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Getting to Decreased ALT & AST Levels

One month ago one of my patients was diagnosed with hepatomegaly (enlarged liver) with fat. At that time, his liver function blood test showed ALT values of 133, and AST 57.

My recommendation to him was to start a fatty liver diet program, and mild physical activity, like walking for 1 hour for 3 times a week.

One month was passed, and now his blood test shows a decreased ALT level – 79, and a decreased AST level –  37. This is extremely good results for such short period of time.

This means that the treatment actually works. ALT and AST values are effected pretty fast when the body receives different, healthy type of food. In a matter of 2-3 month, a new blood test would hopefully reveal these enzymes at their normal levels.

It is extremely important to monitor your progress through taking a new blood test about about 3 weeks. It gives a lot of motivation and keeps you in track.

Keeping normal ALT and AST ratios

ALT (SGPT) Blood Test

Getting decreased ALT and AST levels to normal levels is one thing – but keeping at these levels are completely different task. There is a need to continue eating food with low fat, doing exercise, and generally watch your health and maintaining a healthy life-style.

Even if the blood test would show perfectly normal results, it can be deceiving, because your liver is still fatty. It doesn’t go away that soon. It takes few years at least. The best way to confirm if you still have a fatty liver is a combination of blood test AND a liver ultrasound.

Keep in mind that you will probably need to keep a healthy life-style all of your life, because your liver is vulnerable for fatty liver.

Click here for more information about fatty liver diet program.

Could ALT levels be lowered to normal range?

This letter is from Mike, who was diagnosed to have a fatty liver few years ago:

A few years back I was diagnosed with fatty liver disease (ultimately by way of liver ultrasound after blood test revealed elevated enzymes).

Since that time I have gained 30 pounds and am honestly overweight.

A recent blood test showed only one enzyme elevated, ALT, and the UL was 67.

My question is, is on ongoing ALT elevated above the normal limit of 45 to be expected since there is essentially no cure for fatty liver disease?

Said another way, from what I understand exercise and diet are used to “regulate” the disease as there is no cure.  Even with exercise and diet can it be expected that the ALT would go down to normal levels are still remain elevated above the limit of 45?  I have not exercised and my diet is not great. Thanks.

My answer to this question is short:

Even though fatty liver disease has no official “cure”, the fact is that with proper diet and exercise, fatty liver symptoms can be brought to minimum. Meaning, the ALT levels in the bloodstream would reach to normal if  a new life style is being adapted.

So yes, the ALT levels could be lowered to normal range if you are willing to take the necessary actions in your life.

Liver Enzymes and Exercise

In recent years, there are many indications that liver enzymes levels in the blood and exercise have some kind of association.

For example, taking a blood test close to the time you exercised, could result elevated levels of liver enzymes in the results.

The act of exercising has an affect on the level of liver enzymes, and when taking a blood test timed closely with the exercise, it could result with misleading outcome.

The physician will probably think the blood test results is because of viral infection, which is not true.

However, there is an easy workaround to this situation.

Before taking any blood test, make sure you haven’t exercised beforehand.

It will prevent any unnecessary conclusions regarding your conditions.

It is recommended to wait for about 3 hours after the initial exercise before going through a blood test; this will prevent any mistakes in the blood test related to liver enzymes and exercise.

Fatty Liver Blood Test

The liver creates various chemicals that are carried out to the bloodstream. Therefor, a blood test is playing a key part in diagnosing many liver disorders and diseases, including a Fatty Liver.

Elevated levels of these chemicals may show a damage to the liver or a specific liver disease. A blood test can measure their levels, and we can try to find the problem even before its symptoms start to show up.

This liver functions blood tests requires to fast for at least 6 hours before the test. Some drugs can affect the results, so please consult with your physician about any drug you use regularly.

Fatty Liver blood test usually includes the following checks

ALT (also called SGPT / Alanine Transaminase)

This is an enzyme that assists proteins to process. High level of ALT may suggest a liver injury. The normal levels of ALT is around 5-40 units per liter (range can vary in different labs).
Fatty Liver blood test

AST (also called SGOT)

An enzyme that is located mainly in liver cells. Its levels are usually raised when there is a liver damage or injury (just like ALT). The normal levels of AST are between 5-45, which is very similar to the ALT enzyme.

ALP (Alkaline Phosphatase)

Related to the biliary tract. If ALP is raised, and high levels of alkaline phosphatase has been found in the bloodstream, the cause might be a liver disorder (including a fatty liver). Normal rates of ALP are between 44-147 units per liter.

GGT (Gamma-Glutamyl Transpeptidase)

An enzyme that is mostly found in the liver, kidneys, heart, and other important organs. The normal rates of GGT are between 40 to 78 units per liter. It’s very similar to ALP (Alkaline Phosphatase), so in that respect, raised GGT can be a symptom of a liver disorder. The difference is that elevated ALP can be also be because of a bone disease, but GGT can’t.

Albumin

This is the core protein created by the liver, that passes into the bloodstream. The ability to make albumin (and many other proteins) is influenced in various liver disorders, including a fatty liver. Normal levels of albumin are between 3.4 to 5.4 deciliter.

Bilirubin

This chemical is a direct result of hemoglobin when it’s released – the molecule that ties oxygen into the red blood cells. The causes of higher bilirubin could be a liver disorder. High level of bilirubin also makes you jaundiced (yellow colored), and could affect your skin and eye color. In the bilirubin blood test, there are 3 types of bilirubin:

  • Direct Bilirubin (unconjugated bilirubin) – passes through the liver. Normal levels of direct bilirubin are between 0 to 0.3 deciliter.
  • Indirect Bilirubin (conjugated bilirubin) – doesn’t pass through the liver. Normal levels of Indirect bilirubin are between 0 to 0.3 deciliter.
  • Total Bilirubin – this is the total amount of direct + indirect bilirubin. Normal levels of total bilirubin are between 0.3 to 1.9 deciliter.

A/G Ratio

The ratio of albumin to globulin. Some liver disorders could lead to a low total protein levels. Normal levels of A/G are below 1 deciliter.

High ALT levels in fatty liver and Elevated ALT levels

An elevated ALT levels in your blood test results could be a sign of a related disorders and diseases, such as Fatty Liver disease, Hepatitis B, Hepatitis C, Cirrhosis, and others.

ALT is a commonly required blood test requested by many physicians from their patients. It’s used to confirm or rule out liver disorders, simply because the enzyme is mostly concentrated in the liver, which is why a higher levels of the enzyme may suggest a problem in the liver.

What are the normal ALT enzyme levels?

Elevated ALT LevelsThe normal level of ALT in the bloodstream is 5 to 45 U/L (units per liter). This range can slightly vary depending where you take the blood test.

When a blood test shows elevated ALT levels outside the normal range, even a small amount, fatty liver and other liver disorders might be the cause.

If the cause of the ALT enzyme level increase is due to a severe liver disease (like Cirrhosis), the levels would be higher than what’s found in fatty livers patients.

Please note that some labs name ALT as “Alanine Transaminase”, “Alanine Aminotransferase” or “SGPT”.

What should I do if I have an Elevated ALT levels?

After you got your results, the first thing you need to do it to consult your physician, the one who requested from you to take the test. He can check the results and choose the next course of action.

In most cases, a follow-up blood test is required to confirm that the first results are not a one-time mishap.

If it is confirmed in the second blood test, you are most likely be required to do an abdominal ultrasound scan. The ultrasound is a necessary tool to look at the liver tissue and to confirm the existence of fatty liver and its severity.

How can I lower my ALT levels?

The most important thing to remember is that most liver diseases such as fatty liver, are very treatable. Fatty liver is also the most common cause of an elevated ALT level.

The main course of treatment is through a determined and decisive actions to heal your liver. It will include weight loss if you’re overweight, change in your food habits, exercise, and more.

Stop eating fat-concentrated foods, and start eating healthy. Use foods for fatty liver recommendations to learn more about what you should and shouldn’t eat. For full details please read thoroughly about fatty liver treatment.

Persistence and a real change in your life-style are the keys to lower your ALT levels.

High alt levels fatty liver

You might need some guidance

This a thought and a big change that isn’t so easy to carry out. It will need your full attention. Your health should be the #1 priority. If you need any guidance, I high recommend the fatty liver diet guide written by Dorothy Spencer BSN, RN, that has been a proven liver diet program that works. It helped a lot of my own patients. Click here to learn more about it.