Enarei

Alanine transaminase (ALT)

Alanine transaminase (ALT) is a blood test used to measure liver health, often in combination with other tests such as Aspartate transaminase (AST). The combination is often referred to as LFTs (liver function tests). Levels that are significantly above the normal range can indicate medical problems in some cases.

Expected values

Although reference values vary between different labs, ALT measurements are usually expected to be less than about 34 IU/L (Choi et al., 2024; Lee et al., 2010).

ALT levels can be mildly elevated (30-100 IU/L) for many reasons, including because of medications, alcohol, and obesity. Levels over 100 IU/L often indicate a serious liver problem (Helsper et al., 2012).

Other information

Examples of medications in trans health for which ALT monitoring is often advised include bicalutamide, tamoxifen, and cyproterone acetate.

The manufacturer of bicalutamide advises that the drug should be stopped if ALT levels become higher than twice the normal upper limit, meaning roughly 68 IU/L (Teva Pharmaceuticals, 2009).

See also

References

  • Choi, J., Jo, C., Kim, S., Ryu, M., Choi, W. M., Lee, D., Shim, J. H., Kim, K. M., Lim, Y. S., & Lee, H. C. (2024). Updated Reference Intervals for Alanine Aminotransferase in a Metabolically and Histologically Normal Population. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 22(11), 2240–2249.e6. [DOI:10.1016/j.cgh.2024.04.031]
  • Helsper, C., van Essen, G., Frijling, B. D., & de Wit, N. J. (2012). Follow-up of mild alanine aminotransferase elevation identifies hidden hepatitis C in primary care. The British journal of general practice : the journal of the Royal College of General Practitioners, 62(596), e212–e216. [DOI:10.3399/bjgp12X630115]
  • Lee, J. K., Shim, J. H., Lee, H. C., Lee, S. H., Kim, K. M., Lim, Y. S., Chung, Y. H., Lee, Y. S., & Suh, D. J. (2010). Estimation of the healthy upper limits for serum alanine aminotransferase in Asian populations with normal liver histology. Hepatology (Baltimore, Md.), 51(5), 1577–1583. [DOI:10.1002/hep.23505]
  • Teva Pharmaceuticals. (2009). Bicalutamide: Highlights of prescribing information. [PDF]