Act analysis. The norm of alt and ast in the blood and the reasons for the increase in indicators

Good day to all my readers! Today we will talk about elevated AST and ALT levels in the numbers of a biochemical blood test. People are interested in what this means, especially since the analysis itself is new, carried out not so long ago. It is especially important on Mondays, when people get tests, I have already understood this from my own practice.

What is ALT and AST

Analysis for ALT in most cases comes with AST. For them, the norm is the same. These abbreviations mean the presence in the blood plasma of the enzymes alanine aminotransferase (ALT) and aspartic aminotransferase (AST).

Their activity is considered in conventional units, since it is difficult to accurately determine their concentration in the blood even with modern devices. They are counted by enzymatic activity. I will not describe how the calculation is going on, this is not necessary for us, ordinary people.

These enzymes work inside the cells of our body. Their role is to transfer groups of atoms from one amino acid to another. That is, they perform transport functions. The second name of these enzymes is transaminases. ALT is an alanine transaminase and AST is an aspartic transaminase.

These enzymes are present in all cells, some more, others less. Liver cells have the highest concentration of ALT, and heart cells have more ACT enzymes . In other tissues, the indicators are also different.

These enzymes enter the blood only from the destroyed cells. This means that an increased level of AST and ALT enzymes in the blood indicates that the process of cell destruction is underway in the body. If ALT is elevated, it means that the liver is experiencing certain problems, you need to pay attention to this and take measures to improve it.

If AST is elevated, that means there are some problems in the heart. You need to pay attention to this body.

Norms of ALT in the blood

for women up to 31 units

for men up to 41 units

AST norms in the blood

for women up to 31 units

for men up to 41 units

These are, so to speak, average values for the average person leading a normal life. The norm is not an ideal, but with these indicators people live and feel more or less tolerable.

How much can it increase

If, according to the results of the analyzes, you have some kind of excess, then it is important to imagine how much it has deviated from the norm.

If the indicator is 2-5 times higher than the norm, then this is a moderate increase - it will probably need additional analysis after a while to track the dynamics.

If the indicator is 6-10 times higher, then this is an average increase - consultation with a doctor is recommended.

If the indicator is more than 10 times higher than the norm, then this is a high increase - you need to contact a specialist.

Reasons for increasing AST and ALT

The increase in performance is influenced by viruses, various hepatitis - medicinal and alcoholic, heart attacks, pancreatitis. In general, any health problems are reflected in these indicators.

Therefore, a comprehensive health assessment is required., and it can only be given by your attending physician, or a specialist who deals with you on the problem with which you turned to him.

Increased ALT or AST for no reason

Check your medications, probably among them there is one that can give a side effect on the liver. This is the most common reason for this kind of increase. Most often, ALT can increase from taking statins - cholesterol-lowering drugs.

Experts also advise consult a hepatologist or gastroenterologist. Doctors will prescribe drugs to protect the liver (hepatoprotectors) and treat the gastrointestinal tract.

Elevated ALT during pregnancy

Sometimes you have to deal with the fact that ALT can be elevated in a woman during pregnancy. This is acceptable, and if a woman is under the supervision of a doctor, then there should be no cause for concern. Plus, if you feel relatively normal, then the indicator should be considered only as a signal of pregnancy, no more.

Video - why is the alt analysis increased?

Friends, I am publishing this video solely for your familiarization with the information that the specialist gives. All phone numbers and contacts of clinics present in the video have nothing to do with me.

conclusions

Elevated levels of AST and ALT on a biochemical blood test indicate that the process of cell destruction is underway in the tissues of the heart and liver.

Avoid harmful effects drugs, alcohol, fatty and fried foods. Visit a hepatologist and gastroenterologist who will prescribe you recovery procedures.

But once again, it is not worth drawing any terrible conclusions from this analysis. Do not scare yourself and loved ones ahead of time. It is necessary to find out the cause of the increased indicators by additional examinations, and even then, if they are prescribed by your doctor. If the specialist does not see a reason for concern, then you do not need to worry.

In the comments, you often write your test results, but I will not give you any recommendations. There is an excess of the norm, but what caused it, I will not tell you.

How to lower your ALT levels- pay attention to oatmeal jelly. I talked in detail about the recipe for cooking here, follow the link and cook. Indicators should, if not return to normal, then go down. Oats have a good hepatoprotective effect.

A blood test is an important diagnostic criterion; according to its results, a doctor can tell a lot not only about the general condition of the patient, but also about the health of specific organs. In particular, biochemical analysis can tell about the liver if you carefully consider its AST and ALT parameters. Let's dwell on them in more detail.

Aspartate aminotransferase (AST)

The substance is an enzyme that facilitates the transport of amino acids within the human body. AST (synonyms AST, AST) is present in the cells of the whole organism, but most of all it is observed in the liver and heart, slightly less in muscle tissue, kidneys, spleen and pancreas. The functions of the enzyme also include participation in the processes of bile production, the production of the necessary protein structures, the conversion of nutrients, and the breakdown of toxic compounds. The norm of the state of the blood provides for a minimum amount of the enzyme in the bloodstream, with a change in the level, it can be assumed that there is a serious pathology. Changes in the value of AST are noted earlier than the specific symptoms of diseases.

Increasing the indicator

An elevated AST level is observed in a person if the following phenomena are present:

Liver pathologies (from hepatitis to cirrhosis and cancer);
Disorders in the work of the heart (heart attack, failure of the heart rhythm);
Thrombosis of large vessels;
The appearance of areas of necrotization (gangrene);
Injuries (mechanical damage to muscles), burns.

Reasons for a low increase in AST may indicate significant physical activity or the presence of a recent injection or oral use of a drug, vaccine, or vitamin.

Decrease in indicator

Diagnostic value is not only an increased level of AST, but also its decrease. Liver ruptures are called the most common cause of the condition, but the value may fluctuate downward during pregnancy or a lack of vitamin B6, which is involved in the transport of aspartate.

Normal value

The norm of the AST level differs depending on the research methodology. The results obtained with different methods of determination cannot be compared with each other. Please note that the test system is indicated by the laboratory in the analysis form. This also means that each laboratory has its own reference values, which may differ from the norms adopted in other laboratories.

Result AU 680

For children under the age of one month, the AST norm is 25–75 units per liter. In older patients (up to 14 years of age), the average range is 15–60.

In adult men and women, the norm is different:
For men - 0-50.
For women - 0-45.

Result Cobas 8000

The AST indicator is also recalculated per liter of blood and is measured in arbitrary units:

Alanine aminotransferase (ALT)

ALT (synonyms ALT, ALT), like AST, is an enzyme, but alanine aminotransferase is responsible for moving the amino acid alanine from one cell to another. Thanks to the enzyme, the central nervous system receives energy for its work, immunity is strengthened, and metabolic processes are normalized. The substance is involved in the formation of lymphocytes. Normally, ALT is present in the blood in small amounts. The highest concentration of the enzyme is observed in the tissues of the liver and heart, a little less - in the kidneys, muscles, spleen, lungs and pancreas. A change in the content of ALT in the blood is observed in serious diseases, but can also be a variant of the normal state.

Increasing the indicator

In a biochemical blood test, ALT can be elevated as a result of the following pathologies:

Damage to the liver and biliary tract (hepatitis, cirrhosis, cancer, obstruction);
Intoxication (alcoholic, chemical);
Diseases of the heart and blood vessels (ischemia, heart attack, myocarditis);
Blood diseases;
Trauma and burns.

The ALT value may increase after taking medications, eating fatty foods or fast food, intramuscular injections.

Decrease in indicator

In a biochemical blood test, a decrease in the ALT index may be observed, this indicates a lack of vitamin B6, which is involved in the transport of alanine, or severe liver pathologies: cirrhosis, necrosis, and others.

Normal value

Like AST, ALT in the blood is determined by several methods, the laboratory indicates it in the test result form. Studies performed using different methods cannot be compared with each other.

Result AU 680

In children under one month of age, the ALT norm is 13–45 units per liter of blood.

In children older than one month and adults, normal ALT values vary by gender:

Men - from 0 to 50 units;
Women - from 0 to 35 units.

Result Cobas 8000

According to this test system, the value of the norm of the indicator depends on the age of the person and his gender:

All values are indicated in units per 1 liter of blood.

When is a study ordered?

The doctor may order a biochemical analysis to study the level of AST and ALT enzymes if there are signs of liver damage or some factors that can affect its work.

Common symptoms of liver disease:

loss of appetite;
cases of vomiting;
The presence of a feeling of nausea;
Pain in the abdomen;
Light color of feces;
Dark color of urine;
Yellowish hue of the whites of the eyes or skin;
The presence of itching;
General weakness;
Increased fatigue.

Risk factors for liver damage:

Alcohol abuse;
Hepatitis or previous jaundice;
The presence of liver pathology in close relatives;
Taking potentially toxic drugs (anabolic steroids; anti-inflammatory, anti-tuberculosis, antifungal drugs; antibiotics and others);
Diabetes;
Obesity.

An analysis of AST and ALT enzymes can be performed to assess the effectiveness of treatment (if the elevated level gradually decreases, a positive effect of drug therapy is diagnosed).

Features of diagnostics

For diagnostic purposes, not only the fact of changes in the blood parameters of AST and ALT is important, but also the degree of their increase or decrease, as well as the ratio of the number of enzymes to each other. For example:

An increase in both indicators (AST and ALT) in the analysis by 1.5–5 times indicates myocardial infarction.

If the ratio of AST / ALT is in the range of 0.55–0.65, it can be assumed that viral hepatitis is in the acute phase; an excess of 0.83 indicates a severe course of the disease.

If the AST level is much higher than the ALT level (the AST/ALT ratio is much greater than 1), then alcoholic hepatitis, muscle damage, or cirrhosis may be the cause of such changes.

To exclude errors, the doctor must also evaluate other blood parameters (in the case of liver pathology, this is bilirubin aminotransferase dissociation). If there is an increased level of bilirubin against the background of a decrease in the level of the enzymes in question, then an acute form of liver failure or subhepatic jaundice is assumed.

Rules for the delivery of a biochemical blood test

Failure to follow the rules for preparing for analysis can lead to knowingly false results, which will necessitate an additional examination and a long procedure for clarifying the diagnosis. Preparation includes several main points:

Delivery of the material is carried out on an empty stomach in the morning;
Exclude fatty, spicy foods, alcohol and fast food the day before donating blood;
Do not smoke half an hour before the procedure;
Eliminate physical and emotional stress the night before and in the morning before blood sampling;
You should not take the material immediately after radiography, fluorography, physiotherapy, ultrasound or rectal examination;
It is necessary to tell the doctor about all medications, vitamins, dietary supplements and vaccinations taken before prescribing a biochemical study.

Diagnosis of diseases based on the results of a blood test is a complex process that requires appropriate knowledge, so the interpretation of the results must be entrusted to qualified doctors.

A biochemical blood test, deciphering AST and ALT allow you to assess the condition of the internal organs, heart muscle and liver. AST (AsAt) and ALT (AlAT) are transaminases, enzymes that serve to transport amino acids. AST and ALT are contained in healthy and intact cells of the internal organs, especially a lot of these enzymes in the liver, skeletal muscles and heart muscle. If, as a result of the disease, these cells are destroyed, the enzymes enter the bloodstream. This is how a biochemical blood test allows you to detect pathological changes in the work of internal organs. Which doctor prescribes an AST and ALT blood test?

Gynecologist, to control the course of pregnancy.
Endocrinologist, for hyperthyroidism.
Gastroenterologist, to monitor the state of the liver and pancreas.
Cardiologist, to examine the heart.
Nephrologist, when it is necessary to evaluate the condition of the kidneys.

In women, liver enzymes are screened once per normal pregnancy. If there is an indication, such as chronic liver disease, blood tests may be done more frequently. A biochemical blood test for liver enzymes takes into account not only AST and ALT, but also other substances:

bilirubin;
alkaline phosphatase;
lactate dehydrogenase;
creatine kinase;
gamma-glutamyltransferase.

Evaluation of the volume of a number of enzymes makes the study more reliable.

1 Biochemical composition of blood

The biochemical composition of blood in a healthy person is sensitive to any changes in the functioning of internal organs. Therefore, a blood test is very informative and allows you to detect diseases in the early stages, when there are no obvious symptoms yet. In what cases is an analysis for AST and ALT prescribed?

With gestosis in pregnant women. Preeclampsia is a serious complication during pregnancy, which jeopardizes the bearing of the fetus until the term of delivery. Preeclampsia is characterized by an increase in blood pressure, exhausting nausea and indomitable vomiting, headaches and abdominal pain. Analyzes of women with preeclampsia show an increase in AST and ALT by tens and even hundreds of times.
Hepatitis. Viral and alcoholic hepatitis destroy liver cells, causing enzymes to be released into the blood. A blood test detects the presence of hepatitis before jaundice sets in. In acute viral hepatitis, the results of AST monitoring show an increase of up to 500-3000 conventional units per liter of blood (U/L). After infection with the hepatitis virus, AST and ALT levels rise and reach peak values after 2-3 weeks. In severe cirrhosis, tests show AST and ALT much lower than normal. In addition to hepatitis, blood biochemistry can determine mononucleosis, cancer, and other liver tumors.
Heart diseases. Especially clearly the change in the level of AST and ALT is seen in myocardial infarction. 6 hours after the attack, an increase in the volume of enzymes circulating in the blood begins, peak values are reached after 48 hours, and within 6-8 days the enzymes return to normal. This dynamic is used to evaluate cardiac muscle damage in ischemic disease, myocardial infarction, myocarditis, and pericarditis.
Other diseases. The level of AST and ALT increases with massive hemorrhages, burns, skeletal muscle injuries, hemolytic anemia and pulmonary infarction. As a result of hypoxia, pain or mental shock, the level of ALT and AST can be increased hundreds of times relative to normal.

Changes in the biochemical composition of the blood make it possible to assess the severity of damage to internal organs, especially the liver and heart.

In pregnant women, this study allows you to detect preeclampsia, to suggest what complications from the heart and liver can occur during pregnancy and childbirth. If the results of the analysis for AST and ALAT are unfavorable, women are placed on a separate account and regular additional studies are prescribed to monitor their condition and bring the pregnancy to a successful delivery.

What is the norm for ALT and AST analyzes in women and men? About it .

2 How to prepare for the procedure

In order for the tests to show the real situation, you need to follow the rules for preparing for blood donation:

Alcohol and drugs should not be consumed 1 week before the analysis, since any intoxication affects the volume of enzymes.
For 2-3 days you need to limit stress, excitement and conflict situations.
2-3 days before donating blood, you need to give up intensive physical work, sports training, jogging, weight lifting. This limitation is due to the fact that skeletal muscle microtrauma can give a false increase in AST and ALT.
Stop eating 10 hours before blood sampling. Usually, the analysis is carried out in the morning, so it is undesirable to have breakfast, especially sweets. You can drink plain water, you can not drink strong coffee, tea, energy drinks.
If the patient or patient takes any medications on an ongoing basis, be sure to inform the attending physician about this. It is not necessary to stop taking medications unnecessarily, but information about medications will be taken into account when interpreting the results. A blood test, the decoding of which is carried out by the attending physician, will be informative only if the results are correctly interpreted. The doctor should deal with the decoding, since only he is aware of the entire clinical picture and can take into account all the factors that affect the level of ALT and AST in the blood.

The results of the analysis are affected by acetylsalicylic acid, which is part of Aspirin and some other painkillers.

Paracetamol, which is found in the drug Paracetamol and many non-steroidal anti-inflammatory drugs, can also affect. Vitamin B6 intake changes the analysis data especially strongly, so the doctor must be aware of all the medications that the patient uses.

3 Effects on enzymes

In a healthy adult, fluctuations in ALT and AST in the blood during the day are within 10-30% relative to the norm. What affects the volume of enzymes?

pregnancy in the 1st trimester;
the use of alcohol and drugs;
chronic diseases of the liver, kidneys, pancreas and thyroid glands, heart and blood vessels, skeletal muscles;
taking medicines, vitamins, hormonal contraceptives;
physical activity and overwork, intense sports training;
mental stress, shock, stress, chronic sleep deprivation, nervous strain.

Typically, test results are reported in conventional units per liter (U/L), but some laboratories may use other measurement systems. When converting from one system to another, you need to take into account the rules for converting units in order to get correct results. AsAT and AlAT in the blood, the norm for adults:

for men - 39-41 U / l;
for women - 29-31 U / l.

For pregnant women in the 1st trimester, the indicator may differ from the norm by 5-10% in favor of an increase or decrease. This is not a pathology and does not indicate any serious disease. Fluctuations in the level of AST and ALT are due to the fact that the development of the fetus requires a large amount of vitamin B6, which is involved in the synthesis of transaminase.

When there is not enough vitamin B6, the body takes it from the cells of the liver and muscles, so enzymes are released into the blood. In order to compensate for the increased load on the body that pregnancy gives, special vitamin complexes are prescribed for women. If after the 1st trimester the AST and ALT are still higher or lower than normal, the gynecologist assumes gestosis and prescribes additional studies to clarify the clinical picture. In a normal pregnancy in the 2-3 trimester, the level of enzymes should be from 29 to 31 U / l. This allows us to conclude that the liver, heart and kidneys of a woman do an excellent job of maintaining a pregnancy.

4 De Ritis index

For diagnosis, not only the absolute values of AST and ALT are important, but also their ratio. The de Ritis index is denoted DRr. This is the coefficient that will be obtained if the values of AsAT (AST) are divided by the values of ALT (ALT). Normally, DRr should be equal to 1.3. Fluctuations in a healthy person up or down are 0.42. How to interpret the results of analyzes if the de Ritis index does not match the norm?

if DRr is greater than 1.3, hepatitis can be assumed;
if DRr is less than 1, dystrophic changes occur in the liver;
if DRr is greater than 2, cirrhosis or myocardial infarction can be assumed.

It should be understood that tests for AST and ALT are not used in isolation, but in combination with other studies. When examining the liver are used:

general clinical blood and urine tests;
blood test for cholesterol;
blood test for liver enzymes (including AST and ALT);
Ultrasound of the liver, gallbladder and bile ducts.

Enzymes tend to break down, for ALT and AST the half-life is 12-24 hours, therefore, when monitoring the patient's condition, analyzes are carried out no more than 1 time in 2 days. To diagnose heart diseases, in addition to a biochemical blood test, an ECG is mandatory.

5 Pathological processes

In pregnant women, tests often show reduced levels of liver enzymes. If the decrease is more than 10%, you need to undergo a complete liver examination, take tests for hepatitis, exclude cirrhosis. Liver disease can be asymptomatic as long as the body can compensate for the breakdown of liver cells. This is followed by jaundice and liver failure. The benefit of ALT and AST tests is that they detect pathological processes in the liver even before adverse symptoms appear. The most common reason for a decrease in ALT and AST in the blood of pregnant women is an acute lack of vitamin B6. You can suspect this violation by the following signs:

About blood test AST and ALT

Biochemical blood test for ALT, ALAT, AST in women, men: what is it, the norm

Pregnant women consume B6 much more than any other person. In the usual case, no special food supplements are required to obtain this vitamin, but in women during pregnancy, even good nutrition may not cover the costs that go to the formation of the fetus. In the following cases, injections of B6 in pregnant women are prescribed:

if tests for liver enzymes (AST, ALT and others) differ from the norm;
if there is hepatitis, cirrhosis, HIV, in some cases - with heart disease;
if toxicosis is difficult during pregnancy, preeclampsia develops;
if a woman is taking antidepressants or steroid drugs for another disease.

Only the attending physician should select the dosage and duration of the B6 course. In most pregnant women, a decrease in ALT and AST levels requires vitamin therapy.

If the tests show an increased release of enzymes into the blood, additional studies should be carried out in order to establish the cause of this violation. Therapy of liver diseases is selected by a gastroenterologist or a narrower specialist in the pathologies of the liver, gallbladder and bile ducts - a hepatologist. Heart disease, which often leads to an increase in AST and ALT, is treated by a cardiologist.

Aspartate aminotransferase, AST, AST, or AST in a blood test means the same term in medicine, meaning the content in the human body of an enzyme that is involved in protein metabolism and the breakdown of amino acids. This enzyme is part of many cell membranes, found mainly in the spleen, heart, brain, liver, pancreas, and also in the muscles of the skeleton. But, ast may not show its activity in all organs. Moreover, if ast is elevated, one can think of a rather limited range of possible pathologies. As long as the structure and functions of the cells are not disturbed, and the organs, which mainly contain ast, work fully in the normal mode, the level of the enzyme in question in the blood stream will be minimal and not beyond the norm. An excess release of the ast enzyme into the bloodstream is usually provoked by a violation of the integrity of the cells of a particular organ, as well as a pathological condition that develops in it.

In what situations and under what suspicions a biochemical blood test for AST is prescribed, what does it mean aspatate aminotransferase is increased, and what pathological conditions provoke an excessive release of enzymes into the blood, we will consider all this in the article.

The norm of ast in the blood

To evaluate the results obtained and the intensity of the ast-enzyme in the blood plasma, you need to know how much it should normally be in a healthy person.

Reference values (norm) of the level of aspartate aminotransferase are slightly different in men, women and children. Here are the established limits of the indicator, measured in units per liter (U / l):

from birth to one year - up to 58 U / l;

1-4 years - up to 50 U / l;

4-7 years - up to 48 U / l;

7-13 years - up to 44 U / l;

14-18 years - up to 39 U / l

Adults:

men - no more than 41 U / l;

women - no more than 31 units / l.

It should be noted that slight deviations from the level are allowed in children at the time of active maturation, in pregnant women in the first trimesters of pregnancy, as well as in patients who are treated with drugs and intramuscular injections that affect liver function and provoke an increase in AST activity.

In other cases, if aspartate aminotransferase is elevated, the doctor may suspect the development of extremely serious diseases and pathological conditions.

Causes of increased ast in the blood

Ideally, in a healthy person, the activity of the ast enzyme in the blood should be low. If in the blood test, ast is increased, 5-10 times relative to certain norms, usually this situation is caused by the development of viral infections. Usually, the patient is offered to donate blood several times for a biochemical study in order to exclude the option of a false or temporary deviation. After all, it is not uncommon for aspartate aminotransferase, ast, to be increased as a result of certain conditions, for example:

after an injury or bruise of skeletal muscles received the day before;
after receiving a burn;
after suffering a heat stroke;
after poisoning with poisonous mushrooms.

If the increase in the enzyme is repeated, and is not associated with the above pathological conditions, then it can signal the overtaken serious diseases. Increased ast in the blood causes:

Hepatitis (acute, chronic, viral);
Heart injury (closed or open type);
Myocardial infarction or acute heart failure;
Severe angina pectoris;
Cirrhosis, cancer, liver carcinoma;
Damage to the liver by toxic or hepatotoxic poisons, eg. ethanol or carbon tetrachloride;
Endogenous intoxications inside the body resulting from infectious or purulent lesions of soft tissues and internal organs;
Acute pancreatitis;
Cholestasis (stagnation of bile), as well as the initial cancer of the biliary tract;
Destruction or necrosis of muscle tissue, myodystrophy, myositis, gangrene, etc.;
Launched alcoholism, which led to the death of liver cells.

If the blood test is elevated, what does this mean for a particular person, the doctor must decide, based on several methods of diagnosis and a thorough examination.

As a rule, in order to determine in which particular organ a violation or lesion has occurred, together with aspartate aminotransferase (ast or asat), the level of alanine aminotransferase (alt or alat) is determined. If alt and ast are elevated in the blood test, the reasons most likely lie in the pathological processes occurring in the tissues in which they are present. The ratio of these two enzymes is medically known as the de Ritis ratio. If this parameter is more than 1, then we are often talking about heart diseases, in other cases they talk about liver disorders. Normally, this coefficient should be in the range from 0.9 to 1.8, with a heart attack it can increase 5 times, with hepatitis, on the contrary, fall to 0.5-0.6.

Also, when diagnosing, together with intracellular enzymes, such an indicator as conjugated bilirubin, an increase in which occurs with viral and induced lesions, with cirrhosis, obstruction of the biliary tract, as well as chemical or alcohol poisoning, can be investigated. An increase in alt and ast with normal bilirubin can be with hidden forms of cirrhosis or liver failure, it all depends on how much the level of enzymes is increased. If alat and asat in the blood are increased by less than 2 times compared to the maximum standard value, it is not identified as a dangerous pathological process, in this case, the patient is only recommended to conduct regular monitoring and analysis.

It must be clearly understood that an increase in alt and ast is not an independent disease, but only its consequence. Therefore, in order to lower the enzymes, it is necessary to eliminate the causes of the increase in asat (ast) in the blood.

Take care of your health!

It is necessary to evaluate the AST indicator together with the ALT indicator.. These are the so-called "liver" tests, which can be used to judge the activity of the process. Sometimes an increase in these indicators is the only symptom indicating the development of a serious illness.

Analysis for AST is not expensive, and it can be taken in absolutely any laboratory.

What is ALT in a blood test

ALT, or alanine aminotransferase, in a blood test, is an intracellular enzyme that is involved in cell metabolism, in particular, in the breakdown of the amino acid alanine. Most of all, alanine aminotransferase is found in liver cells, less in the myocardium, skeletal muscles and kidneys.

An increase in ALT in a blood test occurs with any damage to hepatocytes (liver cells). An increase in the enzyme is observed already in the first hours after damage and gradually increases depending on the activity of the process and the number of damaged cells.

An increase in alanine aminotransferase is most characteristic of liver diseases (hepatitis of various origins, toxic damage, cirrhosis, etc.).

Depending on the concentration of ALT in a biochemical blood test, one can judge the degree of hepatitis activity (hepatitis can be with a minimal, moderate or high degree of enzymatic activity), which is necessarily indicated in the clinical diagnosis. It happens that hepatitis occurs without an increase in this enzyme. Then they talk about liver damage without enzymatic activity.

Generally speaking, blood levels of ALT and AST are elevated in hepatitis and reflect the degree of cytolysis - the destruction of liver cells. The more active cytolysis, the less favorable the prognosis of the disease.

AsAT and AlAT norms in a blood test

Reference values are normally very low and depend on gender and age. For example, both indicators are higher for men than for women.

Table of AST and ALT norms for adult men and women:

Reasons for increasing AsAT and AlAT

An increase in alanine and aspartic aminotransferase can be increased in many diseases.

Reasons for an increase in AST in a blood test:

Acute myocarditis;
myocardial infarction;
Pulmonary embolism;
Acute rheumatic heart disease;
Unstable angina;
Various myopathies;
Injuries to the skeletal muscles (severe sprains, ruptures);
Myositis, myodystrophy;
Various liver diseases.

Causes of an increase in ALT in the blood:

Cirrhosis of the liver (toxic, alcoholic);
Acute pancreatitis;
Cholestasis, cholestatic jaundice;
Alcoholic liver damage;
Fatty hepatosis;
Acute and chronic viral hepatitis (hepatitis C, hepatitis B)
Malignant neoplasms of the liver and biliary tract, liver metastases;
Alcoholism;
severe burns;
Taking hepatotoxic drugs (oral contraceptives, psychotropic drugs, anticancer drugs, chemotherapy drugs, sulfonamides, etc.)

If found in a blood test, you should immediately consult a doctor to find out the cause of this phenomenon, since an increase in these indicators often means the presence of serious diseases.

Decreased AST and ALT

In practice, sometimes there are cases when the AST or ALT values become below normal. This can happen with severe and extensive liver necrosis (for example, in the case of advanced hepatitis). A particularly unfavorable prognosis has a decrease in the level of AST and ALT against the background of a progressive increase in bilirubin.

An important reason for the decrease in alanine and aspartic aminotransferase is the depletion of vitamin B6 - pyridoxine.

The fact is that vitamin B6 is necessary for the synthesis of AST and ALT in the norm. The decrease in B6 concentration may be associated with long-term antibiotic treatment. You can make up for its deficiency with the help of drugs (administration of the vitamin intramuscularly) and diet. Pyridoxine is highest in cereal sprouts, hazelnuts, walnuts, spinach, legumes, soybeans, fish, and eggs.

A decrease in liver enzymes can also occur as a result of liver injury (for example, when an organ ruptures). However, such conditions are extremely rare.

The norm of transaminases in a child

The limits of normal values for AST and ALT largely depend on the age of the child:

An increase in the activity of AST and ALT in the blood of a child, as well as in adults, indicates the effect of damaging factors on hepatocytes. But, unlike adults, this increase is rarely associated with acute and chronic hepatitis.

The growth of AST and ALT in the blood of a child may indicate the presence of infectious diseases (leptospirosis, pseudotuberculosis, infectious mononucleosis), congenital malformations.

Often, an increase in liver enzymes is secondary, that is, it develops after some kind of pathology. For example, an increase in the concentration of AST and ALT can occur with myocardial dystrophy, leukemia, lymphogranulomatosis, vasculitis, etc.

It happens that AST and ALT in children increase in response to certain medications. e.g. aspirin, paracetamol. It is also important to remember that AST and ALT may remain elevated for some time after recovery from an infectious disease.

AST and ALT during pregnancy

An increase in AST and ALT during pregnancy may be the first symptom of gestosis, a condition that threatens the life of the mother and fetus. Therefore, even a slight increase in the concentration of transaminases requires urgent medical advice. He will assess the health of the expectant mother, monitor the dynamics and, if necessary, prescribe an examination.

In the blood of a pregnant woman, the concentration of the hormone estrogen increases, which affects the liver (this is especially true for the first trimester). That is why a slight excess of AST and ALT levels in early pregnancy is considered the norm.

As for the third trimester, there should be no increase in transaminases at this time. If during this period there are deviations in the biochemical analysis, it is necessary to examine the woman without delay so as not to miss the onset of the development of preeclampsia.

Preparation for the delivery of the analysis

The result of any biochemical analysis, including a blood test for AST and ALT, largely depends on how to prepare for it.

Rules, observance of which will help to avoid false results of the study:

It is necessary to take tests strictly on an empty stomach, at least after an 8-hour fast. It is allowed to drink pure water in any quantity. Coffee, carbonated drinks, juices and teas are recommended to be excluded for the preparation period. As for alcoholic beverages, they are not recommended to be consumed a week before blood sampling for AST and ALT.
Eliminate foods rich in animal fats from your diet for 3 days. Eat food that is steamed, baked, or boiled. Fried foods must be strictly limited, or better, completely eliminated.
Three days before the proposed analysis, intense physical activity should be canceled.
Blood sampling should be carried out in the morning, from 7 to 11 am.
If you are taking medications, it is advisable to cancel them 3 days before the study. But before that, it is important to consult a doctor.
Try to take tests in the same laboratory.
After receiving the result in your hands, be sure to contact your doctor in order to correctly interpret the results and, if necessary, continue the examination.