In order to interpret your test result, your doctor takes multiple factors into account. These include your current health and health history as well as the levels of other measurements on your test. In addition, your doctor may consider individual factors that can influence your normal level of ALT, including:
- Exercise: Intense or extreme exercise can cause a temporary boost in ALT levels.
- Medications: A number of medications and supplements can alter ALT measurements.
- Sex: Males typically have higher levels of ALT, which is believed to be related to hormonal differences.
- Menstruation: ALT levels can go up or down during the course of the menstrual cycle.
- Age: There is a tendency for ALT levels to decrease with older age, although the exact reason for this is not known.
- Body mass index: Several research studies have found an association between ALT levels and body mass index, which may change the interpretation of test results in people with obesity.
When ALT levels are very high, it may be a sign of an acute liver problem. Mild or moderate elevation, especially if it persists on several tests over time, can be an indicator of a chronic disease. However, the degree of elevation alone is not a reliable predictor of the extent of injury to the liver.
Because many types of liver problems can cause ALT levels to increase, the test alone cannot identify an underlying cause. Although uncommon, ALT can be elevated as a result of disease outside the liver. Looking at how ALT levels relate to other liver enzymes can provide clues that may help the doctor assess your situation and recommend any appropriate follow-up testing.
Your physician can best help you understand the diverse factors that affect the interpretation of your ALT test and what your results mean for your overall health.
Are test results accurate?
Laboratory methods for measuring ALT have been shown to be reliable and reproducible. However, no test is 100% accurate. When errors occur, they are most often related to problems with improperly taking the blood sample.
Do I need follow-up tests?
Follow-up tests are common if an abnormal level of ALT was found on your liver panel or comprehensive metabolic panel test. Further testing may be immediate if you have significantly elevated ALT and/or symptoms of a problem affecting your liver. This follow-up testing may be more thorough and include blood tests, imaging, and in some cases a biopsy.
After an initial abnormal ALT test, repeat testing may be recommended shortly after your first test or at a later date. A series of tests over time may provide a more robust assessment of your liver health and can sometimes avoid the need for more costly or invasive testing.
The most appropriate follow-up depends on your health situation and the interpretation of your test result, and your physician can review the pros and cons of different options for further testing.
A conversation with your doctor about your ALT test can help ensure that you are informed about your results. Some of the following questions may make it easier to cover key information when you talk with your physician:
- What was my ALT level? Was it in the normal reference range?
- Were any other measurements taken? If so, were they normal or abnormal?
- What do the test results mean for my overall health?
- Do you recommend any follow-up tests? If so, which ones and what are their benefits and risks?
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Related Tests
Alanine aminotransferase is one of several enzymes produced in the liver that are commonly tested together. The following sections address some similarities and differences between ALT and other related tests.