Increased alat by 20 points. What is ALT and AST in a blood test

Alanine aminotransferase (also ALT, ALT) is a protein enzyme that is responsible for the transport of certain molecules and acceleration of biochemical processes involving amino acids.

ALTs are found mostly in organ tissue cells. In healthy people, the ALT in the blood cannot be increased, since if ALT is released into the blood, it is likely that a serious disease occurs in some part of the body.

Most of all ALT is found in the liver, it can also be found in the kidneys, heart muscle, nerve connections, lungs. Damage to these organs and tissues can cause an increase in ALT in the blood.

Optimal value in the body

This parameter is measured in units per liter of blood. ALT is age dependent in childhood and sex dependent in adults.

Children under one year old: no more than 55 units / l

Children 1-3 years old: no more than 34 units / l

Children 3-6 years old: no more than 30 units / l

Children 6-12 years old: no more than 39 units / l

Men: no more than 45 units / l

Women: no more than 35 units / l

The norm in this case is not a strict only possible value, but an approximate criterion of assessment. In some laboratories, devices may have different degrees of sensitivity, which means that the analysis results should be discussed with the attending physician of this medical institution.

Alanine aminotransferase is elevated, what does it mean?

According to the degree of difference between the actual result of the analysis and the value taken as the norm, they are distinguished:

• Slight increase (200-500%);
• Moderate increase (up to 1000%, that is, 10 times more);
• Expressed (more than 10 times higher than the norm).

The second and third stages most likely indicate that the elevated ALT in the blood is a consequence of the disease, and the third case occurs in those patients who have already begun serious organ destruction.

In addition to diseases, which we will consider below, elevated ALT may be associated with the following confounding factors:

• Muscle injuries;
• Burns;
• Intramuscular injections given the day before;
• Large weight (body mass index over 30);
• Taking medications (estrogens, antibiotics, cholestatics, heparin, oral contraceptives, anti-epilepsy drugs, warfarin, echinacea, valerian, etc.);
• Mononucleosis;
• Pregnancy (third semester), provided that ALT is slightly increased;
• Chemotherapy;
• Drug use;
• Lead intoxication;
• Laboratory inaccuracies.

In order to get a reliable result, it is necessary to donate blood on an empty stomach, 12 hours after the last meal. Refrain from alcohol a week before going to the clinic, and from smoking an hour before donating blood. Try not to get stressed or physically overwhelmed. If you doubt the accuracy of a blood test, take it to another laboratory.

To determine whether the blood ALT is normal or elevated, blood is often drawn from a vein, but in some cases also from capillaries.

Causes and diseases when ALT is elevated in the blood

Since the enzyme under study can be retained in various organs, it may indicate a problem with their health. Let's consider what it means "ALT is raised" in each case.

1. Liver disease

The largest amount of ALT, as already mentioned, is located here, it is not surprising that this analysis is recognized in time to notice and cure liver diseases.

• Steatosis

The accumulation of fat in liver cells affects the fact that ALT is increased by 2 times. But if the painful condition worsens to steatohepatitis, ALT will increase much more, and the level of bilirubin will also increase.

• Hepatitis

If ALT is increased in the blood test, and the symptoms of the disease have not yet appeared, we can talk about hepatitis A. Usually, the symptoms are delayed, and thanks to the timely donation of blood for analysis, you can speed up the healing process.

With hepatitis B and C, ALT increases even 100 times, since the toxic effect of the virus spread in the liver is especially great on its cells.

Chronic hepatitis causes an increase in ALT during an exacerbation, but the increase is usually no more than 3-4 times.

Other symptoms of hepatitis include pain and discomfort in the right side, under the ribs, a feeling of a bitter taste in the mouth, yellowing of the skin, mucous membranes, whites of the eyes, and stool disorder.

• Cirrhosis

Very high blood ALT may not be observed in cirrhosis. ALT will increase, but 1-5 times from the norm. This is due to the replacement of liver cells with connective tissue.

• Liver cancer

Usually, malignant tumors in the liver appear in people with hepatitis. The level of how much alanine aminotransferase is elevated helps to decide on the further treatment of cancer with surgery. For example, if ALT is very high, the operation has a high risk of complications.

• Autoimmune hepatitis

A disease more common in women than men. To clarify its presence or absence, the doctor may prescribe a biopsy.

1. A heart

Heart disease, or rather heart muscle, is primarily indicated by another analysis - AST, but along with it, ALT is also used for diagnosis.

• Myocardial infarction

The death of a part of the heart muscle, as a result of which a certain amount of AST and ALT enters the blood. If the AST analysis is greatly increased and the alanine transaminase is increased by 5 times, the reasons should be sought in the possibility of myocardial infarction.

Other symptoms: sharp pain in the region of the heart, radiating to the left upper side of the body, the pain can last half an hour or more, the patient has shortness of breath, dizziness, panic fear of death, weakness.

• Myocarditis

Just as for other diseases of the heart muscle, myocarditis cannot be established only on the basis of the fact that ALT is elevated. The reasons for this can be varied. Often, to clarify the diagnosis, an analysis for AST is also considered and the de Ritis coefficient is calculated, equal to ALT / AST.

Symptoms include shortness of breath, weakness, and rapid fatigability of the patient.

Heart failure, rheumatic heart disease, and recent heart surgery can also cause an increase in ALT in the blood.

1. Pancreas

• Pancreatitis

The disease can be acute or chronic. An increase in ALT indicates an exacerbation stage. For people with pancreatitis, it is advisable to donate blood regularly for ALT analysis.

ALT elevated in the blood test can be an alarm bell of any serious and even destructive disease, or it can be a common mistake or a normal reaction of the body. Your further examination determines the prompt diagnosis and possible treatment.

Leave your comments with questions and wishes below.

The cells of the liver, heart and some other organs produce special enzymes that are involved in metabolic processes. Normally, they practically do not enter the bloodstream, and during the analysis they are not detected or are contained in very small quantities. However, diseases that cause destruction cell structure tissues, promote the release of these enzymes into the bloodstream. The most significant in the diagnosis of pathological processes are substances abbreviated as AlAt and AsAt.

This is the abbreviated name for one of the main enzymes that ensure the metabolism of amino acids - alanine aminotransferase. It is produced mainly by hepatocytes - liver cells. It is synthesized in smaller amounts in skeletal and cardiac muscle tissue, pancreas... Usually, in the blood of a healthy person, alanine aminotransferase is not detected or is found in very small quantities in a laboratory biochemical study. At the same time, ALT is increased in men due to the accelerated amino acid metabolism (in women, it is carried out less intensively).

Most often, a comprehensive laboratory analysis is carried out with the determination of the concentration of another substance - aspartate aminotransferase (abbreviated as AsAt). It is produced by the same cells and also participates in amino acid metabolism. The content of the enzyme in the blood plasma also changes in certain diseases of the liver and musculature of the heart, indicating necrotic processes.

But the main diagnostic value is the ratio of these two enzymes, the value of which is called the de Ritis coefficient and allows you to reliably establish the localization pathological process... If the reference (permissible) indicators are exceeded, and the value of the coefficient is less than 0.91 or more than 1.75, one can assume liver problems in the first case or heart disease in the second.

Norma AsAt and AlAt in biochemical blood test

The concentration of these enzymes change over time, which is the norm in childhood... For example, infants have higher levels than adults due to the nature of the period of labor. Due to the massive release of erythrocytes into the blood and their subsequent transformation into bilirubin, jaundice characteristic of newborns develops and, accordingly, an increase in the amount of ALT.

For AsAt and AlAt, the norms in children different ages and adults can be found from the table:

As can be seen from the table, normal indicators constantly fluctuate in childhood and adolescence, and from the age of 12 they also differ according to the sex of the subject. In addition, a slight increase in the level of ALT is the norm in women in the blood during early pregnancy. However, in the last trimester, an increase in the concentration of the enzyme indicates gestosis, which threatens the health of the mother and fetus.

Aspartate aminotransferase is also determined in different quantities according to sex and age. In adult men, the upper limit of the norm is 37 units per liter, for women - 31. The highest level is observed in children of the first days of life (up to 97 units / l), decreasing to 82 by one year, and to 36 by six. -17 years old are considered normal values \u200b\u200bnot exceeding 29 and 25 U / L for boys and girls, respectively.

In the analysis of blood, ALT and ASAT are increased - what does this mean, what are the reasons?

An increase indicates pathological destruction of hepatocytes, heart cells, pancreas. Normally, they enter the bloodstream in a minimal amount, as a result of natural tissue renewal and the death of old cells. Extensive organ damage and massive cell death lead to a sharp increase in their volume in the bloodstream. Thus, an increase in serum AlAt parameters is characteristic of the following diseases and conditions:

• hepatitis, liver cirrhosis, fatty degeneration;
• acute pancreatitis;
• extensive burns, shock;
• viral infections;
• lymphoblastic leukemia;
• shocks of various etiologies;
• disorders of hematopoiesis;
• muscular dystrophy;
• mononucleosis.

Increased blood AST or aspartate aminotransferase appears in blood plasma in large quantities during necrotic processes in the body. Exceeding the maximum permissible indicators several times (from 2 to 20) is a sign of diseases of the following organs:

• Heart - coronary insufficiency, myocardial infarction, thrombosis pulmonary artery, angina attacks, postoperative condition, rheumatic heart disease.
• Gallbladder and liver - cholestasis, cholangitis, amebiasis, liver cancer, hepatitis, cirrhosis.
• Pancreas - acute inflammation or phlegmon.
• Skeletal muscle - damage or dystrophy;

The concentration in the plasma of the amount of the enzyme increases and with such systemic and infectious pathologieslike vasculitis, mononucleosis, hemolytic syndrome.

Could the increase in the content of alanine aminotransferase and aspartate aminotransferase be caused by other causes not associated with diseases? Yes, enzyme levels rise in women early in pregnancy, which is normal. The same phenomenon can be observed when using some medicines: antibiotics, antineoplastic and sedative drugs, barbiturates, oral contraceptives and others. The level of physical activity, intake of sports nutrition, alcoholic beverages also affects the growth of indicators.

Who needs research

A referral to the biochemical blood test AsAt and AlAt is obligatory given to all donors before the blood collection procedure, as well as to persons with identified pathologies of the liver, heart, and pancreas.

The results of this study are also used for hepatitis, cirrhosis, as they allow to determine the degree of organ damage. In addition, it is necessary to control the amount of enzymes during treatment with certain antibiotics, as well as after the ingestion of toxic compounds.

The basis for a biochemical blood test is also a deterioration in general well-being in the form of constant weakness, rapid fatigue, and loss of appetite. Frequent symptoms such as abdominal pain, nausea and vomiting, yellowing of the whites of the eyes, darkened urine, and digestive problems are a reason to see a doctor for a referral immediately.

How to prepare for the analysis for AlAt, AsAt

You need to donate blood from a vein for research, which is done in state polyclinics on a referral basis or on a paid basis in private laboratories. A blood test for AlAt and AsAt is taken in the morning and strictly on an empty stomach: at least 12 hours should pass after the last meal. On the day of visiting the laboratory, you should not smoke, drink any liquid other than water. All week before the test, it is strictly forbidden to drink alcohol.

In addition, the result may be distorted by the intake of any drugs - antimicrobial, contraceptive, choleretic, sedative and others. So the question of their cancellation or temporary suspension of treatment should be discussed with the attending physician in advance. The term for the analysis is a day, that is, the next day you can go for the results. For an additional fee, the process can be accelerated: the express test is done in just 2 hours.

Decoding analysis

The test results must be presented to your doctor. The specialist pays attention to the quantitative indicators of the content of both enzymes, the degree of exceeding the maximum allowable value and their ratio. For example, the concentration of ALT allows one to draw conclusions about the nature of liver diseases. So, hepatitis A, B, C causes a 20-fold excess of the norm, and alcoholic ones - 6 times. With fatty degeneration, there is an increase of 2 or 3 times.

As for oncological diseases (liver cancer, in particular), then one should pay attention to aspartrtaminotransferase and its concentration.

With carcinoma, it increases several times, and progresses over time. At the same time, the values \u200b\u200bof alanine aminotransferase increase slightly. In the late, inoperable stages of cirrhosis, the opposite phenomenon is observed.

Of particular importance is the so-called de Ritis coefficient - the numerical ratio of the increased values \u200b\u200bof AlAt and AsAt, especially if the localization of the pathological process has not yet been precisely established. With liver damage, an increased blood ALT is usually observed, and the content of aspartate aminotransferase decreases. If the myocardium is damaged, the proportion is reversed. Normally, the de Ritis coefficient ranges from 0.91 to 1.75, that is, with the destruction of hepatocytes, it is much less than 1, and with a heart attack - more than 2.

In addition, the concentration of enzymes is reduced. For AlAt and AsAt in the blood test, this is typical in the case of repeated sessions of hemodialysis, rupture of the liver, its necrosis or cirrhosis, as well as with a pronounced lack of B-group vitamins in the body or taking anticoagulants. In any case, a specialist should deal with decoding, taking into account third-party factors that could affect the final result of the study, since it is not always determined by pathological reasons. It is unacceptable to draw conclusions and make diagnoses independently without special education.

How to lower ALT in blood?

If quantitative deviations of indicators from the norm have been identified, first of all it is necessary to exclude the influence of such factors as the intake of dietary supplements and alcohol, excessive physical exercise... A diet that includes too many fatty and "heavy" foods also needs to be adjusted. Often it is food that provokes inflammation of the pancreas, and diet promotes recovery.

When the reason becomes drug therapy, the doctor must adjust the course or replace the drug with a less toxic one. At the same time, the effectiveness of such a measure should be constantly monitored using regular analyzes. If the concentration of enzymes has changed due to liver disease or other pathological process, it must be identified and cured. For this, a full examination with hospitalization is usually assigned.

ALT is an enzyme from the group of transaminases, the full name of which is alanine aminotransferase. Its level is determined by a biochemical blood test. The substance is excreted during all metabolic processes, but in small quantities.

An increase in ALT concentration may mean damage internal organs... The greatest reserves of the enzyme are in the liver, therefore it is considered a marker of pathologies of the hepatobiliary system. The enzyme enters the bloodstream during the destruction of parenchymal organs and muscle tissue, which doctors determine by comparing its level and other indicators of biochemistry.

What is ALT and its role in the body

Alanine aminotransferase is a protein substance necessary for amino acid metabolism. Together with other similar enzymes, low molecular weight proteins are transported in this way:

• ALT is responsible for alanine;
• AST (asparaginaminotransferase) - for aspartic acid;
• GGTP (gamma glutamyl transpeptidase) - for glutamic acid.

The active part of the enzyme is removed by the coenzyme pyridoxine (vitamin B6). ALT is present in all organs and muscle tissue. Increased concentrations of the enzyme are detected in the parenchymal structures. The largest amount is found in the liver. At lower concentrations, ALT is determined in tissues:

• heart muscle;
• pancreas;
• kidney;
• lungs.

A small amount of the substance enters the bloodstream during metabolism. The bulk is in the organs in a bound form. Here's the enzyme:

• regulates metabolic rate;
• participates in immunity;
• involved in the synthesis of energy;
• supports the vital functions of cells.

The release of ALT in large quantities occurs during massive cell death. The more the enzyme is released, the more intense the destruction process. Determination of the ALT level refers to liver tests, since it is with damage to this organ that the deviation of the enzyme indicators is most noticeable.

ALT is an unstable indicator. It depends on age, gender. The amount of the enzyme can change with hormonal fluctuations, changes in the concentration of vitamins and minerals. The level depends on the characteristics of a person's metabolism and other individual factors. Stress, physical activity, medications, some aspects of the patient's lifestyle.

Table - Norms of ALT in blood by age

Population category	Reference value, U / l
Newborns 1-2 days	Up to 31
After 3 days of life	Up to 50
1-6 months	Up to 56
6-12 months	Up to 52
1-3 years	Up to 33
3-6 years	Up to 30
6-18 years	Up to 26
Adult women	Up to 35
Adult men	Up to 40
Pregnant	Up to 32
Elderly people	19‒30

Indications for analysis

The study of blood for ALT is carried out for the purpose of prevention, in order to assess the state of the body as a whole, the safety of the functions of internal organs, the balance of electrolytes and vitamins. Research is relevant to early diagnosis diseases, since it reflects the slightest changes in the basic parameters of the blood and supplements the information obtained in its general analysis. He is prescribed for suspicions of somatic diseases and functional disorders, the reason is the patient's complaints.

Table - Symptoms for which ALT should be assessed

Category	Alarms
Signs of hepatic pathologies	Jaundice (scleral icterus, discoloration of the skin and mucous membranes, dark urine, discoloration of feces) Pain in the right hypochondrium Digestive disorders (alternating constipation and diarrhea, flatulence)
General condition disorders	Sleep disorders (nightmares, insomnia) Psycho-emotional instability (irritability, tearfulness, apathy, aggression) Lack of appetite Weakness, fatigue
Others	Subfebrile condition Headaches, pressure behind the breastbone Dry mucous membranes Brittle nails and hair Sweating

In addition to diseases of the heart and liver, the level of ALT can be suspected of damage to the pancreas. Alcoholics are prone to pancreatitis and pancreatic necrosis, as well as persons who regularly consume fatty, fried, smoked foods.

Deviations in biochemical data are observed with extensive injuries (burns, electric shocks, muscle injuries), bone fractures, hematological pathologies. ALT is often elevated after surgery. Physiological prerequisites for an increase in the level of the enzyme are stress, exercise, carbohydrate diets.

Drugs that increase ALT are oral contraceptives, glucocorticosteroid hormones, chemotherapy drugs, antibiotics and antiviral drugs.

Minor and pathological deviations

Evaluation of the degree of enzyme (the presence of enzymes in the blood) is not considered an accurate measure of disease diagnosis. Focusing on the analysis data, one can only suspect the presence of pathological processes, as well as their intensity. To draw conclusions correctly, you need to be guided by the norms, permissible deviations, as well as their combinations with each other.

Since ALT always indicates cell damage, insignificant violations of the reference values \u200b\u200b(by 2-3 units) are considered physiological. Such changes are not considered a reason for further investigation and are simply ignored. If the level of increase is greater, you need to look for its cause. You can suspect it by how much the ALT indicator has changed:

• up to 2 times - a mistake is possible during the analysis, violation of the rules of preparation, severe stress, overwork, medical procedures the day before, you need to retake the test;
• 2-3 times - suspect alcohol consumption, significant errors in diet, injuries, excessive physical activity;
• 3-5 times - such an increase is observed against the background of the use of hepatotoxic drugs, injuries of internal organs, after surgical interventions, burns, as well as with chronic pancreatitis;
• 5 or more times - inflammation of the liver tissue with an infectious lesion can be suspected;
• 10 times - muscle dystrophy, chronic liver diseases or initial forms of destructive processes are possible;
• 20 times or more - dangerous liver diseases, cancer progression, cirrhosis.

ALT and other indicators

In order to assess the patient's condition with maximum accuracy, doctors analyze not only the compliance of each individual indicator with the norms, but also a combination of deviations. In case of serious diseases, deviations affect most of the biochemical parameters..

Together with ALT, the importance of another enzyme, AST, is considered. It is also present in the cells of the parenchymal organs, but the bulk is concentrated in the heart muscle.

In healthy people, the AST level is about 1.5 times higher than ALT. In the opposite situation, metabolic disorders can be suspected, when proteins are consumed to obtain energy, and carbohydrates are stored as reserves.

An important value for diagnosis is the de Ritis index. This is the ratio of AST and ALT. Its norm is 1.33, a deviation of 0.4 units is allowed upward or downward. A significant increase in the index is observed with myocardial damage (more than 2). The index approaches 2 in chronic alcoholic liver damage. Pathologies of the hepatobiliary tract provoke a significant decrease in the indicator. In most cases, elevated ALT is accompanied by an increase in bilirubin concentration.

To detect liver diseases, it is important to evaluate several enzymes at once (ALT, AST, alkaline phosphatase, gammaglutamyl transpeptidase) and the degree of their deviations. The larger they are, the more intense the pathological process and the higher the threat to the patient's health and life.

Table - Deviation of enzyme levels

Mild and moderate disorders are observed in non-alcoholic fatty liver disease, chronic viral hepatitis, as well as in the initial stages of the development of tumor diseases. The average increase accompanies chronic inflammatory lesions of the gland, ethanol poisoning. A significant increase in indicators is observed in the acute form of hepatitis, toxic damage, as well as in the late stages of cancer or cirrhosis.

Why ALT is elevated during pregnancy

While carrying a child female body is undergoing total changes. First of all, metamorphoses affect the hormonal background. The concentration of bioactive substances is constantly increasing until delivery. The enlargement of the uterus and the baby is accompanied by pressure on the internal organs. All of them suffer from increased loads associated with the need to supply the fetus with nutrients, utilize its metabolic products, and an increase in blood volume.

Normal ALT levels for pregnant women should be below 32 U / L. The indicator increases slightly in the first and third trimester. Moderate changes are considered a normal variation. If a woman did not suffer from heart or liver diseases before conception, does not complain of poor health, treatment is not required. The growth of the indices by more than 1.5 times requires special attention. This can be a signal of the development of gestosis, eclampsia, diseases of cardio-vascular system, liver or gallbladder. Often this happens against the background of long-term use of the progestogen medication - Dyufaston, Utrozhestan, Susten.

ALT in children

The concentration of alanine aminotransferase is increased in children of the first year of life. This is due to the active development of organs and systems, adaptation mechanisms that are aimed at adapting to life outside the mother's womb. The second peak occurs during puberty. At this time, the child is growing rapidly, the formation of hormonal levels occurs. When development slows down, ALT levels decline and remain stable. If the enzyme levels are greatly increased, this indicates dangerous diseases (as in adults).

What to do with elevated ALT

In most cases, doctors recommend taking the test again (in case of an error in the study of blood or violation of the rules of preparation). An additional examination is prescribed only if significant deviations are re-identified. It often includes general analysis blood and urine, ultrasound of the liver and other internal organs, MRI or CT, tests for tumor markers.

Different laboratories use different equipment for analysis, different units of measurement are used. In this case, a high indicator can be perceived by the patient himself as a deviation, when in fact it is not. In addition, ALT should be assessed along with other values. It is difficult to understand the results correctly without special knowledge.

With deviations in the results of blood biochemistry, you should consult a doctor. The child must be shown to the pediatrician, pregnant women must make an appointment with their obstetrician-gynecologist, and adults must see the doctor who ordered the examination or the therapist. It is better not to make independent conclusions, but to entrust the reading of the research protocol to a specialist.

In addition to the analysis itself, it is important to collect a family history, interview the patient for complaints, conduct a physical examination in order to detect objective symptoms of pathology. All this will help narrow the search for the disease that caused the increase in ALT.

How to be treated

ALT level is a laboratory indicator, a sign of destruction of cells of parenchymal organs. The increase in the enzyme itself is not subject to treatment. Therapy is completely aimed at the underlying disease, which provoked a shift in the result outside the normal range. It is important to stop destructive processes and start organ regeneration (if possible). In case of irreversible changes, the task of treatment is to slow down the destruction and provide surgical assistance (liver transplantation, for example).

The list of medications completely depends on the nature of the disease (for infections, antiviral or antibiotics are prescribed, for oncopathologies - chemotherapy drugs). The therapy regimen is selected based on the patient's condition. If the ALT indicator is significantly exceeded, the patient is monitored in the hospital (hepatitis, cirrhosis, cholestasis). Small deviations that do not pose a threat to the patient's life can be eliminated on an outpatient basis.

The main group of drugs that are used when the enzyme indicators deviate from the norm are hepatoprotectors... Means of this group have antioxidant, anti-inflammatory properties. They improve the functioning and start the recovery of hepatocytes, optimize the synthesis and properties of bile, preventing its stagnation in the ducts.

Most of the hepatoprotectors have anti-inflammatory properties. Most of these drugs have similar indications. Some of them are used in the complex therapy of hepatitis, hepatosis and cirrhosis, and some are used for disorders of the biliary tract, accompanied by cholestasis (gallstone disease, cholelithiasis).

Table - The best hepatoprotectors

Frequently asked Questions

Question: Do I need a diet for elevated ALT?

Answer: Diet therapy is a mandatory aspect complex treatment any liver pathology. Its task is to reduce the load on the gland, ensure the normal outflow of bile and optimize metabolic processes. A therapeutic diet is recommended even with minor deviations in children and pregnant women, so as not to aggravate liver damage. It is also necessary to adjust the diet in the case when it is necessary to be treated with drugs that are dangerous to the organ (antiviral agents or powerful antibiotics). In most cases, doctors recommend adhering to the Pevzner diet 5 (for diseases of the liver, bile, pancreas).

Question: The dietary table menu is so complex ... Can I briefly describe general principles nutrition with high enzymes?

Answer: Everything harmful is excluded from the diet - fatty, fried, smoked, flour, sweets, canned food, pickles and pickles, fast food, soda and alcohol. The menu should contain all types of cereals (except for barley), easily digestible proteins (chicken, fish, turkey, dairy products), a lot of vegetables and fruits (in any form). It is important to replace animal fats with cold-pressed vegetable oils (fill cereals and salads with them), add nuts to the menu. You need to eat fractionally, in small portions, every 3 hours to optimize bile flow. Drinking regime should be observed (1.5 liters of water per day, except for other liquids).

Question: Is it possible to reduce the indicator using folk methods (without drugs and diets)?

Answer: As part of the complex therapy of liver pathologies, you can use herbal remedies (decoctions and infusions). For example, hepatic collection, Hepatofit tea, milk thistle meal. The people recommend to brew corn silk, dandelion root, yarrow, St. John's wort, peppermint. All these methods can be auxiliary or used to prevent bile stagnation. In the treatment of serious diseases, herbs alone are indispensable. Moreover, phytotherapy and vitamins during the development of oncopathologies can only harm. Before using any alternative recipe, it is better to consult with your doctor.

Q: Could a high ALT be a false result?

Answer: Maybe. An error should be suspected if only this indicator is increased or the deviations are insignificant (up to 2 times). That is why biochemistry often has to be retaken. In order to be on the safe side, you should properly prepare for the test:

• exclude alcohol and drugs a week before donating blood;
• limit junk food in 3 days;
• eliminate stress, overstrain and physical activity on the eve of the analysis;
• donate blood only in the morning, on an empty stomach.

Even if all the conditions are met, and the result shows deviations, it is better to repeat the analysis. This will eliminate the pointless visit to doctors and the cost of hardware diagnostic methods.

Question: What symptoms can be used to understand that ALT is elevated and it is time to take a biochemical blood test?

Answer: An increase in the level of enzymes in the blood does not cause specific symptoms. According to clinical signs, one can only assume the presence of a disease that can provoke ALT deviations from the norm, for example:

• damage to the pancreas is accompanied by girdle pain in the abdomen, nausea, vomiting, flatulence, stool disorders, fever;
• liver pathologies are manifested by pain under the right rib, jaundice, periodic disorders in the gastrointestinal tract, general disorders of the condition;
• heart disease can be suspected by pressing and stitching pains in the chest (often radiating to the arm, shoulder blade, collarbone), shortness of breath, edema, cyanosis of the extremities.

conclusions

ALT is an important laboratory indicator that helps assess the health of internal organs. The average rate for adults and school-age children is 35 U / l. Deviations mainly indicate diseases of the liver, heart, pancreas and indirectly can talk about the pathology of the kidneys and lungs. With an increase in ALT levels, hepatic disorders are primarily suspected, or rather, cell destruction. To pinpoint the problem, ALT is considered in combination with bilirubin, other enzymes. A full diagnosis can be carried out by comparing the results of biochemistry, general analysis of blood and urine, ultrasound of internal organs. It is not high ALT that needs to be treated, but the disease that caused its growth.

Along with ALT, another enzyme is always considered - A FROMT (aspartate aminotransferase). In women, it should be up to 31 U / l, in men up to 41 U / l. An increase in the concentration of AST in the blood indicates the destruction of cells of the heart, liver, pancreas and other organs.

When cells are destroyed as a result of damage to an organ, ALT enters the bloodstream, representing an important diagnostic indicator.

What is alanine aminotransferase needed for and where is it contained

Alanine aminotransferase plays an important role in the body, participating in the exchange of amino acids, in particular the essential amino acid alanine. He, in turn, plays a role in providing energy to the central nervous system, strengthening of immunity, regulation of metabolism and production of lymphocytes.

Where ALT is contained:

Analysis for ALT, delivery rules and norms

The ALT indicator is included in the biochemical blood test along with other transaminases. It is necessary to take the analysis on an empty stomach, in the morning. Eliminate alcohol for a week. Must be at least eight hours after dinner. All this is important for obtaining reliable data. Taking some medications affects the ALT index, which is why when taking oral contraceptives, aspirin, paracetamol, warfarin, inform your doctor about it.

A blood test is taken from a vein

Reasons for increasing ALT

An increase in ALT in the blood occurs as a result of cell destruction. What diseases lead to this.

Hepatitis is an acute or chronic inflammatory process in the liver of an infectious or alimentary-toxic nature. Viral hepatitis develops when infected with hepatitis viruses (A, B, C, D, E, and F). Moreover, the disease can be asymptomatic for a long time. For example, viral hepatitis C in this regard is called "affectionate killer", since for a long time, damaging liver cells, he does not manifest himself in anything. Ultimately, cirrhosis develops. Alimentary toxic hepatitis develops under the influence of substances that destroy liver cells. Including, long-term alcohol consumption leads to it.

This is the effect of large doses of alcohol on the liver.

Liver cirrhosis is the outcome of all liver damage, when the destroyed cells are replaced by connective tissue, and it can no longer perform its functions. All this leads to liver failure and severe complications.

It is worth noting that, in addition to ALT, acute hepatitis is accompanied by an increase in other transaminases (AST, GGTP), and the level of bilirubin also increases.

Pancreatitis is damage to the pancreas with necrosis of its tissue. The reasons for development are the abuse of fatty foods and alcohol or stones in the biliary tract. Patients with chronic pancreatitis need to check this indicator throughout their lives to prevent exacerbation.

The predominant increase in ALT over AST will be with liver damage, and if vice versa - the heart.

Myocarditis is an inflammatory heart disease characterized by damage to the heart muscle. In this situation, the blood test is also characterized by an increased concentration of ALT and AST.

Burns, frostbite, multiple organ failure, extensive trauma - all these conditions are accompanied by a significant increase in ALT.

Also, oncological processes in the above-named organs are the reasons when ALT is increased.

When ALT is lowered

Decreased ALT content is possible with a deficiency folic acid and some vitamins. With cirrhosis of the liver, a decrease in ALT is a poor prognostic sign, indicating the complete absence of preserved healthy cells.

Pregnancy

During pregnancy, in the first trimester, a slight increase in ALT is possible. There is nothing terrible in this, it is physiological and is connected with the pregnancy itself. If ALT rises significantly, and characteristic symptoms appear, an urgent need to consult a doctor for examination.

Symptoms

Symptoms of an increase in alanine transaminase in the blood are varied. Clinical picture due to the affected organ and the disease that led to it.

From the liver

A characteristic symptom of liver cirrhosis is the "head of a jellyfish", a combination of ascites and varicose veins of the abdominal wall

With liver damage, pain in the right hypochondrium, nausea, and vomiting are possible. Possible jaundice of the skin, icterus of the sclera. When viral etiology there may be hyperthermia. With the development of cirrhosis, rashes appear on the body of the type spider veins, an increase in the abdomen due to ascites (accumulation of fluid in the abdominal cavity).

Varicose veins (esophagus, stomach), which can be complicated by bleeding. Multiple organ failure gradually develops.

From the pancreas

Pancreatitis is manifested by severe pain in the abdomen, in the navel, its swelling, repeated vomiting, weakness, clouding of consciousness later.

From the side of the heart

The main symptom in myocardial infarction is severe, burning pain behind the sternum, which can spread to left hand, jaw, under the scapula

A painless form of a heart attack is possible, or atypical, when pain is localized in the abdomen, or severe shortness of breath develops. In addition to pain, heart rhythm disturbances, a drop in blood pressure are possible. Disturbed by severe weakness, fear of death, chills.

In the presence of an oncological process in the affected organ, severe weight loss in a short period of time, weakness, and increased fatigue are possible.

Diagnostics

Diagnosis of the disease, the reasons for the increase in ALT, is carried out by doctors using all available research methods. In many cases, on an emergency basis, since there are among them life-threatening diseases and leading to disability.

A correctly interpreted biochemical blood test can push you on the right diagnostic path. So, there is the concept of the de Retis index, which is the ratio of increased AST and ALT. Its rate is 0.91-1.75.

If it exceeds two, then the reason is in the heart muscle. If less than one, then the liver is affected.

In the hospital, a full examination is carried out, which also includes MRI or CT, extended blood and urine tests. Invasive methods such as puncture biopsy and angiography of the heart vessels are also used. All this allows you to quickly make the correct diagnosis and start treatment.

Treatment

In order to lower the ALT level, it is necessary to cure the disease that led to this, after which the ALT rate will return on its own.

Approximate set of products for patients with liver and pancreas diseases

Such serious diseases as pancreatic necrosis, extensive myocardial infarction, severe hepatitis complicated by multiple organ failure are treated in the intensive care unit.

The treatment of each disease is specific and it makes no sense to describe it. A few words can be advised for people taking medications that affect the liver, as well as alcohol abusers. In such cases, it will be useful to periodically drink a course of hepatoprotectors (Carsil, Essentiale) and at least somehow protect liver cells from damage, thereby lowering ALT.

For many diseases, such as pancreatitis, hepatitis, diet is very important. Reduce consumption or completely eliminate all fatty, spicy, smoked, salty and alcohol. To prevent flare-ups, a healthy lifestyle should be your goal in itself!

Hello! Can two out of three hepatitis vaccines test positive for hepatitis B? ALT-23, AST-50. Thank you for your answer.

I have alt 180, what does it mean?

And I have AST 1566 and ALT 1555. Viral hepatitis was ruled out, I don't drink alcohol, I go in for sports, I lead a healthy lifestyle, there are no gallstones.

Good afternoon! I have ALT 134 what does it mean and what examinations need to be done? AST is normal

Good afternoon! I have Ast-63.71 Alt-82.57, ultrasound abdominal normal, MRI is normal, pain in the right hypochondrium, doctors cannot deliver anything, what examinations need to be done !? Thanks for the answer!

I have AST 38.4, Alt-46.9, vaccinated against hepatitis B in 2011. I don't drink, I don't smoke, I go in for sports. What is it?

Good afternoon, I have A-ALT-42 U / L, A-AST-32U / L, what could it be? What examination do I need to do?

Good afternoon, I have a blood chemistry test: A-ALT- 42 U / L, A-AST- 32 U / L, what can this mean? Tell me what kind of examination I need to do?

I have AST-39.9, ALT-59.7, total bilirubin 12.4. What can it be, how can I be examined? Answer please.

Good afternoon! I have ALT-45.8; AST-34.8; Bilirubin - 9.8. I live a healthy lifestyle, but I use the statin ROSISTARK (rosuvastatin), 0.5 ml every day. Due to this, the total cholesterol is 4.92 (when I do not use this drug, cholesterol rises to 7). What can I do, please advise. The ultrasound did not find anything special in the liver. Maybe you need to get a statin for example. in Switzerland (there is such an opportunity), maybe there is a "cleaner" drug? Without statins, cholesterol will rise again, especially since there has already been a microstroke.

alt-46.6, ast-28.1. What could be?

This slight increase, most likely, overloaded the liver, monitor the diet, after 2 weeks, do the analysis again.

On the 2nd day after the operation to remove the gallbladder, a blood test was taken, ALT and AST were more than 150, bilirubin was 0.03 higher (they had not yet removed the drainage, because there was a little fluid, an ultrasound scan showed). The hospital said that the tests were almost normal, and the gastroenterologist said that I practically had hepatitis (the tests were normal before the operation), all organs were not inflamed. Is the doctor right? What could it be from?

Good afternoon. I have Alat 50 and Asat 24.2, cholesterol 7.95 and triglycerides 3.79. With cholesterol it is clear, but what are the other indicators talking about? Thanks.

Elevated ALT levels in the blood - the main causes

ALT - alanine aminotransferase. It is a specific enzyme involved in the production and breakdown of proteins. It is synthesized by cells of various organs: liver, spleen, kidneys, lungs, heart muscles. Normally, a small amount enters the bloodstream. An ALT blood test is a common diagnostic test.

Diagnostics based on ALT analysis

Determination of the level of alanine aminotransferase is carried out as part of a general biochemical blood test. Complaints for which a blood test for ALT is prescribed are:

• Increased fatigue;
• Decreased appetite;
• The appearance of weakness in the body;
• Pain on the right side of the abdomen;
• Discoloration of urine;
• Yellowness of the skin;
• Pain in the region of the heart;
• Desire for nausea.

Possible diseases with an increased ALT

It is mandatory to determine the level of aminotransferase in patients suffering from obesity, diabetes mellitus, liver disease.

Important! Blood donation is carried out in the morning on an empty stomach. It is not recommended to consume alcoholic beverages and fatty foods the day before the analysis.

You should also refrain from taking strong medications. The results of the study can be influenced by the psychoemotional state of a person and physical stress.

Exceeding the threshold of the norm

In medical research, the upper limit of ALT is important. The limit for adult men is 45 units / l, for women 34 units / l. An increase in ALT in a blood test indicates an inflammatory process in the body. Below are the diseases that cause this pathology.

1. Pancreatitis Severe damage to the pancreas. It occurs due to the appearance of a tumor that blocks the enzyme ducts. As a result, the accumulated digestive enzymes begin to digest the pancreas itself. Death is possible;
2. Hepatitis. Liver disease. It is characterized by inflammation of the tissues of the organ. It is subdivided into several types. Hepatitis C is considered the most dangerous. The latter often becomes chronic and can cause cirrhosis of the liver. Common causes of hepatitis are: toxic damage to liver cells (for example, alcohol), viral infection;
3. Myocardial infarction. The most serious heart disease. It is characterized by the death of some parts of the heart muscle, due to a critical decrease in blood circulation. There are many reasons for pathology. Basic: smoking, hypertension, obesity, diabetes mellitus, sedentary lifestyle.

There are reasons for exceeding the norm of ALT in the blood test, which are not related to the listed diseases:

• Chemotherapy;
• Injuries accompanied by damage to the muscles of the body;
• Taking potent drugs;
• Physical and emotional stress;
• Eating fatty fried foods
• Taking drugs.

Important! The main recommendations aimed at reducing the likelihood of these diseases will be: proper nutrition, refusal to use drugs (including alcohol, nicotine), moderate physical activity, reduction of stressful situations in life.

De Rittis coefficient

One of the most important research methods is considered to be the comparison of the ALT level with the level of AST - aspartate aminotransferase. The latter is also an endogenous enzyme involved in the synthesis of amino acids. Aminotransferases have similar cut-off blood levels. The diagnosis of this or that pathology depends on the balance of ALT and AST. The AST / ALT ratio is characterized by the de Rittis coefficient.

Important! The normal value of the de Rittis coefficient is 1.33-1.75 U / L.

A decrease in the norm below 1 U / L will mean viral liver damage. An increase in the coefficient up to 2 units / l and higher, subject to an increased content of albumin, indicates a myocardial infarction.

Normal ALT / AST levels in the body:

• Alalnine aminotransferase: men - up to 45 units / l, women - up to 34 units / l;
• Aspartate aminotransferase: men - up to 41 U / L, women - up to 31 U / L.

Self-decryption of analyzes

Often, after reading medical information, patients try to independently decode a blood test for ALT levels. Having received the results in the laboratory, some people, seeing the deviation of indicators from normal values, independently diagnose serious illnesses.

Doctors know that exceeding the ALT threshold is not always a sign of pathology. Results from different laboratories may differ from each other. It depends on the equipment, on the research methods, on the materials used in the analysis. Other factors can also affect the results, be it the patient's improper lifestyle, medication intake, emotional state, and others.

Only a doctor can correctly decipher the research results. He also prescribes medication.

Today, doctors do not use ALT analysis as a means of accurate diagnosis. An excess of ALT indicators in a blood test indicates only the possibility of a disease. To make the final diagnosis, additional studies are used, specialists of a narrow profile are involved: urologists, cardiologists and others.

Normalizing ALT levels with folk remedies

After the examination, the patient with a high ALT level is prescribed medication. But for prevention, the doctor may recommend herbal medicine. Below are examples of using folk remedies to lower alanine aminotransferase levels.

• Milk thistle decoction. To prepare a teaspoon of chopped herbs, pour a glass of boiling water, wrap it up and let it brew for 20 minutes. Then the infusion is filtered. Take the broth in small sips, half an hour before meals, twice a day, for three weeks;
• Herbal collection. They mix immortelle, St. John's wort and celandine. The proportion of herbs is accordingly. The collection is poured with 1 liter of hot water, wrapped up and infused for 12 hours. Then you need to strain the infusion. Take half a glass 4 times a day, for two weeks;
• Dandelion infusion. For cooking, take 200 grams of crushed dandelion flowers. Pour 100 ml of vodka. The tool is insisted during the day. Take 2 tablespoons three times a day, for three weeks;
• A decoction of corn silk. To prepare the product, take dried crushed stigmas. Pour 200 ml of boiling water and leave for a minute. Take the infusion twice a day in a glass. The course of treatment can be six months.

Important! Folk remedies are not a cure! They are used for the prevention of diseases and general strengthening of the body.

Level of evolution modern medicine allows you to accurately diagnose most of the known diseases. One of the generally accepted research methods is a biochemical blood test. It contains many indicators, one of which is the level of alanine aminotransferase.

An excess of the normal level of ALT indicates the possibility of developing serious diseases in the body. But only a doctor can accurately determine the disease. We strongly recommend not to engage in self-diagnostics and even more self-medication. When appearing alarming symptoms go to the clinic immediately. They will conduct all the necessary examinations and help you cope with the problem.

How to get rid of varicose veins

The World Health Organization has officially declared varicose veins as one of the most dangerous masculine diseases of modern times. According to statistics for the past 20 years - 57% of patients with varicose veins die in the first 7 years after the disease, of which 29% - in the first 3.5 years. The causes of death vary - from thrombophlebitis to trophic ulcers and cancer caused by them.

The head of the Phlebology Research Institute and an academician of the Russian Academy of Medical Sciences told in an interview about how to save your life if you were diagnosed with varicose veins. See the full interview here.

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Increased ALT in the blood: causes and treatment

Alanine aminotransferase (ALT) is a special substance involved in amino acid metabolism. It is usually found in organs such as the liver, heart, and kidneys.

The penetration of this enzyme into the bloodstream is evidence of a pathological process. What this means and with what ailments it is connected will be described later in the article.

In most cases, alanine aminotransferase is elevated in diseases that affect the liver. However, the possibility of pathology and other vital organs is not excluded.

The concentration of ALT in the blood is an important diagnostic indicator that determines the localization and severity of the pathology.

The main functions of ALT

This enzyme is essential for health. Thanks to him, metabolic processes are carried out, which helps to strengthen the immune system, provide the body with the necessary energy supply, as well as the production of lymphocytes.

All processes take place inside cells with a small release of the enzyme into the bloodstream.

Due to the destructive process taking place in the cells of the liver and other organs affected by the disease, ALT penetrates into the blood in large quantities. Its presence, exceeding the permissible values, becomes an important indicator for the diagnosis of certain diseases.

The presence of alanine aminotransferase is characteristic of organs such as:

• the liver, where its concentration is highest;
• heart muscle;
• lungs;
• kidneys;
• pancreas.

This becomes a prerequisite for a thorough examination of these particular organs when high ALT values \u200b\u200bare found in the biochemical blood test.

Indications for analysis

An increase in the level of ALT in the blood signals not only the pathology in the listed organs. It also indicates the possibility of the presence of other diseases.

That is why blood biochemistry is evaluated. The analysis reveals deviations, becomes an integral part of preventive measures, effective way diagnosing serious diseases of the liver, myocardium and pancreas.

This study becomes mandatory when observing pathological changes in the liver that occur as a result of taking medications, hepatitis, and poisoning with toxic substances.

A biochemical blood test is prescribed in case of the following symptoms:

• intense pain in the right hypochondrium;
• yellowness of the skin and eye sclera;
• clarification of feces and dark urine;
• lack of appetite;
• general weakness.

Timely detection of an increased ALT content makes it possible to eliminate such signs by making an accurate diagnosis and prescribing an adequate course of treatment.

Other symptoms

In addition to the manifestations listed above, indicating a high level of ALT in the blood, there are symptoms that appear depending on the defeat of a particular organ:

1. Liver. Ailments are accompanied by painful manifestations under the right ribs, discoloration of the skin and yellowness of the eyes. Viral hepatitis occurs against a background of increased body temperature. Cirrhosis is characterized by the accumulation of fluid in the abdominal cavity, the so-called spider veins appear on the skin.
2. A heart. The main symptom of myocardial infarction is intense pain in the area chest, extending to the subscapularis, left arm and jaw. Violated heartbeat, shortness of breath occurs, blood pressure decreases. There is general weakness, chills.
3. Pancreas. Nausea, repeated vomiting, sharp or aching pains in the stomach, bloating, weakness.

If there is oncological process, in addition to these signs, there is a sharp loss of weight and loss of strength.

Diagnostics

Identification of a high level of enzymes in combination with the listed manifestations makes it possible to quickly diagnose diseases, which significantly increases the effectiveness of treatment.

For research, blood from a vein is taken in the morning on an empty stomach. The reliability of the results depends on the preliminary preparation of the patient with the following simple rules:

• the last meal no later than 8 hours before sampling the biomaterial;
• elimination of alcohol and smoking cessation;
• limiting physical activity.

In case of use medications notify the physician.

Only if these requirements are met, the analyzes will be accurate, which will make it possible to make an accurate diagnosis.

Analysis decoding

It should be noted that when decoding the results, the values \u200b\u200bof such an enzyme as AST are also taken into account. According to the Ritis coefficient scale, which considers the ratio of these enzymes, indices up to 1.65 conventional units are taken as the norm.

Exceeding these values \u200b\u200bby 2 times indicates pathological changes in the heart muscle. Readings below 1.0 indicate liver damage.

However, with hepatitis of viral origin, a decrease in these values \u200b\u200bis observed, and liver damage due to alcohol poisoning provokes their significant increase.

A comprehensive examination of a patient with a high level of enzymes involves the use of MRI, CT, general urine and blood tests, and a number of other measures.

ALT norms

In an adult and in children, there is a significant difference in indicators that are considered within the normal range. The table shows that the permissible concentration of this substance depends not only on age, but also on gender:

In a child from 1 to 3 years old

The indicated values \u200b\u200bare approximate, but small fluctuations up or down are allowed - from 1 to 3 units.

Factors affecting performance

The reasons for the increase in ALT are quite varied. But most often they indicate liver pathology and are a kind of marker of its condition. In addition, high values \u200b\u200bare found even with minor diseases of other organs, when they are accompanied by cell destruction.

1. Varieties of hepatitis. At the same time, chronic and viral forms do not cause a significant deviation of ALT from the norm.
2. Obstructive jaundice. High rates are also extremely rare.
3. Cirrhosis of the liver. It is characterized by the absence of pronounced symptoms for a long time.
4. Fatty liver disease - steatosis. This condition is characterized by a slight increase in the blood count. However, if the pathology turns into steatohepatitis, alanine aminotransferase increases significantly, and the level of direct and total bilirubin also increases.
5. Malignant neoplasms in the liver. They are often the result of hepatitis. Biochemical analysis to determine ALT parameters allows not only diagnosing the disease, but also making a conclusion about the need for surgical intervention. ALT values \u200b\u200bincrease significantly after chemotherapy.
6. Pancreatitis With exacerbation inflammatory process in the pancreas, ALT rises. Indicators can increase 3-6 times.
7. Myocarditis (damage to the heart muscle). In addition to increasing enzyme levels, a striking symptom shortness of breath becomes.
8. Myocardial infarction. The pathology is indicated by an excess of ALT values \u200b\u200bby 5 times. An increase at once indicates the progression of deterioration.
9. Alcoholism. There is an increased concentration of ALT, which increases after drinking.
10. Muscular dystrophy. ALT values \u200b\u200bcan increase 8-9 times.

Exceptionally high rates provoke acute hepatitis: exceeding the norm at once.

Other reasons

In addition to diseases, physiological reasons also act as factors causing the ALT values \u200b\u200bto deviate upward. Among them:

• exceeding the permissible physical activity;
• taking alcohol before the examination;
• stressful situations;
• the use of fatty, fried, spicy foods.

Increased rates are observed during pregnancy. A slight deviation is considered natural.

Uncontrolled drug intake significantly affects the test results. Therefore, if possible, you should refrain from using them before performing the analysis.

How to bring the indicators back to normal

Exceptional informational content of the results of blood biochemistry on ALT, which makes it possible to diagnose wide range pathological conditions, does not give grounds for independently drawing conclusions and making decisions.

This prerogative should be given to qualified doctors.

The underlying principle in integrated approach to eliminate the problem is further examination in order to find out the root cause of the deviation from the norm. Having found out which disease triggered the increase in values, the doctor will choose the correct treatment tactics.

Diseases characterized by a particularly severe clinical course require a treatment course in a hospital setting.

These include:

• pancreatic necrosis;
• extensive myocardial infarction;
• acute and infectious hepatitis;
• cirrhosis of the liver;
• oncology.

The treatment of each of them is specific and requires strict adherence to the doctor's recommendations.

Drug treatment

Among the most effective drugs used specifically to lower enzymes in the blood, hepatoprotectors should be noted:

Drugs in this group prevent further destruction of liver cells and other organs. At the same time, they restore cells damaged by the pathological process.

Other measures

In addition to taking hepatoprotectors, choleretic agents and drugs that improve digestive processes, it is recommended to stick to a diet:

• meals should be fractional and frequent;
• fatty, fried and spicy foods should be excluded from the diet;
• banned smoked meats, sausages;
• it is not recommended to use marinades, get carried away with pickles;
• food should be steamed, baked, simmered or boiled;
• limit the use of strong tea, coffee;
• exclude alcohol and smoking.

On the use of folk methods

As an aid, it is allowed to use decoctions and infusions of chamomile, thyme, St. John's wort, peppermint.

However, you should consult your doctor before using them.

The biggest harm comes from self-medication and an irresponsible attitude to one's health.

In order to avoid serious consequences caused by untimely access to a specialist, a blood test should be done 1-2 times a year. This will allow not to miss the beginning of the destructive effect on the body of diseases of the liver, pancreas and heart.

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When is a blood test for ALT prescribed and what is it?

In some diseases, people are prescribed a blood test for the ALT enzyme, and not everyone understands what it is. The abbreviation ALT (ALT) stands for alanine aminotransferase, which is a special endogenous enzyme component. Blood enzymes are synthesized exclusively inside cells. In the blood, the substance is contained in a small amount. With an increased level of transaminase in the blood during the biochemical analysis, it becomes clear that there are some pathologies or abnormalities in the body. Often a high level of the enzyme indicates the destructive processes of some organs (most often it is the liver) and the development of serious diseases. To find out the reasons why the level of the enzyme increased, a biochemical blood test for enzymes is performed.

The enzyme is found in almost all organ tissues. These are kidneys, heart muscle, liver, muscle tissue. The main function of the enzyme is to participate in metabolic amino acid processes. An analysis is carried out regardless of age: by blood, you can determine the level of the enzyme in a child and in an adult.

What is revealed by analysis

The largest amount of the enzyme is found in the liver tissues. Blood biochemistry allows you to identify pathological changes even on early stageswhen the disease does not manifest itself in any way. ALT is the most accurate indicator for detecting pathologies.

The amount of alanine aminotransferase is determined in a general biochemical blood test. The increased content of the enzyme helps to identify even jaundice without obvious signs on the body. Doctors prescribe a blood test for AST (AST - aspartate aminotransferase), ALT with long-term medication in order to exclude the possibility of developing drug hepatitis. The study must be prescribed for increased fatigue, weakness, loss of appetite, frequent nausea and vomiting, pain in the liver due to its enlargement, dark urine and light feces. All these symptoms may indicate developing hepatic pathologies.

At the same time, an increase in the level of AST in the blood and ALT is noted. In infancy, when studying the biochemical blood test of the child's AST, doctors may see an increase in the amount of the enzyme. This condition may be associated with jaundice and does not pose a visible threat to the child.

Biochemical studies can be used as diagnostic methodand the method of analysis during the treatment period to determine how effectively the therapy affects the pathology and at what stage the disease is. People who suffer from alcohol dependence or are at risk (in the presence of diabetes mellitus or overweight, are in contact with patients with hepatitis), an ALT test is prescribed without fail. A study is carried out on venous or capillary blood. In order for the results to be reliable, the patient should not consume spicy foods, alcoholic beverages for 10 hours before donating blood.

Normal ALT readings

The amount of alanine aminotransferase in children and adults is different. In a child, the indicators are as follows: for a newborn up to 4 days, the norm of AST, the norm of ALAT is up to 48 U / l; from 4 days to 6 months - 55; from 6 months to 1 year - 53; 1-3 years - 32; 3-6 years old - 28; 11 years - 38. In childhood, slight fluctuations in indicators may be allowed.

This is explained by physiological growth. By the age of 18, ALT levels stabilize and approach normal. Adults: men - 41; women - 32 U / l.

A deviation in the biochemical blood test is not always considered a pathology. It can be caused by infectious diseases. In some cases, blood-thinning drugs cause large amounts of the enzyme. Therefore, before conducting an examination, a person must be sure to tell the attending physician about concomitant diseases and medications used. The child has elevated level enzyme may indicate that an acute viral disease begins. Deciphering ALT in blood during biochemical analysis is carried out by a doctor, and not by laboratory personnel.

If the study shows an increase in enzymes

An increased level of alanine aminotransferase by 4 times means that a person may develop myocardial infarction. With hepatitis, the amount of the enzyme in the blood test of dow men increases, up to - in women. With muscular dystrophy, ALT in the blood increases by 7 times; acute form pancreatitis, gangrene contribute to an increase of 4-6 times.

If the ALT level is elevated, this indicates that serious pathologies are developing or already present in the body.

When inflammatory diseases liver, for example, with hepatitis different types, the number of enzymes is crowned in units. Hepatitis can be detected by analysis 8-9 days before the appearance of external symptoms. A disease that is caused by viruses or alcohol poisoning raises the level of the enzyme per unit. The development and division of cancer cells in the liver significantly increases the enzyme levels. A biochemical blood test is carried out not only as a diagnostic method, but also as a method for making a decision about surgical intervention... If the enzyme levels are too abnormal, the operation is not performed, because more serious complications may appear.

People who are diagnosed with pancreatitis have to take such a biochemical blood test several times a year. At the same time, lipase rises in the blood (one of the digestive enzymes that is involved in the breakdown of fats). With the help of this study, relapse of the disease is prevented and the course of therapy is monitored. The main symptoms of heart muscle damage are the appearance of shortness of breath in a person, fatigue and an increased amount of an enzyme in the blood. Pathology is diagnosed using the AST definition.

Liver cirrhosis is insidious in that it may not manifest itself for a long time. If a person feels chronic fatigue, fatigue, pain occurs in the liver, he should go to a hospital and undergo a test for the ALT content in the blood. Thus, you can diagnose the disease at the initial stage and prevent cancer, death. With cirrhosis, the indicator increases by one.

The level of the enzyme decreases to normal only when the true cause of the increased production of the enzyme is identified and appropriate measures are taken. With the timely detection of the disease and after undergoing adequate therapy, the indicators will return to normal.

In some cases, it is possible to lower ALT with the help of drugs, they are prescribed only by doctors, taken at a certain dosage under the supervision of a specialist. Medicines have contraindications, so they cannot be used without a doctor's prescription. Such medications are used to reduce the level of the enzyme in cases where the rules were violated before taking the test. Medicines do not eliminate the causes of the increase in the level of the enzyme, they only reduce it for a short period.

False analysis

In some cases, if a person does not follow the rules for passing the analysis, the result may be false. To prevent this, it is necessary:

• do not take medications a week before the analysis (barbiturates, statins, antibiotics provoke an increase in ALT levels);
• do not eat fast food;
• do not drink alcohol;
• try to stay calm, not succumb to stress;
• do not violate the sterility of the procedure;
• analysis is not performed one week after insertion of a catheter into the heart or other operations.

For the result to be reliable, before passing the analysis, a person should definitely consult with a doctor and study in detail the forbidden items. You need to donate blood for ALT analysis on an empty stomach.

Increased ALT in pregnant women

For the female sex in the blood, the norm of the enzyme content is 32 U / l. In the first trimester of pregnancy, this figure may increase slightly, but this does not mean pathological changes. In the second and third trimester of bearing a child, the ALT level should already be normal.

If the level of the enzyme in the blood is increased during 6-9 months of pregnancy, then this may indicate that gestosis is present. This pathology is a complication and manifests itself precisely in the last months of bearing a child. At the same time, the woman develops frequent dizziness, nausea, pressure surges, and tachycardia is possible. The higher the enzyme level is, the more severe the pathology is. This fact is explained by the fact that the liver has too much load, which the body cannot cope with on its own, therefore, the state is manifested by an increase in the level of the enzyme in the biochemical blood test.

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It is imperative to evaluate the AST indicator together with the ALT indicator.... These are the so-called "liver" tests, which can be used to judge the activity of the process. Sometimes an increase in these indicators is the only symptom indicating the development of a serious illness.

Analysis for AST is not expensive, and it can be passed in absolutely any laboratory.

What is ALT in a blood test

ALT, or alanine aminotransferase, in a blood test, is an intracellular enzyme that is involved in cell metabolism, in particular in the breakdown of the amino acid alanine. Most of the alanine aminotransferase is found in liver cells, less in the myocardium, skeletal muscles and kidneys.

An increase in ALT in a blood test occurs with any damage to hepatocytes (liver cells). An increase in the enzyme is observed already in the first hours after damage and gradually increases depending on the activity of the process and the number of damaged cells.

An increase in alanine aminotransferase is most typical for liver diseases (hepatitis of various origins, toxic damage, cirrhosis, etc.).

Depending on the concentration of ALT in the biochemical blood test, one can judge the degree of activity of hepatitis (hepatitis can be with a minimum, medium or high degree of enzymatic activity), which must be indicated in the clinical diagnosis. It happens that hepatitis occurs without an increase in the specified enzyme. Then they talk about liver damage without enzymatic activity.

Generally speaking, ALT and AST blood counts are elevated in hepatitis and reflect the degree of cytolysis - destruction of liver cells. The more active cytolysis, the less favorable the prognosis of the disease.

Norms of AST and ALT in the blood test

The reference values \u200b\u200bare normally very low and depend on gender and age. For example, both indicators are higher for men than for women.

Table of norms of ASAT and ALAT for adult men and women:

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With an increase in AST or AST in men or women, it is advisable to calculate the de Ritis coefficient - the ratio of AST to ALT (AST / ALT). Normally, its value is 1.33 ± 0.42.

An increase in the de Ritis coefficient of more than 2 indicates damage to the heart muscle (that is, AST prevails over ALT). With myocardial infarction or acute myocarditis, AST usually rises 8-10 times, and ALT only one and a half to two times.

If the de Ritis coefficient is less than 1 (that is, ALT prevails), then we can safely talk about the defeat of hepatocytes (liver cells). For example, with active viral hepatitis, the ALT concentration increases 10 times, while AST exceeds the norm by only 2-3 times.

As already mentioned above, the coefficient can be calculated only when the ALT or AST values \u200b\u200bare increased. It should also be remembered that the reference values \u200b\u200bfor biochemical parameters in each laboratory are different and may not coincide with those indicated above.

Reasons for increasing AST and ALAT

The increase in alanine and aspartic aminotransferase can be increased in many diseases.

The reasons for the increase in AST in the blood test:

• Acute myocarditis;
• Myocardial infarction;
• Pulmonary embolism;
• Acute rheumatic heart disease;
• Unstable angina;
• Various myopathies;
• Skeletal muscle injuries (severe sprains, tears);
• Myositis, myodystrophy;
• Various liver diseases.

The reasons for the increase in ALT in the blood:

• Liver cirrhosis (toxic, alcoholic);
• Acute pancreatitis;
• Cholestasis, cholestatic jaundice;
• Alcoholic liver damage;
• Fatty hepatosis;
• Acute and chronic viral hepatitis (hepatitis C, hepatitis B)
• Malignant neoplasms of the liver and biliary tract, liver metastases;
• Alcoholism;
• Severe burns;
• Taking hepatotoxic drugs (oral contraceptives, psychotropic drugs, antineoplastic drugs, drugs for chemotherapeutic treatment, sulfonamides, etc.)

If detected in a blood test, you must immediately consult a doctor to find out the cause of this phenomenon, since an increase in these indicators often means the presence of serious diseases.

Decreased AST and ALAT

In practice, sometimes there are cases when the AST or ALT indicators become below normal. This can happen with severe and extensive liver necrosis (for example, in the case of advanced hepatitis). A particularly unfavorable prognosis has a decrease in AST and ALT levels against the background of a progressive increase in bilirubin.

An important reason for the decrease in alanine and aspartic aminotransferase is the depletion of vitamin B6 - pyridoxine.

The fact is that vitamin B6 is necessary for the synthesis of AST and ALT in normal conditions. The decrease in B6 concentration may be associated with long-term antibiotic treatment. It is possible to compensate for its deficiency with the help of drugs (intramuscular vitamin administration) and diet. The highest amounts of pyridoxine are found in cereal sprouts, hazelnuts, walnuts, spinach, legumes, soybeans, fish, and eggs.

Decreased liver enzymes can also occur as a result of liver injury (eg, ruptured organ). However, such conditions are extremely rare.

The rate of transaminases in a child

The boundaries of normal values \u200b\u200bfor AST and ALT largely depend on the age of the child:

An increase in the activity of AST and ALT in the blood of a child, as well as in adults, indicates the effect of damaging factors on hepatocytes. But, unlike adults, this increase is rarely associated with acute and chronic hepatitis.

The growth of AST and ALT in the child's blood may indicate the presence of infectious diseases (leptospirosis, pseudotuberculosis, infectious mononucleosis), congenital malformations.

Often, an increase in liver enzymes is of a secondary nature, that is, it develops after some kind of pathology. For example, an increase in the concentration of AST and ALT can occur in myocardial dystrophy, leukemia, lymphogranulomatosis, vasculitis, etc.

It happens that AST and ALT in children increase in response to taking certain medicationseg aspirin, paracetamol. It is also important to remember that AST and ALT may remain elevated for some time after recovery from an infectious disease.

AST and ALT during pregnancy

An increase in AST and ALT during pregnancy may be the first symptom of gestosis, a condition that threatens the life of the mother and fetus. Therefore, even a slight increase in the concentration of transaminases requires urgent medical advice. He will assess the state of health of the expectant mother, track the indicators in dynamics and, if necessary, prescribe an examination.

In the blood of a pregnant woman, the concentration of the hormone estrogen increases, which affects the liver (this is especially characteristic of the first trimester). That is why a slight excess of AST and ALT levels in early pregnancy is considered normal.

As for the third trimester, there should be no increase in transaminases at this time. If during this period there are deviations in the biochemical analysis, you need to immediately examine the woman so as not to miss the beginning of the development of gestosis.

Preparation for the test

The result of any biochemical analysis, including a blood test for AST and ALT, largely depends on how to prepare for it.

Rules to follow to avoid false research results:

• It is necessary to take tests strictly on an empty stomach, at least after an 8-hour fast. It is allowed to drink clean water in any quantity. It is recommended to exclude coffee, carbonated drinks, juices and teas during the preparation period. As for alcoholic beverages, they are not recommended to be consumed a week before blood sampling for AST and ALT.
• For 3 days, exclude foods rich in animal fats from your diet. Eat steamed, baked, or boiled foods. Fried must be strictly limited, or better - completely excluded.
• Three days before the intended analysis, intense physical activity must be canceled.
• Blood sampling should be done in the morning, from 7 am to 11 am.
• If you are taking medications, it is advisable to stop them 3 days before the study. But before that, it is important to consult a doctor.
• Try to be tested in the same laboratory.
• Having received the result in your hands, be sure to consult your doctor in order to correctly interpret the results and, if necessary, continue the examination.