AST (=GOT),  ALT (=GPT) - Übersicht (2023)

FAQs

What does it mean if your AST is higher than your ALT? ›

An AST/ALT ratio higher than one (where the AST is higher than ALT) means you may have cirrhosis. An AST/ALT ratio higher than 2:1 (where the AST is more than twice as high as the ALT) is a sign of alcoholic liver disease.

AST and ALT formerly are called serum glutamic oxaloacetic transaminase (GOT) and serum glutamic pyruvic transaminase (GPT), respectively. AST or ALT levels are a valuable aid primarily in the diagnosis of liver disease.

ALT is an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, ALT is released into the bloodstream and levels increase. Aspartate transaminase (AST). AST is an enzyme that helps metabolize amino acids.

ALT is found predominately in the liver, with lesser quantities found in the kidneys, heart, and skeletal muscle. As a result, the ALT is a more specific indicator of liver inflammation than the AST, as the AST may also be elevated in diseases affecting other organs, such as the heart or muscles.

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.

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.

High levels of ALT in your blood may be a sign of a liver injury or disease. Some types of liver disease cause high ALT levels before you have symptoms of the disease. So, an ALT blood test may help diagnose certain liver diseases early.

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.

ALT stands for alanine transaminase, which is another type of liver enzyme. 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.

Which is worse high AST or ALT? ›

Laboratory abnormalities often are the only sign of non-alcoholic fatty liver disease. The most common abnormal laboratory test results are elevated alanine transaminase (ALT) and aspartate transaminase (AST), usually one to four times the upper limits of normal.

ALT levels greater than 15 times the normal range indicate severe acute liver cell injury and evaluation should be initiated immediately. The differential diagnosis for patients with severe acute liver injury (ALT levels >15 times the normal range) is relatively limited.

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.

1. Common causes of mild elevation of ALT and AST in an asymptomatic person. Chronic liver disease such as cirrhosis and chronic hepatitis C may cause mildly elevated AST and ALT. In chronic viral hepatitis, the elevation of liver enzyme may not correlate well with the degree of liver damage.

Avoid drinking alcohol until your AST levels return to the normal range, even if the cause is not alcohol-related [34]. If you are overweight, losing weight may improve your liver health and help reduce AST [35]. Some drugs or supplements can damage the liver, leading to high AST levels.

Aspartate Transaminase (AST): Very high levels of AST (more than 10 times normal) are usually due to Acute Hepatitis, sometimes due to a viral infection. With acute Hepatitis, AST levels usually stay high for about 1-2 months but can take as long as 3-6 months to return to normal.

What causes elevated ALT and AST levels? 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.

Over-the-counter pain medications, particularly acetaminophen (Tylenol, others) Certain prescription medications, including statin drugs used to control cholesterol. Drinking alcohol.

How long does it take to lower AST and ALT levels? ›

Elevated levels caused by these factors will generally return to normal in about 2 to 4 weeks without treatment.

Fatigue (feeling tired). Itching. Jaundice (yellowing of your skin or eyes). Light-colored stools (poop).

Exhaustion (feeling tired) Itching. Jaundice (yellowing of your skin or eyes) Light-colored stools.

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.

ALT is measured in units per liter of blood or U/L. The normal range is around 7-35 U/L in women and 7-40 U/L in men.

In a community-based study of 1346 Japanese patients with diagnostic criteria of NAFLD, the cutoff value of ALT for diagnosis of this disease was estimated to be 25 U/L in men and 17 U/L in women[39].

The sex-specific 95th percentile for ALT among the healthy blood donors was 30 U per L in men and 19 U per L in women, and these were suggested as healthy ALT levels.

In particular, increased serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) indicate acute hepatocellular injury, such as viral infection, toxic injury, hypoxia, and hypoperfusion, where ALT and AST levels can rise by thousands of times the levels in the normal range.

In typical viral or toxic liver injury, the serum ALT level rises more than the AST value, reflecting the relative amounts of these enzymes in hepatocytes. However, in alcoholic hepatitis, the ratio of AST to ALT is greater than 1 in 90 percent of patients and is usually greater than 2.

How can I detox my liver in 3 days? ›

An ALT blood test is often included in a liver panel and comprehensive metabolic panel, and healthcare providers use it to help assess your liver health. High levels of ALT in your blood may indicate that you have damage to your liver and/or a liver condition.

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.

Medical treatment

For most causes of high ALT, treatment involves lifestyle changes, such as exercise, a modified diet, and reducing alcohol intake. Depending on the results of your liver panel and your medical history, your healthcare professional may recommend checking them again at a later date.

Pain in your liver itself can feel like a dull throbbing pain or a stabbing sensation in your right upper abdomen just under your ribs. General abdominal pain and discomfort can also be related to swelling from fluid retention and enlargement of your spleen and liver caused by cirrhosis.

A high AST level often means there is some liver damage, but it is not necessarily caused by hepatitis C. A high AST with a normal ALT may mean that the AST is coming from a different part of the body. It is important to realize that the AST level in most patients with hepatitis C goes up and down.

An increased AST level is often a sign of liver disease. Liver disease is even more likely when the levels of substances checked by other liver blood tests have also increased. An increased AST level may be due to any of the following: Scarring of the liver (cirrhosis) Death of liver tissue.

Laboratory abnormalities often are the only sign of non-alcoholic fatty liver disease. The most common abnormal laboratory test results are elevated alanine transaminase (ALT) and aspartate transaminase (AST), usually one to four times the upper limits of normal.

How long does it take for AST and ALT to return to normal? ›

In a community-based study of 1346 Japanese patients with diagnostic criteria of NAFLD, the cutoff value of ALT for diagnosis of this disease was estimated to be 25 U/L in men and 17 U/L in women[39].