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What causes elevated ALT levels in healthy adults?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My previous lab report showed ALT mildly elevated at 60, and I repeated in July, which showed ALT mildly elevated at 62. AST normal (28), alkaline phosphatase normal (77), total bilirubin normal (0.6). No known symptoms, normal BMI.

What can be the cause?

Please help.

Thank you.

Answered by Dr. Ajeet Kumar

Hello,

Welcome to icliniq.com.

Well, first of all, I need to know what the reference level of the lab is where this test is performed. Because asymptomatic ALT (alanine transaminase) levels just above the limit of the normal can be completely ignored and do not have a cause. Some medications like Tylenol, excessive exercise, and higher-than-normal body temperature can cause this.

If the levels are 1.5 times the upper limit or twice, to be precise, then this is a concern. Possible causes for such asymptomatic significant elevation of ALT can occur in various causes, but notably in lean NAFLD (nonalcoholic fatty liver disease), drugs, chronic viral hepatitis, Wilson disease, and Alpha antitrypsin deficiency.

So it is important first to differentiate between abnormal lab results vs. just above the limit of normal value based on that lab reference. Athletes with good muscle mass, dehydration, are other causes of asymptomatic nonsignificant ALT elevation.

Thank you.

Answered byDr. Ajeet Kumar

Medically reviewed byDr. Vinodhini J.

Published At August 3, 2020
Reviewed AtDecember 10, 2025

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar
Dr. Ajeet Kumar

Medical Gastroenterology

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