ALT (alanine aminotransferase) is a liver enzyme. When your ALT is above the lab’s reference range, it can indicate liver irritation or injury — but elevations are common and often mild. Context matters: alcohol, medications/supplements, temporary illness, and recent intense exercise can all nudge ALT upward.
Important: Always interpret ALT alongside
AST,
ALP, and
bilirubin, and use the reference ranges printed on your own report. Discuss persistent or marked elevations with your clinician.
What counts as “high” ALT?
Each lab sets its own range, so your report defines “normal.” Values just above the limit are often rechecked; larger or persistent elevations may prompt faster follow-up. If ALT is only slightly high after heavy exercise or illness, it often normalizes on repeat testing.
Common reasons ALT is high
- Metabolic fatty liver (MASLD/NAFLD)
- Alcohol-related liver irritation
- Medications or herbal supplements
- Viral hepatitis or other infections
- Recent strenuous exercise or muscle injury
- Autoimmune or genetic liver conditions (less common)
Patterns that help interpretation
- ALT ↑ + AST ↑ → liver inflammation pattern (often with symptoms/history)
- ALP ↑ + bilirubin ↑ → consider bile duct/cholestatic processes
- ALT normalizes on repeat → transient elevation (exercise, illness, short-term meds)
What you can do before your next test
- Review meds/supplements with your clinician (acetaminophen, statins, some herbals)
- Moderate alcohol and consider timing your repeat test after recovery from illness/exertion
- Discuss metabolic risks (weight, diabetes, lipids) and lifestyle steps (nutrition, activity)
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