Many medications (eg, statins) commonly cause asymptomatic elevation of hepatic enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase).
There are many causes of mildly elevated ALT and AST levels. The most common causes are nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease. In NAFLD, the liver has more fatty tissue in it than normal. Regular or heavy alcohol use can also hurt the liver and increase liver enzymes.
Many medications can cause increases in AST, such as acetaminophen, NSAIDs, ACE inhibitors, nicotinic acid, INH, sulfonamides, erythromycin, and antifungal agents such as griseofulvin and fluconazole. In acetaminophen overdose, transaminase levels greater than 10,000 IU/L are also noted.
Your ALT level is considered high if it exceeds the normal range of 0 to 44 IU/L. Some laboratories may present a slightly different reference interval, but a test result of 55 IU/L or above could indicate liver problems.
Abnormal liver function test with raised alanine aminotransferase (ALT) and raised aspartate aminotransferase (AST) are commonly seen in primary care setting. Chronic alcohol consumption, drugs, non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis are common causes associated with raised ALT and AST.
Acetaminophen. Taking acetaminophen in excess is the leading cause of drug-induced liver injury.
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.
ALT is most commonly increased in response to liver disease or liver damage, caused by alcohol, drugs, supplements, or toxins. Other causes of high ALT include obesity, anorexia, biliary disease, muscle damage and disease, heart attack, hypothyroidism, and infections and diseases that can impair liver function.
Fatigue (feeling tired). Itching. Jaundice (yellowing of your skin or eyes). Light-colored stools (poop).
It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the prevalence of diseases that cause asymptomatic transaminase elevations can help clinicians efficiently identify common and serious liver disease.
It is estimated that alcohol-related fatty liver disease develops in 90% of people who drink more than 40g of alcohol (or four units) per day. That's roughly the equivalent of two medium (175ml) glasses of 12% ABV wine, or less than two pints of regular strength (4% ABV) beer.
However, as your liver loses its ability to function properly, you're likely to experience a loss of appetite, nausea and itchy skin. In the later stages, symptoms can include jaundice, vomiting blood, dark, tarry-looking stools, and a build-up of fluid in the legs (oedema) and abdomen (ascites).
Experimental studies and clinical observations have shown that stress can damage hepatic tissue both directly and indirectly. Many studies have partially revealed the contributors of stress‐induced liver injury; however, the whole process has not yet been uncovered.
Too Much Alcohol
Alcoholic fatty liver, which causes liver inflammation (alcoholic hepatitis), eventual scarring (cirrhosis) and even liver cancer, is a process that begins on as little as four drinks a day for men and two for women. By the time you show symptoms, your liver may be damaged beyond repair.
If you have high levels of AST and/or ALT, it may mean that you have some type of liver damage. You may also have an AST test as part of a group of liver function tests that measure ALT, and other enzymes, proteins, and substances in the liver.
Usually, the upper limit of ALT is 35 - 40 U/L. Moderate increase in ALT (such as 70 U/L) is seen in chronic hepatitis, chronic obstruction of bile ducts, heart damage, alcohol abuse, liver tumor, skeletal muscle damage. In any acute liver conditions, ALT is much more elevated.