ALT and AST — Liver Enzymes — 60-Second Protocol
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lab guide · 2026-09-11
A mildly raised liver enzyme is the most common early signal of fatty liver.
ALT and AST are enzymes measured on liver blood tests. ALT is found mostly in the liver, while AST is also found in the heart and muscles. An increased level is often a sign of liver disease, and it is read against the lab's range and alongside the other liver tests.
The protocol
| Units | U/L |
| Standard range | ALT 4–36; AST 8–33 (ranges vary by lab) |
| within the lab's range | read alongside the rest of the liver panel (ALP, bilirubin) |
| above the lab's range | often a sign of liver disease, more likely when other liver tests are also raised; review with a clinician |
| outside the range, context | does not always mean a condition that needs treatment; pregnancy, exercise, certain medicines, age and sex affect results |
| AST/ALT ratio above 2:1 | per Cleveland Clinic, suggestive of alcohol-related liver disease; a clinician reads it with GGT and history |
| Testing | ALT and AST are usually run with other liver tests (ALP, bilirubin); ask what the whole panel shows |
| Clinician | discuss any result outside the lab's range with a clinician before drawing conclusions |
Full transcript
A mildly raised liver enzyme is the most common early signal of fatty liver. ALT and AST leak into the blood when liver cells are stressed. Optimal is ALT seven to twenty and AST eight to twenty-five, while the standard reference runs much wider. A mild elevation, one to two times the range, is where you look at weight, alcohol and fatty liver. Two to five times means clinician follow-up, and five times or more is an urgent referral. Less alcohol, fewer refined carbs, daily zone two, and a five to ten percent weight loss often normalises ALT. agegen.ai. Generate your prime age! ~~ Mr. Age
Sources
- https://medlineplus.gov/lab-tests/alt-blood-test/
- https://medlineplus.gov/lab-tests/ast-test/
- https://medlineplus.gov/ency/article/003473.htm
- https://medlineplus.gov/ency/article/003472.htm
- https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/liver-tests
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