What does it mean when alanine aminotransferase (ALT) is elevated, and what should be done?

Apr 10, 2023 Source: Cainiu Health

Dr. Lu Haiying

Introduction

Alanine aminotransferase refers to alanine transaminase (ALT). In general, elevated ALT levels may be associated with factors such as medication effects, fatty liver, hepatitis, pancreatitis, or liver cirrhosis. Treatment may involve lifestyle adjustments and medication. If these conditions persist, timely medical evaluation is recommended to prevent serious complications.

Alanine aminotransferase refers to alanine transaminase (ALT). In general, elevated ALT levels may be associated with factors such as medication effects, fatty liver, hepatitis, pancreatitis, and cirrhosis. Management may involve lifestyle adjustments and medication use.

1. Medication effects: Certain medications, particularly some prescription and over-the-counter drugs, may adversely affect the liver, leading to increased ALT levels. These include certain antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, antiepileptic drugs, and antihypertensive medications. When using these medications, doctors typically monitor ALT levels to ensure normal liver function.

2. Fatty liver: Fatty liver occurs when fat accumulates in the liver beyond normal levels, commonly caused by factors such as obesity, high-fat diet, and diabetes. Elevated ALT levels are often associated with fatty liver. Patients should maintain a light diet and, under medical guidance, may use medications such as Hepatoprotective Capsules or Bicyclol Tablets to alleviate symptoms.

3. Hepatitis: Hepatitis is a viral infection causing inflammation of the liver. Viral attack on liver cells and the resulting immune response can lead to increased ALT levels. Treatment may include medications such as Ribavirin Tablets or Lamivudine Tablets, used under medical supervision.

4. Pancreatitis: Pancreatitis can also cause elevated ALT levels, as pancreatic enzymes and ALT are both produced in the liver and pancreas, meaning pancreatitis may affect ALT levels. Under medical guidance, medications such as Omeprazole Enteric-coated Capsules or Pantoprazole Sodium for Injection may be used to relieve symptoms.

5. Cirrhosis: Cirrhosis results from chronic liver tissue damage and fibrosis, usually due to long-term hepatitis, excessive alcohol consumption, or other chronic liver conditions. In cirrhosis, ALT levels may rise. Treatment may include medications such as Furosemide Injection or Bumetanide Tablets, taken as prescribed by a doctor.

If any of these conditions persist, timely medical evaluation is recommended to prevent serious complications.

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Normal aspartate aminotransferase (AST), elevated alanine aminotransferase (ALT)—what does this indicate?

If the elevation is caused by physiological factors, it commonly occurs after recent sleep deprivation, excessive alcohol consumption, intense exercise, or taking certain medications. Alanine aminotransferase (ALT) is primarily present in the cytoplasm of hepatocytes; these factors can temporarily increase hepatocyte membrane permeability, leading to enzyme leakage into the bloodstream and thus elevated levels. However, they do not cause severe hepatocyte necrosis. Aspartate aminotransferase (AST), mainly located within mitochondria, therefore remains normal.