ALT (ALT, Alanine aminotransferase, alanine transaminase, SGPT, Alanine aminotransferase)

What may affect the results

Intense physical activity the day before and even a few days before the test can lead to damage to muscle tissue (the so-called muscle fiber tear) and, accordingly, an increase in ALT levels. For the same reason, analysis taken after injury is uninformative. Taking alcohol and certain medications (antibiotics, nonsteroidal anti-inflammatory drugs, antitumor drugs, oral contraceptives, etc.) often distort the results of the study. The list of medications taken should be discussed with the doctor who prescribed the test, and those that are taken should be discontinued without risk to health.

Which doctor should I contact?

You should start by visiting a therapist. This doctor interviews and examines the patient and decides which specialist needs to be contacted. Options:

1. Cardiologist, if after Covid the AST level increased more than ALT. This indicates that, most likely, there are problems with the myocardium.
2. Endocrinologist, if the virus has negatively affected the liver or kidneys.

Help from other specialists may be required.

Under no circumstances should you self-medicate. This leads to a worsening of the condition. Then you still have to contact a doctor. But time will be lost. In such a situation, specialists are not always able to help in any way.

ALT (ALT, Alanine aminotransferase, alanine transaminase)

For research, blood is taken from a vein. Usually, AST (AST, Aspartate aminotransferase) is determined simultaneously and the AST/ALT ratio (de Ritis coefficient) is assessed. You can take a blood test for ALT (ALT, Alanine aminotransferase, alanine transaminase) at the nearest INVITRO medical office. A list of offices where biomaterial is accepted for laboratory research is presented in the “Addresses” section. Interpretation of study results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

What are ALT and AST in blood biochemistry

Let's look at the abbreviations and find out what enzymes are hidden behind them:

1. ALT or ALT – alanine aminotransferase – is an enzyme that is present in the cells of various organs. Most of it is in the liver and kidneys. When organs are damaged, ALT enters the blood. The presence of an enzyme in the red liquid may indicate the development of jaundice. ALT analysis is one of the “liver tests”, the results of which indicate problems with the organ, namely, its destruction. A large amount of enzyme in the blood may indicate not only liver disease. If your ALT level is high, there are likely problems with other organs. We use the words “may”, “possibly” - because ALT analysis is the primary diagnosis. Based on it alone, it is impossible to make an accurate diagnosis. More research is needed.
2. AST or ASAT - aspartate aminotransferase is an enzyme that is found in the greatest quantities in the liver, kidneys, and myocardium. It, like ALT, enters the blood during tissue destruction. An increase in AST is a sign indicating possible liver disease. A complete diagnosis is necessary to make an accurate diagnosis.

Thus, AST and ALT are enzymes that are found primarily in the liver and kidneys in the body. They are involved in the synthesis of many useful substances. If the organs in which aspartate aminotransferase and alanine aminotransferase are located are destroyed, the enzymes enter the blood. This is revealed through analysis.

Normal indicators

Units of measurement: U/l.
Reference values

Stages of determination and normalization of ALT and AST

A blood test allows you to identify the problem - to establish that the amount of enzymes is not normal. If there is more ALT and AST in the vessels than they should be, it is necessary to undergo a full examination to establish an accurate diagnosis.

Next, you should undergo therapy using the methods outlined by the specialist. In order not to worsen the situation, all medications should be taken exclusively as prescribed by a doctor.

You can undergo diagnostics, determine the level of enzymes in the blood and determine which organs the coronavirus has caused complications at the LaSalute clinic. There is all the necessary diagnostic equipment and experienced specialists work here.

What do increased indicators mean?

First of all, when ALT increases, liver problems should be suspected: fatty hepatosis, hepatitis of viral or toxic etiology, liver cirrhosis, liver cancer - primary or metastatic.
The degree of increase in ALT is usually associated with the volume or severity of liver damage, but cannot be considered as a determining factor for the prognosis of the disease. Maximum levels of ALT (and AST) - more than a hundred times higher than normal - are observed in patients with acute viral and drug-induced hepatitis.

A significant increase in alanine aminotransferase can be observed in acute cholecystitis, cholelithiasis, and acute destructive pancreatitis. Another reason may be taking hepatotoxic drugs that damage liver cells.

An increase in ALT levels is detected with extensive injuries to skeletal muscles, severe myositis and muscular dystrophy, and frequent intramuscular injections.

A less significant increase in ALT is recorded in acute myocardial infarction and myocarditis.

Symptoms of increased ALT and AST

Signs are divided into primary and late. First, the following manifestations of an increase in AST and ALT occur:

• nervousness;
• itching;
• poor sleep;
• weakness of the body;
• decreased appetite, which leads to weight loss.

Late symptoms:

• darkening of urine;
• stool discoloration;
• yellowish tint to the skin and whites of the eyes;
• swelling of the arms and legs;
• nausea;
• general poor health.

If the primary symptoms can indicate both problems with elevated levels of ALT and AST, and other disorders in the body, then later ones clearly indicate that not everything is in order with the liver. Additional diagnostics are required to make an accurate diagnosis. For example:

• coronavirus test;
• blood test for hepatitis B and C;
• Ultrasound of the abdominal organs;
• heart diagnostics;
• clinical blood test;
• study of the concentration and quality of thyroid hormones;
• liver biopsy.

If after coronavirus there are elevated levels of ALT and AST enzymes, contact the LaSalute clinic. It has all the necessary equipment to establish an accurate diagnosis, as well as specialists who are involved in the rehabilitation of people who have suffered from coronavirus.

Symptoms

Symptoms of increased alanine transaminase in the blood are varied. The clinical picture is determined by the affected organ and the disease that led to it.

From the liver

If the liver is damaged, pain in the right hypochondrium, nausea, and vomiting are possible. Yellowness of the skin and icterus of the sclera are possible. With a viral etiology, there may be hyperthermia. When cirrhosis has developed, rashes like spider veins appear on the body, and an enlarged abdomen due to ascites (fluid accumulation 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, swelling, repeated vomiting, weakness, and subsequent clouding of consciousness.

From the side of the heart

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

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

When is an ALT test prescribed?

The amount of alanine aminotransferase is determined as part of a general biochemical blood test. Often only one type of examination is prescribed when there is no need to use additional methods. They get tested for ALT. This is due to the selective tissue specialization that the enzyme has.

The amount of alanine aminotransferase in case of liver problems helps to identify them even before the appearance of the most characteristic symptom - jaundice. Therefore, a doctor most often prescribes an ALT test to check for damage to this important organ as a result of taking medications or any other substances that are toxic to the body. The study is also carried out if hepatitis is suspected. An ALT test is required if the patient has symptoms such as fatigue and weakness. He loses his appetite and often feels nausea, turning into vomiting. Yellow spots on the skin, abdominal pain and discomfort, yellowing of the whites of the eyes, light-colored stool and dark urine can all be signs of liver disease. In such cases, this analysis is required.

ALT can be compared with AST to provide additional information about the causes of liver damage. This is done if the amount of enzymes significantly exceeds the norm. The ratio of AST to ALT is known in medicine as the de Ritis ratio. Its normal value ranges from 0.91 to 1.75. If this indicator becomes more than 2, then damage to the heart muscle is diagnosed, which occurs with the destruction of cardiomycytes. Myocardial infarction is also possible. A de Ritis coefficient not exceeding 1 indicates liver disease. Moreover, the lower the value of the indicator, the greater the risk of an unfavorable outcome.

ALT analysis can be used not only as a diagnostic method, but also during treatment. This allows you to determine the dynamics of the disease and identify improvements or deteriorations in the patient’s condition. ALT testing is necessary if factors contributing to liver disease are present. These include abuse of alcoholic beverages or drugs that destroy organ cells. If the level of alanine aminotransferase in the blood exceeds the normal level, other medications are prescribed. It is imperative to check the amount of ALT if the patient has been in contact with people with hepatitis or has recently had it, has diabetes and is overweight. Some people are predisposed to liver disease. They are also shown an ALT test.

It uses either venous or capillary blood. To obtain reliable results, certain requirements must be met. Firstly, do not eat 12 hours before the test and do not drink alcohol for a week. Even a small amount of food can make a significant difference in your results. Secondly, for half an hour before the analysis, stop smoking, don’t worry, and avoid mental and physical stress. The results are usually ready a day after the test.

What is an enzyme

AST or AST is a protein synthesized inside the cells of the human body. Its highest concentrations are observed in the tissues of the myocardium, muscles and liver. To a lesser extent, the enzyme is present in the kidneys, pancreas, cells of the central nervous system and brain. It is encoded by the GOT 1 and GOT 2 genes. In a healthy person, the level of the enzyme is quite low. Its active release into the blood begins when the heart muscle ruptures, as well as liver destruction as a result of hepatitis, cirrhosis or cancer. The enzyme is important because it contains vitamin B6, which is involved in amino acid metabolism and, accordingly, the synthesis of insulin. In tests, the indicator is measured in units per liter of blood.

How to prepare for analysis

To increase the reliability of the analysis, some rules and restrictions should be observed. So on the eve of the study, you should refrain from eating fatty and smoked foods, as well as confectionery. It is best if the test is performed on an empty stomach in the morning. When taking medications, you should consult your doctor about their possible withdrawal. The fact is that during a biochemical blood test, many medications can affect the results of the study. When treated with antidepressants, antibiotics, diuretics and other drugs, the test readings may be distorted. In addition, immediately before a visit to the treatment room, it is prohibited to perform ultrasound, x-ray examination and physiotherapy procedures.