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High (ALT) Alanine Aminotransferase level in the blood

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High (ALT) Alanine Aminotransferase level in the blood

What is high ALT level in the blood called?

  • ALT Hypotransaminasemia

What is the normal level of ALT in the blood?

If you need to know which are the ALT reference ranges or you require more information about the role of ALT in the blood you can visit: Normal ALT level in the blood

What does a high ALT level in the blood mean?

High level of ALT (alanine aminotransferase) in the blood, formerly named glutamic pyruvic transaminase (GPT), is very specific of a liver injury. Sometimes an ALT increase in the blood can be related to pancreas or gallbladder disorders.

ALT increase usually suggests liver disorders. It can be due to minor illness such as fatty liver or due to more severe diseases like cirrhosis or hepatitis (inflammation of the liver).

ALT Hypertransaminasemia or a high ALT level in the blood mean:

  • Mild ALT hypertransaminasemia (50 – 150 U/l in adult men, 35 - 105 U/l in adult women):

    The ALT levels in the blood are a bit higher than normal but if you are not experienced any symptom it is usually not a matter of concern.

    An ALT slight increase can be due to obesity, alcohol intake or because you are taking some drugs to treat any other disease.

    If you are taking medication talk to your doctor because maybe this is the reason for the elevation.

    Do physical exercise on regular basis and keep a balanced diet. If you follow this advice, it is probably that your ALT values return to normality in the following assay.

  • Moderate ALT hypertransaminasemia (150 - 250 U/l in adult men, 105 - 175 U/l in adult women) :

    A moderate ALT elevation can be a first sign of liver problems. It can be just fatty liver, also called hepatic steatosis, a benign disease in which extra fat builds up in the liver.

    Cut down on your alcohol intake and tell your doctor about your diet and the medication you are taking. He will decide if it is necessary to perform additional screening tests.

  • Marked ALT hypertransaminasemia (250 - 500 U/l in adult men, 175 - 350 U/l in adult women):

    A marked ALT elevation suggests a liver disease. It may be a consequence of suffering from chronic hepatitis (inflammation of the liver) or cirrhosis.

    It can also be due to not liver diseases, for example:

    • Related with pancreas (pancreatitis)
    • Related with gallbladder (cholecystitis)

    You must visit your doctor as soon as possible. He will study your case and will stablish an appropriate treatment protocol.

  • Severe ALT hypertransaminasemia (> 500 U/l in adult men, > 350 U/l in adult women) :

    Your ALT level is very high and suffering from a severe liver damage is a very likely possibility.

    Very high ALT levels in the blood can be present in case of:

    • Acute hepatitis
    • Legal or illegal drugs overdose (paracetamol poisoning for example)
    • Liver ischemia

    You must find urgent medical attention to avoid irreversible damage to your liver.

Which factors can raise ALT blood levels?

There are some health circumstances or drugs than can raise your ALT level in the blood:

  • Alcohol
  • Illicit drugs
  • Excess intake of vitamin A
  • Cardiac surgery
  • Burns
  • Muscle trauma
  • Drugs
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Indomethacin
    • Antiarrhythmic agents
      • Procainamide
    • Antibiotics
      • Nalidixic acid
      • Ampicillin
      • Cephalosporin
      • Cloxacillin
      • Nitrofurantoin
      • Sulfonamide
      • Tetracycline
    • Antineoplastics
      • Methotrexate
    • Oral Contraceptives
    • Anti-diabetic medication
      • Chlorpropamide
    • Antiepileptic drugs
      • Carbamazepine
      • Phenytoin
    • Antifungal
      • Fluconazole
      • Itraconazole
    • Antihypertensives
      • Propanolol
    • Antipsychotics
      • Phenothiazines
    • Antituberculars
      • Isoniazid
    • Fibrate
      • Clofibrate
    • Opiate
      • Codeine
    • Paracetamol
    • Thiopurines
      • Azathioprine
    • Uricosuric
      • Allopurinol

Which diseases can raise your ALT level in the blood?

There are many diseases why the ALT level in the blood can be higher than normal:

  • Cholestasis
  • Hepatic cirrhosis
  • Hepatitis
  • Liver cancer
  • Liver ischemia
  • Liver failure
  • Wilson's disease
  • Acute pancreatitis
  • Chronic cholecystitis
  • Acute cholecystitis
  • Mononucleosis
  • Hemolytic anemia
  • Hemochromatosis
  • Myocardial infarction
  • Ehrlichiosis
  • Muscular dystrophy
  • Kidney failure

What can I do to lower ALT level in the blood?

If your ALT level in the blood is slightly high, you should keep in mind the following tips:

  • Cut down on your alcohol intake.
  • Keep a balanced diet. Do not eat too much junk foods because they are high in calories fat, sugar and salt. Try to eat more fruit and vegetables.
  • Do regular physical activity to prevent obesity.
  • Talk to your doctor about the medication you are taking. There may be another choice of medication to treat your diseases.

Where can I find more information about ALT in the blood?

You can visit our pages about:

Which values are considered a high ALT level in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in U/L. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

ALT Alanine Aminotransferase
Mild ALT hypertransaminasemia
51 U/L52 U/L53 U/L54 U/L55 U/L56 U/L57 U/L58 U/L
59 U/L60 U/L61 U/L62 U/L63 U/L64 U/L65 U/L66 U/L
67 U/L68 U/L69 U/L70 U/L71 U/L72 U/L73 U/L74 U/L
75 U/L76 U/L77 U/L78 U/L79 U/L80 U/L81 U/L82 U/L
83 U/L84 U/L85 U/L86 U/L87 U/L88 U/L89 U/L90 U/L
91 U/L92 U/L93 U/L94 U/L95 U/L96 U/L97 U/L98 U/L
99 U/L100 U/L101 U/L102 U/L103 U/L104 U/L105 U/L106 U/L
107 U/L108 U/L109 U/L110 U/L111 U/L112 U/L113 U/L114 U/L
115 U/L116 U/L117 U/L118 U/L119 U/L120 U/L121 U/L122 U/L
123 U/L124 U/L125 U/L126 U/L127 U/L128 U/L129 U/L130 U/L
131 U/L132 U/L133 U/L134 U/L135 U/L136 U/L137 U/L138 U/L
139 U/L140 U/L141 U/L142 U/L143 U/L144 U/L145 U/L146 U/L
147 U/L148 U/L149 U/L150 U/L    
Moderate ALT hypertransaminasemia
151 U/L152 U/L153 U/L154 U/L155 U/L156 U/L157 U/L158 U/L
159 U/L160 U/L161 U/L162 U/L163 U/L164 U/L165 U/L166 U/L
167 U/L168 U/L169 U/L170 U/L171 U/L172 U/L173 U/L174 U/L
175 U/L176 U/L177 U/L178 U/L179 U/L180 U/L181 U/L182 U/L
183 U/L184 U/L185 U/L186 U/L187 U/L188 U/L189 U/L190 U/L
191 U/L192 U/L193 U/L194 U/L195 U/L196 U/L197 U/L198 U/L
199 U/L200 U/L201 U/L202 U/L203 U/L204 U/L205 U/L206 U/L
207 U/L208 U/L209 U/L210 U/L211 U/L212 U/L213 U/L214 U/L
215 U/L216 U/L217 U/L218 U/L219 U/L220 U/L221 U/L222 U/L
223 U/L224 U/L225 U/L226 U/L227 U/L228 U/L229 U/L230 U/L
231 U/L232 U/L233 U/L234 U/L235 U/L236 U/L237 U/L238 U/L
239 U/L240 U/L241 U/L242 U/L243 U/L244 U/L245 U/L246 U/L
247 U/L248 U/L249 U/L250 U/L    
Marked ALT hypertransaminasemia
251 U/L252 U/L253 U/L254 U/L255 U/L256 U/L257 U/L258 U/L
259 U/L260 U/L261 U/L262 U/L263 U/L264 U/L265 U/L266 U/L
267 U/L268 U/L269 U/L270 U/L271 U/L272 U/L273 U/L274 U/L
275 U/L276 U/L277 U/L278 U/L279 U/L280 U/L281 U/L282 U/L
283 U/L284 U/L285 U/L286 U/L287 U/L288 U/L289 U/L290 U/L
291 U/L292 U/L293 U/L294 U/L295 U/L296 U/L297 U/L298 U/L
299 U/L300 U/L301 U/L302 U/L303 U/L304 U/L305 U/L306 U/L
307 U/L308 U/L309 U/L310 U/L311 U/L312 U/L313 U/L314 U/L
315 U/L316 U/L317 U/L318 U/L319 U/L320 U/L321 U/L322 U/L
323 U/L324 U/L325 U/L326 U/L327 U/L328 U/L329 U/L330 U/L
331 U/L332 U/L333 U/L334 U/L335 U/L336 U/L337 U/L338 U/L
339 U/L340 U/L341 U/L342 U/L343 U/L344 U/L345 U/L346 U/L
347 U/L348 U/L349 U/L350 U/L351 U/L352 U/L353 U/L354 U/L
355 U/L356 U/L357 U/L358 U/L359 U/L360 U/L361 U/L362 U/L
363 U/L364 U/L365 U/L366 U/L367 U/L368 U/L369 U/L370 U/L
371 U/L372 U/L373 U/L374 U/L375 U/L376 U/L377 U/L378 U/L
379 U/L380 U/L381 U/L382 U/L383 U/L384 U/L385 U/L386 U/L
387 U/L388 U/L389 U/L390 U/L391 U/L392 U/L393 U/L394 U/L
395 U/L396 U/L397 U/L398 U/L399 U/L400 U/L401 U/L402 U/L
403 U/L404 U/L405 U/L406 U/L407 U/L408 U/L409 U/L410 U/L
411 U/L412 U/L413 U/L414 U/L415 U/L416 U/L417 U/L418 U/L
419 U/L420 U/L421 U/L422 U/L423 U/L424 U/L425 U/L426 U/L
427 U/L428 U/L429 U/L430 U/L431 U/L432 U/L433 U/L434 U/L
435 U/L436 U/L437 U/L438 U/L439 U/L440 U/L441 U/L442 U/L
443 U/L444 U/L445 U/L446 U/L447 U/L448 U/L449 U/L450 U/L
451 U/L452 U/L453 U/L454 U/L455 U/L456 U/L457 U/L458 U/L
459 U/L460 U/L461 U/L462 U/L463 U/L464 U/L465 U/L466 U/L
467 U/L468 U/L469 U/L470 U/L471 U/L472 U/L473 U/L474 U/L
475 U/L476 U/L477 U/L478 U/L479 U/L480 U/L481 U/L482 U/L
483 U/L484 U/L485 U/L486 U/L487 U/L488 U/L489 U/L490 U/L
491 U/L492 U/L493 U/L494 U/L495 U/L496 U/L497 U/L498 U/L
499 U/L500 U/L      
Severe ALT hypertransaminasemia
501 U/L502 U/L503 U/L504 U/L505 U/L506 U/L507 U/L508 U/L
509 U/L510 U/L511 U/L512 U/L513 U/L514 U/L515 U/L516 U/L
517 U/L518 U/L519 U/L520 U/L521 U/L522 U/L523 U/L524 U/L
525 U/L526 U/L527 U/L528 U/L529 U/L530 U/L531 U/L532 U/L
533 U/L534 U/L535 U/L536 U/L537 U/L538 U/L539 U/L540 U/L
541 U/L542 U/L543 U/L544 U/L545 U/L546 U/L547 U/L548 U/L
549 U/L550 U/L551 U/L552 U/L553 U/L554 U/L555 U/L556 U/L
557 U/L558 U/L559 U/L560 U/L561 U/L562 U/L563 U/L564 U/L
565 U/L566 U/L567 U/L568 U/L569 U/L570 U/L571 U/L572 U/L
573 U/L574 U/L575 U/L576 U/L577 U/L578 U/L579 U/L580 U/L
foto de Dr. Javier Muga Bustamante
Written by

Dr. Javier Muga Bustamante

Last update: 26/03/2020

Bibliography

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  • Thomas L. Alanine aminotransferase (ALT), Aspartate aminotransferase (AST). In:Thomas L, ed. Clinical laboratory diagnostics. Use and assessment of clinical laboratory results. Frankfurt/Main: TH-Books Verlagsgesellschaft, 1998:55-65 ISBN: 9783980521543.
  • Schumann G, Bonora R, Ceriotti F et al. IFCC Primary Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes at 37°C. Part 4. Reference Procedure for the Measurement of Catalytic Concentration of Alanine Aminotransferase. Clin Chem Lab Med 2002;40:718-24.
  • Thomas L, Müller M, Schumann G et al. Consensus of DGKL and VDGH for interim reference intervals on enzymes in serum. J Lab Med 2005;29:301-08.
  • Painter PC, Cope JY, Smith JL. Chapter 50. Reference information for the clinical laboratory. In: Burtis CA, Ashwood ER, eds. Tietz textbook of clinical chemistry. Philadelphia:WB Saunders Company, 1999;1802pp. ISBN 9780721656106.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Disponible en: https://ctep.cancer.gov
  • Severity grading in drug induced liver injury. U.S. National Library of Medicine. Disponible en: https://livertox.nih.gov

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