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Alanine-aminotransferase-alt



Why Get Tested

To screen for liver damage and or to help diagnose liver disease

When To Get Tested

When a healthcare practitioner thinks that you have symptoms of a liver disorder such as abdominal pain nausea and vomiting jaundice yellow skin or potential exposure to hepatitis virus as part of a comprehensive metabolic panel CMP when you have a routine health exam

Sample Required

A blood sample drawn from a vein in your arm

Test Preparation Needed

None




Common Questions


The alanine aminotransferase ALT test is typically used to detect liver injury It is often ordered in conjunction with aspartate aminotransferase AST as part of a liver panel or comprehensive metabolic panel CMP to screen for and or help diagnose liver disease ALT is an enzyme found mostly in the cells of the liver and kidney When the liver is damaged ALT is released into the blood This makes ALT a useful test for early detection of liver damage AST and ALT are considered to be two of the most important tests to detect liver injury although ALT is more specific to the liver than is AST Sometimes AST is compared directly to ALT and an AST ALT ratio is calculated This ratio may be used to distinguish between different causes of liver damage and to help recognize heart or muscle injury ALT values are often compared to the results of other tests such as alkaline phosphatase ALP total protein and bilirubin to help determine which form of liver disease is present ALT is often used to monitor the treatment of persons who have liver disease to see if the treatment is working and may be ordered either by itself or along with other tests for this purpose

ALT may be ordered as part of a comprehensive metabolic panel when a person has a routine health examination A healthcare practitioner usually orders an ALT test and several others to evaluate a person who has signs and symptoms of a liver disorder Some of these signs and symptoms may include Weakness fatigue Loss of appetite Nausea vomiting Abdominal swelling and or pain Jaundice Dark urine light-colored stool Itching pruritus ALT may also be ordered either by itself or with other tests for people who are at an increased risk for liver disease since many people with mild liver damage will have no signs or symptoms Even without other symptoms ALT will be increased with mild liver damage Some examples include Persons who have a history of known or possible exposure to hepatitis viruses Those who are heavy drinkers Individuals whose families have a history of liver disease Persons who take drugs that might damage the liver Persons who are overweight and or have diabetes When ALT is used to monitor the treatment of people who have liver disease it may be ordered on a regular basis during the course of treatment to determine whether the therapy is effective

A low level of ALT in the blood is expected and is normal Liver disease is the most common reason for higher than normal levels of ALT 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 Levels of ALT may also be markedly elevated sometimes over 100 times normal as a result of exposure to drugs or other substances that are toxic to the liver or in conditions that cause decreased blood flow ischemia to the liver ALT levels are usually not as high in chronic hepatitis often less than 4 times normal In this case ALT levels often vary between normal and slightly increased so the test may be ordered frequently to see if there is a pattern Other causes of moderate increases in ALT include obstruction of bile ducts cirrhosis usually the result of chronic hepatitis or bile duct obstruction heart damage alcohol abuse and with tumors in the liver ALT is often performed together with a test for AST or as part of a liver panel For more about ALT results in relation to other liver tests see the Liver Panel article In most types of liver diseases the ALT level is higher than AST and the AST ALT ratio will be low less than 1 There are a few exceptions the AST ALT ratio is usually greater than 1 in alcoholic hepatitis cirrhosis and with heart or muscle injury and may be greater than 1 for a day or two after onset of acute hepatitis

A shot or injection of medicine into the muscle tissue or strenuous exercise may increase ALT levels Many drugs may raise ALT levels by causing liver damage in a very small percentage of patients taking the drug This is true of both prescription drugs and some natural health products Be sure to tell your healthcare provider about all of the drugs and or health supplements you are taking

ALT is more specific for the liver than AST and so is much less affected by conditions affecting other parts of the body Nevertheless injury to organs other than the liver such as the heart and skeletal muscle can cause elevations of ALT For example small increases may be seen with skeletal muscle damage or heart attacks

After a thorough physical exam and evaluation of a person s medical history there are several other tests that may be performed as follow up depending on what is suspected to be the cause of liver damage Some of these include Tests for hepatitis A hepatitis B and hepatitis C Testing for exposure to drugs and other substances toxic to the liver see Drug Abuse Testing and Emergency and Overdose Drug Testing Ethanol level Copper and ceruloplasmin for Wilson disease Iron tests and genetic tests for hereditary hemochromatosis A liver biopsy may be performed to help determine the cause of liver injury and to evaluate the extent of liver damage For more information see the article on Liver Disease