If you live in the US, normal ranges for AST(formerly known as SGOT)
are in the ballpark of range of 5-47, but can vary a few units up or
down, depending on the laboratory ), and ALT (formerly known as (SGPT)
range is 7-56. Have you ever been tested for any form of hepatitis?
You mention no illegal drug use (Good!), but some OTC medications such
as Tylenol, Advil, etc. and some prescription drugs can be the source
of your mildly elevated AST, especially if you take then regularly.
African-American males normally have slightly higher liver enzyme
values than Caucasian men. There is also a diurnal variation in liver
enzyme levels, meaning the level will be higher in the morning than n
the afternoon. If you are dehydrated at all when your blood is drawn,
it will be reflected in higher values. Heavy exercise will also raise
Generally speaking elevated liver enzymes indicate liver disorders,
but you need other values, such as T.bilirubin, ALP, Total protein and
albumin to help make that diagnosis. An AST value of 57 is not very
high, and you need to know the performing lab?s range of normal
values, in order to compare.
?The normal range of values for AST (SGOT) is from 5 to 40 units per
liter of serum (the liquid part of the blood).
The normal range of values for ALT (SGPT) is from 7 to 56 units per
liter of serum.?
?AST (SGOT) is normally found in a diversity of tissues including
liver, heart, muscle, kidney, and brain. It is released into serum
when any one of these tissues is damaged. For example, its level in
serum rises with heart attacks and with muscle disorders. It is
therefore not a highly specific indicator of liver injury.
ALT (SGPT) is, by contrast, normally found largely in the liver. This
is not to say that it is exclusively located in liver but that is
where it is most concentrated. It is released into the bloodstream as
the result of liver injury. It therefore serves as a fairly specific
indicator of liver status.?
Since AST can also be released from muscles, your slightly elevated
value could be due to your weight-lifting.
?A family history of liver disease may raise the possibility of
inherited diseases such as hemachromatosis, Wilson's disease, or
alpha-1- antitrypsin deficiency.?
?If abnormal liver enzymes persist despite abstinence from alcohol,
weight reduction and stopping certain suspected drugs, blood tests can
be performed to help diagnose treatable liver diseases. The blood can
be tested for the presence of hepatitis B and C virus and their
related antibodies. Blood levels of iron, iron saturation, and
ferritin (another measure of the amount of iron stored in the body)
are usually elevated in patients with hemachromatosis. Blood levels of
a substance called ceruloplasmin are usually decreased inpatients with
Wilson's disease. Blood levels of certain antibodies (anti- nuclear
antibody or ANA, anti-smooth muscle antibody, and anti-liver and
kidney microsome antibody) are elevated in patients with autoimmune
?Because AST is found in many other organs besides the liver,
including the kidneys, the muscles, and the heart, having a high level
of AST does not always (but often does) indicate that there is a liver
problem. For example, even vigorous exercise may elevate AST levels in
the body. On the other hand, because ALT is found primarily in the
liver, high levels of ALT almost always indicate that there?s a
problem with the liver. (Conversely, a normal ALT level does not
necessarily mean that the liver is definitely normal- but, more about
Despite what one might expect, high levels of transaminases in the
blood don?t always reveal just how badly the liver is inflamed or
damaged. This is an extremely important point to keep in mind. The
normal ranges for AST and ALT are around 0 to 40 IU/L and 0 to 45 IU/L
respectively. (IU/L stands for international units per liter and is
the most commonly accepted way to measure these particular enzymes.)
But someone who has an ALT level of 50 IU/L is not necessarily in
better condition than someone with an ALT level of 250 IU/L! This is
because these blood tests measure inflammation and damage to the liver
at an isolated point in time. For instance, if the liver is inflamed
on the day that blood was drawn?let?s say if a patient consumes an
alcoholic drink a few hours prior to blood being drawn?the levels of
the transaminases may be much higher than if the alcohol had not been
consumed. Following the same reasoning, if the liver was damaged years
before?by excessive alcohol use?the results of a blood test done today
may be normal, but a damaged liver may still be present.?
?The ratio of the ALT and AST may also provide useful information
regarding the extent and cause of liver disease. Most liver diseases
are characterized by greater ALT elevations than AST elevations. Two
exceptions to this rule exist. Both cirrhosis and/or alcohol abuse
are associated with higher AST levels than ALT levels, often in a
ratio of approximately 2:1.
Elevations of the transaminases occur due to so many causes that they
give the doctor only a vague clue of the diagnosis. Additional testing
is required in order to determine more precisely what is wrong with
the liver. Some possible causes of elevated transaminase levels
include the following:
? A fatty liver
? Alcoholic liver disease
? Drug/medication-induced liver disease
? Autoimmune hepatitis
? Herbal toxicity
? Genetic liver diseases
? Liver tumors
? Heart failure
- Strenuous exercise
I was going to explain about the Bell curve, and standard
deviation, and how some people fall outside of the Bell curve, but
that can get long and drawn out, not to mention boring. However, I
found a site that does touch on this:
?Epidemiology Incidence: 6% in population without symptoms. Remember
that to a laboratory, "abnormal" usually means outside two standard
deviations of normal population (and 5% of a normal population are
outside this range) - ie only 1% are truly abnormal.
The term "liver function test" is misleading as most tests measure
hepatocellular damage not function. Enzymes serum alanine
aminotransferase and aspartate both released from damaged hepatocytes.
ALT is considered specific for hepatocellular injury. AST is
abundantly expressed in several tissues other than the liver. Both the
ratio and the absolute rise of AST and ALT are informative.?
?Isolated raised liver enzymes - these are significant in only a small
percentage of patients (more likely if abnormality continues for six
months). Appropriate management is very dependent on the clinical
context - alterations to lifestyle (medication, alcohol, weight loss,
diet) can bring improvement.
Mild ALT and AST elevation (<5 times upper limit of normal with ALT predominant):
? Chronic viral hepatitis is a common cause. HCV is highly prevalent
(around 2% of population) ? question for risk factors, consider
testing for HCV.
? Chronic hepatitis B is also common (carrier rate 0.1-2%) ? check for
risk factors and test for HBV.
? Many drugs cause raised serum liver enzymes including OTC drugs
(paracetamol) as well as herbal preparations. Non-essential medication
should be stopped and if continue to be abnormal, essential medication
? Many industrial chemicals cause liver damage.
? Hepatic steatosis/steatohepatitis (fatty infiltration):
non-alcoholic steatohepatitis usually asymptomatic - occurs in 6-26%
of obese. Weight loss, exercise, diabetic control and treatment of
hyperlipidaemias indicated, but if abnormalities remain after 6-12
months consider liver biopsy.
? Hereditary haemochromatosis is a common genetic disease causing
mildly elevated ALT/AST. Where ALT is raised without obvious cause,
check serum ferritin, iron and total iron binding capacity. Consider
biopsy if cirrhosis suspected.
? Autoimmune hepatitis associated with thyroid disease and other
autoimmune disorders. Test for other markers of autoimmune disease.
Liver biopsy recommended where suspected.
? Wilson's disease, alpha1-antitrypsin deficiency, coeliac disease can
cause a rise in transaminases.
? Acute viral hepatitis, Epstein-Barr virus or CMV infections are
usually associated with higher levels of liver enzymes.
?There are two general categories of ?liver enzymes.? The first
group includes the alanine aminotransferase (ALT) and the aspartate
aminotransferase (AST), formerly referred to as the SGPT and the SGOT.
These are enzymes that indicate liver cell damage. The other
frequently used liver enzymes are the alkaline phosphatase (alk.
phos.) and the gammaglutamyltranspeptidase (GGT) that indicate
obstruction to the biliary system, either within the liver or in the
larger bile channels outside the liver.
The ALT and AST are enzymes that are located in liver cells and
leak out and make their way into the general circulation when liver
cells are injured. The ALT is thought to be a more specific indicator
of liver inflammation, since the AST may be elevated in diseases of
other organs such as the heart or muscle. In acute liver injury, such
as acute viral hepatitis, the ALT and AST may be elevated to the high
100s or over 1,000 U/L. In chronic hepatitis or cirrhosis, the
elevation of these enzymes may be minimal (less than 2-3 times normal)
or moderate (100-300 U/L). Mild or moderate elevations of ALT or AST
are nonspecific and may be caused by a wide range of liver diseases.
ALT and AST are often used to monitor the course of chronic hepatitis
and the response to treatments, such as prednisone and interferon.?
It is possible that a diet excessively high in protein can cause
elevated liver enzymes.
?High-protein diets are generally well tolerated by healthy adults.
But a dramatic increase in protein-rich foods may be dangerous for
people with liver or kidney disease. This is because they lack the
ability to get rid of the waste products left from protein metabolism.
Protein is essential to human life ? every cell in your body has it.
Your skin, bones, muscle and organ tissue all contain protein. It's
found in your blood, hormones and enzymes as well.
Your body can store only small amounts of excess protein. During
digestion and metabolism, protein is broken down into amino acids.
These are the building blocks of protein. Next, nitrogen is removed
from these extra amino acids. The nitrogen is processed by your liver
and then excreted in urine as waste.
Your body uses amino acids to make enzymes and other essential
proteins. It also uses amino acids for energy. Any amino acids that
your body doesn't use for building other proteins or for energy are
eventually converted into fat.
Although high-protein diets generally aren't harmful for people in
good health, they may increase the risk of kidney stones and
osteoporosis. They may also limit disease-fighting foods, such as
fruits, vegetables and whole grains. In addition, many high-protein
foods ? such as meat, milk and eggs ? are high in fat and cholesterol.
So choose your sources of protein wisely. Good choices include fish,
beans and lentils, which are lower in fat and cholesterol, and low-fat
Be sure and drink plenty of water while taking whey protein and
creatine (Kre-Alkalyn). Excessive amounts of creatine and protein can
be hard on your kidneys and liver.
?Creatine is an amino acid, but unlike most amino acids it is not
incorporated into protein. The best sources are meat, poultry, and
fish. In the body it's found mostly in the muscles (in the form of
creatine phosphate), where it plays a unique role in energy
production?it helps restore a compound called adeno-sine triphosphate
(ATP), which supplies quick energy. On average, people get 1 to 2
grams of creatine a day from food. The body also makes it in the
liver, pancreas, and kidneys.
Why few, if any, should try it
? Some small, short studies (most sponsored by companies that make the
supplements) have found that creatine may slightly boost short-term
muscle strength and the body's ability to perform very short,
high-intensity activities. Most have involved only young, highly
trained athletes. But some studies have found no benefits.
? If creatine does have an effect, it would help only in activities
that require such short, explosive bursts of energy. That would limit
its usefulness to only a small group of athletes. It won't help with
aerobic performance, and may, in fact, impair it. That's a big
drawback, since most sports and types of exercise call for both
aerobic and anaerobic energy.
? Reported side effects include diarrhea, dizziness, and cramping,
which can impair performance, though these have not occurred in most
studies. Weight gain (from water, not muscle) is also a potential
? The long-term health effects of high doses of creatine are unknown,
especially for people who have liver or kidney problems or diabetes.
Taking creatine supplements may depress the body's own synthesis of
the substance, which may not return to normal once you stop taking the
supplements. At high doses, kidney damage is a possibility, though
probably not if you take them for only a few days.
? Your muscles can store only so much creatine. Most people have
adequate levels, so taking the supplements would have little or no
? If creatine did improve performance, the difference would be very
small. Such a small edge might be important for some competitive
athletes, but it is meaningless for casual exercisers or players.?
Please read the site for complete information.
Side effects of creatine:
?CONTRAINDICATIONS - Creatine is contraindicated in those with renal
failure and renal disorders such as nephrotic syndrome.
Creatine supplements should be avoided by children, adolescents,
pregnant women, nursing mothers and anyone at risk for renal disorders
such as diabetics. Those taking creatine should have serum creatinine
The deaths of three American college wrestlers had been linked to the
use of creatine supplements. However, results of post mortem tests led
to the conclusion that the deaths were caused by severe dehydration
and renal failure, and were not due to creatine. Apparently, the
wrestlers were trying to lose enough weight through perspiration to
allow them to compete in lower-weight classes. Typical adverse effects
are gastrointestinal and include nausea, diarrhea and indigestion.
Also common are muscle cramping and strains. Weight gain may occur
from water retention. During a five day loading period, weight gains
of 1.1 to 3.5 pounds have been reported. There are reports of elevated
serum creatinine, a metabolite of creatine and a marker of kidney
function, in some who take creatine and have normal renal function.
This is reversible upon discontinuation of creatine.
Anecdotal reports of adverse events to FDA have included rash,
dyspnea, vomiting, diarrhea, nervousness, anxiety, migraine, fatigue,
polymyositis, myopathy, seizures and atrial fibrillation?
?The present review is not intended to reach conclusions on the
effect of creatine supplementation on sport performance, but we
believe that there is no evidence for deleterious effects in healthy
individuals. Nevertheless, idiosyncratic effects may occur when large
amounts of an exogenous substance containing an amino group are
consumed, with the consequent increased load on the liver and kidneys.
Regular monitoring is compulsory to avoid any abnormal reactions
during oral creatine supplementation.?
?A retrospective chart review was performed for 70 players on a
single professional football team, all of whom were evaluated 48 hours
postcompetition. Twenty-three players were identified who had
participated in a game 48 hours previously, were asymptomatic, and had
completed medical records. All players had undergone a limited
physical examination, submitted a blood sample for determination of
plasma CK, aspartate aminotransferase (AST), lactate dehydrogenase
(LDH), and a urine specimen for urinalysis and microscopic
examination. All tests were completed in a single laboratory.
Additional information pertaining to position played and body mass
index (kg/m2) was obtained.
Among the 23 players, 6 played a skill position (offensive back,
defensive back, or wide receiver), 10 played defensive end,
linebacker, or tight end (DE/LB/TE), and 7 were either offensive or
defensive linemen. No player was symptomatic for myalgias or chest
discomfort at the time of testing. The mean value (+/- SD) for CK for
all players was 1028 U/L (+/- 575.1 U/L), for AST was 33 U/L (+/- 11.6
U/L), and for LDH was 190 U/L (+/- 78.4 U/L) (see Table). By position
played, linemen had a higher mean CK level of 1215 U/L (+/- 440.3 U/L)
than DE/LB/TE, 1098 U/L (+/-675.5 U/L), and higher than the skilled
position players, 694 U/L (+/- 456.7 U/L). The mean values for AST and
LDH were not significantly different among positions played.
All 23 players demonstrated an elevated CK level (normal, < 235 U/L)
ranging from an elevation of 3.4% (243 U/L) to 1053% (2475 U/L). Yet,
only 3 players had an elevated AST level (normal, <42 U/L), and only 8
players had an elevated LDH level (normal, 75-200 U/L). There was no
statistically significant association among levels of CK and race,
body mass index, position played, or levels of either AST or LDH.
Urinalysis for 22 of the 23 players was negative for blood on the
urine dipstick (an indicator for myoglobin) and negative for red blood
cells on microscopic examination. A single player demonstrated 3+
blood on urine dipstick, greater than 100 red blood cells per
high-powered field on microscopy, and had a CK level of 824 U/L.?
Personally, I would not be too worried about your levels of AST and
ALT, but please discuss this concern with your doctor, and be sure to
reveal any and all supplements you are taking. In the meantime,
consider abandoning the creatine and whey for a few weeks, and have
your blood drawn again. Your doctor should rule out any liver disease
(sounds unlikely that you have any), to ease your mind.
If any part of my answer is unclear, please request an Answer
Clarification, and allow me to respond, before you rate. I will be
happy to assist you further on this question, before you rate the
Slightly elevated liver enzymes
SGOT + SGPT
excessive protein intake + whey protein + liver enzymes
Kre-Alkalyn + liver or kidney
creatine + AST enzymes