You should also refrain from taking strong medications. The results of the study may be affected by a person’s psycho-emotional state and physical stress.

Exceeding the normal threshold

In medical research, the upper limit of normal ALT is important. The limit for adult men is 45 units/l, for women 34 units/l. An increase in ALT in a blood test indicates an inflammatory process in the body. Below are the diseases that cause this pathology.

1. Pancreatitis. Severe damage to the pancreas. Occurs due to the appearance of a tumor blocking the enzyme ducts. As a result, the accumulated digestive enzymes begin to digest the pancreas itself. Possible death;
2. Hepatitis. Liver disease. Characterized by inflammation of organ tissue. It is divided into several types. Hepatitis C is considered the most dangerous. The latter often becomes chronic and can cause cirrhosis of the liver. Common causes of hepatitis are: toxic damage to liver cells (for example, alcohol), viral infection;
3. Myocardial infarction. The most severe heart disease. It is characterized by the death of some parts of the heart muscle due to a critical decrease in blood circulation. The pathology has many causes. The main ones: smoking, hypertension, obesity, diabetes, sedentary lifestyle.

There are reasons for exceeding the ALT norm in a blood test that are not related to the diseases listed:

• Chemotherapy;
• Injuries accompanied by damage to the muscles of the body;
• Taking potent drugs;
• Physical and emotional stress;
• Eating fatty fried foods
• Taking drugs.

Important! The main recommendations aimed at reducing the likelihood of the occurrence of these diseases will be: proper nutrition, avoidance of drug use (including alcohol, nicotine), moderate physical activity, and reduction of stressful situations in life.

De Rittis coefficient

One of the most important research methods is considered to be a comparison of the ALT level with the level of AST - aspartate aminotransferase. The latter is also an endogenous enzyme involved in the synthesis of amino acids. Aminotransferases have similar threshold levels in the blood. The diagnosis of a particular pathology depends on the balance of ALT and AST. The AST/ALT ratio is characterized by the de Rittis coefficient.

Important! The normal value of the de Rittis coefficient is 1.33-1.75 units/l.

A decrease in the norm below 1 unit/l will mean viral liver damage. An increase in the coefficient to 2 units/l or higher, subject to an increased albumin content, indicates myocardial infarction.

Normal ALT/AST levels in the body:

• Alalnine aminotransferase: men – up to 45 units/l, women – up to 34 units/l;
• Aspartate aminotransferase: men – up to 41 units/l, women – up to 31 units/l.

Independent interpretation of analyzes

Often, patients, having read enough medical information, try to independently decipher a blood test for ALT levels. Having received the results in the laboratory, some people, seeing a deviation of the indicators from normal values, independently diagnose themselves with serious diseases.

Doctors know that exceeding ALT threshold values ​​is not always a sign of pathology. Results from different laboratories may vary. It depends on the equipment, on the research methods, on the materials used in the analysis. Also, other factors can influence the results, be it the patient’s poor lifestyle, taking medications, emotional state, and others.

Only a doctor can correctly decipher the research results. He also prescribes medication.

To date, doctors do not use ALT analysis as a means of accurate diagnosis. Exceeding ALT levels in a blood test only indicates the possibility of a disease. To make a final diagnosis, additional studies are used and specialized specialists are involved: urologists, cardiologists and others.

Normalization of ALT levels with folk remedies

After the examination, the patient with high ALT levels is prescribed medications. But for prevention, the doctor may recommend herbal medicine. Below are examples of using folk remedies to reduce alanine aminotransferase levels.

• Milk thistle decoction. To prepare, pour a teaspoon of chopped herbs into a glass of boiling water, wrap it and let it brew for 20 minutes. Then filter the infusion. Take the decoction in small sips, half an hour before meals, twice a day, for three weeks;
• Herbal collection. Immortelle, St. John's wort and celandine are mixed. The proportion of herbs is accordingly. The collection is poured with 1 liter of hot water, wrapped and infused for 12 hours. Then you need to strain the infusion. Take half a glass 4 times a day for two weeks;
• Dandelion infusion. To prepare, take 200 grams of crushed dandelion flowers. Pour in 100 ml of vodka. The product is infused for 24 hours. Take 2 tablespoons three times a day for three weeks;
• Decoction of corn silk. To prepare the product, take dried crushed stigmas. Pour 200 ml of boiling water and leave for a minute. Take the infusion twice a day, a glass. The course of treatment can be six months.

Important! Folk remedies are not a cure! They are used to prevent diseases and generally strengthen the body.

The level of development of modern medicine allows us to accurately diagnose most known diseases. One of the generally accepted research methods is a biochemical blood test. It contains many indicators, one of which is the level of alanine aminotransferase.

Exceeding the normal level of ALT indicates the possibility of developing serious diseases in the body. But only a doctor can accurately determine the disease. We strongly recommend not to engage in self-diagnosis, much less self-medication. If alarming symptoms appear, contact the clinic immediately. They will conduct all the necessary examinations and help you cope with the problem.

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Why is ALT elevated, what does it mean?

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes that are active participants in amino acid metabolism. They can be found in the cells of the kidneys, liver, heart muscles and other organs.

If they enter the blood, this indicates the presence of some kind of organ dysfunction due to cell destruction.

When ALT levels are elevated, this most often indicates the development of a certain disease affecting the liver. A decoding of a blood test can show in more detail which organ is damaged; the level of ALT or AST will be significantly increased in it.

What is ALT in a blood test?

Why is ALT elevated in a blood test, and what does it mean? Alanine aminotransferase (ALT) is an endogenous enzyme belonging to the group of transferases, a subgroup of transaminases, or aminotransferases. Determining its level in the blood is widely used in medical practice to identify pathologies of the liver and some other organs. A blood test for ALT is almost always carried out in conjunction with determining the AST level.

An assessment of these two laboratory parameters allows the doctor to suggest the localization of the pathological process and determine the likely severity of the disease. The Ritis coefficient (AST/ALT ratio) is used for assessment, which is normally 1.33. In acute viral hepatitis, this coefficient decreases, while in myocardial infarction and alcoholic liver damage it increases.

Where is ALT found:

The main function of alanine aminotransferase is associated with the metabolism of amino acids. This substance acts as a catalyst in the transfer of certain molecules. When energy metabolism is disrupted, the permeability of cell membranes increases, which leads to cell destruction and the release of the enzyme into the blood serum.

Norm

The norms within which alanine aminotransferase in the blood must fit are as follows:

• children under 1 year: 13 – 45 U/l;
• men up to 1 – 60 years old: 10 – 40 U/l;
• women 1 – 60 years old: 7 – 35 U/l.

When analyzing this enzyme, high accuracy is required, and it is directly related to the use of certain drugs that can distort the analytical picture. Therefore, before checking your ALT level, you should consult with your doctor, who will either temporarily stop taking medications or take into account deviations in test results associated with drug therapy.

Increased ALT in the blood: causes

In simple terms, alanine aminotransferase is an enzyme that, in addition to the liver, where its concentration is especially high, is found in literally all parenchymal organs, occupying mainly the cytoplasm of tissue cells. It is not for nothing that ALT is considered a kind of marker of liver pathology and is regarded as a reliable sign of damage to its parenchyma, because the activity of the enzyme in the blood plasma is directly dependent on the degree of involvement of the tissue of this important organ in the pathological process.

Given this high sensitivity of ALT, it can be expected that alanine aminotransferase will be elevated in cases of the slightest damage to the hepatic parenchyma.

So, an increase in ALT levels occurs in the following cases:

1. Hepatitis. This inflammatory liver disease can come in several forms. For chronic or viral hepatitis, the excess level of alanine aminotransferase in the blood is insignificant.
2. Rarely, an increase in ALT can be observed in cases of obstructive jaundice, but high values ​​of this indicator are extremely rare.
3. Cirrhosis. This disease is dangerous because it may not have pronounced symptoms for a long time. Patients quickly get tired and feel tired.
4. Liver cancer. This malignant tumor often forms in patients with hepatitis. ALT analysis in this case is necessary both for diagnosing the disease and for making operational decisions.
5. Non-alcoholic fatty liver disease (steatosis): ALT levels increase slightly – 2-3 times. When the disease transitions to the steatohepatitis phase, there is a marked increase in ALT, high levels of total and direct bilirubin, as well as indicators of inflammatory blood activity.
6. Pancreatitis. The presence of this disease is also indicated by the level of ALT. Its increased amount indicates an exacerbation of pancreatitis.
7. Myocarditis. It manifests itself in lesions of the heart muscle. Its main symptoms are shortness of breath, rapid fatigue of the patient and increased ALT levels in the blood.
8. Myocardial infarction. This disease is a consequence of impaired blood flow, resulting in necrosis of cardiac muscle tissue.
9. Tests may show an increase in ALT levels during alcoholism and immediately after drinking alcoholic beverages.

When the ALT level increases by 5 times, myocardial infarction can be assumed; if it reaches the level, we can talk about the deterioration of the patient’s condition after the attack. The value of the de Ritis coefficient also changes upward.

Acute hepatitis provokes an increase in the enzyme content in the blood at once, muscular dystrophy and dermatomyasitis - by 8. Gangrene and acute pancreatitis are indicated by exceeding the upper limit of the indicator by 3-5 times.

Reasons for increased ALT not related to diseases

Other reasons can also increase the level of ALT in the blood, for example, some drugs, such as estrogens, oral contraceptives, cholestatics, steroids, iron salts, nicotinic acid, sulfonamides, methyldopa, azithromycin, aminoglycosides, cephalosporins, fluoroquinolones, clofibrate, clindamycin.

In some cases, the cause of increased alanine aminotransferase levels is physiological:

What to do when ALT in the blood is elevated?

Most often, hepatoprotectors are prescribed to reduce ALT levels:

These drugs have numerous effects. First of all, they protect liver cells from further damage, and also restore cells that are already damaged but not yet dead.

What is ALT or alanine aminotransferase in the blood, the reasons for its increase in men and women

Among the indicators of a biochemical blood test, the ALT factor is used as a diagnostic marker for many diseases. Decoding the abbreviation ALT (or AlAT) - alanine aminotransferase - gives some idea of ​​​​the activity of the enzyme in the body: its functions include the breakdown of keto and amino acids that are part of the cellular composition of hepatocytes, heart muscle, kidney and liver cells.

With normal amino acid metabolism, the level of ALT in the blood is not high. If ALT is elevated, this means that there are interruptions in the activity of some organ. Diagnosis of diseases is carried out, of course, on the basis of other tests, in particular liver tests.

Features of normal ALT levels

The level of ALT in the blood is directly dependent on the age, gender and functional characteristics of a person. This is due to greater enzyme activity in the blood of men compared to women, as well as instability of growth in children. Therefore, in men, ALTED/L is considered normal, and in women, it is U/L.

As for children, the normal level of alanine aminotransferase decreases and increases extremely unevenly throughout the entire period of active growth of the child.

Another category where the ALT level can deviate greatly from the norm without special prerequisites is women in the first trimester of pregnancy. If during this period a blood test shows an excess of the factor by several tens of units, this does not mean that the pregnancy is pathological and can only indicate a change in the level of hormones in the woman’s body. Such a change in background is a physiologically based phenomenon and does not require special measures.

In what cases is a test for ALT levels in the blood prescribed?

Typically, the level of alanine aminotransferase is one of the indicators of a general biochemical blood test. But sometimes, for a number of reasons, the doctor may prescribe a special blood test to check for ALT levels.

The fact is that liver diseases, which can be asymptomatic until the appearance of characteristic jaundice, are manifested by an increase in alanine aminotransferase in the earliest stages, when treatment of the disease can be most effective.

Therefore, if there is any suspicion of hepatitis or cirrhosis, it is advisable to conduct such an analysis.

Indications for prescribing an ALT test may include symptoms such as:

• nausea, vomiting;
• discomfort in the gastrointestinal tract;
• general weakness and increased fatigue;
• yellowness of the eye sclera;
• lightening of stool and darkening of urine.

Typically, all of these symptoms indicate the onset of serious liver problems, which is why blood tests are compared to liver test results.

If the analysis shows a significant excess of the norm of the endogenous enzyme, it makes sense to compare the samples and ALT values ​​with the AST indicator - aspartate aminotransferase, which is a marker enzyme for deciphering the state of the myocardium. In order to verify the provoking cause of the increase in alanine aminotransferase, data from the so-called de Ritis coefficient is used, which is determined by the ratio of AST to ALT. An indicator of this coefficient of more than 2 means that a destructive process has begun in the heart muscle, and this means that there is a serious risk of developing myocardial infarction.

Typical diseases with elevated ALT

For the convenience of determining pathology, levels of ALT elevation are divided into three degrees:

• high - an increase of 10 times or more;
• average – from 6 to 10 times;
• light – from 1.5 to 5 times.

The degree of enzyme increase shows the underlying pathology due to which the deviation occurred:

• in case of uncomplicated myocardial infarction, the level of ALT increase is mild, however, parallel AST tests can determine the presence of an attack;
• in case of cirrhosis, the degree of deviation exceeds the norm by 5 or more times, other symptoms may not be pronounced;
• for pancreatitis, regular tests for ALT are recommended, since sometimes only they help prevent another attack;
• in liver cancer, the degree of ALT deviation may become a decisive factor in deciding on surgical intervention;
• with hepatitis A, the amount of enzyme can determine the disease a week before the onset of pronounced symptoms;
• with viral and alcoholic hepatitis, a high degree of enzyme increase is observed.

Why does ALT increase?

An increase in ALT in the blood, both in men and women, can be caused by a number of reasons:

• hepatitis;
• mononucleosis - an infectious disease manifested by changes in blood composition, damage to the spleen and liver;
• lead poisoning;
• taking drugs;
• necrosis of malignant formation;
• chemotherapy;
• steatosis - hepatosis, the so-called fatty liver;
• various types of surgical interventions, including myocardial catheterization;
• increased physical and emotional stress, psychological shock;
• damage to muscle tissue;
• frequent consumption of alcoholic beverages;
• the predominance of fast food in the diet;
• taking certain medications - antibiotics, statins, barbiturates, contraceptive and therapeutic hormones, as well as corticosteroids for building muscle mass in men.

In women in the last weeks of pregnancy, an increase in ALT activity may indicate the onset of gestosis, a complication accompanied by nausea, dizziness, increased blood pressure and weakness.

Minor changes in samples can also be the result of poor-quality (non-sterile) analysis, so compliance with basic recommendations when donating blood for testing is mandatory.

Ways to lower ALT in the blood

To answer the question of how to reduce ALT in the blood, you must first find the reason for its increase.

Competent therapy for underlying diseases usually brings all laboratory parameters back to normal, which means correct diagnosis is the most important factor for success in reducing ALT in the blood.

In cases of increased indicators due to the harmful effects of alcohol or drugs, or an unbalanced diet, methods such as giving up bad habits and following a diet that excludes fatty, spicy, smoked foods and processed foods that have a detrimental effect on the liver are effective.

There are methods of forcibly reducing the level of the enzyme with medications - Duphalac, Heptral or Hefitol, but their effect is short-lived, and if the underlying cause remains the same, the indicators will quickly return to their previous figures. In addition, most drugs have side effects and negative effects on the liver, so their selection and prescription must be carried out strictly under medical supervision.

Increased ALT in the blood: causes and treatment

Alanine aminotransferase (ALT) is a special substance involved in amino acid metabolism. It is usually found in organs such as the liver, heart, and kidneys.

The penetration of this enzyme into the bloodstream is evidence of the presence of a pathological process. What this means and what ailments it is associated with will be discussed later in the article.

In most cases, alanine aminotransferase is elevated in diseases affecting the liver. However, the possibility of pathology of other vital organs cannot be ruled out.

The concentration of ALT in the blood is an important diagnostic indicator that determines the location and severity of the pathology.

Basic functions of ALT

This enzyme is important for health. Thanks to it, metabolic processes are carried out, which helps strengthen the immune system, provide the body with the necessary energy reserves, and also produce lymphocytes.

All processes occur inside cells with a small release of the enzyme into the bloodstream.

Due to the destructive process occurring in the cells of the liver and other organs affected by the disease, ALT enters the blood in large quantities. Its presence, exceeding acceptable values, becomes an important indicator for the diagnosis of certain diseases.

The presence of alanine aminotransferase is characteristic of such organs as:

• the liver, where its concentration is highest;
• heart muscle;
• lungs;
• kidneys;
• pancreas.

This becomes a prerequisite for a thorough examination of these particular organs when high ALT levels are detected in a biochemical blood test.

Indications for analysis

An increase in the level of ALT in the blood signals not only pathology in the listed organs. It also indicates the possibility of other diseases.

That is why blood biochemistry is assessed. The analysis reveals deviations, becomes an integral part of preventive measures, and an effective way to diagnose serious diseases of the liver, myocardium and pancreas.

Carrying out this study becomes mandatory when monitoring pathological changes in the liver that occur as a result of taking medications, hepatitis and poisoning with toxic substances.

A biochemical blood test is prescribed if the following symptoms occur:

• intense pain in the right hypochondrium;
• yellowness of the skin and eye sclera;
• lightening of stool and dark urine;
• lack of appetite;
• general weakness.

Timely detection of elevated ALT levels makes it possible to eliminate such signs by making an accurate diagnosis and prescribing an adequate course of treatment.

Other symptoms

In addition to the manifestations listed above, indicating a high level of ALT in the blood, there are symptoms that appear depending on the damage to a particular organ:

1. Liver. The ailments are accompanied by painful manifestations under the right ribs, changes in skin color and yellowness of the eyes. Viral hepatitis occurs against a background of elevated body temperature. Cirrhosis is characterized by the accumulation of fluid in the abdominal cavity, and so-called spider veins appear on the skin.
2. Heart. The main symptom of myocardial infarction is intense pain in the chest area, radiating to the subscapular area, left arm and jaw. The heart rhythm is disturbed, shortness of breath occurs, and blood pressure drops. There is general weakness and chills.
3. Pancreas. Nausea, repeated vomiting, sharp or aching pain in the stomach, bloating, weakness.

If an oncological process occurs, in addition to these signs, sudden weight loss and loss of strength are observed.

Diagnostics

Detection of high levels of enzymes in combination with the listed manifestations makes it possible to quickly diagnose diseases, which significantly increases the effectiveness of treatment.

For testing, blood from a vein is taken in the morning on an empty stomach. The reliability of the results depends on the preliminary preparation of the patient by following simple rules:

• last meal no later than 8 hours before collection of biomaterial;
• eliminating alcohol and quitting smoking;
• limiting physical activity.

If you use medications, you should inform your doctor.

Only if these requirements are met will the tests be accurate, which will make it possible to make an accurate diagnosis.

Analysis transcript

It should be noted that when interpreting the results, the values ​​of an enzyme such as AST are also taken into account. According to the Ritis coefficient scale, which considers the ratio of these enzymes, indicators up to 1.65 conventional units are taken as the norm.

Exceeding these values ​​by 2 times indicates pathological changes in the heart muscle. Indicators below 1.0 indicate liver damage.

However, with hepatitis of viral origin, a decrease in these values ​​is observed, and liver damage due to alcohol poisoning provokes a significant increase in them.

A comprehensive examination of a patient with a high level of enzymes involves the use of MRI, X-ray CT, a general analysis of urine and blood, and a number of other measures.

ALT norms

In adults and children, there is a significant difference in indicators that are considered within normal limits. The table shows that the permissible concentration of this substance depends not only on age, but also on gender:

For a child from 1 year to 3 years

The indicated values ​​are approximate, but small fluctuations up or down are allowed - from 1 to 3 units.

Factors influencing performance

The reasons for increased ALT are quite varied. But most often they indicate liver pathology and are a kind of marker of its condition. In addition, high values ​​are found even with minor diseases of other organs, when they are accompanied by cell destruction.

1. Types of hepatitis. At the same time, the chronic and viral forms do not cause a significant deviation of ALT from the norm.
2. Mechanical jaundice. High rates are also observed extremely rarely.
3. Cirrhosis. Characterized by the absence of pronounced symptoms for a long time.
4. Fatty liver disease – steatosis. This condition is characterized by a slight increase in blood levels. However, if the pathology develops into steatohepatitis, alanine aminotransferase increases significantly, and the level of direct and total bilirubin also increases.
5. Malignant neoplasms in the liver. They often result from hepatitis. Biochemical analysis to determine ALT indicators allows not only to diagnose the disease, but also to draw a conclusion about the need for surgical intervention. ALT values ​​increase significantly after chemotherapy.
6. Pancreatitis. With an exacerbation of the inflammatory process in the pancreas, ALT increases. Indicators can increase 3-6 times.
7. Myocarditis (damage to the heart muscle). In addition to an increase in enzyme levels, shortness of breath becomes a striking symptom.
8. Myocardial infarction. Pathology is indicated by a 5-fold increase in ALT values. An increase in time indicates progression of deterioration.
9. Alcoholism. There is an increased concentration of ALT, which increases after drinking alcohol.
10. Muscular dystrophy. ALT values ​​can increase 8-9 times.

Extremely high rates are provoked by acute hepatitis: exceeding the norm at once.

Other reasons

In addition to diseases, physiological reasons also act as factors causing upward deviations in ALT values. Among them:

• exceeding permissible physical activity;
• drinking alcohol before the examination;
• stressful situations;
• eating fatty, fried, spicy foods.

Increased rates are observed during pregnancy. A slight deviation is considered natural.

Uncontrolled use of medications significantly affects the results of the analysis. Therefore, if possible, you should refrain from using them before performing the analysis.

How to get your numbers back to normal

The exceptional information content of the results of blood biochemistry on ALT, which allows diagnosing a wide range of pathological conditions, does not provide grounds for independently drawing conclusions and making decisions.

This prerogative should be left to qualified doctors.

The fundamental principle in an integrated approach to eliminating the problem is further examination in order to determine the root cause of the deviation from the norm. Having found out which disease served as the trigger for the increase in values, the doctor will choose the right treatment tactics.

Diseases with a particularly severe clinical course require a course of treatment in a hospital setting.

These include:

• pancreatic necrosis;
• extensive myocardial infarction;
• acute and infectious hepatitis;
• cirrhosis;
• oncology.

The treatment of each of them is specific and requires strict adherence to the doctor’s recommendations.

Drug treatment

Among the most effective medications used specifically to lower enzymes in the blood, hepatoprotectors should be noted:

Drugs in this group prevent further destruction of liver cells and other organs. At the same time, they restore cells damaged by the pathological process.

Other measures

In addition to taking hepatoprotectors, choleretic agents and drugs that improve digestive processes, it is recommended to adhere to the following diet:

• meals should be small and frequent;
• Fatty, fried and spicy foods should be excluded from the diet;
• smoked meats and sausages are prohibited;
• It is not recommended to use marinades or get carried away with pickles;
• food should be steamed, baked, simmered or boiled;
• limit the consumption of strong tea and coffee;
• exclude alcohol and smoking.

About the use of traditional methods

As auxiliary agents, it is allowed to use decoctions and infusions of chamomile, thyme, St. John's wort, and peppermint.

However, you should consult your doctor before using them.

The greatest harm comes from self-medication and irresponsible attitude towards one’s health.

To avoid serious consequences caused by late contact with a specialist, you should do a blood test 1-2 times a year. This will allow you not to miss the onset of the destructive effects of liver, pancreas and heart diseases on the body.

Increased alanine aminotransferase (ALT) in the blood

ALT belongs to a class of transferase enzymes that are involved in the transfer of certain chemical molecules, thereby catalyzing biochemical processes. Normal ALT levels and activity are extremely important in the ornithine cycle, the main task of which is the formation of non-toxic urea from ammonia.

In healthy people, the blood serum contains a relatively small amount of ALT (0.1-0.68 µmol/h·ml or 3-26 IU).

The highest content of ALT is in the liver (in the cytosol of cells); in lower concentrations, this enzyme is found in the following tissues:

Based on a high level of ALT, a laboratory diagnosis of cytolytic syndrome is made, which characterizes liver damage with destruction of the integrity of its membrane and the release of intracellular enzymes into the blood. At the same time, ALT is more specific for diagnosing liver pathologies than AST. To monitor the condition of a patient with pathology of the hepatobiliary tract, it is more appropriate to determine the level of ALT in the dynamics of treatment.

Determination of the concentration of this aminotransferase is carried out on an empty stomach, the material for the study is venous blood.

The main indications for prescribing this laboratory test are the following:

• diagnosis and evaluation of the effectiveness of treatment of liver diseases;
• clarification and differentiation of pathologies of the pancreas and biliary tract;
• monitoring the condition of patients suffering from viral hepatitis;
• differential diagnosis of suprahepatic and hepatic jaundice;
• donor screening.

An increase in ALT occurs in the following cases:

• Non-alcoholic fatty liver disease (steatosis): the level of this aminotransferase increases slightly - 2-3 times. When the disease transitions to the steatohepatitis phase, there is a marked increase in ALT, high levels of total and direct bilirubin, as well as indicators of inflammatory blood activity.
• Acute viral and toxic hepatitis, in which the concentration of ALT increases 20 times or more. In some cases of Botkin's disease, an increase in the concentration of this enzyme in the blood may precede icteric discoloration of the skin. With viral hepatitis B and C, the ALT level can increase even 100 times, characterizing the toxic effect of the virus on liver cells. In people with chronic hepatitis, an increase in the level of the described enzyme can serve as a marker of a new exacerbation of the disease. However, in the latter case, ALT increases no more than 3-5 times. At the same time, the concentration of AST, alkaline phosphatase and total bilirubin in the blood increases due to the direct fraction.
• In liver cirrhosis, the increase in ALT is quite small (1-5 times the increase above the upper limit of normal). This is due to the active replacement of liver cells with connective tissue.
• In some cases, an increase in ALT may occur with metastatic liver disease. In this case, the level of the described enzyme in the blood reflects the area of ​​the lesion. In hepatocellular carcinoma, ALT levels increase slightly, which complicates the diagnosis of this disease. If primary liver cancer is suspected, in addition to the study of ALT and AST, it is recommended to prescribe a determination of alpha-fetoprotein.
• Rarely, an increase in ALT can be observed in cases of obstructive jaundice, but high values ​​of this indicator are extremely rare. To clarify the diagnosis, it is recommended to study GGT and alkaline phosphatase. With biliary tract obstruction, the increase in ALT is accompanied by an increase in AST, and this process is transient (a decrease in the activity of these enzymes occurs within 72 hours).
• A slight increase in ALT can occur in the following pathological conditions: infectious mononucleosis, myocardial infarction, severe widespread burns, sepsis, acute pancreatitis, late gestosis, myocarditis, heart failure, shock, alcoholic hepatitis, acute lymphoblastic leukemia.

It is important that in addition to diagnosing alcoholic liver damage, the de Ritis coefficient (AST/ALT) is used in the diagnosis of myocardial infarction. Moreover, its value also exceeds 1.3.

In acute and chronic inflammatory liver diseases, the de Ritis coefficient is less than 1.0. This fact is explained by the higher content of ALT in the blood serum compared to AST.

Muscle injuries, polymyositis and dermatomyositis can distort the results of laboratory tests and lead to a false increase in ALT. In this case, determining the level of CPK (an enzyme specific to muscle tissue) will help determine the final diagnosis and choose the right treatment tactics. In some cases, an increase in ALT is associated with intramuscular injections performed the day before. Also, an increase in the level of the described aminotransferase is typical for patients with a body mass index exceeding 30.0. However, in the latter case, the increase in ALT is most likely due to the development of non-alcoholic fatty liver disease.

Some medications can increase the level of ALT in the blood, such as estrogens, oral contraceptives, cholestatics, iron salts, nicotinic acid, sulfonamides, methyldopa, azithromycin, aminoglycosides, cephalosporins, fluoroquinolones, clofibrate, clindamycin. An increase in the level of ALT when using the above pharmacological agents by more than 2.5 times requires correction of treatment with the abolition of the hepatotoxic drug.

ALT blood test is elevated: causes and diseases

Periodically, the person is sent for a blood test. This may be preceded by some complaints, or simply a routine examination during medical examination. Sometimes, purely by chance, an increase in the level of alania aminotransferase (or ALT for short) is detected, which is a specific protein found and produced inside cells. That is why, if suddenly, as part of a simple biochemical blood test, it is revealed that the ALT level is elevated, then this may indicate a number of diseases.

What is ALT

What role does ALT play in the blood?

Before moving on to what deviations in the analyzes will mean and what their cause is, it is necessary to become better acquainted with the component itself and understand what role it plays in the human body.

It should be noted right away that this enzyme is produced exclusively inside cells and enters the blood in limited quantities, because, in fact, it is no longer needed. And if, for some reason, an increased content of it was noticed in the blood test, then this indicates deviations in the functioning of the entire system.

The main function of alanine amine transferase is the metabolism of amino acids.

In addition, it acts as a catalyst for reversible alanine transfers. Alanine is needed in the body to be converted into glucose. In addition, alanine plays a major role in supplying the brain with nutrients, and also strengthens the immune system, produces lymphocytes and regulates the metabolism of sugar and acids.

Most of the enzyme can be seen in organs such as the heart, kidneys, liver, lungs and pancreas. Scientists have discovered an unusual feature. Enzyme activity is much higher in the male body than in the female body.

When is a blood test for ALT prescribed?

Blood test appointment

As mentioned above, the level of alanine aminotransferase is determined in a simple biochemical blood test. And that’s why sometimes there are no special appointments.

But in order to find out more accurately what the level of the enzyme is in the blood, you need to take an ALT test, which your doctor can prescribe if:

• There is a suspicion that the person has hepatitis.
• A person quickly gets tired and at the same time feels constant weakness, which is a very dangerous symptom.
• A person gradually or abruptly loses his appetite, while he feels nauseous, and sometimes has the urge to vomit.
• Signs of jaundice appeared.
• It is necessary to identify the effect of medications on the liver to prevent the development of jaundice. This is usually done during treatment with strong drugs, which can negatively affect many organs.
• A person abuses alcoholic beverages.

A doctor can prescribe an ALT test simply by suspecting some kind of ailment, because in most cases they are all related to the liver, kidneys, and heart. And if there are deviations in the tests, namely an increase in alanine aminotransferase in the blood, then it means that the problem actually exists.

Normal indicators

Normal ALT level in blood

Separately, it is necessary to say about the normal levels of alanine aminotransferase in the blood. They are different for men, women and children, and also directly depend on age.

If we talk about children, the level of alanine aminotransferase in the blood should be within the range (measured in U/l):

• In newly born babies up to five days of life, the ALT level normally does not exceed 49.
• In children from the 6th day of life to six months, the ALT level normally does not exceed 56.
• In children from six months to one year, the ALT level is normally no higher than 54.
• In children aged one to three years, the ALT level normally does not exceed 33.
• In children aged three to six years, the ALT level normally does not exceed 29.
• In children from six to twelve years of age, ALT levels normally do not exceed 39.

At the same time, it is in children that slight fluctuations in indicators are possible, which are due to uneven growth (some children at 12 years old are already going through the stage of puberty, while others are not, some at 6 years old will be 126 cm tall, others 112, etc.). Over time, as growth slows and organ development stalls, enzyme levels will settle to normal levels. As for women and men, the indicators for them are slightly different, because in males the enzyme is more active than in women.

In women, the normal level of ALT will be up to 30 U/L, but in men it is 40 U/L.

Sometimes this happens. That ALT levels in the blood may not be within normal limits and not due to some inflammatory processes, this can be affected by taking medications (of a certain group), as well as increased physical activity.

Increased performance

Elevated ALT levels in the blood

By taking a simple blood test, every person hopes that everything is fine. But sometimes it happens that one of the indicators is higher than normal. Moreover, sometimes this is a slight deviation, and sometimes it is several times larger.

Depending on how much the deviation was detected, the severity of the disease will depend. Thus, few people pay attention to a deviation of one or two units, since this may be due to simple physical workload. But if the level of alanine aminotransferase is several times higher, then you should undergo a more complete examination to find out the reason.

It is believed that when alanine aminotransferase increases approximately 5 times, it is possible to stage a myocardial infarction, when heart cells die. If the level is increased by 10 or even 15 times, then the patient’s condition after an attack (myocardial infarction) has sharply worsened.

An 8-fold increase in enzyme levels may indicate muscular dystrophy and dermatomyositis, diseases no less dangerous than myocardial infarction.

In patients with hepatitis, the rate increases a record number of times and reaches 20-50. Separately, it is necessary to say about the acute stage of pancreatitis, when ALT is increased by 3 or 5 times.

As a rule, not only the level of alanine aminotransferase in the blood increases. Along with it, other important indicators are also deviated from the norm.

More information about the ALT blood test can be found in the video.

Reasons for increased ALT

There are a number of reasons, other than certain medical conditions, that can cause enzyme levels to increase.

• Taking certain medications, including antibiotics.
• Eating fast food, especially before taking a blood test.
• Damage to any muscle.
• Drinking alcoholic beverages a week before the blood test for ALT.
• Emotional stress, which can lead to disruptions in the functioning of the nervous system, and as a result, the body’s reaction to this.
• Greater physical activity as a result of intense training.
• The operation was performed shortly before the test.
• Chemotherapy sessions.
• Poisoning of the body with dangerous metals, such as lead.
• Psychological shock.
• Drug use, and this can be either once or several times.

Of course, mostly the enzyme level increases due to other health problems, but it is for the above reasons that the indicator can be increased, but only slightly.

Diseases and increased ALT in the blood

In most cases, elevated ALT indicates the presence of some serious disease, for example:

• Hepatitis. With hepatitis, especially if it is of viral or alcoholic origin, the level of alanine aminotransferase increases many times. This phenomenon can be noticed even a week before the first symptoms appear. If we talk about hepatitis A, then it is the increase in ALT that makes it possible to identify the infection at an early stage.
• Liver cancer. In this case, the level of the enzyme is significantly increased, since the malignant tumor disrupts the functioning of the entire organ. And if the level of alanine aminotransferase in the blood is significantly increased, doctors may even postpone surgery due to the risk of complications.
• Pancreatitis. When the level of the enzyme in the blood increases, doctors can diagnose an exacerbation stage. And therefore, people suffering from the disease have to undergo tests throughout their lives in order to notice the onset of an attack in time.
• Myocarditis, during which, in addition to an increase in ALT, shortness of breath and fatigue are also observed.
• Cirrhosis. With liver cirrhosis, the ALT level increases slightly, about 5 times. And if the patient suffers only from pain in the liver area, this analysis will help make a diagnosis and detect the problem.
• Myocardial infarction, during which, due to damage to the heart muscle, ALT levels may rise, but only slightly.

If the ALT blood test is elevated, then a more complete examination is necessary to identify the cause of this change. And the sooner this is done, the much more prosperous the outcome will be.

Alanine aminotransferase (abbreviated as ALT) is an enzyme that acts inside cells and is involved in the breakdown of keto and amino acids. The maximum concentration of ALT is observed in the liver, kidneys, muscle tissue, pancreas and heart. If some abnormalities appear in the functioning of these organs, the blood immediately releases a large amount of the enzyme ALT.

Analysis of the concentration of alanine aminotransferase in the blood is basic for diagnosing diseases of the liver and some other organs. Laboratory analysis helps identify the disease before its symptoms appear.

Indications for alanine aminotransferase analysis

Main reasons for ordering analysis

The main indications for a doctor to prescribe a blood test for alanine aminotransferase are:

• liver disease research;
• diagnosis of the donor's condition;
• monitoring the dynamics of viral hepatitis;
• diagnosis of diseases of the pancreas and gall bladder;
• detection of hepatic and hemolytic jaundice.

Possible symptoms to get tested

It is necessary to test the blood for ALT concentration if the following symptoms are present:

• increased fatigue;
• body weakness;
• nausea or vomiting;
• decreased and complete lack of appetite;
• yellowness of the skin, whites of the eyes;
• dark color of urine;
• stool discoloration;
• painful sensations in the abdomen;
• bloating.

Risk factors

• previous hepatitis or contact with a patient with hepatitis;
• hereditary prevalence of liver diseases;
• excessive alcohol consumption;
• taking medications that have a toxic effect on liver cells;
• excess weight;
• diabetes mellitus

A doctor may order an alanine aminotransferase test if a patient wants to test or improve the functioning of organs such as:

• liver;
• kidneys;
• heart;
• pancreas;
• biliary tract;
• skeletal muscles.

Preparing for the alanine aminotransferase test

For the results of the analysis to be true, the procedure is carried out in the morning, on an empty stomach, 8-12 hours after eating.

Blood alanine aminotransferase level

What are the normal levels of ALT in the blood?

Normally, the concentration of alanine aminotransferase in the blood is quite low. Acceptable ALT levels according to the patient's gender and age are shown in the table.

What can an increase in ALT levels indicate?

An increase in the concentration of alanine aminotransferase in the patient’s blood may indicate processes such as:
• Hepatitis. In viral or toxic forms of the disease, the ALT level increases 20 times or more. After 3 weeks from the onset of the disease, normalization of the enzyme may be observed. Persistent hepatitis in chronic form is also accompanied by an increase in ALT levels.
• Metastases in the liver. Often, when a tumor first appears, there are no noticeable changes in alanine aminotransferase levels. Further, liver metastases make themselves felt by a moderate increase in ALT in the blood.
• Mechanical jaundice. A sharp increase in alanine aminotransferase levels (more than 600 U/l) is observed within 12-72 hours from the onset of the disease.
• Cirrhosis. This disease is accompanied by a slight increase in ALT (1-5 fold increase).
• Liver steatosis. The concentration of alanine aminotransferase increases 2-3 times.
• A slight increase in ALT levels may be observed in acute pancreatitis, severe gestosis in the 2nd trimester of pregnancy, myocardial infarction, myocarditis, shock, alcoholic hepatitis, high-grade burns, and heart failure.

What does a decrease in ALT concentration in the blood indicate?

Reduced levels of alanine aminotransferase in the blood serum can be noted with:

• various neoplasms;
• infections of the genitourinary system;
• alcoholic hepatitis;
• fatty liver infiltration;
• liver metastases;
• liver cirrhosis;
• pyridoxal phosphate deficiency, which occurs from alcohol abuse or poor diet.

What causes ALT levels in the blood to change?

It is important to remember that factors that increase or decrease the concentration of alanine aminotransferase can be:

• muscle injuries;
• rhabdomyolysis;
• dermatomyositis (muscle inflammation);
• polymyositis;
• obesity;
• intramuscular injections;
• taking medications such as aspirin, interferon and others;
• pregnancy.

Serum glutamic pyruvic transaminase (SGPT), now called alanine aminotransferase (ALT), is a liver enzyme that is vital for energy production. It is present in various tissues such as the liver, skeletal muscle and heart. However, it is found in the highest concentration in the liver. When the liver is damaged, ALT leaks from the cells into the blood. Normal ALT levels range from 7 to 56 units per liter of blood. High levels of ALT in the blood can indicate liver problems and damage, but it can also be increased by exercise. If you're concerned about persistently high ALT levels, eating the right diet, lifestyle changes, and treatment if needed can help normalize your levels. Start with step 1 to lower your ALT levels.

Steps

Part 1

1. Get more vitamin D. A damaged liver allows ALT to leak into the blood. According to a recent study, vitamin D prevents liver damage and helps in reducing ALT levels. People with high levels of vitamin D are less vulnerable to liver disease than those with low levels of vitamin D. Therefore, to prevent liver disease, it is worth including at least one fruit and vegetable in every meal to get your daily dose of vitamin D.

   • Good sources of vitamin D include green leafy vegetables, cod liver, fish, fortified cereals, oysters, caviar, tofu, soy milk, dairy products, eggs, mushrooms, apples and oranges.

2. Eat a plant-based, nutrient-rich diet. Consuming natural foods helps regulate liver function, allowing it to detoxify and create new cells to stop ALT leaking into the blood. These foods are often rich in antioxidants, vitamins, and minerals, in addition to being low in fat—in other words, they're great for your entire body. Build your diet from fresh, whole foods that you prepare yourself. Stay away from foods that have undergone unnecessary processing that strips them of nutrients.

   • Make sure your diet has enough color. Your diet should include not only green leafy vegetables, broccoli, carrots, zucchini and a variety of fresh fruits, but also nuts, whole grains, low-fat dairy products and lean meats.

3. Avoid foods high in fat. Fatty foods make it difficult for the liver to process nutrients in general. The liver should normally have a certain amount of fat, but if your liver contains more than 10% fat, the condition is called fatty liver disease. The presence of these fat cells can lead to inflammation in the liver and damage to surrounding liver tissue. If the liver is damaged, the damaged liver cells release ALT into the bloodstream, increasing its levels.

   • It is best to avoid fatty foods such as those that are deep fried, meat fats, pork and chicken skin, coconut oil, butter, cheese, processed foods, sausages, bacon, junk food and carbonated drinks.

4. Avoid foods high in salt or sodium. Excessive salt in the body, especially in the liver, causes swelling and fluid retention. This makes it harder for the liver to filter waste. Over time, this can cause liver damage, which allows ALT from the liver to leak into the blood, increasing its levels.

   Part 2

   Make Lifestyle Changes

   1. Give up alcohol Alcohol is very harmful to the liver, and with prolonged use, the liver can completely stop working. When alcohol enters the body, it goes directly into the bloodstream. All the blood is then taken in and filtered by the kidneys. The liver filters all toxic waste from the body, including toxins from alcohol. This can cause serious liver damage over time. The more damaged the liver is, the more ALT can leak from liver cells into the blood.

      • Alcohol consumption is one of the main causes of liver diseases such as hepatosis, liver cirrhosis and hepatitis. Monitor yourself to avoid exacerbation of diseases caused by too much alcohol consumption - this will help you reduce the flow of ALT into the blood.

   2. Exercise daily. Simple exercises such as brisk walking, jogging and swimming can improve your overall health and help your liver stay healthy. Stay physically active to help your body eliminate toxins through sweating. Exercise also helps you burn fat, which will help you stay in shape. Thanks to exercise, your muscles will be developed and your organs, including your liver, will be healthy; your whole body will be in first-class condition. The fewer toxins the liver has to cleanse, the more energy it can use to strengthen cells.

      • Do at least 30 workouts a day, which will have a positive effect on your liver. When fewer toxins enter the body, the workload of the liver decreases, and ALT levels remain normal.

   3. Quit smoking . Cigarette smoke contains toxins such as nicotine and ammonia. When you are exposed to these toxins, they become trapped in the skin and are absorbed, increasing the workload on the liver, which is supposed to rid the body of all toxins. Additionally, second-hand smoke should also be avoided, as it has similar effects.

      • Smoking negatively affects not only ALT levels, but also the heart, lungs, kidneys, skin, hair and nails. Moreover, the people around you probably don’t like this habit either. If your ALT level is normal, then quit smoking for these reasons alone.

   4. Prevent exposure to other harmful chemicals. Soot from air pollution contains fumes from gasoline and ammonia, among other harmful chemicals, that disperse into the air. If you live or work in an area where you are regularly exposed to these toxins, reduce your exposure as much as possible. These toxins can seep into the body through the skin, causing liver damage and increasing ALT levels.

      • If you must be around toxic fumes, wear long sleeves, pants, a mask, and gloves at all times. The more precautions you take, the healthier you will be - especially in the long term.

   5. Lose extra pounds if you are overweight or obese. Excess weight increases the risk of fatty liver disease, which in turn can lead to increased ALT levels. Talk to your doctor about safe and effective ways to lose weight, or ask your doctor to refer you to a good nutritionist.

      • Sport is the most effective and safe way to lose weight for most people. You should also reduce your portions and avoid processed foods. Discuss with your doctor what will be most useful and effective in your case.

   Part 3

   Medical assistance

   1. Get your blood tested. ALT levels are measured in the blood. In cases of acute liver injury, ALT levels rise sharply as they leak through cell walls into the blood. However, increases in ALT levels should be carefully monitored because they may increase in association with recent exercise or strenuous activity.

      • A high ALT level does not confirm the diagnosis of liver damage. It should be considered along with other liver tests and examinations to check whether the patient is actually suffering from liver damage.
      • ALT levels can be higher or lower - it all depends on the diseases that affect it. For example, nonalcoholic fatty liver disease is the leading cause of moderately elevated ALT levels in the United States. Fatty liver disease is a disease associated with obesity and insulin resistance. Moderately elevated ALT levels can be caused by intense exercise or thyroid disease.

   2. Stop taking over-the-counter medications. If your liver is already damaged and you are still taking medications that your doctor did not prescribe, the organ is overworked to metabolize those drugs and filter out harmful substances that can further contribute to liver damage. It is best to take only the medications prescribed by your doctor.

      • If in doubt, consult your doctor. There are drugs that are hepatotoxic (toxic to the liver); Perhaps a specialist will offer you non-hepatotoxic drugs.
      • Medicines such as antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) may increase ALT and AST levels. It is advisable to talk with your primary care physician about the different types of medications to prevent possible liver damage.
      • Be especially careful when using medications containing paracetamol. Paracetamol is a common ingredient in many over-the-counter medications, including pain relievers and cold and flu remedies.

   3. Consider taking corticosteroids. These drugs work by reducing the activity of the body's immune system. They also reduce inflammation by reducing the production of inflammatory chemicals to reduce tissue damage. They can be taken orally or injected into a vein. The most common corticosteroids are hydrocortisone, prednisolone, and fludrocortisone.

      • When inflammation decreases, liver cells begin to regenerate, so the release of ALT into the bloodstream decreases.
      • Talk to your doctor about using corticosteroids. No treatment should be started without your doctor's approval.

   4. Take antiviral medications. The liver may be damaged due to an infection caused by a virus, such as occurs with hepatitis. Once you have a blood test, your doctor will know that a virus may be the underlying cause of the infection and will prescribe antiviral drugs such as entecavir, sofosbuvir, telaprevir and others.

      • They work in the same way as corticosteroids. Once the infection is cleared, liver cells will begin to regenerate, so the release of ALT into the bloodstream will be reduced.

Before you start talking about the enzymes that the liver produces, you need to understand the question of what this organ is, what functions it performs and why it is needed in the body.

A little about the structure of the liver and its functions

The liver can rightfully be called the largest gland and the largest organ of our body. In addition, the liver is the most patient organ - the destruction of even 70% of the tissue does not entail the loss of the gland’s functionality.

The liver occupies the entire right hypochondrium and extends slightly onto the left half of the ribs. The shape of the liver can be compared to a mushroom cap - its upper part is convex due to its tight fit to the diaphragm and the back surface of the ribs, and the lower part is slightly concave, because this side of the liver is tightly adjacent to the stomach, duodenum and colon. On the outside, the liver is covered with a dense and smooth capsule; it is in it that the nerve endings are located, and the pain syndrome that occurs with various liver injuries comes from here.

The liver consists of many cells called hepatocytes, which perform a large number of functions - digestive (produce bile), neutralize (neutralize all toxins that enter the blood), metabolic (participates in the metabolism of proteins, fats and carbohydrates), hematopoietic (during prenatal fetal life).

It is also worth mentioning the storage function of the liver - this is where many fat- and water-soluble vitamins, for example A, D, B12, microelements, and especially iron, copper and cobalt, are stored. In addition, the liver can accumulate most of the blood in its tissues and, in urgent need, it releases it into the vascular bed to replenish the required volume and maintain blood pressure at the proper level.

What is the role of the liver in metabolism?

The liver is a real chemical laboratory, because... tissues contain a large list of enzymes that are actively involved in the production of many blood proteins (albumin and globulins), amino acids, fats, urea, and glycogen. When there is a lack of proteins in the body, the liver generously shares its reserves with other organs and blood. The role of the liver is also great in the balance of hormones, because it is here that the oxidation of sex hormones, adrenaline, and histamine occurs.

Naturally, with such a large number of functions performed, it is not at all surprising that the slightest breakdown in the liver can affect the normal functioning of all other organs. But how do you find out what exactly “broke” in the liver?

How to understand what is happening to the liver?

Quite often, a doctor can judge liver disorders only by indirect symptoms - heaviness or discomfort in the hypochondrium, bitterness in the mouth, belching, yellowing of the skin, enlarged liver. The most accurate diagnosis can only be made by studying the liver tissue, and for this you need to do a biopsy, which is not possible in all cases. Every doctor understands that the effectiveness of treatment and the patient’s health depend on the accuracy of the diagnosis.

Most often, in liver diseases, cytolysis of hepatocytes occurs; in other words, liver cells, under the influence of any aggressive factors, are destroyed and die. The activity of this process can be judged by the patient’s external manifestations and a biochemical blood test.

The following symptoms indicate cytolysis of liver cells:

• Yellowing of the skin and conjunctiva of the eyes;
• Nausea, bitterness in the mouth;
• Heaviness and dull pain in the right hypochondrium;
• Enlarged liver;
• Fever, weakness, lethargy, weight loss.

These symptoms help the doctor first of all to suspect problems in the liver and to roughly assess the degree of cytolysis activity. The more symptoms a patient has and the more pronounced they are, the more active cell death occurs.

To confirm the diagnosis and clarify the processes occurring in liver pathology, a biochemical blood test is always prescribed. Its meaning is to determine the content of basic substances in the blood that are produced or synthesized with the direct participation of the liver. Normally, these substances (they are also called indicators of cytolysis) are much more in the liver cells than in the blood, but when hepatocytes are destroyed, they rush into the blood. Indicator substances primarily include liver enzymes and bilirubin (free and bound).

Indicator enzymes:

1. Alanine aminotransferase (ALT);
2. (AST);
3. Aldolase;
4. Lactate dehydrogenase (LDH);
5. γ-glutamyl transpeptidase (GGT).

Not only their quantitative content in the blood is important, but also the ratio of these substances to each other, for example, AST/ALT, GGT/AST, (ALT + AST)/GDH, LDH/AST, ALT/GDH.

The easiest way to assess the degree of cytolysis is to find out the level of alanine transferase.

The norm of alanine transferase in blood serum is 0.10−0.68 mmol/(h*l) or 1.7−11.3 IU/l.

Minimal necrosis of hepatocytes is usually not accompanied by changes in biochemical analysis. If alanine aminotransferase (ALT) is three times higher than normal, then a mild degree of hepatocyte cytolysis is indicated; if its level increases by 3–10 times, moderate cytolysis is indicated, and an increase in ALT of more than 10 times indicates a severe liver condition and extensive cell necrosis.

It is worth saying that these are general indicators typical for adults. In children, especially newborns, the normal ALT level will be significantly higher than in adults. To put it simply, what is the upper limit of acceptable values ​​for adults is the norm for a newborn. The norm for children from 0 to 6 months of age for alania aminotransferase is approximately 12.0−15.0 IU/l.

During a normal pregnancy, all blood parameters change in the direction of their decrease; during this period, pregnant women undergo a serious restructuring of the body, which immediately affects the main biochemical indicators. During pregnancy, ALT is considered normal in the range of 1.5−8.2 IU/l. However, during a difficult pregnancy with symptoms of toxicosis in the second half, ALT levels may rise above normal.

However, these indicators can vary significantly, as well as their measurement values. This mainly depends on the methods used for diagnosis. The doctor is usually aware of the methodology used in the institution and always interprets the data obtained taking these features into account.

Reasons for increased alaniaminotransferase

The reasons for increased alania aminotransferase may lie both in the liver and in other organs. But still, the most common culprits for increasing ALT are the liver and heart.

• Cell necrosis due to any reason;
• Acute and chronic hepatitis;
• Cholangitis;
• Fatty liver degeneration;
• Cirrhosis;
• Obstructive jaundice;
• Liver tumors;
• Toxic liver damage;
• Acute fatty liver degeneration during pregnancy;
• Pancreatitis;
• Burn disease;
• Infectious mononucleosis;
• Hemolytic disease;
• Extensive injuries to skeletal muscles (ruptures, crushing);
• Dermatomyositis;
• Myocarditis;
• Myocardial infarction;
• Myopathy.

Some chemicals, for example, anticoagulants, fluorothan, ethanol, hormonal contraceptives, sulfonamide drugs can also cause alanine aminotransferase to be increased in the blood.

Reasons for decreased alanine aminotransferase

Diseases in which alanine aminotransferase is reduced are somewhat smaller and, as a rule, they are less associated with liver pathology.

• Infections of the genitourinary organs;
• Tumor formations of various localizations;
• Alcoholic hepatitis;
• Insufficient formation of pyridoxal phosphate due to poor nutrition and excessive consumption of alcoholic beverages.

In addition, not only the level of ALT, but also AST, as well as their ratio, is of great importance. These parameters are very important for making a correct diagnosis and developing treatment tactics.

Treatment of elevated alanine aminotransferase

You need to understand that they are treating laboratory tests, and the patient with his disease. Therefore, in order to normalize basic biochemical tests, you need to find the cause and begin treatment immediately. And the doctor, first of all, thinks not about how to reduce ALT levels, but about how to most effectively influence the disease.

Based on the fact that an increase in ALT always signals damage to cells, especially hepatocytes, in treatment, in addition to drugs that act on the cause of the disease, it is necessary to use hepatoprotectors, i.e. drugs that can protect liver cells from aggressive influences.

Also, every doctor understands that in case of active cell death, drugs that have a hepatotoxic effect cannot be prescribed. In other words, drugs that can aggravate further necrosis of hepatocytes are not used.

Plant hepatoprotectors protect liver cells most effectively.