Your ALAT level is one of the most important liver enzymes measured in a blood test. ALAT (alanine aminotransferase) is found primarily in liver cells. When liver cells are damaged, ALAT leaks into your bloodstream. For the full picture, read our overview on understanding liver values.
Normal values
Men: below 45 U/L. Women: below 35 U/L. Some guidelines use lower thresholds for better early detection.
Causes of elevated ALAT
Non-alcoholic fatty liver disease (most common in the Netherlands), excessive alcohol, medications (statins, paracetamol), viral hepatitis and intense exercise. Less common: autoimmune hepatitis, haemochromatosis, coeliac disease.
How high is too high?
1-2x upper limit: mild. 2-5x: moderate, warrants investigation. 5-10x: significant liver damage. Above 10x: severe, requires immediate medical assessment.
What to do
Limit alcohol, work towards a healthy weight (5-10% loss significantly improves fatty liver), review medications with your doctor, and consider repeat testing after 4-6 weeks.
Frequently asked questions
Can I have elevated ALAT without symptoms?
Yes, this is common. The liver has no nerve endings, so early damage typically causes no pain. This makes blood testing valuable as screening.
Is your value elevated? Read what to do about elevated liver values, or measure your values with the Vital Check liver function test, with review by a doctor.
References
- Younossi ZM, et al. Global epidemiology of nonalcoholic fatty liver disease - meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016. PubMed
- Botros M, Sikaris KA. The de Ritis ratio: the test of time. Clinical Biochemist Reviews. 2013. PubMed
- Pettersson J, et al. Muscular exercise can cause highly pathological liver function tests in healthy men. British Journal of Clinical Pharmacology. 2008. PubMed
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