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What does it mean when alanine aminotransferase (ALT) levels are high?

Aug 18, 2025 Source: Cainiu Health
Dr. Shen Yonghua
Introduction
Under normal circumstances, after hepatitis virus invades liver cells, it replicates within the cells and damages the liver cell structure, causing a large release of alanine aminotransferase into the bloodstream. This may be accompanied by symptoms such as loss of appetite and jaundice. Doctors may prescribe medications such as entecavir tablets, tenofovir disoproxil fumarate tablets, or lamivudine tablets for treatment.

Generally, elevated alanine aminotransferase (ALT) levels may be caused by strenuous exercise, staying up late, fatty liver disease, viral hepatitis, cirrhosis, and other conditions. If abnormalities are detected, timely medical consultation is recommended. Detailed explanations are as follows:

1. Strenuous exercise: During intense physical activity, the body's energy consumption significantly increases, placing additional metabolic burden on liver cells and potentially increasing their permeability, which may lead to elevated ALT levels. It is recommended to maintain appropriate exercise intensity and ensure adequate rest after exercise to avoid excessive physical exhaustion.

2. Staying up late: Long-term sleep deprivation can disrupt the liver's normal metabolic rhythm and impair liver cell repair and regeneration, leading to increased ALT levels. It is recommended to adjust sleeping habits and ensure sufficient sleep each night to allow adequate rest for the liver.

3. Fatty liver disease: Excessive fat accumulation in the liver can impair normal liver cell function, causing ALT to be released into the bloodstream. This may be accompanied by symptoms such as fatigue and discomfort in the upper right abdomen. Doctors may prescribe medications such as silymarin capsules, polyene phosphatidylcholine capsules, or bicyclol tablets for treatment.

4. Viral hepatitis: Hepatitis viruses invade liver cells, replicate within them, and damage liver cell structures, causing a large release of ALT into the bloodstream. Symptoms may include loss of appetite and jaundice. Doctors may prescribe medications such as entecavir tablets, tenofovir disoproxil fumarate tablets, or lamivudine tablets for treatment.

5. Cirrhosis: Long-term liver cell damage leads to fibrosis and eventually cirrhosis, with widespread liver cell necrosis and significantly elevated ALT levels. Symptoms may include ascites and gastrointestinal bleeding. Doctors may prescribe medications such as spironolactone tablets, furosemide tablets, or ademetionine enteric-coated tablets for treatment.

In daily life, maintaining a healthy lifestyle—including balanced nutrition, smoking and alcohol cessation, avoiding drug abuse, and regular health checkups—is important to protect liver function and reduce the risk of abnormal ALT elevation.

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