What is Alanine Aminotransferase?
ALT is an enzyme that helps convert alanine (an amino acid) into energy your body can use. Under normal conditions, ALT stays inside liver cells. When those cells become irritated or damaged, ALT levels in the blood rise.
Why Does ALT Matter?
- Helps maintain steady energy levels by converting amino acids into glucose for fuel
- Reflecting liver health, as ALT rises when liver cells are injured or stressed
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How to Interpret ALT
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing ALT
- Improved metabolic health
- Prevention of liver disease
- Lower cardiovascular disease risk
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Low ALT Levels
Low ALT low levels may be caused by nutritional deficiencies or underlying conditions.
Symptoms:
- Often asymptomatic
- Fatigue
- Weakness
- Numbness in the limbs
Causes:
- Vitamin B6 deficiency
- Malnutrition
- Chronic kidney disease
- Aging
- Liver dysfunction
Healthspan impacts:
High ALT Levels
Elevated ALT levels can signal metabolic dysfunction, fatty liver disease, viral hepatitis, or strain due to alcohol or certain medications.
Symptoms:
- Fatigue
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Bone pain
- Intense itching
- Light-colored stool
- Right-sided abdominal pain
Causes:
- Medication-induced liver injury (e.g., painkillers, statins)
- Hepatitis
- Liver disease
- Strenuous exercise (only temporarily raises ALT levels)
- Muscle damage (rhabdomyolysis)
- Celiac disease
- Iron overload
Healthspan impacts:
How Hone Treats Out of Range ALT
Your Hone physician will evaluate your ALT results from a blood test along with other liver enzymes and other biomarkers to determine a personalized treatment plan.
- Medication adjustment – to reduce high ALT levels caused by certain medications
- Antivirals* – to treat certain types of chronic hepatitis
- Steroids*– to reduce inflammation associated with severe acute alcoholic hepatitis
*Your Hone Physician does not prescribe these treatments but will recommend further evaluation and help coordinate care with your primary care provider when medical treatment is indicated.
Ramaty E, et al. (2014). Low ALT blood levels predict long-term all-cause mortality among adults. A historical prospective cohort study. Eur J Intern Med.
↑Sonneveld MJ, et al. (2020). Very low probability of significant liver inflammation in chronic hepatitis B patients with low ALT levels in the absence of liver fibrosis. Aliment Pharmacol Ther.
↑Wannamethee SG, et al (2005). Hepatic enzymes, the metabolic syndrome, and the risk of type 2 diabetes in older men. Diabetes Care.
↑Wang, C., et al. (2012). Impact of increasing alanine aminotransferase levels within normal range on incident diabetes. Journal of the Formosan Medical Association.
↑Kim, K., & Kim, K. N. (2018). Serum Alanine Aminotransferase Level as a Risk Factor for Coronary Heart Disease Prediction in Koreans: Analysis of the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011). Korean Journal of Family Medicine.
↑Katzke V, et al (2020). Circulating liver enzymes and risks of chronic diseases and mortality in the prospective EPIC-Heidelberg case-cohort study. BMJ Open.
↑Molaqanbari, M.R., et al. (2023). Effects of Folic Acid Supplementation on Liver Enzymes, Lipid Profile, and Insulin Resistance in Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Advanced Biomedical Research.
↑Li, Z., et al. (2024). Natural products and dietary interventions on liver enzymes: An umbrella review and evidence map. Frontiers in Nutrition.
↑Aziz, T., et al. (2024). Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Cureus.
↑Vargas-Pozada, E. E., et al. (2025). Coffee for the liver: A mechanistic approach. Biochemical Pharmacology.
↑Heath, R.D., et al. (2017). Coffee: The magical bean for liver diseases. World Journal of Hepatology.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
