High Alanine Transaminase in Blood

Introduction

Alanine transaminase is an enzyme present in the liver. ALT blood test is normally included in the liver ad comprehensive metabolic panel. These are used to help assess liver health. Increased levels of ALT in the blood indicate a damaged liver or liver condition.

What Is Meant by Alanine Transaminase (ALT)?

Alanine transaminase is also called alanine aminotransferase, an enzyme mainly located in the liver, even though it is seen in other body parts. An enzyme is a protein that helps in certain body processes by acting as a catalyst. There are many enzymes present throughout the body which performs various important functions.

ALT enzymes help break down liver protein, making them easier to be absorbed by the body. When the liver is damaged, it releases ALT enzymes into the blood. This increases the levels of ALT, which is an indication of a liver problem.

What Is an Alanine Transaminase Blood Test?

Alanine transaminase blood test is done to measure the amount of ALT present in the blood. When there is damage in the liver, the level of ALT increases in the blood. So, doctors often use this blood test method to check the liver's health. As various types of liver conditions can increase the ALT in blood, not only the blood test is used to diagnose the condition. The ALT blood test is often added to the blood tests panel, like the HFP, LFT (liver enzyme panel), or CMP (comprehensive metabolic panel). A blood panel is used to check various aspects of the blood with a single sample, which helps to provide more detailed information about a person's overall health.

Common ALT Blood Tests Include:

1. Alanine transaminase (ALT).

2. Alanine aminotransferase.

3. Serum glutamic-pyruvic transaminase.

What Are the Causes of the Increase in ALT Levels?

There may be many causes for the increase in ALT levels; these are:

• Non-alcoholic fatty liver disease (NAFLD).

• Over-the-counter medication.

• Prescribed medications are used to control cholesterol.

• Alcohol consumption.

• Obesity.

• Hepatitis A, B, or C.

• Heart failure.

• Hereditary hemochromatosis is an inherited condition of the liver which is caused due to overloading of iron.

• Thyroid disorders.

• Muscle disorders.

• Celiac disease.

Some of the Rare Causes of This Condition Are:

• Autoimmune hepatitis.

• Alpha-1 antitrypsin deficiency is a condition that is inherited and results in lung or liver disease.

• Wilson’s disease is an inherited condition that results in a buildup of copper in the body.

How to Reduce the ALT Level in the Blood?

It is important to find and address the underlying cause, but in the meantime, a few changes can help reduce the level of ALT in the blood. Some are:

• Drink Coffee:

Many studies have shown that coffee has a protective effect on the liver, and drinking coffee can reduce liver enzymes. In addition, the 2017 review says that having one to four cups of coffee daily helps decrease ALT levels and lowers the risk of liver conditions and cancer.

• Consumption of More Folate and Intake of Folic Acid:

Intake of more folate and folic acid is related to lower ALT levels. However, both folate and folic acid are not the same; they are different types of vitamin B9. Folate is a natural form of B9 found in food supplements, whereas folic acid is a synthetic form of B9 added in supplements and processed food. The body also processes them in different ways.

A deficiency of folate is associated with an increased level of ALT in the blood, whereas folic acid in supplements is known to reduce the level of ALT in those with liver damage. Folic acid is as effective as silymarin treatment, which reduces liver enzymes in children due to drug-induced liver conditions from antiepileptic therapy. More folate-rich food can be added to the diet, such as:

1. Leafy greens.

2. Asparagus.

3. Legumes.

4. Brussels sprouts.

5. Beets.

6. Banana.

7. Papaya.

• Alteration in the Diet:

Intake of a healthy diet can reduce ALT and the risk of liver damage. Decreased amounts of carbohydrates and fat can help in the treatment and prevention of NAFLD, which is a common cause of increased ALT. Some changes can be made in the eating habits, such as:

1. Reduce fruits and vegetables which contain high calories or added sugar and salt.

2. Intake fish twice a week, which are high in omega-3 fatty acids, like salmon or trout.

3. Fat-free or low-fat milk or dairy products can be chosen.

4. Monounsaturated or polyunsaturated fats can be used instead of saturated or trans fats.

5. Intake of rich whole grain.

6. Take lean animal protein like skinless chicken and fish.

7. Fried, baked, or roasted ones should be avoided.

Why Does a Person Need an ALT Blood Test?

The main need for an ALT blood test is to analyze the liver's health. If the liver cells are damaged, it results in leakage of ALT into the blood. A blood panel test is done, including an ALT test, that helps screen, monitor, and diagnoses the liver condition.

• Screening:

Screening is a process to check for potential health issues before a person experiences any symptoms. For example, the doctor will advise a screening test with a liver panel blood test if a person is at higher risk of liver disease, which includes:

1. Heavy alcohol use.

2. Family medical history of liver disease.

3. Diabetes.

4. Obesity.

5. Injecting using shared needles.

• Monitoring:

Suppose a person is affected by any liver condition. In that case, they will be recommended an ALT test t to see whether the condition is improving, worsening, or the same with or without any treatment. In addition, the doctor may recommend an ALT test if a person is under any medication with a higher chance of liver damage.

• Diagnosing:

A person experiencing any signs and symptoms of liver disease can be diagnosed through an ALT test. It plays a significant role in diagnosis but can not be solely based on the ALT test. Signs and symptoms include:

1. Nausea and vomiting.

2. Belly pain.

3. Itchy skin.

4. Jaundice.

5. Tiredness.

6. Appetite loss.

How Can This Condition Be Treated?

There is no particular treatment for this condition; treatment depends on the cause of the condition. Treatment for most cases of increased ALT includes lifestyle alterations, such as regular exercise, changes in diet, and decreased alcohol intake. Based on the result of the liver panel, the doctor may recommend checking them at a later date. If there is an increased level of ALT and a higher risk of liver disease, further testing and consultation with a liver specialist are advised to determine the underlying cause. Any of the following tests may be recommended:

1. Blood tests rule out other conditions such as hepatitis B and C and diabetes.

2. Liver ultrasound.

3. Abdominal CT (computed tomography).

4. Biopsy.

5. Thyroid-stimulating hormone (TSH) test.

6. Creatine kinase test.

7. Lipid panel.

8. Iron study to rule of hereditary hemochromatosis.

Conclusion

Any abnormal test result may be stressful, but not all high levels of ALT tests indicate a medical condition and require treatment. For example, an increase in ALT level in the blood is an indication of any liver damage or liver condition, but only this test can not be used to confirm any condition. The increased level of ALT can be reduced through various lifestyle and dietary changes.