ALT and AST: What Your Liver Enzyme Results Mean

ALT and AST are enzymes released when liver cells are stressed. Learn what mildly elevated liver enzymes mean, typical ranges, and the most common causes.

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What it is

ALT (alanine aminotransferase) sits mostly inside liver cells, so it is the more liver-specific of the two. AST (aspartate aminotransferase) is also found in muscle and heart tissue.

Both leak into the blood when cells are damaged or stressed, which is why they are read together with ALP, bilirubin, and albumin as a liver panel.

Why it matters

The most common reason for mildly elevated ALT in adults is fatty liver related to insulin resistance, often alongside high triglycerides and central weight gain.

The AST-to-ALT ratio is a useful clue. A ratio above 2 points more toward alcohol-related liver injury; muscle injury raises AST much more than ALT.

Typical reference ranges

Ranges vary by lab and individual circumstances. These are common adult reference ranges for orientation only.

GroupCommon range
ALT (men)7–55 U/LSome labs use a stricter 30 U/L upper limit
ALT (women)7–45 U/LSome labs use a stricter 19–25 U/L upper limit
AST8–48 U/L
Marked elevation> 3× upper limitNeeds prompt evaluation

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What can move your result

Alcohol, intense or unaccustomed exercise, acetaminophen and statins, supplements, viral hepatitis, weight change, and thyroid disease all affect these enzymes.

Frequently asked questions

Can exercise raise liver enzymes?
Yes. A hard workout in the 48 hours before a draw can raise AST notably and ALT somewhat, especially with heavy lifting.
What is a mildly elevated ALT?
Usually a value one to two times the upper limit. It is common, often reversible, and most often related to fatty liver or alcohol.
Should I repeat abnormal liver enzymes?
Yes, typically in four to eight weeks after avoiding alcohol and heavy exercise before the draw.

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