Mildly Elevated Liver Transaminase Levels: Causes and Evaluation
Other possible causes of elevated liver enzymes include: Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption) Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder) Celiac disease (small intestine damage caused by gluten). Nov 27, · Several things can cause high ALT levels, including: nonalcoholic fatty liver disease (NAFLD) over-the-counter pain medications, especially acetaminophen prescription medications used to control cholesterol alcohol consumption obesity hepatitis A, B, or C heart failureAuthor: Adrienne Santos-Longhurst.
Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the cause by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis. Mayo Clinic does what language was spoken before the tower of babel endorse companies or products. Advertising revenue supports our not-for-profit mission.
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The elevated liver enzymes most commonly found are: Alanine transaminase (ALT) Aspartate transaminase (AST) Alkaline phosphatase (ALP) Gamma-glutamyl transpeptidase (GGT). Dec 01, · Elevations in ALT generally are more specific for liver injury, whereas elevations in AST can also be caused by extrahepatic disorders, such as thyroid disorders, celiac sprue, hemolysis, Cited by:
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Note that each number in parentheses [1, 2, 3, etc. Alanine aminotransferase ALT is commonly tested as a marker of liver health. High levels often point to liver damage or disease. Read on to find out what can cause your levels to increase. Healthy liver cells store most of your ALT, but small amounts are also found in the muscles and blood. When liver cells are damaged due to illness, injury, or medication, they release ALT, increasing its blood levels [ 3 ].
Therefore, ALT blood levels are a marker of liver health: low levels typically indicate a healthy liver, while high levels suggest liver damage [ 4 ]. If your blood tests reveal you have elevated ALT levels, speak with your doctor about what the results might mean. Your doctor might recommend further testing to determine what the underlying cause of the elevated ALT is.
There may be some lab-to-lab variability in ranges due to differences in equipment, techniques, and chemicals used. Causes listed below are commonly associated with high ALT. Work with your doctor or other health care professional for an accurate diagnosis. Your doctor will interpret your ALT result, taking into account your medical history, signs and symptoms, and other test results. ALT levels increase in response to liver diseases, such as [ 5 ]:.
However, not all people with liver disease will have high ALT e. Excessive alcohol consumption is the most common cause of liver disease in the Western Hemisphere [ 16 ]. In multiple studies from around the world 1. Long term, excessive alcohol consumption leads to liver cell death, which releases ALT from the liver into the bloodstream [ 23 , 24 , 16 ]. Limited drinking may not increase ALT levels in normal-weight individuals due to its ability to improve insulin sensitivity , which seems to reduce ALT, according to trials on almost 14k people [ 25 , 26 ].
There are many drugs that can increase ALT by causing liver damage, but this usually only happens in a small percentage of the people taking the drug. But while the percentage is small, it adds up when we look at it on the population level. In fact, over-the-counter and prescription drugs are among the most common causes of elevated ALT. The same applies to natural products and supplements. ALT can also increase when there is liver damage due to toxins such as lead, mercury, or pesticides [ 27 , 37 , 38 ].
ALT is often abnormal in anorexia, occurring in almost half of all people with the disorder. Weight loss and fasting can cause mild elevations in ALT x normal , while further elevations x normal can happen in more severe cases with starvation [ 39 ].
ALT is often elevated in people who are obese [ 40 , 41 , 42 ]. Stomach fat is more dangerous than general obesity and often accompanies conditions such as diabetes and liver disease. Waist circumference and stomach fat more accurately predicted elevated ALT than the measurement of body mass index BMI , as seen in multiple studies of over 17, adults, adolescents, and children [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].
ALT can increase due to gallstones and gallstone induced inflammation of the pancreas pancreatitis [ 51 , 52 ]. In a study of patients with inflamed gallbladders cholecystitis , those without gallstones had moderately raised ALT levels Gallstones also cause pancreatitis by blocking the bile duct and forcing the bile back into the pancreas [ 54 ].
Since small amounts of ALT are stored in muscle cells, muscle injury and disease can also cause ALT to leak into the blood and raise its levels [ 56 , 57 , 58 ]. In a study with 16 patients with various muscle injuries, extreme exercise and seizures increased ALT levels [ 59 ]. Muscle damage due to surgery or burn injury also increases ALT [ 60 , 61 ]. ALT levels can increase after a heart attack or heart failure, due to a shortage in the supply of oxygen to the liver [ 62 , 28 ].
Underactive thyroid gland hypothyroidism is often associated with being overweight, fatty liver, and higher ALT levels [ 28 ]. ALT can also increase in health conditions that are not typically associated with the liver but can affect liver function, such as:. Abnormal destruction of red blood cells hemolysis can falsely increase ALT levels [ 70 , 71 , 72 ]. There are several large population studies that have found a link between higher ALT levels and health conditions such as diabetes, heart disease, or and other metabolic issues.
However, there is no proof that any of these associations are causal. It is much more likely that they are all results of underlying issues such as obesity and chronic inflammation. In a meta-analysis of 17 studies involving over 60k participants, higher ALT levels were associated with a higher risk of type 2 diabetes.
However, the association was modest, and scientists think it may not be clinically relevant i. In a 5-year study with participants, elevated ALT levels slightly improved the prediction of future development of diabetes, in addition to other factors, such as BMI, fasting blood sugar, and family history [ 74 ]. Metabolic syndrome describes a number of interconnected symptoms that increase the risk of heart disease and diabetes. These include high blood pressure, high cholesterol, high blood sugar, high triglycerides, and insulin resistance [ 75 ].
In another study with over 28k people, those with the highest ALT levels were more likely to suffer from metabolic syndrome than those with the lowest levels [ 77 ]. According to a meta-analysis of 29 studies with 1. In another meta-analysis of over 1 million participants, lower ALT levels were associated with a higher risk of heart disease [ 79 ]. In a meta-analysis of 29 studies with 1.
In a study with k Asian participants, men with elevated levels of ALT were more likely to suffer a stroke than men with low ALT, though this association was less prominent in women [ 80 ]. In a meta-analysis of 19 studies with 9. This association was not seen in North American participants [ 81 ]. 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. Higher ALT levels have been linked with adverse health effects such as diabetes, heart disease, stroke, and metabolic syndrome.
This post is part of a series about ALT. Find out how to naturally lower your levels in the next part. Learn more about the functions of ALT and why doctors order the test here.
If your ALT levels are abnormally low, read this post. Joe Cohen won the genetic lottery of bad genes. As a kid, he suffered from inflammation, brain fog, fatigue, digestive problems, anxiety, depression, and other issues that were poorly understood in both conventional and alternative medicine. All of our content is written by scientists and people with a strong science background. Liver diseases increase ALT levels. However, ALT levels are not proportional to liver damage.
In addition, some people maintain normal ALT levels despite liver damage. Heavy drinking worsens liver health and increases ALT as a result. Many drugs and supplements can increase ALT by causing liver damage, but this usually only happens in a small percentage of users. Toxins that cause liver damage also increase ALT levels. Both anorexia and obesity can increase ALT levels. Gallstones can increase ALT levels, especially in people who also have pancreatic inflammation.
Muscle-wasting diseases, muscle injuries, damage due to surgery, burns, or intense exercise can all increase ALT levels. Other causes of elevated ALT include heart attack or heart failure, hypothyroidism, and hemolysis abnormal destruction of red blood cells. Higher ALT levels may be associated with a higher risk of developing type 2 diabetes and metabolic syndrome. Elevated ALT is likely not associated with heart disease, but appears to be associated with a modestly increased likelihood of stroke.
Takeaway ALT is most commonly increased in response to liver disease or liver damage, caused by alcohol, drugs, supplements, or toxins. What is Considered a High Level? Joe Cohen, CEO. Blood Tests 0.
Blood Tests 2.