What Does It Mean When You Have High ALT?

High ALT blood test levels may indicate several issues.

Alanine transaminase (ALT), originally named serum glutamic pyruvic transaminase (SGPT), is an enzyme fundamentally found in the liver and kidney, which our bodies utilize to break down food into energy.

Normally, ALT levels in the blood are low; however, when the liver cells are damaged, they discharge excess ALT into the blood making ALT blood tests high.

• An ALT test helps estimate the measure of ALT in the blood.
• ALT is typically estimated simultaneously with aspartate transaminase (AST) as a feature of a liver function panel to decide the source of organ damage.

The possible causes of high ALT levels in the body include liver disease, alcoholism, obesity, muscle damage, heart failure, and more.

Mild elevation in ALT levels may not cause symptoms, although if your blood test returns with ALT levels high, you need to find the cause and address it. If suspected liver damage is the cause of increased alanine transaminase levels, you might have symptoms such as:

• Abdominal pain especially in the right upper area
• Dark-colored urine
• Exhaustion (feeling tired)
• Itching
• Yellowing of skin or eyes (jaundice)
• Light-colored stools (amelanotic stool)
• Loss of appetite
• Weight loss
• Nausea and vomiting

The doctor will interpret your alanine transaminase (ALT) result, considering your clinical history, symptoms, and other lab tests.

Some of the common causes of high ALT levels in the blood include:

1. Liver disease. ALT levels increase because of liver diseases such as:
   • Fatty liver or nonalcoholic fatty liver disease
   • Viral hepatitis (usually results in extremely high ALT levels)
   • Autoimmune hepatitis
   • Reduced blood flow to the liver
   • Liver cancer
2. Alcoholism. Liquor breakdown negatively affects liver health and gets your ALT elevated, by causing free radical damage and increased levels of inflammatory markers (TNF-α). In the long run, excessive liquor consumption prompts liver cell death, which allows ALT out of the liver into the bloodstream.
3. Liver damage due to drugs, supplements, and toxins. Many medications can increase ALT by causing liver damage. Over-the-counter and doctor-prescribed medications are among the most widely recognized reasons for high ALT blood test results. Too much iron in the blood (hemochromatosis) can also damage the liver.
4. Obesity. ALT is regularly high in individuals who are obese. Visceral fat is more harmful than general obesity and frequently occurs with conditions such as diabetes and liver infection.
5. Muscle damage. Because a modest amount of ALT is stored in the muscle cells, muscle injury and diseases can likewise make ALT leak into the blood and increase its levels.
6. Drugs. Anti-cholesterol drugs (statins), overuse of acetaminophen (Tylenol), overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil, Motrin), antibiotics such as fluoroquinolones and cephalosporins, and vitamin A overdose among others, can make ALT blood tests high.
7. Heart failure. ALT and aspartate transaminase may be often elevated in cases of heart failure due to engorgement in liver blood vessels.
8. Alpha-1 antitrypsin deficiency. This is an enzyme required for cellular functions of the lungs and liver. Genetically inherited alpha-1 antitrypsin deficiency may cause liver and lung damage making your ALT levels high.

If your alanine transaminase (ALT) levels are high, it is important to identify the cause and treat any underlying conditions.

Improved lifestyle or dietary modifications can help prevent and treat high ALT blood test levels, which include:

1. Drinking coffee. Drinking coffee can help lower ALT levels, which may be due to the caffeine content that has liver-protecting properties or antioxidant properties.
2. Regular exercise. Exercising daily might assist with improving liver health. Research suggests being physically active is a significant factor in treating liver diseases.
3. Losing excess weight. Weight reduction is a significant factor in treating fatty liver disease and preventing fibrosis of the liver. Weight reduction further develops insulin sensitivity and reduces inflammation. Normal exercise, alongside a decrease in calories, may likewise lessen the danger of liver cancer.
4. Increasing folic acid consumption. A folate deficiency may cause damage to the liver and possibly have a connection to liver cancer. Thus, people can work on their liver health by eating food sources high in folate, such as:
   • Beef liver
   • Spinach
   • Black-eyed peas
   • Fortified breakfast cereals
   • Asparagus

When should I worry about high ALT?

When to worry about ALT levels depends on how much higher it is above the normal values and the reason for it. For instance, treatment with some medications can make your ALT levels high, the doctors monitor this side effect, and levels typically come down with the completion of treatment. If your lifestyle is the reason for it, you can control your ALT by making lifestyle modifications. If your ALT levels are high because of reasons such as liver damage, heart disease, or other conditions, you should take corrective steps and treatment.

The normal range for ALT may vary from laboratory to laboratory but is usually less than 50 IU/L. According to the recommendations of the American Association for the Study of Liver Diseases (AASLD), the upper limit of normal (ULN) for ALT is 35 IU/L for men and 25 for women. ALT elevated up to 100 IU/L is considered mild elevation, and may be due to alcohol use, obesity, and/or medication. This can be reverted with diet, exercise, weight loss, and other lifestyle changes. An ALT level that's above 100 IU/L clearly indicates serious liver disease and must be treated appropriately.

How do you fix high ALT levels?

High ALT levels can usually be fixed by lifestyle modifications unless the liver disease has progressed to liver cirrhosis.

Some ways to fix high ALT levels are:

• Avoid or at least cut down alcohol consumption.
• Eat a liver-friendly diet (cut down on fats and eat more vegetables and fiber; coffee is believed to help too).
• Exercise regularly and manage your weight.
• Keep your blood fat levels in control.
• Increase your folic acid intake.
• Avoid overuse of acetaminophen (Tylenol).
• Make sure that you are not taking any supplements that can affect the liver. Discuss with your doctor if any of your medications could be the reason for high ALT, and what you could do about it.

What happens if ALT count is high?

High ALT blood test results indicate liver injury or disease. The increase in ALT count itself does not do anything, but it is a sign that the liver is affected. ALT can continue to rise if the cause is not identified and treated, and it can progress to permanent damage to the liver and cirrhosis, which cannot be reversed.

Does high ALT mean fatty liver?

Fatty liver is one of the reasons for high ALT, but an elevated ALT level can be from a number of medical reasons.

Can a high ALT return to normal?

Most cases of high ALT can return to normal with lifestyle modifications, cholesterol and weight management, and appropriate treatment. With some inherited, genetic, and other liver conditions, ALT can mostly be controlled and maintained at acceptable levels.

What is an alarming ALT?

In normal healthy adults, ALT levels of up to 100 IU/L are considered mild elevation, but anything above that is alarming because it is a sign of serious liver disease. But in some cases, such as people undergoing cancer treatment, ALT levels can go up much higher and this is an inevitable side effect of treatment. In such cases, doctors may consider a higher ALT level of 3 to even 5 times the upper limit of normal (ULN) as acceptable until treatment is completed or discontinued, and then allow a period for recovery to normal ALT levels.