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

Generally, elevated serum alanine aminotransferase (ALT) levels may be caused by intense physical exercise, staying up late, excessive alcohol consumption, non-alcoholic fatty liver disease, viral hepatitis, drug-induced liver injury, and other factors. Appropriate measures can be taken based on specific circumstances. Detailed analysis is as follows:

1. Intense Exercise

High-intensity exercise increases the permeability of liver cells, leading to enzyme release into the bloodstream and elevated ALT levels. Reducing exercise intensity, ensuring adequate rest, and rechecking after 1–2 weeks usually results in normalization.

2. Staying Up Late and Excessive Alcohol Consumption

Staying up late disrupts the liver's metabolic rhythm, while alcohol directly damages liver cells, jointly causing abnormal ALT levels. Maintain regular sleep patterns, avoid late nights, strictly abstain from alcohol, and follow a light, easily digestible diet.

3. Non-Alcoholic Fatty Liver Disease (NAFLD)

Accumulation of fat within liver cells disrupts their structure and leads to elevated ALT levels, often associated with obesity. Under medical guidance, medications such as silybin capsules, polyene phosphatidylcholine capsules, or diammonium glycyrrhizinate enteric-coated capsules may be used. Additionally, weight control and reduced intake of high-fat foods are recommended.

4. Viral Hepatitis

Hepatitis B or C viruses invade liver cells, triggering inflammatory responses that elevate ALT levels. For hepatitis B, medications such as entecavir tablets, tenofovir disoproxil fumarate tablets, or lamivudine tablets may be prescribed. For hepatitis C, sofosbuvir tablets can be used. During treatment, proper precautions should be taken to prevent transmission.

5. Drug-Induced Liver Injury

Long-term use of certain medications—such as anti-tuberculosis drugs or lipid-lowering agents—can lead to liver cell damage due to toxic metabolites. Discontinue any suspected medication immediately. Under medical supervision, take reduced glutathione tablets, tiopronin enteric-coated tablets, or ornithine oxoglutarate tablets. Hospitalization may be necessary for observation in severe cases.

Maintain regular sleep habits and avoid excessive fatigue; follow a balanced diet, reduce intake of high-fat and high-sugar foods, and consume more fresh fruits and vegetables; avoid taking supplements or prescription drugs without medical advice, and always consult a doctor before starting new medications; undergo regular liver function tests to detect and address issues early.