What is ALT? Why does ALT rise and why does it fall?

By | 6 June 2021

The most common tests used to investigate whether there is liver damage are liver enzymes called ALT and AST. The question of what is ALT in the blood can be answered as the short name for the liver enzyme called alanine aminotransferase. Whether any disease in the liver, the use of heavy drugs, or injuries cause damage can be understood by looking at the amount of this enzyme in the blood. Normally, in healthy individuals, the enzyme alanine aminotransferase is found in the liver tissue. Its release into the bloodstream is an indication of the destruction of liver cells. There can be many reasons for a high ALT test. Although patients do not have any complaints, they can learn the ALT elevation by chance if liver function tests are also performed in routine blood tests. In this case, further diagnostic tests should be applied to find out the cause of the elevation in liver enzymes.

What is ALT

Many individuals undergoing liver function tests search for the answer to the question of what is ALT and AST. Alanine aminotransferase (ALT); is a type of enzyme found mainly in the liver, and in small amounts in the kidney and other organs. It is also called serum glutamic pyruvic transaminase (SGPT). It functions in the conversion of nutrients that reach the liver after being digested and taken into the body with food into energy. Under normal conditions, this enzyme is located inside the liver cells, and in the bloodstream, it is found in trace amounts originating from the dying liver cells. An above-normal level of ALT in the blood is a strong indicator of liver damage. Damage to the liver can be caused by many diseases. Further diagnostic tests should be performed after the elevation of ALT and other liver enzymes are detected to plan the treatment process and prevent damage before liver failure develops. It can be said that the higher the level of the enzyme in the blood, the more serious the damage. Simple elevations may occur due to an unhealthy, unbalanced, and excessively fatty diet, fatty liver. However, the treatment process should be started as soon as possible for further elevations.

The ALT test is a very simple procedure that requires only a blood draw. No special preparation is required for the blood test, but it would be healthier to go on an empty stomach in the morning, in case your doctor may order different tests such as blood sugar and hemogram in addition to ALT and other liver function tests.

In which situations is the ALT test performed?

ALT test; Along with other liver function test markers such as AST, LDH, it is among the tests requested by physicians in cases where liver diseases are suspected or during routine health screenings. The following conditions that may raise suspicion for liver disease or damage are among the most important reasons for ALT testing:

  • Swelling and pain sensation in the abdomen and stomach area
  • Nausea and vomiting
  • Yellowing of the skin surface with the whites of the eyes, also known as jaundice
  • rapid weight loss
  • Constant feeling of tiredness
  • Unexplained itching on the skin surface
  • dark urine
  • light-colored stool

In addition to the above factors, ALT tests are more frequently applied because of the higher risk of liver damage in people who have a habit of using alcohol continuously. In addition, the levels of ALT and other liver enzymes in the blood should be checked regularly in people who have a family history of liver disease, have had a previous hepatitis virus-related infection, and use drugs that are likely to cause liver damage.

What causes ALT elevation and low?

The ALT level in the blood should be in the range of 10-40 U/L in healthy men and 7-35 U/L in women. Having an ALT level below these values ​​usually has no medical significance or danger. Therefore, people who see that their ALT level is low as a result of a routine blood test and wonder why ALT drops do not need to worry. However, further diagnostic tests should be performed for the cause of ALT detected above these values. To answer the question of why ALT rises, the most common problems and risk factors that can cause liver damage and therefore elevated ALT levels are:

  • fatty liver
  • Continually used heavy drugs or unconscious drug use
  • excessive alcohol use
  • Obesity
  • diabetes disease
  • cholesterol drugs
  • Heart failure
  • Hepatitis A, B, and C infections
  • Cirrhosis

Apart from the above problems, people with a family history of liver disease have a higher risk of developing liver diseases than other individuals. Therefore, these individuals should take care to have their liver function tests done regularly. At the same time, all individuals should have hepatitis vaccinations on time to be protected from liver diseases.

What to do in case of ALT elevation?

ALT is usually done as part of a series of liver function tests. In these tests, the levels of different proteins and enzymes are measured in the blood and it is investigated whether the liver is working at a sufficient level and whether there is liver damage. High ALT levels usually indicate liver infection, hepatosteatosis (fatty liver), cirrhosis, hepatitis, liver cysts, and cancers, and similar diseases. In this case, the liver should be examined with radiological imaging techniques, a physical examination should be performed, and more advanced blood tests should be performed. After a clear diagnosis of the underlying disease is made, the treatment process should be initiated to prevent damage to the liver as soon as possible. In case of detection of any infection in the liver, antibiotic and antiviral drug treatments should be started immediately. If a tumor is detected in the liver, considering the size of these tumors, a biopsy should be taken in cases recommended by the physician, and it should be investigated whether the tumor tends to become cancerous, and if necessary, the tumor should be removed with the help of surgical operations. If the tumor sent for pathological examination is determined to be malignant, it should be investigated whether it has spread to the surrounding tissues and organs, and oncological treatment should be initiated when necessary. Since alcohol is one of the biggest enemies of the liver, if alcohol is used, this habit should be stopped as soon as possible.

Another factor that is very effective in the treatment of liver diseases and therefore in lowering the ALT level is a balanced diet. In all liver diseases and in the case of fatty liver, a low-fat diet with healthy foods should be applied. Folic acid intake should be given due care. Among the liver-friendly foods such as artichoke, cabbage, spinach, all green leafy vegetables, asparagus, and beet, seasonal foods should be consumed regularly. Individuals with high liver enzymes should also be very careful about the use of drugs. Patients with high ALT and other enzymes should notify their physicians when they apply to health institutions to prevent damage to the liver, which is involved in the metabolism and removal of drugs from the body, and they should ask their physicians to prescribe drugs that will not harm the liver. Regular exercise is another factor that affects the protection and improvement of liver health. Individuals who want to lower their ALT level and protect their liver health should create an exercise plan for themselves and adapt to it and make sports a part of their life.

If you have any liver disease or if you have not had your routine liver function tests in the last 6 months, you can apply to a health institution immediately and be examined, and ask your doctor to perform ALT and other liver function tests on you. If an elevation in your liver enzymes is detected, you can prevent damage to your liver by having detailed examinations for your disease, and at the same time, you can prevent more serious health problems that you may encounter in the future by starting your treatment process in the early period.




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