Before donating blood fluid for transaminase levels, it is important to properly prepare for the analysis and become familiar with the ALT norm in men and women. After all, alanine aminotransferase is a very important element that helps to identify existing pathologies.

AlAt is a marker enzyme for the liver, which belongs to the class of enzymes. Its amount is measured in units per liter of blood fluid. Transferase is responsible for the exchange of aminocarboxylic acids and serves as a catalyst for chemical reactions.

The protein structure is found in the tissues of the following organs:

• lungs;
• spleen;
• excretory organs;
• myocardium

The ALT enzyme is of endogenous origin and is necessary for the proper functioning of the body.

His role is quite large:

• increases the speed of the metabolic process;
• strengthens defenses;
• provides the body with strength and energy;
• promotes the production of lymphocytes.

Detection of ALT concentration is a common diagnostic method that helps identify liver and vascular diseases. Biochemistry analysis is mandatory for people suffering from obesity and diabetes. It also allows you to monitor the progress of the therapeutic course, showing the success of the drugs used.

How the research is carried out

Blood fluid from the venous system is taken for study before lunch. A person should not eat anything before being diagnosed. More than eight hours must have passed since your last meal. The day before the procedure, you should not drink alcohol or eat fatty or fried foods. It is recommended to reduce active loads.

You should also not take a biochemical test after the following procedures:

• X-ray;
• colonoscopy;
• physiotherapy.

You should stop taking medications 10-14 days before. If this is unacceptable, a note is made during the study regarding the treatment and dosage of medications.

When deciphering biochemistry, the level of aspartate aminotransferase (AST) is also taken into account. There is a Ritis scale, which determines the proportions of two structures: alanine aminotransferase (ALT) and aspartate aminotransferase.

Normally, their ratio is 1.33. The error is no more than 0.42.

If, when dividing AST by ALT, the result is a number less than 1.33, this is a sign of a painful abnormality in the exocrine gland, if higher, this is a symptom of a cardiac disease. Thus, the de Ritis coefficient helps to make a more accurate conclusion regarding a particular patient.

ALT norm in women and men

In the stronger sex, the concentration of transaminases is higher due to better endurance and greater muscular mass. However, men more often suffer from bad habits, eat poorly, and experience stress and nervous strain.

Therefore, the stronger sex is more susceptible to internal pathologies that manifest themselves as excess ALT. In women, the process involving a specific substance does not proceed so quickly.

Thus, the following figures are considered acceptable indicators:

• the minimum norm of ALT in the blood of women is thirty-one units per thousand milliliters of blood, the maximum is thirty-five;
• the lowest threshold for men is forty-one units, the maximum is forty-five.

The slightest deviations from the norm by a couple of units are allowed. After fifty years, alanine aminotransferase is increased due to a deterioration in the metabolic process.

In women carrying a fetus, the norm is from thirty to thirty-two units. The concentration of the substance varies depending on the trimester. The reason for this reaction is hormonal changes in the body.

Especially rises transaminases in the first and last three months of embryo development. Then its performance increases two to three times. If the figure is exceeded tens of times, this indicates the presence of an illness. The level of catalyst in the blood of young children and adolescents differs from the permissible limits in adults.

The accuracy of the result depends on the following parameters:

• equipment manufacturer;
• diagnostic method;
• laboratory materials.

A specialist should judge the final value. You cannot diagnose your illness yourself based on laboratory tests.

Alanine aminotransferase is elevated - what does this mean?

An increased number of ALT in liquid tissue means a disruption of the normal functioning of the body. This usually indicates liver problems. Moreover, the higher the concentration of transaminases, the more advanced the disease.

Indications for diagnostic testing for ALT are some signs:

• pain on the right side of the chest;
• general malaise;
• lack of desire to eat;
• dark colored urine;
• light stool;
• yellowing of the skin and eyeballs.

Timely detection of an increase in the concentration of an element will make it possible to eliminate alarming signs and correctly make a diagnosis in order to prescribe quality therapy.

Causes of increased enzyme levels in the blood

An increase in catalyst levels may be associated with certain pathological processes:

1. Hepatitis. It is a liver inflammation that causes a modest excess of the substance.
2. Steatosis. A pronounced increase in protein structure is observed in steatohepatitis.
3. Pancreatitis. A strong deviation from the norm indicates an exacerbation of inflammation of the pancreas.
4. Myocarditis. Along with an increase in protein structure, shortness of breath and severe fatigue are present.
5. Clinical form of ischemia. The disease manifests itself due to impaired blood flow and causes tissue necrosis.
6. Oncological disease. Often results from hepatitis.
7. Cirrhosis. The disease usually does not have a clear clinical picture.
8. Muscle degeneration. With it, the indicators of the substance can increase 7-8 times.

Analysis of biological fluid shows an increase in ALT immediately after drinking ethanol-containing drinks and in alcohol dependence. There are other reasons for increased ALT, which are triggered by external factors.

These include:

• taking estrogens, anabolic steroids, contraceptive pills;
• loads that are too heavy;
• nervous exhaustion;
• taking niacin;
• drug addiction;
• chemical therapy;
• injuries;
• poor nutrition (consumption of soda, fast food).

These factors provoke a modest increase in the marker enzyme in cells.

What to do when ALT in the blood is elevated

In case of deviation from the ideal designation, it is necessary to carefully examine the body using MRI, CT, and ultrasound. The sooner a diagnosis is made, the better the prognosis.

Typically, the following medications are taken to reduce the catalyst in liquid tissue:

• Tykveol;
• Prohepar;
• Hepatosan;
• Karsil.

These drugs protect the liver from destruction and regenerate damaged tissue. In addition to taking medications, it is recommended to adhere to a special diet, excluding spicy, fried and fatty foods from the diet. It is forbidden to indulge in pickles, pickled foods, smoked meats and sausages. It is important to remove strong tea and coffee from your diet, and eliminate alcohol and other bad habits.

As additional measures, it is permissible to use decoctions and infusions from the following plants:

• mint;
• thyme;
• milk thistle;
• immortelle;
• dandelion;
• corn silk;
• chamomile.

It is important to talk to your doctor before starting self-medication. In order not to miss the development of serious pathologies, you should take a biochemical blood test from a vein 1-2 times a year.

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.

Enzyme synthesis occurs inside cells. Alanine aminotransferase is mainly found in liver and kidney cells. Smaller amounts are found in heart and muscle cells. In a normal state, only a small part of the enzyme is found in the blood.

Damage to liver tissue cells leads to the release of ALT and its entry into the bloodstream. An increase in the level of this enzyme in most cases is an indicator of pathologies of the liver tissue. helps identify the disease before other characteristic signs appear, such as jaundice.

Enzyme rate

Under normal conditions, the level of alanine aminotransferase in the blood is quite low.

For women it is 31, for men it is slightly higher – 41.

In childhood, the figures are significantly higher.

• in newborns up to the fifth day of life, the enzyme level is considered to be up to 49;
• for babies from 5 days to 6 months of age the figure is 56;
• from 6 months to 1 year – 54;
• from one year of age to 3 years – 33;
• 3 years – 6 years – 29;
• from 6 to 12 years – 39;
• from 12 to 17 years of age, the indicator already begins to change depending on the gender of the child:

For girls, the norm is 24, for boys - 27.

Reasons for increased ALT levels

The main reason for an increase in alanine aminotransferase levels is liver damage - for example, in various forms of hepatitis or. In this case, cytolysis (destruction of cells) occurs, as a result of which the enzyme contained in them penetrates into the blood, where it is detected during laboratory tests. ALT levels increase more than the levels of another enzyme, AST (aspartate aminotransferase).

1. The highest rates are recorded for acute hepatitis (toxic, viral, etc.). In this case, the indicator can exceed the norm by 20, sometimes even 100 times. With hepatitis A, the enzyme level begins to increase long before the onset of jaundice (2-3 or more weeks). The level returns to normal after 3-3.5 weeks. If present, the indicator changes unpredictably: it can either sharply increase or decrease, but then returns to normal.
2. The level of alanine aminotransferase also increases with obstructive or obstructive jaundice. Moreover, changes occur spasmodically: in a short period of time, the indicator can reach a significant level or change to a small extent. Sometimes the indicator reaches 600 units and begins to decrease, returning to normal in 2-3 days. This phenomenon is very typical for this type of jaundice.
3. Liver steatosis (fatty degeneration of the organ) leads to an increase in ALT by 2 or 3 times.
4. Liver cirrhosis also causes a twofold or threefold increase in alanine aminotransferase levels.
5. With metastasis of the liver tissue, slight jumps in ALT levels are observed, while the primary tumor in many cases may not have any effect on this indicator.
6. With alcoholic hepatitis, ALT increases no more than 6 times.

Among other reasons that influence the level of alanine aminotransferase, it is necessary to mention:

• myocardial damage (myocarditis, myocardial infarction) - in this case, AST increases more than ALT;
• heart failure;
• in the acute stage;
• pregnancy (increased enzyme levels are observed mainly during the second trimester);
• states of shock;
• severe burns;
• lymphoblastic leukemia (is a malignant pathology of the hematopoietic system);
• (leads to an almost tenfold increase in ALT);
• necrosis of skeletal muscles;
• myositis;
• muscular dystrophy;
• primary carnitine deficiency;
• obstruction of the biliary tract;
• hepatic ischemia, leading to a slowdown in blood flow to the liver;
• infections of viral origin.

In most cases, the ALT level is higher than the AST level. Thus, the ratio of the levels of these two enzymes will be low. The exceptions are:

• cirrhosis;
• alcoholic hepatitis;
• damage to muscle tissue.

High alanine aminotransferase levels may be associated with long-term (in some cases even short-term) use of certain medications. The reason is their toxic effect on liver cells. In most cases, this phenomenon is observed when using the following medications:

• cholestatics;
• anabolic steroids;
• estrogen preparations and oral contraceptives;
• nicotinic acid;
• mercaptopurine;
• metohifuoran;
• methyldopa;
• methotrexate;
• sulfonamides;
• salicylates;
• sulfonylurea drugs;
• fibrates;
• psychotropic drugs;
• immunosuppressants;
• means for chemotherapy, anesthesia;
• antitumor drugs.

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

Reasons for the analysis

1. Analysis for alanine aminotransferase is prescribed primarily in the case of diagnosing liver pathologies and diseases associated with the pancreas and bile ducts.
2. It is very important to carry out this analysis during monitoring the effectiveness of treatment for viral hepatitis and for examining contacts within the focus of viral hepatitis.
3. The level of this enzyme is also determined for differential diagnosis between two types of jaundice: hemolytic and hepatic.
4. The analysis must be carried out during the examination of donor blood.
5. The level of alanine aminotransferase is determined in the case of pathologies of the heart muscle and heart failure.
6. This indicator is also determined for diseases of skeletal muscles.

It should be noted that normal ALT levels do not prove the absence of liver pathologies.

Analysis is mandatory if the following symptoms are present:

• fatigue;
• weaknesses;
• nausea;
• vomiting;
• loss of appetite;
• yellowing of the skin, whites of the eyes;
• darkening of urine;
• discoloration of feces;
• pain in the abdominal area;
• bloating.

An alanine aminotransferase test is recommended in the presence of risk factors that contribute to the development of liver pathologies:

• history of hepatitis or contact with a patient with hepatitis infection;
• hereditary predisposition to liver diseases;
• alcohol abuse;
• taking medications that have a toxic effect on liver cells;
• overweight;
• diabetes mellitus

This indicator must be determined periodically during treatment to monitor its effectiveness.

Treatment

In order to lower the level of ALT, treatment of the disease that provoked the high level of the enzyme is first necessary. Some medications are used at the same time:

• hepatoprotectors;
• choleretic;
• means to improve digestion.

If an increase in alanine aminotransferase concentration is a consequence of the use of sulfonylureas, it is necessary to reconsider the course of treatment. Patients are prescribed medications that do not reduce the amount of vitamins B6 and B12.

If high ALT levels are caused by long-term therapy with fibrates and salicylates, they must be completely eliminated. If the patient suffers from a chronic pathology that requires the constant use of these drugs, it is necessary to find alternative drugs that do not affect ALT levels.

It should be noted that treatment takes a fairly long period of time, during which biochemical studies of blood composition are periodically carried out.

Alanine aminotransferase (also ALT, AlAT) is a protein enzyme that is responsible for transporting certain molecules and accelerating biochemical processes involving amino acids.

ALTs are found mostly in organ tissue cells. In healthy people, ALT in the blood cannot be elevated, since if ALT is released into the blood, a serious disease is probably occurring in some part of the body.

Most of ALT is found in the liver; it can also be found in the kidneys, heart muscle, nerve connections, and lungs. Damage to the listed organs and tissues can cause an increase in ALT in the blood.

Optimal value in the body

This parameter is measured in units per liter of blood. ALT is age dependent in childhood and gender dependent in adults.

Children under one year: no more than 55 units/l

Children 1-3 years old: no more than 34 units/l

Children 3-6 years old: no more than 30 units/l

Children 6-12 years old: no more than 39 units/l

Men: no more than 45 units/l

Women: no more than 35 units/l

The norm in this case is not a strict only possible value, but an approximate evaluation criterion. In some laboratories, devices may have varying degrees of sensitivity, which means the results of the analysis should be discussed with the attending physician of this medical institution.

Alanine aminotransferase is elevated, what does this mean?

According to the degree of difference between the actual result of the analysis and the value accepted as the norm, the following are distinguished:

• Slight increase (200-500%);
• Moderate increase (up to 1000%, that is, 10 times more);
• Pronounced (more than 10 times the norm).

The second and third stages most likely indicate that increased ALT in the blood is a consequence of the disease, and the third case occurs in those patients in whom serious organ destruction has already begun.

In addition to the diseases that we will discuss below, elevated ALT may be associated with the following confounding factors:

• Muscle injuries;
• Burns;
• Intramuscular injections given the day before;
• Heavy weight (body mass index exceeds 30);
• Taking medications (estrogens, antibiotics, cholestatics, heparin, oral contraceptives, anti-epileptic drugs, warfarin, echinacea, valerian, etc.);
• Mononucleosis;
• Pregnancy (third semester), provided that the ALT level is slightly increased;
• Chemotherapy;
• Drug use;
• Lead intoxication;
• Laboratory inaccuracies.

In order to get a reliable result, you need to donate blood on an empty stomach, 12 hours after your last meal. Refrain from alcoholic beverages a week before going to the clinic, and from smoking an hour before donating blood. Try not to worry or become physically overloaded. If you doubt the reliability of the blood test, take it to another laboratory.

To determine whether ALT is normal or elevated in the blood, blood is often taken from a vein, but in some cases also from capillaries.

Causes and diseases when ALT is elevated in the blood

Since the enzyme under study can be retained in various organs, it may indicate problems with their health. Let’s look at what “ALT is elevated” means in each specific case.

1. Liver diseases

The largest amount of ALT, as already mentioned, is located here; it is not surprising that this analysis is recognized as a timely detection and treatment of liver diseases.

• Steatosis

The accumulation of fat in liver cells affects the fact that ALT is increased by 2 times. But if the painful condition worsens to steatohepatitis, ALT will increase much more, and bilirubin levels will also increase.

• Hepatitis

If ALT is elevated in a blood test, but symptoms of the disease have not yet appeared, it may be hepatitis A. Symptoms usually linger, and through timely blood testing, the recovery process can be accelerated.

With hepatitis B and C, ALT increases even 100 times, since the toxic effect of the virus distributed in the liver is especially great on its cells.

Chronic hepatitis causes an increase in ALT during an exacerbation, but the increase usually occurs no more than 3-4 times.

Other symptoms of hepatitis include pain and discomfort in the right side, under the ribs, a bitter taste in the mouth, yellowing of the skin, mucous membranes, whites of the eyes, and abnormal bowel movements.

• Cirrhosis

Very high ALT in the blood may not be observed in cirrhosis. ALT will increase, but 1-5 times the norm. This is explained by the replacement of liver cells with connective tissue.

• Liver cancer

Typically, malignant tumors in the liver appear in people with hepatitis. The extent to which alanine aminotransferase is elevated helps decide whether to further treat the cancer with surgery. For example, if ALT is very high, the operation has a high risk of complications.

• Autoimmune hepatitis

A disease more common among women than men. To clarify its presence or absence, the doctor may prescribe a biopsy.

1. Heart

Diseases of the heart, or rather the heart muscle, are primarily indicated by another analysis - AST, but along with it, ALT is also used for diagnosis.

• Myocardial infarction

Death of part of the heart muscle, as a result of which a certain amount of AST and ALT enters the blood. If the AST analysis is greatly increased and alanine transaminase is increased by 5 times, the reasons should be sought in the possibility of myocardial infarction.

Other symptoms: sharp pain in the area of ​​the heart, radiating to the left upper side of the body, the pain can last for half an hour or more, the patient experiences shortness of breath, dizziness, panic fear of dying, weakness.

• Myocarditis

Just as for other diseases of the heart muscle, myocarditis cannot be diagnosed solely on the basis that ALT is elevated. The reasons for this can be varied. Often, to clarify the diagnosis, an AST analysis is also considered and the de Ritis coefficient equal to ALT/AST is calculated.

Symptoms include shortness of breath, weakness, and rapid fatigue of the patient.

Heart failure, rheumatic heart disease, and recent heart surgery can also cause an increase in ALT in the blood.

1. Pancreas

• Pancreatitis

The disease can occur in acute or chronic form. An increase in ALT indicates an exacerbation stage. It is advisable for people suffering from pancreatitis to regularly donate blood for an ALT test.

Elevated ALT in a blood test can be an alarm bell of some serious and even destructive diseases, or it can be a common mistake or a normal reaction of the body. Your further examination will determine the speedy diagnosis and possible treatment.

Leave your comments with questions and suggestions below.

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 diseases 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. For evaluation the Ritis coefficient is applied (AST/ALT ratio), 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:

1. Liver (most of all);
2. Kidneys;
3. Lungs;
4. Pancreas;
5. Muscles;
6. Heart.

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, increasing ALT levels occurs in the following cases:

1. . 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. . This disease is dangerous because it may not have pronounced symptoms for a long time. Patients quickly become 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. . 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. . 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, a myocardial infarction can be assumed; if it reaches 10-15 times, we can talk about a deterioration in 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 by 20-50 times, 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 reasons:

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.

What to do when ALT in the blood is elevated?

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.

Most often, hepatoprotectors are prescribed to reduce ALT levels:

1. Heptral;
2. Essentiale N;
3. Karsil;
4. Tykveol.

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.