ALT

The ALT test contains 1 test with 1 biomarker.

Brief Description: The Alanine Aminotransferase (ALT) test is a blood test that measures the level of ALT in the bloodstream. ALT is an enzyme found primarily in the liver, but it is also present in small amounts in other tissues like the heart and kidneys. The ALT test is a standard liver function test and is used to assess the health of the liver and detect liver damage or disease.

Also Known As: Alanine Aminotransferase Test, Alanine Transaminase Test, GPT Test, SGPT Test, Serum Glutamic Pyruvic Transaminase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alanine Transaminase test ordered?

When a person undergoes a standard health examination, ALT may be ordered as part of a full metabolic panel.

When a person has signs and symptoms of a liver problem, a healthcare provider will usually prescribe an ALT test.

Because many people with minor liver damage have no signs or symptoms, ALT may be ordered alone or in combination with other tests for persons who are at an elevated risk for liver disease. With modest liver injury, ALT levels will rise even if there are no other symptoms.

ALT may be ordered on a frequent basis during the course of treatment to establish whether the medication is effective when it is used to monitor the treatment of persons with liver disease.

What does an Alanine Transaminase blood test check for?

Alanine aminotransferase is an enzyme found mostly in liver and kidney cells. It's also found in much lesser concentrations in the heart and muscles. This test determines the amount of ALT in your blood.

The enzyme ALT converts alanine, a protein amino acid, into pyruvate, an important intermediary in cellular energy production. ALT levels in the blood are low in healthy people. ALT is released into the bloodstream when the liver is injured, frequently before more evident indications of liver injury, such as jaundice, appear. As a result, ALT is a useful test for detecting liver disease early on.

The liver is a critical organ positioned directly behind the rib cage on the upper right side of the abdomen. It is engaged in a variety of vital bodily functions. The liver aids in the digestion of nutrients, creates bile to aid in fat digestion, produces a variety of essential proteins such as blood clotting factors and albumin, and breaks down potentially hazardous compounds into safe substances that the body may utilize or discard.

Damage to liver cells can be caused by a variety of factors, resulting in an elevation in ALT. The test is most useful for detecting damage caused by hepatitis or medications or other toxins that are harmful to the liver.

As part of a liver panel, ALT is frequently tested alongside aspartate aminotransferase, another liver enzyme. When the liver is injured, both ALT and AST levels rise, albeit ALT is more specific for the liver and may be the only one to rise in some circumstances. An AST/ALT ratio can be used to help distinguish between different types of liver injury and their severity, as well as to distinguish liver injury from heart or muscle damage.

Lab tests often ordered with an Alanine Transaminase test:

When an ALT test is ordered, it's often part of a broader evaluation of liver function and to investigate causes of liver injury. Here are some tests commonly ordered alongside it:

  1. Aspartate Aminotransferase (AST):

    • Purpose: To measure the level of AST, another liver enzyme.
    • Why Is It Ordered: AST is also released into the bloodstream when the liver is damaged. The AST/ALT ratio can provide insights into specific liver conditions.
  2. Alkaline Phosphatase (ALP):

    • Purpose: To measure the level of ALP, an enzyme related to the bile ducts.
    • Why Is It Ordered: High levels of ALP can indicate blockage of bile ducts, liver injury, or bone disease.
  3. Bilirubin:

    • Purpose: To measure the level of bilirubin, a byproduct of red blood cell breakdown.
    • Why Is It Ordered: Elevated bilirubin levels can indicate liver dysfunction or bile duct obstruction.
  4. Gamma-Glutamyl Transferase (GGT):

    • Purpose: To measure GGT, an enzyme involved in bile formation.
    • Why Is It Ordered: Elevated GGT levels can support the diagnosis of liver and bile duct diseases.
  5. Liver Function Panel:

    • Purpose: A comprehensive assessment of liver health, including ALT, AST, ALP, bilirubin, and albumin.
    • Why Is It Ordered: To provide a broader picture of liver function and help determine the cause of liver injury.
  6. Complete Blood Count (CBC):

    • Purpose: Provides a broad picture of overall blood health.
    • Why Is It Ordered: To assess for signs of anemia or infection, which can be associated with certain liver conditions.
  7. Prothrombin Time (PT) and International Normalized Ratio (INR):

    • Purpose: To assess blood clotting function.
    • Why Is It Ordered: Liver damage can affect the production of clotting factors, so these tests can be important in assessing liver function.
  8. Hepatitis Serology Tests:

    • Purpose: To test for hepatitis A, B, and C, which can cause liver inflammation and damage.
    • Why Is It Ordered: To determine if hepatitis infection is the cause of elevated liver enzymes.
  9. Ferritin and Iron Tests:

    • Purpose: To assess iron levels in the body.
    • Why Is It Ordered: Hemochromatosis, a condition of excess iron storage, can lead to liver damage.
  10. Alpha-Fetoprotein (AFP):

    • Purpose: To measure AFP, a tumor marker.
    • Why Is It Ordered: Elevated levels of AFP can indicate liver cancer, particularly hepatocellular carcinoma.

These tests, when ordered alongside an Alanine Aminotransferase test, provide a comprehensive view of liver health. They are essential for diagnosing the cause of liver injury, monitoring liver disease, and guiding treatment. The specific combination of tests will depend on the individual’s symptoms, medical history, and initial test results.

Conditions where a an Alanine Transaminase test is recommended:

The ALT test is used to detect and monitor various liver conditions, including:

  1. Hepatitis: Both viral and non-viral hepatitis can cause liver inflammation and increase ALT levels.

  2. Alcoholic Liver Disease: Chronic alcohol abuse can lead to liver damage and increased ALT levels.

  3. Non-Alcoholic Fatty Liver Disease (NAFLD): A condition characterized by the accumulation of fat in the liver.

  4. Liver Cirrhosis: Advanced scarring of the liver can cause ALT levels to rise.

  5. Liver Cancer: Malignant liver tumors can lead to elevated ALT levels.

How does my health care provider use an Alanine Transaminase test?

The alanine aminotransferase test is commonly used to diagnose liver damage. It's frequently ordered as part of a liver panel or complete metabolic panel with aspartate aminotransferase to screen for and/or diagnose liver disease.

ALT is an enzyme found mostly in liver and kidney cells. ALT is released into the bloodstream when the liver is injured. As a result, ALT is a useful test for detecting liver disease early on.

Although ALT is more specific to the liver than AST, they are both considered to be two of the most significant tests for detecting liver impairment. When AST is directly compared to ALT, an AST/ALT ratio is calculated. This ratio can assist distinguish between different types of liver disease and identify cardiac or muscle harm.

To assess which type of liver illness is present, ALT values are frequently matched to the results of other tests such as alkaline phosphatase, total protein, and bilirubin.

ALT is frequently requested to monitor the therapy of people with liver disease to evaluate if it is effective, and it can be ordered alone or in combination with other tests.

What do my ALT test results mean?

A low ALT level in the blood is normal and anticipated. The most prevalent cause of ALT levels that are higher than normal is liver disease.

Acute hepatitis and viral infections are the most common causes of very elevated ALT values. ALT levels are normally elevated for 1-2 months after acute hepatitis, but they might take up to 3-6 months to return to normal. ALT levels may also be significantly raised as a result of exposure to liver-toxic medications or other chemicals, or in situations that produce reduced blood flow (ischemia) to the liver.

In chronic hepatitis, ALT levels are frequently less than four times normal. Because ALT levels in this scenario regularly fluctuate between normal and slightly elevated, the test may be ordered frequently to observe if a trend emerges. Other reasons of mild ALT elevations include bile duct obstruction, cirrhosis, heart damage, alcohol addiction, and liver cancers.

ALT is frequently used in conjunction with an AST test or as part of a liver panel. See the Liver Panel article for more information on ALT values in relation to other liver tests.

The ALT level is usually greater than the AST level in most forms of liver disorders, and the AST/ALT ratio is low. There are a few exceptions: in alcoholic hepatitis, cirrhosis, and heart or muscle injury, the AST/ALT ratio is frequently more than 1, and it may be greater than 1 for a day or two after the onset of acute hepatitis.

Most Common Questions About the ALT test:

Understanding the ALT Test

What is the ALT test?

The ALT (Alanine Aminotransferase) test is a blood test that measures the level of ALT, an enzyme mostly found in the liver. When liver cells are damaged or die, they release ALT, leading to increased blood levels.

What is the purpose of the ALT test?

The purpose of the ALT test is to evaluate liver function and to help identify possible liver injury or disease. It's often ordered in conjunction with other liver tests, such as aspartate aminotransferase (AST).

When should the ALT test be ordered?

The ALT test is typically ordered when a person has symptoms of liver disease, such as jaundice, dark urine, nausea, vomiting, or abdominal pain. It's also ordered for those who have been exposed to hepatitis viruses or have conditions or take medications that might damage the liver.

How frequently should the ALT test be done?

The frequency of ALT testing depends on the individual's health status, whether they have known liver disease, and their response to treatment. Your healthcare provider will determine the appropriate frequency of testing.

Interpreting ALT Test Results

What does a high ALT level indicate in the ALT test?

A high level of ALT in the blood usually indicates liver damage. The level of ALT may increase in conditions such as hepatitis, cirrhosis, liver cancer, or in response to certain medications or toxins.

What does a low ALT level indicate in the ALT test?

Low ALT levels are generally considered normal and aren't usually a cause for concern. However, in rare cases, low ALT could indicate certain types of liver disease or malnutrition.

Can the ALT test give false positive results?

False positives, in the sense of having high ALT without liver disease, can occur. Certain medications, strenuous exercise, or muscle injury can increase ALT levels without any liver damage.

Can the ALT test give false negative results?

A normal ALT level doesn't always rule out liver disease. In certain types of liver disease, such as non-alcoholic fatty liver disease, ALT can be normal or only slightly elevated.

ALT Test and Specific Conditions

How does the ALT test relate to hepatitis management?

The ALT test is crucial in diagnosing and monitoring hepatitis. High ALT levels can indicate active hepatitis, and decreasing levels can show response to treatment.

How does the ALT test relate to the management of liver cirrhosis?

In liver cirrhosis, ALT levels can fluctuate and may not reflect the severity of the disease. However, persistently high ALT could indicate ongoing liver damage.

Can the ALT test be used to diagnose liver cancer?

While ALT levels can be high in liver cancer, the test is not specific enough to diagnose liver cancer on its own. Imaging studies and liver biopsy are typically needed for diagnosis.

Can the ALT test be used to monitor the liver's response to medications or toxins?

Yes, ALT is often measured to monitor for potential drug-induced liver injury. If ALT levels increase significantly, it may necessitate a change in medication.

How is the ALT test used in the context of alcohol use?

Chronic heavy alcohol use can damage the liver and elevate ALT. Monitoring ALT levels can help assess this damage and guide interventions to limit further harm.

General Questions About the ALT Test

Are there any medications that can affect the ALT test results?

Yes, certain medications like statins, antibiotics, antifungals, and anti-seizure medications can raise ALT levels. Always inform your healthcare provider of all medications you're taking.

Can the ALT test be used in the elderly?

Yes, the ALT test can be used in individuals of all ages, including the elderly. However, normal levels may be slightly lower in the elderly due to decreased muscle mass.

Can I have a normal ALT test result and still have liver disease?

Yes, in some cases, ALT can be within the normal range even with liver disease. Certain conditions, like non-alcoholic fatty liver disease and early cirrhosis, might not cause significant elevations in ALT.

What other tests might be done along with the ALT test?

The ALT test is often performed as part of a liver panel, which includes other tests like aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin, and albumin.

How does ALT test relate to AST test?

ALT and AST are both enzymes found in the liver. They're often measured together as part of evaluating liver function. In certain conditions, the ratio of AST to ALT can provide additional diagnostic information.

Is ALT test used in the evaluation of unexplained fatigue?

Yes, if liver disease is suspected as a cause of unexplained fatigue, the ALT test may be used as part of the evaluation.

How does the ALT test help in the diagnosis of mono (mononucleosis)?

Mononucleosis can sometimes cause liver inflammation, leading to elevated ALT levels. The ALT test can therefore contribute to the diagnosis and monitoring of mono.

Can the ALT test be used to monitor the effectiveness of liver disease treatment?

Yes, ALT levels can help monitor the effectiveness of treatment for liver disease. A decrease in ALT levels may indicate that the treatment is working.

Does the ALT test have a role in diagnosing celiac disease?

Celiac disease can sometimes cause liver damage, leading to elevated ALT. While it's not a primary diagnostic test for celiac disease, ALT levels may be checked if there are concerns about associated liver injury.

How can I reduce my ALT levels if they're high?

Addressing the underlying cause of the high ALT is the best way to lower levels. This could mean treating liver disease, changing a problematic medication, or reducing alcohol consumption. Regular exercise and maintaining a healthy weight can also support liver health.

How does the ALT test help in diagnosing Wilson's disease?

Wilson's disease, a rare genetic disorder causing excessive copper buildup, can lead to liver damage and high ALT. While not a primary diagnostic test, ALT levels can contribute to the diagnostic process.

Can the ALT test be used to monitor liver health in patients with diabetes?

Yes, people with type 2 diabetes have a higher risk of liver disease, including non-alcoholic fatty liver disease. The ALT test can be used to monitor liver health in these patients.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Alt

Alanine transaminase (ALT) is an enzyme found in the highest amounts in the liver. Injury to the liver results in release of the substance into the blood.
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