An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
What ALT level is considered high? The upper limit of normal for ALT is 55 IU/L. When an ALT level is double to triple the upper limit of normal, it is considered mildly elevated. Severely elevated ALT levels found in liver disease are often 50 times the upper limit of normal.
A normal AST:ALT ratio should be <1. In patients with alcoholic liver disease, the AST:ALT ratio is >1 in 92% of patients, and >2 in 70%. AST:ALT scores >2 are, therefore, strongly suggestive of alcoholic liver disease and scores <1 more suggestive of NAFLD/NASH.
Normal serum ALT is 7–56 U/ L [2]. Any type of liver cell injury can reasonably increases ALT levels. Elevated values up to 300 U/L are considered nonspecific.
Mild, asymptomatic elevations of alanine transaminase (ALT) and aspartate transaminase (AST) levels, defined as less than five times the upper limit of normal, are common in primary care.
People can lower their ALT levels by making lifestyle changes, such as taking regular exercise and changing their diet. Increasing fiber intake, reducing saturated fats and processed foods, as well as consuming a range of nutrients from fruits and vegetables may all help to lower levels.
An ALT test result of >100 IU/l is a clear indicator of serious liver disease, but a mildly elevated ALT result (30–100 IU/l) is often ascribed to the use of medication (for example statins) or alcohol, obesity, or, for lower ALT levels (<50 IU/l), considered as part of the normal distribution of test results.
In general, high levels of ALT may be a sign of liver damage from hepatitis, infection, cirrhosis, liver cancer, or other liver diseases. The damage may also be from a lack of blood flow to the liver or certain medicines or poisons.
The alanine aminotransferase (ALT) is a specific marker for liver inflammation and is typically elevated in individuals with a fatty liver. If your ALT test results are elevated, your doctor may order additional blood tests to check for other conditions including viral hepatitis.
Normally, levels of ALT in the blood are low. Very high levels of ALT (more than 10 times normal) are usually due to acute hepatitis, sometimes due to a viral infection. In acute hepatitis, ALT levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal.
Typically, ALT levels in these conditions can be two-to-five times the upper limit of normal, which is around 40 IU/l in most hospitals. Occasionally ALT levels can rise to levels of >1,000 IU/l.
Elevated liver enzymes might be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated.
Can Stress Cause Elevated Liver Enzymes? Stress and anxiety are proven to contribute to high liver enzyme levels since they can reduce blood flow to the liver.
Chronic alcohol consumption, drugs, non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis are common causes associated with raised ALT and AST. In chronic viral hepatitis, the elevation of liver enzyme may not correlate well with the degree of liver damage.
In healthy individuals, ALT levels can vary 10 to 30% from one day to the next. ALT levels can fluctuate 45% during a single day, with highest levels occurring in the afternoon and lowest levels at night. A high body mass index can increase ALT levels by 40 to 50%. Reference range is 14 - 63 IU/L.
An abnormally high level generally indicates that the liver cells are damaged and releasing their contents into the bloodstream. High ALT levels (300 units per litre (U/L) or more) are often caused by acute viral hepatitis.
Higher consumption of fast foods (> 11.39% kcal/week) was associated with elevated ALT to AST ratio (OR: 3.27; 95% CI: 1.90–5.63) and elevated ALT (OR: 2.74; 95% CI: 1.57–4.76).
Liver-associated enzymes
Determine alkaline phosphatase, total bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels to search for evidence of gallstone pancreatitis. An ALT level higher than 150 U/L suggests gallstone pancreatitis and a more fulminant disease course.
10–40 IU/L. High. >36 U/L. >1,000 U/L are very high levels and may be a sign of liver injury or hepatitis. >40 IU/L which may be a sign of liver inflammation.
Normal Results
The normal range is 4 to 36 U/L. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your health care provider about the meaning of your specific test results.