Here’s what a liver doctor says about the ALT and AST blood tests.

The cut-off point for whether or not an ALT or AST value should be of concern, can be confusing, especially since values can vary from one lab to the next.

“There is no definite value for this,” says Michael Blume, MD, a gastroenterologist at MedStar Good Samaritan Hospital, Baltimore.

“For example, patients with hepatitis C can have normal or near normal liver enzyme values and still have significant liver disease. In short, just because your liver enzymes are normal, does not mean that everything is necessarily normal.”

The AST and ALT number are not the be-all, end-all.

Dr. Blume explains “that you cannot interpret an isolated laboratory value or group of laboratory values as numbers that tell you something.

” You need to interpret these numbers in the context of why they were ordered in the first place, and what question they were supposed to answer.”

Dr. Blume adds: “It is important to remember that we treat people, not laboratory test numbers, so one needs to answer, what that number means in that particular person.”

Symptoms of Liver Disease

  • Jaundice: the skin has a yellowish tinge. This may also be present in the eyes and inner lips.
  • Abdominal swelling or pain (fluid buildup)
  • Swelling in the legs and ankles caused by fluid buildup as well
  • Itchy skin
  • Urine that’s the color of tea or cola
  • Pale bowel movements
  • Blood in the BMs or BMs that have what looks like gooey tar in them (old blood)
  • Unexplained fatigue
  • Nausea or vomiting
  • Appetite loss
  • Tendency to bruise easily

Risk Factors for Liver Disease

  • Heavy drinking
  • Drug use with shared needles
  • Unprotected sex
  • Diabetes
  • Obesity
  • Exposure to toxic chemicals like insecticides and aerosol sprays.
  • Tattoos or body piercings

Problems with the liver can also be caused by heart failure. The ALT and AST values won’t necessarily be as high as expected for this.

In practice for 20+ years, Dr. Blume treats over 65 conditions including abdominal pain, appetite loss, blood in stool, celiac disease, colon cancer, esophageal and liver disease, gas and IBS.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. 


Top image: Shutterstock/goodluz