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Aspartate-aminotransferase-ast



Why Get Tested

To detect 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 a hepatitis virus as part of a comprehensive metabolic panel 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 blood test for aspartate aminotransferase AST is usually used to detect liver damage It is often ordered in conjunction with another liver enzyme alanine aminotransferase ALT or as part of a liver panel or comprehensive metabolic panel CMP to screen for and or help diagnose liver disorders AST and ALT are considered to be two of the most important tests to detect liver injury although ALT is more specific for the liver than is AST and is more commonly increased 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 distinguish liver injury from damage to heart or muscle AST levels are often compared with results of other tests such as alkaline phosphatase ALP total protein and bilirubin to help determine which form of liver disease is present AST is often measured to monitor treatment of persons with liver disease and may be ordered either by itself or along with other tests for this purpose Sometimes AST may be used to monitor people who are taking medications that are potentially toxic to the liver If AST levels increase then the person may be switched to another medication

AST may be ordered as part of a comprehensive metabolic panel CMP when someone has a routine health examination An AST test may be ordered along with several other tests when a person has signs and symptoms of a liver disorder Some of these may include Weakness fatigue Loss of appetite Nausea vomiting Abdominal swelling and or pain Jaundice Dark urine light-colored stool Itching pruritus Swelling in the legs and ankles Tendency to bruise easily AST 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 Some examples include Persons who might have been exposed to hepatitis viruses Persons who are heavy drinkers Persons who have a history of liver disease in their family Persons taking drugs that can damage the liver Persons who are overweight and or have diabetes When AST is used to monitor treatment of persons with liver disease it may be ordered on a regular basis during the course of treatment to determine whether the therapy is effective

Low levels of AST in the blood are expected and are normal 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 Levels of AST may also be markedly elevated often over 100 times normal as a result of exposure to drugs or other substances that are toxic to the liver as well as in conditions that cause decreased blood flow ischemia to the liver With chronic hepatitis AST levels are usually not as high often less than 4 times normal and are more likely to be normal than are ALT levels AST often varies between normal and slightly increased with chronic hepatitis so the test may be ordered frequently to determine the pattern Such moderate increases may also be seen in other diseases of the liver especially when the bile ducts are blocked or with cirrhosis or certain cancers of the liver AST may also increase after heart attacks and with muscle injury usually to a much greater degree than ALT AST is often performed together with the ALT test or as part of a liver panel For more about AST results in relation to other liver tests see the Liver Panel article In most types of liver disease 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 increased in alcoholic hepatitis cirrhosis hepatitis C virus-related chronic liver disease and in the first day or two of acute hepatitis or injury from bile duct obstruction With heart or muscle injury AST is often much higher than ALT often 3-5 times as high and levels tend to stay higher than ALT for longer than with liver injury

Pregnancy a shot or injection of medicine into muscle tissue or even strenuous exercise may increase AST levels Acute burns surgery and seizures may raise AST levels as well In rare instances some drugs can damage the liver or muscle increasing AST levels This is true of both prescription drugs and some natural health products Be sure to tell your healthcare practitioner about all of the drugs and or health supplements that you are taking

Conditions that affect other organs such as the heart and skeletal muscle can cause elevations of AST Mild to moderate increases may be seen with vigorous exercise and skeletal muscle injury or in conditions such as acute pancreatitis and 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