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AST blood test: essence and indications. Elevated levels of asts in the blood Analysis of asts 17

Why, at the very first visit to the hospital, to any doctor, from a general practitioner to a highly specialized specialist, the patient is immediately sent for a blood test? Because it is by the biochemical study of blood that you can find out about the presence of pathologies in the body. Even if there are no other obvious signs of a disease that is emerging and developing in a patient, even if the disease has not yet had a serious impact on organs and systems, certain indicators will already be changed in “biochemistry”. And this will prompt the doctor to suspect the presence of pathology. And if necessary, the doctor will send the patient for further examination in order to prescribe the required treatment.

One of the main indicators of a biochemical blood test is ALT (or AlAT) and AST (or AsAT). Any increase or decrease in these indices indicates that something is going wrong in the human body. What exactly can be indicated by the fact that ALT and AST are elevated, and what treatment is prescribed for such indications?

One of the main indicators of a biochemical blood test - ALT and AST

What is ALT and AST

First you need to answer the main question: what are alt and ast? The full medical name for these indicators is aspartate aminotransferase (ASAT) and ALAT, called alanine aminotransferase. As doctors say, the enzymes AST and ALT (also sometimes referred to as transaminase) are active participants in the metabolism in the human body. in plain language, what it is? ALT "lives" in hepatocytes (liver cells) and, together with other participants in the process, breaks down the amino acid alanine. Liver enzymes - this is the name of this substance.

AST is responsible for what? This enzyme also "works" on the breakdown of amino acids, but only aspartic. And it is mainly found in the tissues of the heart muscle.

What does the deviation of the level of these enzymes from normal values during the measurement show?

The ALT index rises if there are any malfunctions in the liver or some pathologies of this gland occur. Also in medicine, there are cases when an increase in the level of this enzyme in the blood indicated developing diseases of the kidneys, skeletal muscles and tissues. nervous system.

AST is considered a marker of myocardial destruction. If this indicator in the blood test deviates in a positive direction, then it is urgently necessary to monitor the work of the heart.

Preparation for analysis

ALT and AST blood test is given, like the rest of the "biochemistry", on an empty stomach

According to doctors, special preparation for donating blood for these indicators is not required. ALT and AST blood test is given, like the rest of the "biochemistry", on an empty stomach. It is essential that the patient does not eat for at least 12 hours prior to blood donation. Also, at least two days before the analysis, you can not drink alcohol, smoke for 10-12 hours. In addition, doctors recommend on the eve of donating blood for research to protect yourself from emotional and physical overload. And you should not go for an analysis immediately after any even the most minimal surgical interventions or after dental treatment.

It should be noted that ALT in hepatitis C is always elevated. And, if the patient is aware that he has been diagnosed with this disease, it is worth warning the doctor and the laboratory assistant who takes the blood. It is also necessary to know that the ALT norm in women is somewhat lower than in the representatives of the stronger sex.

The norm of ALT and AST in the blood

Of course, there is an established ALT and AST norm - indicators in numbers that are characteristic of the average healthy person. There is a special table in which the norms for age and gender are entered. The level of this enzyme is measured in different ways: there are units for measuring indicators in mol, but many laboratories issue research results that indicate data in units / l. We give the norm-indicators that can be seen in adults in the table in these units.

In men, the normal levels of these enzymes in the blood test during life, if the person is healthy, do not change. In representatives of the stronger sex, biochemistry, in the case of order in the body, gives ALT a maximum of 18 units / l, and AST - a maximum of 22 18 units / l.

But women have different norms at different stages of life. So a biochemical blood test in a healthy woman shows ALT no higher than 15, and AST no higher than 17 units / l. Blood from a vein in women who are expecting a baby will give the level of these enzymes slightly lower (by 5-10%) than usual.

The numbers in the transcript of the study in nursing mothers and young ladies who have menstrual bleeding at the time of the test are gradually returning to normal. Although, slight deviations can be observed, for example, in nursing mothers, the level of substances may increase slightly.

But the norm in the blood after 50 years in both men and women remains at the same level as at a young age.

As for children, the highest levels of AST and ALT are recorded in infants. In newborns under the age of one month, ALT is considered to be at the level of 38 units / l, and AST - up to 32. In children under the age of one year, the maximum threshold of AsAT and ALT is fixed at 36 and 27 units (respectively), in children under 16 years - 31 and 22 (respectively).

What does the deviation of the level of these enzymes in the body from the norm indicate? As already mentioned, this indicates one thing: something went wrong with some internal organs and their functions. To understand what kind of failure happened and accurately determine the problem, doctors look at other indicators of a biochemical blood test, and also prescribe additional examinations.

Reasons for the increase

So, what exactly can be evidence of an increase in ALT and AST in the blood? It has already been noted that if ALT and AST are elevated, then this clearly indicates pathologies of the heart and liver and indirectly indicates problems with the kidneys, muscles, blood vessels, and the nervous system.

Reasons why ALT enzyme levels are elevated:

High rates for this substance are given by a blood test for cirrhosis of the liver of various etiologies.

High rates for this substance are given by a blood test for cirrhosis of the liver of various etiologies (alcoholic, toxic, arising as a result of other hepatic pathologies), with prolonged and regular use of alcohol, as well as with alcoholic liver damage.
A high ALT level indicates the development of acute pancreatitis in a patient.
The numbers increased relative to the norm will be in the conclusion of the analysis for acute hepatitis or the chronic development of this disease.
Elevated ALT in the analysis may indicate that an oncological neoplasm is progressing in the liver and / or biliary tract. And also about the fact that these organs began to spread metastases of the tumor, "living" in another organ.
An increase in the concentration of the substance is observed with fatty hepatosis.
The level of this enzyme also increases if the patient develops cholestasis or cholestatic jaundice.
Such a development of events is also possible: ALT rises with normal bilirubin. This, as a rule, indicates that the patient is taking various drugs - oral contraceptives, drugs that prevent the development of tumors, chemotherapeutic and psychotropic drugs.
ALT levels are also elevated in severe burns.

In this case, the doctor will also pay attention to such a line in the conclusion about the patient's blood test as gamma-glutamyl transferase (GGT). Information about the level of this substance can confirm or refute the presence of a particular liver pathology.

Why can there be high content in the blood of ast-enzyme:

The patient has acute myocarditis or myocardial infarction.
Increased AST levels can be with serious muscle injuries - sprains, ruptures.
It can be elevated ast with hepatitis C and other liver pathologies.
The indicator for the enzyme changes to “plus” if the patient is diagnosed with myopathy, myositis, myodystrophy.
Unstable angina and thromboembolism pulmonary artery can also give an increase in the substance.

An increase in the level of both enzymes at once can be caused by severe physical overwork or a prolonged state of stress in which the patient is.

It is especially dangerous when these indicators were about to be normal, and suddenly increased sharply at 2 by 2 times. This suggests that some kind of negative scenario with dysfunctions is developing. internal organs, and at the same time there is a lack of vital substances for a person.

Reasons for the decline

Low levels of these enzymes in the test results should also alert the patient and the doctor. ALT and AST levels may be below normal in hepatitis, moreover, when the disease is started, when it has not been diagnosed and treated for a long time, and the tissues of the organ have already undergone necrosis.

Also decrease in ALT and AST means in biochemical analysis blood that a person lacks vitamin B6-peredoxin. Usually this condition provokes long-term use of antibiotics.

Indicators in pregnant women and children

As already mentioned, the analysis of ALT, AST, bilirubin in pregnant women may differ from the conclusion of a blood test of a lady who is not expecting a baby. The level of these enzymes in the first trimester of pregnancy, due to changes in the hormonal background, usually slightly increases, and later, in the second and third trimester, it turns out to be slightly below normal. As a rule, this does not lead to anything bad, but is simply caused by the current state of the expectant mother.

But if the situation suddenly gets out of control, and the numbers for enzymes decrease significantly or, conversely, increase catastrophically, the gynecologist leading the pregnancy prescribes additional tests and examinations. This is necessary to exclude the presence of a serious pathology in the mother or the unborn baby. For example, an increase in ALT and AST may indicate the development of preeclampsia, which negatively affects the condition of the mother and fetus.

Deciphering the results by the De Ritis coefficient

In a biochemical study of a patient's blood, there is another very important indicator - the De Ritis coefficient. This is the ratio of AST to ALT, the quantitative ratio of enzymes to each other. Reference values for ALT and AST are 1.33 units. If the patient's indicators are less than these values, then he, for sure, develops some kind of serious hepatic pathology. In the case when the De Ritis coefficient is above the norm, then the patient has problems with the myocardium.

What to do if ALT and AST are above normal

Of course, in a situation where the level of enzymes is above or below normal, it is necessary to take action. As a rule, with such test results, the doctor, if they do not immediately make a diagnosis, then send the patient for an additional examination, after which they prescribe adequate treatment. Usually, when eliminating pathologies that cause an increase in the level of substances, it is possible to automatically lower the indicators. How quickly this happens depends on the correctness of the prescribed therapy and on the response of the patient's body to it.

What to do, if you reduce the numbers in the lines with the inscriptions "ALT" and "AST" in the conclusion of the blood test, it does not work? Perhaps this is due to the fact that the diagnosis is incorrectly made and / or the treatment is incorrectly prescribed. Most likely, in this case, an adjustment of prescriptions and / or a new examination will be required.

Medications

Hepatoprotectors will help restore liver cells

How to reduce the level of enzymes with drugs if they are still high, and the patient has been treated as required, and the patient has absolutely no pathologies at this stage. There are a number medical preparations decrease in the level of ALT and AST. How to effectively lower the level of these enzymes? In this case, hepatoprotectors will help, “working” to restore liver tissues and cells, normalizing its functions; enzymes that “put in order” the stomach and pancreas; heart medicines; and painkillers that relieve spasms.

Of course, self-medication in this case is not worth it. And all drugs must be taken only as prescribed by the attending physician.

A child under the age of 16 has physiologically elevated levels of these substances. A decrease, if everything is in order in the body, occurs as a small patient grows up.

Folk remedies

It is believed that it is possible to normalize the level of these enzymes with folk remedies. For this, it is recommended to take various liver fees, a decoction of milk thistle, tincture of dandelion flowers, as well as an infusion of corn stigmas. To maintain the heart, you can drink an infusion of adonis.

Certainly, folk remedies are good. But with serious pathologies and serious deviations from the norm, with their help, the result cannot be achieved. They can be used, but only in conjunction with drugs. And only then can you achieve good result from the therapy.

Diet and prevention

What is the prevention of the occurrence of such deviations in the results of blood tests? Of course, first of all, it is necessary to prevent the occurrence of pathologies and diseases that provoke an increase or decrease in the level of enzymes in the human body. Certainly there must be a waiver bad habits, use alcoholic beverages, some potent and / or illegal drugs, smoking. It is also necessary to maintain correct and healthy lifestyle life, which consists in rational and timely nutrition and the organization of moderate and adequate physical activity.

When it is necessary to reduce the content of enzymes in the blood, a reasonable diet should be used along with the medication prescribed by the doctor and auxiliary folk remedies.

In case of pathologies associated with the liver, they recommend a complete rejection of alcohol, fried in oil and fatty, smoked and overly salty, sweet. The patient's diet should consist of the right combination of proteins, fats and carbohydrates, poultry and lean meats, as well as fish, vegetables and cereals can be eaten. And you need to cook everything for a couple or stew without adding oil.

Video

About the blood test AST and ALT.

The purpose of the AST test is to determine the level of the enzyme aspartate aminotransferase in the blood. This specific cellular enzyme is involved in amino acid metabolism. Found mainly in the liver, myocardium, nervous tissue, skeletal muscles, which is associated with a high level of metabolic processes in these tissues. In a smaller amount is found in the kidneys, lungs, pancreas. The level of AST in the blood should normally be low. If this indicator is increased, this indicates the destruction of any tissues and the release of the enzyme from damaged cells and their release into the bloodstream. The more active the process of tissue destruction, the more AST enzyme enters the blood. Thus, an increase in the level of this indicator indicates pathological processes occurring in the body.

How is the research done?

To determine AST in the blood, a biochemical blood test is performed. The fence is made from a vein in the morning on an empty stomach. A tourniquet is applied to the arm above the elbow. The needle and injection site are disinfected with alcohol. The needle is inserted into a vein and 15-20 ml of blood is taken, after which the tourniquet is removed, the injection site is clamped with a cotton swab. The patient should bend the arm at the elbow and wait until the blood stops.

With the help of centrifugation, the plasma is separated from the formed elements, then, using chemical reactions, the activity of aspartate aminotransferase in the blood is determined.

The results are usually ready the next day. Decoding is within the competence of the attending physician, who is familiar with the standards of the laboratory in which the analysis was carried out. It should be said that in different laboratories can be used different ways and reagents.

How to prepare?

To obtain reliable results, blood donation occurs on an empty stomach, that is, after eating, at least 8 hours must pass. In addition, one day before the study, you need to give up alcoholic beverages, fatty and fried foods, avoid physical, mental and emotional stress. In the morning before the analysis, you can not drink tea, coffee, juice, but only clean water. It is recommended to stop taking any medications 1-2 weeks before the study. If this is not possible, the attending physician should be notified. As a result, the procedure will be postponed to another time, or the decoding will take place taking into account the possible effects of medications on the result. In addition, the doctor must be informed about allergies to any drugs and about pregnancy.

You can’t donate blood within a few hours after some procedures, including:

radiography;
physiotherapy;
rectal examinations;
fluorography;

What influences the test result?

Taking certain medications. It is very important to tell your doctor about all medications you are taking. Your doctor may recommend that you stop taking some of them a few days before the test.
Reception of some herbal remedies such as valerian and echinacea.
Large doses of vitamin A.
Recent heart surgery or catheterization.

Norm AST

AST levels differ in women, men, and children. The norm for women is no more than 30 units / liter, for men - no more than 37 units / liter. The norm for a child depends on age. For newborns under the age of five days, it should not exceed 100 units / liter. By the age of 10, the norm is 50 units / liter.

What is it for?

This analysis is used to:

Checking the liver for damage.
Detection of diseases such as cirrhosis of the liver, hepatitis.
Finding out the causes of jaundice: liver disease or problems in the circulatory system.
Checking the effectiveness of the treatment.
Evaluation of the effect on the liver of drugs that can lead to liver damage.
Diagnosis of heart disease.

Indications for analysis are all liver diseases

The analysis for AST allows you to determine the cytolysis (the process of cell destruction) of the heart muscle and liver. An increase in this parameter with damage to other organs is not observed. The purpose of the study is to detect damage to specific tissues, as well as differential diagnosis and exclusion of liver and heart disease.

Indications for analysis

A biochemical blood test, during which the level of AST is determined, is prescribed for a number of diseases, including:

All pathologies of the liver.
Diseases of the circulatory system.
Chronic and acute diseases hearts.
kidney failure.
Infections.
Intoxication.
All types of jaundice and disorders of bilirubin metabolism.
Autoimmune diseases.
Purulent-septic pathologies.
Encephalopathy of unknown etiology.
Violations of the outflow of bile, cholelithiasis.
Chronic pancreatitis.
Endocrine diseases.
Malignant tumors.
Allergic skin diseases.
Long-term treatment with antibiotics, chemotherapy drugs and various toxic drugs.
abdominal trauma and chest.
Preparing for a difficult surgical operation.
Evaluation of the treatment of hepatic and cardiac pathologies.

When does AST rise?

The reasons for the increase in the enzyme in most cases are associated with diseases. Among them:

acute myocardial infarction is the most common cause of a high level of AST, while the more extensive tissue damage, the higher the concentration of the enzyme in the blood;
infectious or autoimmune myocarditis;
rheumatic heart disease;
heart injury (open);
liver cancer;
liver metastases;
viral hepatitis;
alcoholic hepatosis;
fatty hepatosis;
toxic liver damage;
damage to the liver and heart with malignant myeloid leukemia;
heart failure;
angina;
massive muscle destruction: generalized myositis, crush syndrome, myodystrophy;
acute pancreatitis.

In addition, the enzyme can be increased with alcohol intoxication, heat stroke, skeletal muscle injuries, burns, emboli in blood vessels, poisoning with poisonous mushrooms. A slight increase is observed while taking certain drugs (antibiotics, sedatives, etc.) and with significant physical exertion.

AST rise levels

There are three levels of increase in plasma AST:

insignificant - with fatty deposits in the liver, taking certain medications (antibiotics, statins, aspirin, anticancer drugs, barbiturates, etc.);
medium - with a heart attack, heart failure, cirrhosis of the liver, certain types of cancer, alcoholism, autoimmune diseases with muscle damage, taking high doses of vitamin A, damage to the lungs and kidneys, muscular dystrophy, mononucleosis;
high - with multiple liver injuries in viral hepatitis, reactions to drugs and medications, with necrosis of a large tumor.

AST in the blood diagnostic value with myocardial infarction

The highest level of AST is observed at the onset of the disease with significant tissue destruction. A decrease in the enzyme in the blood means the beginning of liver recovery, recovery. A slight increase in AST is not yet a sign of tissue destruction. Diagnostic value is the level of AST, exceeding the norm by more than two times.

Reasons for the downgrade

A significant decrease in AST is possible with a deficiency of vitamin B6 and with severe liver damage, such as ruptures, cirrhosis.

How to downgrade?

An increase in AST in the blood is always due to the development of some kind of pathology associated with the destruction of cells of the heart muscle, liver and some other tissues. It is important to understand that it is impossible to lower the concentration of the enzyme without treating the primary disease. Therefore, the main task of the doctor when detecting increased activity of AST in the blood plasma is to diagnose and prescribe treatment. The decrease in AST will occur only after the elimination of the disease. With proper and timely treatment, normalization is possible in a month and a half.

Conclusion

AST analysis allows diagnosing severe and dangerous diseases at an early stage, when the symptoms are still absent and may appear after a sufficiently long period of time. This parameter has a particularly important diagnostic value in myocardial infarction. Enzyme activity can be reduced only by curing the underlying disease, which caused this condition.

Today, each of us can go to the laboratory and donate blood to see if there are any serious deviations in health, and if there are any, start treatment in time. If, after receiving the results of the analysis, it is found that all indicators are more or less normal, but AST in the blood is elevated, then questions immediately arise: how dangerous is it, what do the three capital mysterious letters mean and many other related questions. Our article will help you get answers to them.

What is AST

Aspartate aminotransferase, or AST for short, is the name of an enzyme that is part of absolutely all cellular structures of our body. But the greatest amount of aspartate aminotransferase is found in the myocardium and skeletal muscles, then in the liver cells, in the nervous tissue, in the kidneys. If the body is normal, then the indicators of AST activity in the blood are quite low.

But when various organs or systems of the body are damaged, the enzyme begins to be released and enter the bloodstream. Thus, in a biochemical analysis, it becomes clear that AST is elevated in the blood - this gives the doctor reason to suspect the onset of destructive processes in cells. The enzyme aspartate aminotransferase is essential for proper cell function. It performs transport functions, delivering groups of atoms to various amino acids.

Normal AST values

Normal indicators for the optical method of determination (in IU) look like this:

in women - up to 35 IU;
in men - up to 41 IU;
in children - up to 50 IU.

Reitman-Frenkel reaction (µmol/h/ml):

in women - up to 0.35;
in men - up to 0.45;
in children - up to 0.5.

If she showed AST not exceeding the indicated values, this indicates that the enzyme systems of the heart, liver, kidneys are functioning normally, and the cellular composition of the organs is not damaged. If there are deviations in the analyzes and it is found that AST is elevated in the blood, other specific markers (troponins, creatine phosphokinase, ALT, etc.) should also be checked.

I must say that different laboratories may use different reagents and research methods. Therefore, the results obtained in different places may differ slightly from each other.

Elevated AST in the blood: causes

If the level of the enzyme in the blood is elevated, then this may indicate the presence of any disease from the following list:

myocardial infarction is one of the most common causes too high a level of AST, and the larger the area of myocardial damage, the higher the concentration of the enzyme aspartate aminotransferase in the blood;
open either closed injury hearts;
rheumatic heart disease;
angina;
autoimmune or infectious myocarditis;
bile duct cancer;
liver cancer;
cholestasis;
fatty hepatosis;
viral hepatitis;
toxic liver damage;
heart failure;
extensive destruction of muscle tissue (crash syndrome, generalized myositis, myodystrophy);
acute pancreatitis.

Also, if AST is elevated in the blood, this can be observed when skeletal muscles are injured, with severe alcohol intoxication, burns, heat stroke, emboli in the vessels, and poisoning with poisonous mushrooms.

A slight increase in the level of AST occurs with strong physical exertion and while taking certain pharmacological preparations(sedatives, antibiotics, etc.).

What can be learned by determining the level of aspartate aminotransferase in the blood

In the event that AST in the blood is slightly increased (about 5 times), then this may be due to fatty hepatosis, taking some medicines(barbiturates, statins, antibiotics, drugs, chemotherapy drugs, etc.).

A moderate, average increase in the enzyme (up to ten times higher than normal) can be caused by chronic liver diseases, cirrhosis, myocardial infarction, myocardiostrophy, processes that occur with damage to kidney and lung cells, mononucleosis, and cancer.

If AST in the blood is greatly increased (10 times or more) - this tells the doctor that the patient may have viral hepatitis in the acute stage, toxic damage to the liver structures, drug-induced hepatitis (acute), and this may also indicate a course in the body processes accompanied by tissue necrosis (for example, with tumors).

At the beginning of the disease, in its acute stage, when the process of tissue destruction is the fastest, the highest level of aspartate aminotransferase is observed. A decrease in AST in the blood serum indicates the beginning recovery processes in the cells of organs and the recovery of the patient. Slight excesses of the norm are not a sign of destruction in the tissues.

What can distort the results of the analysis

Sometimes a doctor, seeing that AST in the blood is elevated, but not finding any visible signs of illness in the patient, recommends that he donate blood again, and this additional analysis shows normal level enzyme. Upon detailed questioning, it turns out that the patient took medications on the eve of the first blood donation, which affected the correctness of the indicators. To avoid such situations, you need to know what can distort the result:

Taking certain pharmaceuticals. It is important to let your doctor know about all medications you are taking. The doctor may prohibit certain medications a few days before donating blood.
The use of herbal remedies: echinacea or valerian.
The intake of large doses of vitamin A.
Pregnancy.
Severe allergy.
Catheterization or recent heart surgery.

If AST in the blood is elevated, the reasons may be different, sometimes even unexpected. In order not to worry later due to incorrect results, it is not recommended to donate blood for research for several hours after undergoing the following procedures:

fluorography;
rectal examination;
physiotherapy;
radiography.

How is the study on the content in the blood of AST

A blood test, whether the level of the enzyme is elevated or not, is done in the following sequence: a biochemical study is necessary to determine the content of aspartate aminotransferase in the blood. The material is taken from a vein only in the morning and only on an empty stomach.

First, the nurse applies a tourniquet to the arm above the elbow, then a needle is inserted into the vein and about 15-20 ml of blood is taken. The tourniquet is then removed and a cotton swab is applied to the injection site. The patient is instructed to bend the arm at the elbow and hold the injection site firmly to stop the bleeding. You can sit for a few minutes and then go home.

And in the taken blood with the help of a centrifuge, plasma is separated, the necessary chemical products are produced. reactions and AST activity is determined. The results are usually ready the very next day. It is better not to engage in independent decoding of the results handed out, this should be done by a doctor.

what treatment is needed?

It is important to understand that if an analysis was made and it was confirmed that AST in the blood was greatly increased, then this could not happen just like that, by itself. This can be associated with the presence of any pathology in the body, with the destruction of the structures of the liver, heart muscle or other tissues. And this means that it is impossible to lower AST without treating the disease that caused the jump in enzyme concentration.

Therefore, the main task of the attending physician will be to find, in the case when AST in the blood is elevated, the reasons for this. That is, the early diagnosis comes to the fore, and then the appointment of treatment. After elimination of the disease, the level of aspartate aminotransferase will also decrease.

How to properly prepare for the delivery of an analysis for the content of AST

In order for the test results to be more reliable, it is necessary to donate blood on an empty stomach. Moreover, at least 8 hours should pass after the last meal. It is very important one day before going to the laboratory to give up alcohol, fatty and fried foods, as well as avoid both physical and emotional or mental overload. In the morning before the analysis, you can drink only clean water, but in no case should you drink coffee, juices or teas - this can adversely affect the blood test.

AST is elevated or not, they find out no earlier than seven days after being sent for analysis, so that there is time for preparation. One, and preferably two weeks before the study, experts strongly recommend that you stop taking medication. In the event that it is not possible to fulfill this requirement, it is imperative to notify your doctor about this so that he, when deciphering the analysis data, makes the necessary corrections or schedules the procedure for another day. If there is an allergy or pregnancy, then this should also be reported to the doctor.

Indications for the purpose of the analysis

The described analysis is prescribed for certain diseases:

Acute or chronic diseases hearts.
All diseases of the liver.
Diseases of the circulatory system.
Infections.
Renal failure.
Autoimmune diseases.
Encephalopathy of unknown etiology.
Disorders of bilirubin metabolism and different types jaundice.
Pathologies are purulent-septic.
Chronic pancreatitis.
Gallstone disease and violation of the outflow of bile.
Malignant tumors.
Endocrine diseases.
Skin diseases caused by allergies.
Preparing for major surgery.
Injuries to the chest or abdomen.

In addition, it is prescribed to assess the dynamics in the treatment of cardiac and hepatic pathologies and while taking antibiotics (long-term), various toxic drugs, as well as chemotherapy drugs.

About ALT

What is elevated AST in the blood, we found out the reasons for this phenomenon. Now let's talk about an equally important indicator. Usually, when prescribing, the doctor wants to see not only the level of AST, but also the content of another enzyme - ALT.

This is alanine aminotransferase, which, like AST, is present in the cells of all organs, but its largest amount is in the liver and kidneys. When problems arise in the liver, ALT enters the bloodstream. Its increase makes it possible to diagnose serious liver diseases even before the onset of jaundice - characteristic symptom various hepatitis. Therefore, the increased content of ALT in the blood is interpreted by physicians as an indication of damage to the named organ.

If a person has passed a blood test for a biochemical analysis, AST and ALT are elevated, then this may mean that serious destructive processes are taking place in the body. Recall that both enzymes enter the blood in increased quantities only if there is a destruction of cellular structures. This does not necessarily indicate the presence of a disease. Correct conclusions can only be made by a doctor, after additional diagnostic procedures. There is no need to panic, but it is also not worth delaying a visit to the doctor.

Final word

In the blood is not yet a sentence, even if these figures are much higher than the norm. The main thing is a timely diagnosis and treatment under the guidance of an experienced specialist. We wish you all good tests and good health!

To diagnose a number of diseases, an ALT blood test is prescribed, what is it? Alanine aminotransferase (ALT, Alat) is an enzyme involved in the transport of the amino acid alatine. ALT is found ubiquitously in all cells of the body, in large quantities it can be found:

in muscles, including cardiac;
in the cells of the pancreas, liver and kidneys.

For an adult, a normal ALT blood level is:

in men - 39-40 U / l;
in women - 29-30 U / l.

In inflammatory processes, necrosis and other destruction of internal organs, the ALT index rises. Therefore, if the blood contains more ALT than is required by the standard, this allows you to determine the stage to which the damage to the organ has reached. An analysis for ALT is often prescribed in combination with another biochemical study, for AST. Simultaneous blood testing for AST and ALT allows for a more accurate diagnosis. AST is an enzyme that transports the amino acid aspartate. The greatest amount of AST is found:

in the liver;
in skeletal muscles and heart;
in the kidneys.

They are prescribed as additional diagnostic measures in combination with other studies.

The ALT enzyme is found in greater quantities in liver cells; if these cells are damaged, it is released into the circulatory system, which makes it possible to diagnose cirrhosis, hepatitis and other diseases in which the liver mainly suffers. The AST enzyme is present in greater amounts in muscle tissue myocardium, therefore, with ischemia, myocardial infarction, myocarditis and other heart diseases, an increased content of AST in the blood makes it possible to detect pathology.

Which doctor will prescribe the analysis

Most often, a biochemical blood test for AST and ALT is prescribed by a cardiologist or gastroenterologist. What other doctors can give direction to this study?

gynecologist;
endocrinologist;
orthopedist;
nephrologist.

A blood test for AST and ALT can be taken at any state clinic and in almost every private laboratory. It is better to order a survey along with a transcript, since the data laboratory research may be presented differently in the conclusion depending on the standards of a particular institution.

How to take an analysis of ALT and AST

The level of enzymes is affected by stress, alcohol and drug intoxication. Therefore, in order for the test data to reflect the real situation, the patient needs special preparation:

7 days to stop the use of alcoholic beverages and drugs;
refrain from strong excitement and stress;
10 hours before the tests, refrain from food, do not drink anything except plain water.

If the patient is taking any medications should be reported to the attending physician. Many medications (especially steroids and enzymes) can interfere with test results. In men, the enzyme composition of the blood quickly responds to intense physical activity (weight lifting, running, sports training), so you should refrain from going to the gym and other strenuous muscle work before the tests. In men and women, the enzymatic composition of the blood is sensitive to nervous strain, to stress. To get results that correspond to the real situation, before donating blood, you should get a good night's sleep and limit conflict situations.

What diseases require AST and ALT tests

For diagnostics the following diseases use ALT and AST analysis:

Viral hepatitis, cirrhosis of the liver, liver tumors, including cancer, mononucleosis.
Heart failure, ischemic disease heart, myocardial infarction, inflammation of the heart muscle (myocarditis, pericarditis).
skeletal muscle disease, inflammatory processes in muscles, myositis, myopathy.
Lung infarction.
Hypothyroidism.
hemolytic anemia.
Trauma, shock conditions, burns, hypoxia.

An increase in ALT and AST shows necrotic changes, therefore it is widely used to quickly determine the severity of the disease. Deciphering the results of the analysis is carried out by the attending physician. The AST and ALT index is influenced by many factors that the doctor takes into account when interpreting the results:

pregnancy;
obesity;
gender, age;
chronic diseases;
taking medications, such as hormonal contraceptives, non-steroidal anti-inflammatory drugs.

Due to the destruction of muscle tissue and liver cells, the ALT index is increased due to severe mental shocks, extensive burns, pain shock and injuries.

In conditions that threaten the life of the patient, a biochemical blood test for ALT and AST is not used, but it is widely used to diagnose diseases of the heart muscle and liver.

Deciphering the results

AST and ALT indicators are measured in conventional units per liter (U/l). Some laboratories use different units of measurement, so when analyzing data, you need to clarify how to convert results from one system to another. How does the amount of these enzymes change with age?

the optimal indicator for a newborn child up to 5 days of life is 49 U / l;
the norm for children under 6 months - 56 U / l;
from 6 months to 1 year - 54 U / l;
from 1 to 3 years - 33 U / l;
from 3 to 6 years - 29 U / l;
from 6 to 12 years old - 39 U / l.

Fluctuations in AST and ALT are associated with human growth. For each age, a person is characterized by a certain hormonal background and the biochemical composition of the blood. A slight increase in enzymes in children does not necessarily indicate any serious illness. In adolescents from 12 to 14 years old, AST and ALT levels gradually reach the values characteristic of adults. The norm of ALT and AST in the blood for adults:

in men, optimal performance is up to 40 U / l;
in women - up to 30 U / l.

For diagnosis, it is not the ALT (ALT in Latin abbreviation) and AST (AST) indicators themselves that matter, but their ratio. This ratio is named after Dr. de Ritis (DRr). To calculate it, the AST indicator must be divided by ALT. You get a number by which you can draw a conclusion about the presence or absence of pathology. For men and women, the de Ritis coefficient is estimated the same.

In hepatitis, the DRr coefficient is less than one; in dystrophic processes in the liver, it is greater than or equal to one. For a more accurate clinical picture, an analysis of albumin is used. If the DRr coefficient is greater than 2, and the albumin value is less than 35 g/l, this indicates liver necrosis. AST and ALT blood test allows you to determine viral hepatitis And 2 weeks before jaundice starts, and viral hepatitis B - 2-10 weeks before obvious changes. The diagnosis is never made only on the basis of the DRr coefficient, the attending physician also prescribes other studies.

Changes in indicators for various diseases

As an additional diagnostic measure, a biochemical blood test for AST and ALT is used to monitor the condition of the liver and heart, less often the pancreas. How do enzyme parameters change relative to the norm during pathological processes in the heart and liver?

Preeclampsia. If the levels of AST and ALT are normal in the first trimester of pregnancy, what does this mean? Most often, the reason is not in any serious diseases, but in the lack of vitamin B6. For the normal development of the fetus, a large amount of vitamin B6 is required, which is involved in the synthesis of AST and ALT enzymes. When avitaminosis B6 is compensated, homeostasis of the liver and muscle tissue is restored. In the 2-3 trimesters, the level stabilizes, which indicates that the woman's liver and kidneys are coping with the increased load. If the indicators are significantly higher than normal, this indicates gestosis.
Hepatitis. Acute viral hepatitis leads to an increase in ALT to 500-3000 U / l. The indicator reaches peak values at 2-3 weeks after infection, then a decrease begins. A repeated increase in the level of ALT indicates cirrhosis of the liver. In alcoholic hepatitis, the ALT and AST indicators are 500-600 U / l. A biochemical blood test can detect diseases that do not have symptoms in the early stages, such as viral hepatitis B.
Hyperfermentation. Moderate hyperfermentation of the liver gives an increase in ALT and AST by 1.5-5 times, moderate hyperfermentation - by 6-10 times, severe - an increase of more than 10 times compared to the norm. Change in the volume of enzymes circulating in circulatory system, allows us to conclude that there is a serious violation in the liver. If these enzymes enter the blood in large volumes, what does this mean? Liver cells are damaged and destroyed by pathological process. Other studies specify what kind of pathology in question. If the increase in AST is greater than ALT, hyperfermentation may indicate cirrhosis, liver metastases of a malignant tumor, intrahepatic cholestasis, and infectious mononucleosis.
Heart disease. In myocardial infarction, the increase in enzyme levels does not occur synchronously. AST increases 8-10 times, and ALT - 1.5-2 times. After an attack, an increase in AST and ALT occurs within 6-8 hours, the maximum value is reached after 16-48, to normal values indicators are returned in 3-6 days.

In myocardial infarction, the increase in enzyme levels does not occur synchronously. AST increases 8-10 times, and ALT - 1.5-2 times.

In order for the test data to be reliable, the doctor evaluates not only AST and ALT, but also other liver enzymes:

bilirubin;
creatine kinase;
alkaline phosphatase;
gamma-glutamyltransferase;
lactate dehydrogenase.

An increase in liver enzymes by 5-10% in the first trimester of pregnancy is the norm in women. The examination is usually carried out 1 time per pregnancy, most often in the 2-3 trimesters, if there are no indications for an urgent analysis. If heart disease is suspected, in addition to AST and ALT, a biochemical blood test includes:

myoglobin;
C-reactive protein;
troponins;
MB fractions of creatine kinase.

It is used not only for diagnosis, but also for disease control.

The half-life of AST and ALT is from 12 to 24 hours, therefore, when monitoring the patient's condition, studies are carried out no more than 1 time in 2 days. In adult men and women, indicators can fluctuate during the day within 10-30% of the norm. AST in women increases naturally during childbearing, within 2-3 months after conception, the level of enzymes normalizes.

The indicator is below the norm

Decreased AST and ALT levels are determined in the analyzes due to two violations:

lack of vitamin B6, which is involved in the synthesis of these enzymes;
severe cirrhosis of the liver, in which the body can no longer produce enzymes in sufficient quantities.

Vitamin B6 does not accumulate in cells, therefore, for the effective synthesis of AST and ALT, its constant intake with food is necessary. What are the signs of beriberi B6?

from the side immune system: reduced immunity, vulnerability to infectious diseases;
from the side of the heart: jumps blood pressure, dizziness, fainting, lack of blood supply;
diseases of the nervous system and psyche: depression, anxiety, insomnia, decreased concentration;
on the part of the muscles: convulsions, myalgia;
on the part of the skin: a decrease in the rate of tissue regeneration;
on the part of the liver: lack of liver enzymes, which leads to indigestion.

B6 deficiency negatively affects the work of all organs and systems of the body without exception. B6 - pyridoxine - is a substance that is indispensable in many chemical reactions. Therefore, if vitamin B6 deficiency is suspected, it is useful to take a biochemical blood test.

In women, ALT values are considered good if the concentration of these enzymes does not exceed 31 U / l.

The norm of ALT in women in the blood is a value ranging from 20 to 40 units.

The norm of AST in women in the blood of ME.

The presence of deviations of indicators up or down is evidence that certain changes are taking place in the body. If the indicators are increased by 2-5 times, then the increase is considered moderate. An increase of 6-10 times indicates an average increase in results.

If the indicators are higher than the norm by 10 times or more, then this is high boost. As a rule, to find out the causes and correct the results, an individual consultation with a specialist is required with the appointment of additional examinations.

The meaning of the terms ALT and AST

These are types of enzymes from the transferase group, which are widely used in medical practice to detect the level of damage to internal organs.

Normally, only a small part of these enzymes enters the bloodstream. In the presence of certain pathologies, these enzymes are determined in the blood to a lesser or greater extent from the norm, which is determined by laboratory methods.

The level of ALT in the blood of a woman allows you to find out the presence and extent of liver damage. The level of AST allows you to assess, in addition to the state of the liver, the degree of damage to the heart muscle.

Causes of increased enzyme levels

Depending on the age of a woman, certain disorders in the tissues of the body may occur. In the future, this leads to the presence of overestimated ALT and AST.

Only a specialist can determine the cause of the increase, based on research.

Isolated increase in ALT

The main reason for the increase in ALT in women is the presence of liver diseases - hepatitis, cirrhosis of the liver, liver cancer. Also causes at any age are diseases of the pancreas, heart disease, diseases of the skeletal muscles and muscles, hypothyroidism. An important role in the list of causes is also occupied by injuries of the body, shock conditions and the presence of burns.

Isolated increase in AST

The most common reason for detecting an elevated level of AST is the presence of heart pathologies in a woman, which increase with the age of older people.

When a myocardial infarction occurs, AST usually rises tenfold. Also, the increase in results is affected by the presence of such diseases as hepatitis, cirrhosis and liver cancer, obstruction of the biliary tract, acute pancreatitis.

Reasons for Simultaneously Increased Enzyme Levels

The simultaneous determination of the level of ALT and AST in the blood of a woman is considered a more informative and reliable result, showing the level of damage to internal organs.

In medical practice, there is the de Ritis coefficient, which indicates the ratio of ALT / AST. Normally, this coefficient is 1.3. With heart disease, the coefficient is detected above the norm, and with liver pathology - below.

After an attack of myocardial infarction, there is a simultaneous increase in ALT and AST, but AST increases by about 10 times, and ALT by about 2 times.

A simultaneous increase in these indicators can be in the absence of external signs - this indicates that hepatitis occurs externally without symptoms, but there are active internal processes of liver destruction.

In some cases, a slight increase in results may be in healthy women as a result of stress, physical overstrain and the use of certain medications.

Signs that require mandatory testing:

The presence of weakness.
Feeling of prolonged loss of appetite.
Presence of nausea and vomiting.
Pain in the abdomen.
Yellow skin tone and eyes.
Darkening of the color of urine.
The presence of a light stool.
Feeling of itching.

Factors conducive to an increase in signs of ALT and AST after 40 and 50 years:

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Important information on video

Research as a criterion for diagnosing diseases

A biochemical blood test, including these indicators, is prescribed if the following pathologies are suspected:

Any diseases of the heart and blood vessels.
Any pathology of the liver.
Renal failure.
various infections.
Any autoimmune disease.
Cholelithiasis.
Pancreatitis - chronic and acute.
Pathology of the endocrine system.
Skin diseases accompanied by itching.
Malignant tumors of any localization.
Body poisoning.
Encephalopathy of unknown origin.

In case of unfavorable results of ALT and AST, a pregnant woman is prescribed an additional series of examinations.

Treatment of diseases depending on the results of the analysis

The results of ALT and AST tests are necessary for treatment and health monitoring during and after the prescribed therapy.

ALT and AST indicators are used in preparation for any types of surgical interventions in order to identify contraindications and possible complications.

Also of no small importance is the long-term use of drugs that affect the internal organs - antibiotics. a wide range actions, hormonal drugs, chemotherapy drugs.

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Rules for passing the analysis

The analysis is carried out in any public clinic and private laboratory.

In order to receive reliable results analyzes for ALT and AST, a woman must adhere to the following rules:

Do not eat for 8-12 hours before the study.
Exclude any physical exercise and overexertion 30 minutes before the study.
Eliminate psychological stress 30 minutes before the study.
Stop smoking 30 minutes before the test.
Refrain from drinking alcohol and fried foods a day before the study.
Warn the specialist about the medications you are taking.

Folk remedies to normalize the level of enzymes in the blood

The indicators of ALT and AST in the body of each woman indicate the presence of her actual health. The norm is ALT - 32 units per liter, AST - from 20 to 40 units per liter, any deviation from the norm in one direction or another is considered a reason for additional examinations in order to identify the presence of diseases of the internal organs. I would also like to note that for women during the period of bearing a child, there are their own ALT and AST values.

Most women, before embarking on a rational traditional treatment, usually use folk remedies. It turns out that this is not only possible, but even supported by the attending physicians.

There are a great many recipes for reducing overestimated indicators, the most effective ones are listed below.

Milk thistle seed drink. Crushed seeds in the amount of 1 teaspoon pour 200 milliliters of boiling water. The vessel with the contents is tightly sealed and allowed to infuse for 20 minutes at room temperature. Then the infusion is filtered and taken orally 2 times a day, 1 glass half an hour before the main meal. It should be remembered that you can not drink the decoction in one gulp. Course treatment lasts 21 calendar days.
Herbal tea. To prepare it, you need to have St. John's wort, immortelle and celandine in the ratio 2:2:1 (tablespoons). Grind the grass, put it in a vessel that can be tightly sealed, pour a liter of boiling water and put it in a dark place for 12 hours to infuse. After the time has elapsed, the infusion is boiled for 10 minutes, and then cooled at room temperature. Next, the broth should be filtered and taken orally 100 milliliters after meals 4 times a day. Course treatment lasts 2 weeks.
Dandelion root extract. Pour 200 grams of crushed root with 100 milliliters of vodka and add 30 milliliters of glycerin. Seal the vessel with the contents tightly and place in a dark, cool place for 24 hours. Then strain the infusion and take orally 2 tablespoons before the main meal 3 times a day. The duration of the course of treatment should be discussed with the doctor.
Collect hairs from ripe corn cobs. Dry them naturally and grind them. Next, prepare a drink from 1 teaspoon of chopped dry hairs and 200 milliliters of boiling water. It should be kept after pouring for ¼ hour, then strain and take orally 1 glass 2 times a day. Course treatment can last up to six months.

The general opinion of those who took these funds

Before starting treatment folk methods, many patients are interested in the reviews of those people who have already tried these recipes on themselves.

So, the above are the most effective of folk recipes to reduce AST and ALT. Therefore, there are a lot of reviews about them, but putting them all together, we get the following picture:

after taking milk thistle, the indicators were significantly reduced by the second biochemical blood test;
corn hairs have the necessary effect, but it is not possible to sharply reduce the performance;
dandelion root infusion is very effective but should not be taken while driving vehicle because alcohol is present in the composition;
herbal tea helps to cope with the situation and after two weeks of daily intake you feel much better, especially since it allows you to strengthen your immune system, but the main inconvenience is its 4-fold use, you have to take it with you in a thermos to work so as not to miss a dose .

Each patient should remember that his body is individual and even with a million positive feedback treatment may not work. For example, when taking milk thistle in the first two days, there may be sensations of pain in the liver area - this is the norm, but if this feeling does not leave the person during subsequent treatment, then this fact indicates individual intolerance.

Therefore, starting any treatment, you should strictly monitor the reaction of your body and if you have any questions, you should always consult with your doctor. Since the patient needs to get rid of the disease, and not aggravate the situation.

Possible consequences of elevated enzyme levels if left untreated

Sometimes, it seems to women that they can start treating the disease later, because nothing supernatural will happen in one or two days, and today there is absolutely no time to go to the doctor and prescribe drugs. Of course, if the indicators are not very high, then one day will not play a role, but when the start of rehabilitation is postponed for a month or more, then there is nothing good to expect. The thing is that while a person delays his visit to the doctor, the disease does not doze, but conquers a new large territory.

And before you give up on elevated ALT and AST, you need to know very well what this can turn out to be if left untreated:

cirrhosis of the liver;
hepatitis;
myocardial infarction;
stagnation of bile and, as a result, intoxication of the body;
liver oncology;
hepatosis.

Each of the above diseases, in the absence of measures taken to eliminate it, can provoke a fatal outcome. But in cases of determining its development on early stages you can get rid of the disease without deplorable consequences.

Prevention of the occurrence of an increase in women

Any disease is best prevented than long-term treatment, which is why there is a concept of preventive measures.

In order for the indicators of ALT and AST in the blood of women not to rise to the heights, you should first of all reconsider your entire algorithm of life.

Give up bad habits. Alcohol and tobacco do not benefit anyone, but female body more addictive.
Follow nutrition. Avoid fried, salty, spicy and smoked foods. Enrich your diet with raw vegetables and fruits. Get into the habit of having breakfast in the morning not with coffee sandwiches, but with porridge with tea or jelly.
Avoid unnecessary stress. In cases where, nevertheless, fate has presented an unpleasant surprise, then perhaps you should drink a course of sedatives, rather than drive yourself into a trap.
Take as a basic rule - to be in the fresh air for at least 2 hours a day. If it fails in daytime, means it should be evening walks.
Make a daily routine and stick to it. Only the correct alternation of work and rest of the body will allow a woman to save it.
Have a permanent sexual partner. Promiscuity in intimate relationships can be a provocateur of the development of various kinds of diseases and, as a result, an increase in ALT and AST.
Periodically donate blood for analysis and monitor your ALT and AST levels (at least once every six months), especially after reaching the age of 35.

All these simple rules, if followed, will allow a woman to maintain her own health, which means that the ALT and AST indicators will remain within acceptable values.

What is AST in the blood of a woman? What is its rate?

Ast (the full name of the substance sounds like aspartate aminotransferase) is a cellular enzyme involved in the process of amino acid metabolism. It is found in the tissues of the heart, kidneys, liver, skeletal muscles, nervous and some other tissues. When various disorders and damage occur in these organs and tissues, the level of AST content deviates significantly from the norm, which can be seen when conducting an appropriate blood test. Usually, a simultaneous blood test for the content of AST, ALT and bilirubin is carried out.

Speaking about what should be the normal level of AST in a woman, it is necessary to proceed from the age of the female representative. From the moment of birth to the full maturation of a woman, the content of AST in her body changes, tending to decrease.

So, in a newborn, up to a month or two, girls, the normal upper threshold is 75 units / l. In the next period of time, up to a year, the Ast norm in women decreases to 60 units / l. In the subsequent period, until the age of 14, normal top score stops at 45 U/l. Up to 31 units / l - the amount of AST in a healthy body of an adult woman. The minimum level of AST in a woman should not be less than 5 units / l.

What problems indicate deviations from the norms

Indicators can be increased in the event of:

Heart problems such as myocardial infarction, rheumatic heart disease, angina;

Liver diseases, including cirrhosis, hepatitis, oncological, accompanied by cholestatic syndrome;

Thrombosis and thromboembolism of the pulmonary artery;

Jaundice as a symptom of diseases of the liver and blood;

Muscular pathologies: myopathy, muscle dystrophy, dermatomyositis, in which not only muscles are involved in the painful process;

some severe liver conditions;

Deficiency in the body of vitamin B6.

What you need to observe when planning to take an analysis for AST

The results of the study can be distorted under the influence of a number of factors, so you should prepare for the delivery of the analysis.

So that there is no excess fat in the blood, food containing it, you need to stop eating a day before the procedure. The same applies to fried foods and alcohol. And a few hours before blood sampling, at least eight, you need to give up any other food.

One, and preferably two weeks before the analysis, it is strongly recommended to abandon the medication. If it is absolutely impossible to exclude them from the reception, all the drugs taken and their doses should be indicated by the doctor in the direction for analysis.

You can’t donate blood without taking a break after strenuous physical activity and conducting certain studies - ultrasound, fluorography, rectal examination, x-rays. Physiotherapeutic procedures should not immediately precede the AST analysis. Subject to all the rules, the results will be as truthful as possible.

Deciphering the norms of AST AST in the blood of women, men, children

AST (aspartate aminotransferase) and ALT (alanine aminotransferase) are enzymes from the group of transaminases that are produced by the liver. To determine their level, a biochemical blood test or individual liver tests are performed, which reflect the functionality of the liver. Together with other indicators of biochemistry or separately, AST and ALT may indicate serious illnesses any organs and systems. Therefore, it is so important to know what the norm of these enzymes should be in women, men and children.

What do they mean

Transaminases are produced in the cells of various organs and transfer the amino acids alanine and aspartate from one biomolecule to another.

In the liver, the amount of enzymes reaches its maximum concentration. Also, ALT and AST are detected in the heart muscle, pancreas, kidneys and muscle tissue.

From the organs, only a small amount of enzymes enters the blood, but with various diseases their level and activity in the blood increases.

Norms

Normal liver function tests vary by sex and age.

in women (from 18 years old) - 32;
in men (from 18 years old) - 41;
in newborns (the first 3-4 days) - 48;
4-6 months - 55;
3 years - 32;
6 years - 28;
11 years - 38.

Liver enzymes in pregnant women change slightly depending on the duration of pregnancy. In the first trimester, the indicators may differ from the norm by 5-10% upward or downward. This is not a pathology and does not indicate any serious illness.

Fluctuations in the level of ALT and AST are due to the fact that for the proper development of the baby, a large amount of vitamin B6 is needed, which is involved in the production of transaminases. When vitamin B6 is not enough, the body begins to take it from the muscles and liver cells, so enzymes are released into the blood. To compensate for the increased load on the body during pregnancy, women are prescribed a special complex of vitamins.

If, after the first trimester, the AST and ALT levels exceed the norm, the doctor may assume preeclampsia and prescribe additional research to clarify the clinical situation.

In the normal course of pregnancy in the second and third trimester, the level of enzymes should be from 29 to 31 units per liter. Such indications confirm that a woman's heart, liver and kidneys cope well with the increased load during pregnancy.

De Ritis coefficient

This indicator is very important for diagnosis. Although AST is a cardiac indicator, and ALT is a liver indicator, their relationship to each other more correctly indicates a disease developing in the body.

The normal de Ritis coefficient is 1.3. Its increase is characteristic of a heart attack, and its decrease is characteristic of liver disease.

Reasons for deviations

Alanine aminotransferase (ALT)

A slight increase in the activity of the ALT enzyme in the blood can occur due to the following factors:

taking medicines - oral contraceptives, antibiotics, NSAIDs (Aspirin, Nurofen, Diclofenac, Paracetamol and others), cytostatics, sedatives (valerian, motherwort), echinacea, drugs, and so on;
severe stress;
drinking alcoholic beverages and/or eating fatty/fried foods 7 days before the test;
intensive growth in adolescence;
serious physical activity (typical for athletes);
various injuries.

In the case when the level of ALT is increased in the biochemical blood test, it is necessary to inform the doctor about all the medications taken in the last 2-3 weeks, especially about drugs and their analogues such as Carbamazepine (an antiepileptic drug), Cordarone (an antiarrhythmic drug), Fluconazole and Nizoral (antifungal drugs), Ciprofloxacin (antibiotic), Atorvastatin and Simvastatin (cholesterol-lowering drugs), Metformin (drug used to treat diabetes). After taking any of the indicated medications, the ALT level rises.

Increased ALT is the first sign of acute liver pathology. The growth of the enzyme is noted even in the incubation phase (1-2 weeks before the onset of symptoms) and precedes the maximum increase in blood bilirubin by 8-10 days.

The acute period of the disease is accompanied by an increase in the level of ALT by 5-10 times, while with implicit forms, liver tests may remain normal. If increased rate the enzyme does not decrease for a long time or its growth is observed, extensive necrosis of the liver cells is likely.

Elevated ALT is characteristic of the following pathologies:

obstructive jaundice due to cholelithiasis;
acute hepatitis (with hepatitis C, the rate increases 10 times);

Reasons for a decrease in the amount of ALT:

oncological pathologies of various origins;
infections of the genitourinary system;
diseases of the pancreas;
severe liver pathology (necrotic atrophy of the organ);
lack of vitamin B6.

Aspartate aminotransferase (AST)

The enzyme often increases with injuries and burns, heat stroke, mushroom poisoning.

High AST levels cause:

hepatosis, hepatitis (drug, viral);
liver cancer;
cholestasis (stagnation of bile);
mononucleosis;
cirrhosis and developing necrosis of liver cells;
autoimmune diseases that occur with muscle damage, for example, Duchenne myodystrophy;
alcoholic toxic liver damage.

The AST indicator is of great importance in the diagnosis of myocardial infarction and the prognosis of the disease. The level of the enzyme increases to the maximum (exceeds the norm by 4-5 times) with the occurrence of necrosis of the heart. If the indicator does not decrease or increases in the next 5 days after a heart attack, the prognosis for the patient is very unfavorable. An increase in AST activity indicates widespread areas of necrosis.

Too low an AST value indicates extensive liver damage or a deficiency of vitamin B6, which is also involved in enzyme reactions.

When to take an analysis for ALT and AST

Basically, when a liver disease occurs in a patient, cytolysis is observed, in which the cells of the organ (hepatocytes) are destroyed.

The first signs of cytolysis:

nausea and vomiting;
bitter taste in the mouth;
weight loss;
gravity on the right side pain in the right hypochondrium;
yellowness of the skin;
fatigue, weakness, lethargy;
increase in body temperature.

Blood analysis

Biochemical blood test AST and ALT are prescribed for:

taking medications that can adversely affect the liver;
abuse of alcoholic beverages;
hereditary predisposition to the development of liver pathologies;
after hepatitis (or suspicion of hepatitis);
availability diabetes and excess body weight;
suspicion of a violation of the liver, if the patient complains of nausea, vomiting, abdominal pain, lack of appetite, flatulence, discoloration of feces, yellowing of the whites of the eyes and skin;
during therapy to determine the effectiveness of treatment.

The result of the analysis of ALT and AST is compared with other indicators in order to determine a more accurate form of pathology.

In addition to aspartate and alanine, they also determine:

total protein in the blood. An increase in protein concentration indicates dehydration of the body, the development of chronic inflammatory processes.
urea concentration.
albumin concentration. An increase in the indicator indicates dehydration and liver failure.
creatinine concentration. Increased values indicate renal dysfunction, rupture Bladder, blocking the urethra.
ALP (alkaline phosphatase). An increase in the value confirms hyperthyroidism, liver damage, biliary tract disease, intestinal damage, Itsenko-Cushing's disease, generalized tissue damage (including neoplasms) and the presence of barbiturates in the body.
GGT (gamma-glutamyl transferase). An increase in values indicates liver necrosis and hepatocellular inflammatory processes.

Also for setting accurate diagnosis it is necessary to control the level of bilirubin, iron (to exclude hemochromatosis), cholesterol, prothrombin time, determination of antibodies to hepatitis viruses (C, D, B).

Preparation for analysis

To reliably determine the level of enzymes before testing, it is necessary:

How to downgrade

To reduce the level of ALT and AST, the doctor prescribes drugs for the disease that caused the increase in enzyme levels in the blood. Treatment with hepatoprotectors will help protect the liver from exposure to various aggressive factors.

These medicines have a positive effect on the liver:

protect cells from further damage, improve their nutrition;
contribute to the restoration of cells;
partially remove toxins from the body;
speed up metabolism.

Hepatoprotectors differ in the mechanism of action:

Essential phospholipids (Essentiale forte, Rezalut Pro, Phosphogliv, Phospholip, Livolin, Essliver forte), which are produced from soybeans. Effective herbal hepatoprotectors that help lower liver enzymes. They are similar to the cells of the human liver and therefore are naturally embedded in diseased areas and help to restore them. Plant phospholipids have virtually no side effects. Rarely do they cause allergic reaction with individual intolerance or loosening of the stool.
Vegetable flavonoids (Karsil, Silimar, Gepabene, Galstena, Legalon, Hepatofalk Planta). Natural compounds, natural antioxidants, the action of which is aimed at neutralizing free radicals. The preparations include medicinal plants: officinalis fumes, celandine, turmeric, milk thistle. The drugs have not only a hepatoprotective effect, but also eliminate the spasm of the gallbladder, improve the outflow of bile and its production. Therefore, they are prescribed for hepatitis, accompanied by cholecystitis and biliary dyskinesia.
Amino acid derivatives (Heptor, Heptral, Hepasol A, Hepa-Merz, Hepasol-Neo, Hepasteril, Remaxol). They consist of protein components and other substances necessary for metabolism. They have a detoxifying effect, normalize metabolic processes and strengthen the body. They are prescribed for liver failure and severe intoxication. However, these drugs often cause such side effects like nausea, vomiting, diarrhea, abdominal discomfort.
Ursodeoxycholic acid preparations (Ursodez, Ursodex, Urdox, Ursosan, Urso 100, Ursofalk, Choludexan and others). The composition of the drugs includes Himalayan bear bile, which improves the solubility and excretion of bile from the body, reduces damage and subsequent death of liver cells in various diseases, and has an immunomodulatory effect. Drugs that lower enzymes are prescribed for cholelithiasis, biliary cirrhosis, fatty hepatosis, alcohol intoxication.
Vitamins (Vitrum, Supradin, Undevit and others). The drugs are effective for restoring liver functions, but only in combination with other drugs.

In addition to medicines, dietary supplements (Ovesol, Hepatrin, Milona-10, Dipana, LIV-52, Sibektan, Gepagard, Gepafor) and some homeopathic remedies(Hepel, Sirepar).

Diet

To reduce ALT and AST levels, it is also important to follow dietary nutrition.

From the diet should be completely excluded:

alcoholic and carbonated drinks;
smoked meats and pickled foods;
flavoring seasonings;
fatty meat and fish broths;
fried foods;
cereals and legumes;
mushrooms;
egg yolks;
muffin;
lard, fatty pork, lamb;
coffee;
chocolate.

soups with light vegetable broth;
low-fat dairy products;
porridge (boil to a viscous state);
natural juices without sugar;
rosehip decoction;
black tea with lemon;
dietary meats (rabbit, beef, turkey, chicken);
biscuit cookies;
jelly;
stale bread;
fruits (apples, oranges);
green leafy vegetables, broccoli, zucchini, carrots;
nuts;
cod liver, caviar.

You need to eat at least 5 times a day in small portions, you should also limit your daily salt intake to 8 grams per day and drink at least 2 liters of water.

How to boost

Diagnose and treat the disease that caused the deviation.
Take hepatoprotectors.
Vitamin therapy is prescribed if the cause of the decrease in the level of AST and ALT was a deficiency of vitamin B6.
Stick to a diet.