Asth is elevated causes in women. The level of alt and ast in the blood, the norms and causes of violations. Why are liver transaminases elevated during pregnancy?

The doctor ordered a biochemical blood test for you, and in the long list of the form, for some reason, your eyes lingered on the AST, circled in red. What is it for? What is this indicator, what processes can occur in our body, if AST is elevated in the blood, we will try to tell you in as much detail as possible.

AST or aspartate aminotransferase is a special enzyme, without which normal amino acid metabolism is impossible, as well as providing organ tissues with aspartic acid. Most of all, AST contains tissues of the spleen, heart, liver, kidneys, brain, pancreas, and skeletal muscles. Therefore, most often this particular indicator (as a rule, in conjunction with ALT - alanine aminotransferase) is of interest to the doctor if there are concerns about the development of pathological processes in these organs.

You may not know the meaning of these words

• Amino acids - simply put, the main element of the protein of cells.
• Aspartic or alpha-amino acid is responsible for the health of the nervous and endocrine systems, in part for the production of hormones such as testosterone, prolactin and somatotropin (growth hormone).
• An enzyme is an organic substance that is produced by a cell and is responsible for metabolism.
• ALT - alanine aminotransferase is an enzyme and is designed to break down amino acids.

AST norm for men, women and children

An adult and a child have different rates of enzyme activity. Normal values ​​of the ACT index are usually quite low. Normal values ​​​​of the indicator in men over 18 years of age should not exceed 45 U / l, in women - 31 U / l.

The amount of AST in the blood of children depends on age. For babies of the first year of life, the norm is considered to be an indicator not exceeding 58 U / l, from one year to 4 years - 59, at the age of 4–7 years - 48 U / l, from 7 to 13 - 44 and from 13 to 18 years - 39 units per liter.

The level of AST has increased: what can this mean

AST blood test is elevated, what does it mean? Since AST is included in the structure of the membranes of many body cells, its active release into the blood indicates a violation of their integrity. The enzyme in the blood is increased most often due to a viral infection, a reaction to medications or toxins in the liver, diseases in which the blood supply to the liver is disturbed (ischemia). In general, there are a lot of reasons for increasing AST.

Enhanced activity of the enzyme is observed in chronic, acute or viral hepatitis, as well as obstruction and the initial stage of cancer of the biliary tract, cirrhosis and oncological diseases of the liver, with myocardial infarction, heart failure, angina and heart injuries, endogenous intoxications, after intramuscular injections, intense physical loads.

The AST index is higher than normal during acute pancreatitis and in cases of advanced alcoholism. Dermatomyositis, gangrene, destruction (necrosis) of muscles and muscular dystrophies, including Duchenne-Becker myodystrophy, also give an increase in the AST indicator in the blood test.

Maybe you don't know the meaning of these words.

Endogenous intoxication - poisoning of the body with poisons produced by itself as a result of serious violations of the internal organs.

A blood test to determine the level of AST is prescribed for suspected ascites and portal hypertension, in a complex of examinations for encephalopathy, autoimmune diseases, allergic skin diseases, detection of endocrine pathologies, as well as in preoperative preparation.

Does an increase in AST always indicate a serious pathology?

If the level of AST is elevated, what does this mean? It should be noted that exceeding the indicators declared as the norm by only a few units does not always indicate the presence of a dangerous pathology. Isolated cases of deviation from the norm also do not always cause concern among doctors.

A diagnostically significant fact is considered if AST is elevated:

• 5 times. In this case, the deviation from the norm is considered moderate and is most often associated with the development of viral infections;
• 10 times - as an average, meaning that there are certain problems in the body;
• more than 10 times - as a dangerous value indicating the presence of pathology.

In order to exclude the fact of a temporary increase (decrease) in the activity of the level of AST in the blood plasma, patients are often offered to donate blood for a biochemical study several times. This is explained, first of all, by the fact that the cause of deviation from the norm can be not only serious pathological processes, but also transient factors, such as muscle injuries, heat stroke, soft tissue burns, and poisoning.

The attention of parents should be drawn to the fact that the level of AST in the blood may increase during the period of active maturation.

During pregnancy, the level of AST may decrease slightly.

So, whether AST is elevated in the blood due to a serious pathology or as a result of a bruise or for another not so significant reason, only a doctor can say.

AST level - an indicator of the state of the heart

The "behavior" of AST is an important diagnostic factor in myocardial infarction. The level of enzyme activity in this case is elevated in almost 93-98% of patients and is recorded after 6-8 hours, often even before the appearance of signs of a heart attack on the electrocardiogram. The peak of AST activity occurs after a day of development of the disease, it can exceed the norm up to 20 times and returns to it, as a rule, on the 5-6th day. If on the 3rd-4th day a tendency to decrease in the level of AST does not begin to be observed, then the prognosis for the patient is often not favorable.

In the case of expansion of the myocardial infarction zone, the degree of AST activity also increases.

That is, by the amount of the enzyme in the blood plasma, one can judge the mass affected by myocardial infarction.

In clinical practice, experts note an increased level of AST activity in severe cases of coronary insufficiency on the first day after an attack with a return to normal on days 2–3.

AST and ALT in the diagnosis of liver diseases

As we already mentioned, often in order to determine the area and extent of damage to a particular organ, the AST indicator is considered in relation to AST:ALT. If we talk about liver diseases, then there are even diagnostic rules based on this. So if the indicated ratio is 1 and at the same time the level of activity of both enzymes is very high, then most likely the doctor will assume that the patient has viral or narcotic hepatitis. When AST:ALT is greater than 2:1, this probably indicates liver disease associated with alcoholism.

An AST:ALT ratio greater than one may indicate cirrhosis of the liver, which has developed for a reason other than alcoholic hepatitis.

However, to make an accurate diagnosis today, a whole range of studies is used, in which blood biochemistry is only one of the components.

How to prepare for a AST blood chemistry test

To obtain objective results, the patient must stop taking medications 7–10 days before the examination, and if this is not possible, inform the laboratory assistant and the doctor who sent you for analysis about the medications and their dosages. Women should also be told about a possible pregnancy, during which the results may be somewhat distorted.

2-3 days before the analysis, it is necessary to exclude from the diet fried, fatty, smoked, salty, as well as foods high in proteins and carbohydrates, alcoholic beverages. It is better to postpone vigorous physical activity, as it can affect the purity of the results of a blood test. It is recommended to drink only non-carbonated water on the eve of the examination.

Hemolysis and chilez can affect the result of the study.

• Hemolysis or destruction of red blood cells.
• Chilez or excess levels of neutral fats in the blood.

For research, in our case, 15-20 ml of venous blood is taken, which, in fact, is almost painless. The result is obtained, as a rule, quite quickly - within 6-12 hours.

It is important to know that the procedure is performed on an empty stomach or at least 8 hours after the last meal.

Self-decoding of biochemistry indicators: “for” and “against”

To please the consumer, modern Internet resources are equipped with many convenient services and features, which, of course, increases their demand and popularity. Alas, far from the last place here is occupied by free mechanisms for decoding a blood test.

Exhibited in such a simple way "diagnoses", unfortunately, are often the reason for the refusal or delay of the treatment prescribed by the specialist, self-treatment, which leads to unpleasant and even irreversible consequences for the body.

When resorting to this method of self-diagnosis, you must remember that only an experienced doctor can determine the true cause of your condition, often based on the results of more than one diagnostic procedure. Here we only bring to your attention information that can help you ask the doctor the right questions and understand the cause-and-effect relationships of the disease that has overtaken you.

If the AST blood count is elevated, contact your doctor. You should not try on the role of a super-diagnostician, because it can cost too much. Remember that elevated levels of the enzyme may not always indicate the presence of a disease. However, this issue cannot be taken lightly. It is better to consult a doctor once than to regret later that the disease was not detected at an early stage.

In contact with

AST, AST, AST or aspartate aminotransferase is the same concept, denoting one of the enzymes of protein metabolism in the body. This enzyme is responsible for the synthesis of amino acids that make up cell membranes and tissues. Not in all organs AST shows its activity. Moreover, this type of aminotransferases can be attributed to specific enzymes, the excess activity of which indicates a rather narrow range of pathological conditions. Most of all, AST is found in the myocardium (heart muscle), hepatocytes (liver tissue), brain neurons, and skeletal muscle tissue. This is explained by a rather high level of metabolic processes in them and the need for maximum adaptability of cells to maintain their structure. This enzyme helps them in this.

As long as the structure of cells containing AST is not disturbed, the amount of this enzyme in plasma is minimal and does not go beyond the normal range. As soon as their integrity is violated, this leads to its excessive release into the systemic circulation. Such a phenomenon will be recorded in the form of a regular increase in AST activity. The dependence should be directly proportional: the more active the cytolysis, the higher the level of AST. Important is the time after the onset of cell destruction - the longer it is, the less the enzyme activity in plasma will be.

When prescribing a biochemical blood test, they imply an analysis of the enzymatic activity of the plasma, among other indicators of which AST is necessarily examined. This requires venous blood, which is obtained by puncturing one of the peripheral veins in the amount of 15-20 milliliters. Its centrifugation allows you to separate the plasma from the formed elements, which then lends itself to various chemical reactions. In their course, the activity of AST in the blood is determined.

The study of AST allows you to determine the presence of cell destruction (cytolysis) of the myocardium or liver. With the defeat of other organs, this indicator does not increase. Very often, it is prescribed not only to confirm the defeat of specific tissues, but to conduct a differential diagnosis or exclude cardiac and hepatic pathology!

When is an AST analysis scheduled?

According to international protocols and standards for diagnosing diseases, a biochemical blood test, including an indicator of AST activity, is mandatory for many types of somatic pathology.

It can be:

Poisoning and intoxication;

Kidney damage with renal insufficiency;

Infectious pathology;

Purulent-septic conditions;

Various kinds of jaundice and disorders of bilirubin metabolism;

Endocrine pathology;

Toxic lesions of the liver with hepatotoxic poisons and drugs;

Fatty and alcoholic hepatosis;

Endogenous intoxications against the background of infectious and purulent-septic diseases of internal organs and soft tissues;

Cholestasis caused by a mechanical obstruction in the bile ducts (stones, tumors, congenital anomalies);

Violation of hepatic blood flow and portal hypertension;

Massive destruction of muscle tissue (myodystrophy, generalized, crash syndrome, reperfusion syndrome against the background of restored blood flow in the ischemic limb;

Not every increase in AST should be taken as a sign of cellular cytolysis. If the indicator is higher than normal values ​​​​by several units of measurement, this does not mean anything. Diagnostic value has an increase in AST two or more times higher than normal.

In this regard, we can talk about:

Moderate increase (when AsAT rises five times);

Average increase (when an increase in the indicator up to ten times higher than the norm is recorded);

Severe increase (exceeding the level of AST ten or more times compared to the norm).

The main diagnostic value of AST is the damage to the heart during a heart attack. The study is carried out in dynamics with short time intervals (about an hour). Any changes in the indicator that exceed the norm, in doubtful cases, speak in favor of a heart attack!

How to lower AST in the blood?

People who are looking for an answer to a similar question need to clearly understand: an increase in AST is not an independent disease and therefore there are no separate measures to lower it!

Since this symptom signals the destruction of cells containing this enzyme (heart, liver, muscles), it is necessary to diagnose and treat diseases of these organs. Only healthy tissues will be able to function normally and normalize all indicators of a biochemical blood test, including AST.

It must be clearly understood that an increase in AST is not the cause of the disease. This is her consequence. Therefore, only the elimination of the causative disease will be able to interrupt the causal relationship, which will be reflected in the form of normalization of AST activity and will become a criterion for victory over this disease. Any cases of increased aspartate aminotransferase are a reason for seeking specialized medical care. Behind this harmless and asymptomatic symptom, severe chronic diseases are often hidden, which will manifest themselves only after a while.




Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".

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 a greater volume in the muscle tissue of the myocardium, therefore, with ischemia, myocardial infarction, myocarditis and other heart diseases, an increased content of AST in the blood allows detecting 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 public clinic and in almost every private laboratory. It is better to order an examination along with a transcript, since laboratory data can 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, the attending physician should be informed. 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 visiting 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

ALT and AST analysis is used to diagnose the following diseases:

1. Viral hepatitis, cirrhosis of the liver, liver tumors, including cancer, mononucleosis.
2. Heart failure, coronary heart disease, myocardial infarction, inflammation of the heart muscle (myocarditis, pericarditis).
3. Diseases of the skeletal muscles, inflammatory processes in the muscles, myositis, myopathy.
4. Lung infarction.
5. Hypothyroidism.
6. hemolytic anemia.
7. 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, for example, 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 tests can detect viral hepatitis A 2 weeks before jaundice begins, 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?

1. 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.
2. 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.
3. 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. A change in the volume of enzymes circulating in the 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 the pathological process. Other studies specify what kind of pathology we are talking about. If the increase in AST is greater than ALT, hyperfermentation may indicate cirrhosis, liver metastases of a malignant tumor, intrahepatic cholestasis, and infectious mononucleosis.
4. 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, the indicators return to normal values ​​after 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?

• on the part of the immune system: decreased immunity, vulnerability to infectious diseases;
• from the side of the heart: jumps in 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.

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 simple terms, what is it? 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 of the 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 an 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 a high content of ast-enzyme in the blood:

• 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, as well as pulmonary embolism, 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 is developing with dysfunctions of 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 a decrease in ALT and AST means in a biochemical blood test 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 suddenly the situation 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 herself and the 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 of medications available to lower ALT and AST levels. 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. To do this, it is recommended to take various liver fees, a decoction of milk thistle, a tincture of dandelion flowers, as well as an infusion of corn stigmas. To maintain the heart, you can drink an infusion of adonis.

Of course, 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 you can achieve a 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. Of course, there must be a rejection of bad habits, the use of alcoholic beverages, some potent and / or illegal drugs, smoking. It is also necessary to lead a correct and healthy lifestyle, 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 intake of medications 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.

In the human body, each organ has a certain range of enzymes - specific proteins that act as biological "accelerators" of chemical reactions. The most active participants in biochemical processes are alanine aminotransferase (ALT) and aspartate aminotransferase (AST) - without their participation, amino acid metabolism is impossible.

What does ALT and AST mean in a biochemical blood test?

As the pathological process develops, the integrity of the cellular structure of organs is damaged and enzymes leak. The diagnostic value of the increase in the activity of ALT and AST in the peripheral blood of a person was clarified as early as the 50s of the last century. In subsequent years, biochemical studies have confirmed that an increase in enzymatic activity indicates the presence of a serious disease.

Amino transferases are assigned the function of transporting molecules from one group of amino acids to another , which is why these enzymes are called transaminases.

• The largest amount of ALT (alanine transaminase) contains liver and kidneys, smaller - heart muscle, pancreas and skeletal muscles.
• AST (aspartic transaminase) distributed in all tissues of the human body, the highest level of its content is observed in the liver, muscle mass, red blood cells and the heart.

When the cell walls of organs are damaged, enzymes "leak" into the circulating blood, causing an increase in concentration.

What is ALT and AST on video

Due to the high content of transaminases in hepatocytes (liver cells), changes in the level of their content in the patient's blood are medical experts most often associate with a violation of the function of the liver and biliary tract.

Norms of AST and ALT in the blood of men, women and children

Transaminase indicators are included in a biochemical blood test, which allows you to evaluate protein, fat, carbohydrate and pigment metabolism.

Research by the Italian biochemist Fernando de Ritis showed that Of clinical importance is not only the concentration of transaminases in the patient's blood, but also the ratio of their levels.

He developed a criterion that is used for the differential diagnosis of various diseases with an increase in the content of amino-transferases:

DRr = ALT score: AST score

Reference value of the Ritis coefficient: from 0.9 to 1.75.

Why is ALT elevated in men and women? Reasons for the increase in ALT

A change in the concentration of ALT indicates the presence of an inflammatory process in the human body.

An increase in the concentration of ALT is also noted with:

• steatosis - fatty degeneration of the liver;
• muscle damage;
• abuse of alcoholic beverages;
• the use of narcotic substances;
• increased physical and psycho-emotional stress;
• gestosis in pregnant women.

Causes of increased AST in adults

An increase in the concentration of AST is a marker of diseases of the cardiac and vascular systems, liver, and pancreas.

Qualified specialists distinguish several pathological processes in which the level of aspartic enzyme in the patient's blood significantly exceeds the permissible limits:

• myocardial infarction - the main reason for the increase in level. Compared with the concentration of ALT, which rises slightly, AST levels increase tenfold.
• Biliary cirrhosis - a special type of pathology that develops with prolonged damage to the biliary tract and cholestasis.
• Pancreatitis (acute or chronic) causes a sharp increase in the concentration of the enzyme.
• Serious damage to muscle mass (burns, injuries).
• Alcohol poisoning.
• Malignant liver disease .

Why are ALT and AST elevated in the blood of children?

An increase in the concentration of enzymes in the child's body is associated with increased permeability of hepatocyte membranes when exposed to damaging factors on the liver.

Most often this is due to:

• congenital anomalies in the development of the bile ducts;
• hereditary pathologies of the liver (hematochromatosis, autoimmune hepatitis);
• acute viral or chronic hepatitis;
• medicinal lesions of the liver;
• infectious mononucleosis, which causes diffuse changes in the cells of the spleen and liver;
• cardiological pathologies - myocardial dystrophy (disturbance of metabolism in the cells of the heart muscle) or myocarditis;
• endocrine diseases - dysfunction of the pituitary gland or diabetes mellitus;
• hemorrhagic vasculitis - inflammation of the vascular walls;
• oncological pathology.

Parents should take the following symptoms very seriously and seek immediate medical attention:

• increase in the child's blood enzymatic activity;
• the baby has complaints of weakness;
• lack of appetite;
• nausea;
• the appearance of yellowness of the skin and sclera;
• darkening of urine and lightening of feces.

What to do if the results of analyzes for AST and ALT are overestimated?

To reduce transaminase levels in the blood, first of all, you need to undergo a comprehensive examination, which consists in advanced laboratory diagnostics and instrumental research. After establishing the correct diagnosis, it is necessary to eliminate the cause of the increase in the concentration of enzymes.