What does a low alanine aminotransferase (ALT) and aspartate aminotransferase (AST) indicate?

Generally, low levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) may be caused by inadequate nutrient intake, prolonged bed rest, vitamin B6 deficiency, hypothyroidism, or Sheehan's syndrome. Patients can choose appropriate interventions such as lifestyle modifications or medication based on their specific conditions. Detailed analysis is as follows:

1. Inadequate Nutrient Intake

Long-term dieting or a strictly vegetarian diet may lead to protein deficiency, depriving liver cells of the necessary building blocks for enzyme synthesis, thereby causing low enzyme levels. Adjust the diet by increasing intake of high-quality proteins such as eggs, milk, and fish, along with whole grains, vegetables, and fruits to ensure balanced nutrition and avoid excessive dieting.

2. Prolonged Bed Rest and Inactivity

Lack of physical activity over time slows down metabolic rate, reduces hepatocyte activity, and decreases enzyme production. Develop an individualized exercise plan according to one’s physical condition, starting with gentle activities like walking or tai chi, gradually increasing activity levels to promote recovery of metabolic function.

3. Vitamin B6 Deficiency

Vitamin B6 is an essential cofactor in the synthesis of aminotransferases; its deficiency directly impairs enzyme production. Under medical guidance, patients may take supplements such as vitamin B6 tablets, compound vitamin B tablets, or mecobalamin tablets. Additionally, increase dietary intake of vitamin B6-rich foods like bananas, lean meat, and nuts.

4. Hypothyroidism

Insufficient thyroid hormone secretion leads to slowed overall metabolism and suppressed liver cell function, resulting in reduced enzyme synthesis. Follow medical advice to take medications such as levothyroxine sodium tablets, thyroid tablets, or levothyroxine tablets, and regularly monitor thyroid function to adjust dosage accordingly.

5. Sheehan's Syndrome

Postpartum hemorrhage can cause pituitary insufficiency, leading to growth hormone deficiency that affects liver function and reduces enzyme synthesis. Under medical supervision, treatment may include hydrocortisone tablets, prednisone acetate tablets, or growth hormone injections to replace deficient hormones and alleviate symptoms.

There is no need to become overly anxious about a single instance of low enzyme levels. Begin by improving dietary and exercise habits. If symptoms such as fatigue or unexplained weight changes occur, seek medical attention promptly to identify the underlying cause. After completing prescribed treatment, schedule regular follow-up liver function tests to maintain ongoing health monitoring.