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ALT vs AST: Key Differences Explained

Discover the differences between ALT and AST to understand their health implications.

Written by

Mito Team

Introduction

ALT and AST are liver enzymes commonly used to evaluate liver function and injury. While they often rise together, they offer different clues depending on the tissue affected. This comparison explores their clinical differences.

What Is ALT?

ALT is a liver enzyme primarily found in the liver. It plays a key role in amino acid metabolism and is a sensitive marker for liver cell injury.

What Is AST?

AST is found in both the liver and other tissues like the heart and muscles. It helps assess liver damage but is less liver-specific than ALT.

Comparison Table

Criteria

ALT

AST

Primary Function

Involved in amino acid metabolism; more specific to liver injury.

Also involved in amino acid metabolism; found in liver, heart, muscle.

Diagnostic Relevance

Highly sensitive for detecting liver cell injury and inflammation.

Used in liver panels but less specific for liver damage alone.

Speed of Response

Elevates quickly in response to liver injury or hepatitis.

Also elevates quickly, but may reflect injury from other tissues.

Specificity

More liver-specific; elevated levels usually indicate liver disease.

Less specific; elevated in muscle injury, MI, or hemolysis as well.

Clinical Use

Detecting hepatitis, liver inflammation, and fatty liver disease.

Used in conjunction with ALT to calculate the AST/ALT ratio.

Measurement Units

U/L (units per liter)

U/L (units per liter)

Normal Range

7–56 U/L

10–40 U/L

Best Use Case

Monitoring liver-specific damage and disease.

Identifying systemic or non-liver causes of enzyme elevation.

Clinical Use Cases

ALT is commonly used to detect early signs of liver injury, such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, or medication toxicity.

AST is often interpreted with ALT and is useful in evaluating broader organ damage, including cardiac or muscular injury, especially when ALT remains normal.

Which Test Should You Choose?

ALT is preferred for detecting liver-specific issues. AST is useful when you want a broader view, especially if muscle or heart damage is suspected. Both are typically ordered together for liver panels.

Using Both Together

The AST/ALT ratio is clinically important. A ratio above 2 often suggests alcoholic liver disease, while a low ratio favors NAFLD or viral hepatitis. Both markers provide more insight when analyzed together.

Pros and Limitations

  • ALT Pros: High liver specificity, reliable marker of hepatocellular injury.

  • ALT Limitations: Can miss non-hepatic sources of inflammation.

  • AST Pros: Reflects multiple organ systems and useful in multisystem evaluation.

  • AST Limitations: Lack of liver specificity limits diagnostic value in isolation.

When to Test

Both ALT and AST are tested when evaluating liver health, fatigue, jaundice, or during medication monitoring. They are also part of routine physicals and metabolic assessments.

FAQs

Why is ALT more specific than AST?

ALT is concentrated in the liver, while AST is found in multiple tissues.

What does a high AST/ALT ratio indicate?

It may point toward alcoholic liver disease or cirrhosis, especially if ALT is lower.

Can exercise affect AST and ALT?

Yes. Strenuous activity can elevate both, especially AST due to muscle involvement.

ALT vs AST: Key Differences Explained

Discover the differences between ALT and AST to understand their health implications.

Written by

Mito Team

Introduction

ALT and AST are liver enzymes commonly used to evaluate liver function and injury. While they often rise together, they offer different clues depending on the tissue affected. This comparison explores their clinical differences.

What Is ALT?

ALT is a liver enzyme primarily found in the liver. It plays a key role in amino acid metabolism and is a sensitive marker for liver cell injury.

What Is AST?

AST is found in both the liver and other tissues like the heart and muscles. It helps assess liver damage but is less liver-specific than ALT.

Comparison Table

Criteria

ALT

AST

Primary Function

Involved in amino acid metabolism; more specific to liver injury.

Also involved in amino acid metabolism; found in liver, heart, muscle.

Diagnostic Relevance

Highly sensitive for detecting liver cell injury and inflammation.

Used in liver panels but less specific for liver damage alone.

Speed of Response

Elevates quickly in response to liver injury or hepatitis.

Also elevates quickly, but may reflect injury from other tissues.

Specificity

More liver-specific; elevated levels usually indicate liver disease.

Less specific; elevated in muscle injury, MI, or hemolysis as well.

Clinical Use

Detecting hepatitis, liver inflammation, and fatty liver disease.

Used in conjunction with ALT to calculate the AST/ALT ratio.

Measurement Units

U/L (units per liter)

U/L (units per liter)

Normal Range

7–56 U/L

10–40 U/L

Best Use Case

Monitoring liver-specific damage and disease.

Identifying systemic or non-liver causes of enzyme elevation.

Clinical Use Cases

ALT is commonly used to detect early signs of liver injury, such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, or medication toxicity.

AST is often interpreted with ALT and is useful in evaluating broader organ damage, including cardiac or muscular injury, especially when ALT remains normal.

Which Test Should You Choose?

ALT is preferred for detecting liver-specific issues. AST is useful when you want a broader view, especially if muscle or heart damage is suspected. Both are typically ordered together for liver panels.

Using Both Together

The AST/ALT ratio is clinically important. A ratio above 2 often suggests alcoholic liver disease, while a low ratio favors NAFLD or viral hepatitis. Both markers provide more insight when analyzed together.

Pros and Limitations

  • ALT Pros: High liver specificity, reliable marker of hepatocellular injury.

  • ALT Limitations: Can miss non-hepatic sources of inflammation.

  • AST Pros: Reflects multiple organ systems and useful in multisystem evaluation.

  • AST Limitations: Lack of liver specificity limits diagnostic value in isolation.

When to Test

Both ALT and AST are tested when evaluating liver health, fatigue, jaundice, or during medication monitoring. They are also part of routine physicals and metabolic assessments.

FAQs

Why is ALT more specific than AST?

ALT is concentrated in the liver, while AST is found in multiple tissues.

What does a high AST/ALT ratio indicate?

It may point toward alcoholic liver disease or cirrhosis, especially if ALT is lower.

Can exercise affect AST and ALT?

Yes. Strenuous activity can elevate both, especially AST due to muscle involvement.

Mito Health: Helping you live healthier, longer.

In-depth bloodwork & holistic health advice, backed by the latest longevity science. Only $399.

Mito Health: Helping you live healthier, longer.

In-depth bloodwork & holistic health advice, backed by the latest longevity science. Only $399.

ALT vs AST: Key Differences Explained

Discover the differences between ALT and AST to understand their health implications.

Written by

Mito Team

Introduction

ALT and AST are liver enzymes commonly used to evaluate liver function and injury. While they often rise together, they offer different clues depending on the tissue affected. This comparison explores their clinical differences.

What Is ALT?

ALT is a liver enzyme primarily found in the liver. It plays a key role in amino acid metabolism and is a sensitive marker for liver cell injury.

What Is AST?

AST is found in both the liver and other tissues like the heart and muscles. It helps assess liver damage but is less liver-specific than ALT.

Comparison Table

Criteria

ALT

AST

Primary Function

Involved in amino acid metabolism; more specific to liver injury.

Also involved in amino acid metabolism; found in liver, heart, muscle.

Diagnostic Relevance

Highly sensitive for detecting liver cell injury and inflammation.

Used in liver panels but less specific for liver damage alone.

Speed of Response

Elevates quickly in response to liver injury or hepatitis.

Also elevates quickly, but may reflect injury from other tissues.

Specificity

More liver-specific; elevated levels usually indicate liver disease.

Less specific; elevated in muscle injury, MI, or hemolysis as well.

Clinical Use

Detecting hepatitis, liver inflammation, and fatty liver disease.

Used in conjunction with ALT to calculate the AST/ALT ratio.

Measurement Units

U/L (units per liter)

U/L (units per liter)

Normal Range

7–56 U/L

10–40 U/L

Best Use Case

Monitoring liver-specific damage and disease.

Identifying systemic or non-liver causes of enzyme elevation.

Clinical Use Cases

ALT is commonly used to detect early signs of liver injury, such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, or medication toxicity.

AST is often interpreted with ALT and is useful in evaluating broader organ damage, including cardiac or muscular injury, especially when ALT remains normal.

Which Test Should You Choose?

ALT is preferred for detecting liver-specific issues. AST is useful when you want a broader view, especially if muscle or heart damage is suspected. Both are typically ordered together for liver panels.

Using Both Together

The AST/ALT ratio is clinically important. A ratio above 2 often suggests alcoholic liver disease, while a low ratio favors NAFLD or viral hepatitis. Both markers provide more insight when analyzed together.

Pros and Limitations

  • ALT Pros: High liver specificity, reliable marker of hepatocellular injury.

  • ALT Limitations: Can miss non-hepatic sources of inflammation.

  • AST Pros: Reflects multiple organ systems and useful in multisystem evaluation.

  • AST Limitations: Lack of liver specificity limits diagnostic value in isolation.

When to Test

Both ALT and AST are tested when evaluating liver health, fatigue, jaundice, or during medication monitoring. They are also part of routine physicals and metabolic assessments.

FAQs

Why is ALT more specific than AST?

ALT is concentrated in the liver, while AST is found in multiple tissues.

What does a high AST/ALT ratio indicate?

It may point toward alcoholic liver disease or cirrhosis, especially if ALT is lower.

Can exercise affect AST and ALT?

Yes. Strenuous activity can elevate both, especially AST due to muscle involvement.

Mito Health: Helping you live healthier, longer.

In-depth bloodwork & holistic health advice, backed by the latest longevity science. Only $399.

ALT vs AST: Key Differences Explained

Discover the differences between ALT and AST to understand their health implications.

Written by

Mito Team

Introduction

ALT and AST are liver enzymes commonly used to evaluate liver function and injury. While they often rise together, they offer different clues depending on the tissue affected. This comparison explores their clinical differences.

What Is ALT?

ALT is a liver enzyme primarily found in the liver. It plays a key role in amino acid metabolism and is a sensitive marker for liver cell injury.

What Is AST?

AST is found in both the liver and other tissues like the heart and muscles. It helps assess liver damage but is less liver-specific than ALT.

Comparison Table

Criteria

ALT

AST

Primary Function

Involved in amino acid metabolism; more specific to liver injury.

Also involved in amino acid metabolism; found in liver, heart, muscle.

Diagnostic Relevance

Highly sensitive for detecting liver cell injury and inflammation.

Used in liver panels but less specific for liver damage alone.

Speed of Response

Elevates quickly in response to liver injury or hepatitis.

Also elevates quickly, but may reflect injury from other tissues.

Specificity

More liver-specific; elevated levels usually indicate liver disease.

Less specific; elevated in muscle injury, MI, or hemolysis as well.

Clinical Use

Detecting hepatitis, liver inflammation, and fatty liver disease.

Used in conjunction with ALT to calculate the AST/ALT ratio.

Measurement Units

U/L (units per liter)

U/L (units per liter)

Normal Range

7–56 U/L

10–40 U/L

Best Use Case

Monitoring liver-specific damage and disease.

Identifying systemic or non-liver causes of enzyme elevation.

Clinical Use Cases

ALT is commonly used to detect early signs of liver injury, such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, or medication toxicity.

AST is often interpreted with ALT and is useful in evaluating broader organ damage, including cardiac or muscular injury, especially when ALT remains normal.

Which Test Should You Choose?

ALT is preferred for detecting liver-specific issues. AST is useful when you want a broader view, especially if muscle or heart damage is suspected. Both are typically ordered together for liver panels.

Using Both Together

The AST/ALT ratio is clinically important. A ratio above 2 often suggests alcoholic liver disease, while a low ratio favors NAFLD or viral hepatitis. Both markers provide more insight when analyzed together.

Pros and Limitations

  • ALT Pros: High liver specificity, reliable marker of hepatocellular injury.

  • ALT Limitations: Can miss non-hepatic sources of inflammation.

  • AST Pros: Reflects multiple organ systems and useful in multisystem evaluation.

  • AST Limitations: Lack of liver specificity limits diagnostic value in isolation.

When to Test

Both ALT and AST are tested when evaluating liver health, fatigue, jaundice, or during medication monitoring. They are also part of routine physicals and metabolic assessments.

FAQs

Why is ALT more specific than AST?

ALT is concentrated in the liver, while AST is found in multiple tissues.

What does a high AST/ALT ratio indicate?

It may point toward alcoholic liver disease or cirrhosis, especially if ALT is lower.

Can exercise affect AST and ALT?

Yes. Strenuous activity can elevate both, especially AST due to muscle involvement.

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Upload past labs and monitor your progress over time

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Billed annually - cancel anytime

Bundle options:

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or 4 interest-free payments of $87.25*

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(For 2)

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$668

/year

or 4 interest-free payments of $167*

Pricing for members in NY, NJ & RI may vary.

Checkout with HSA/FSA

Secure, private platform

What's included

Comprehensive lab testing (Core)

100+ biomarkers - Test at 2,000+ labs nationwide

In-depth health insights & action plan

Expert designed recommendations across exercise, nutrition, and supplements

1:1 Consultation

Meet with your dedicated care team to review your results and define next steps

Lifetime health record tracking

Upload past labs and monitor your progress over time

Biological age analysis

See how your body is aging and what’s driving it

Order add-on tests and scans anytime

Access to advanced diagnostics at discounted rates for members

Concierge-level care, made accessible.

Mito Health Membership

Codeveloped with experts at MIT & Stanford

Less than $1/ day

Billed annually - cancel anytime

Bundle options:

Individual

$399

$349

/year

or 4 interest-free payments of $87.25*

Duo Bundle (For 2)

$798

$668

/year

or 4 interest-free payments of $167*

Pricing for members in NY, NJ & RI may vary.

Checkout with HSA/FSA

Secure, private platform

What's included

Comprehensive lab testing (Core)

100+ biomarkers - Test at 2,000+ labs nationwide

In-depth health insights & action plan

Expert designed recommendations across exercise, nutrition, and supplements

1:1 Consultation

Meet with your dedicated care team to review your results and define next steps

Lifetime health record tracking

Upload past labs and monitor your progress over time

Biological age analysis

See how your body is aging and what’s driving it

Order add-on tests and scans anytime

Access to advanced diagnostics at discounted rates for members

Concierge-level care, made accessible.

Mito Health Membership

Codeveloped with experts at MIT & Stanford

Less than $1/ day

Billed annually - cancel anytime

Bundle options:

Individual

$399

$349

/year

or 4 payments of $87.25*

Duo Bundle
(For 2)

$798

$668

/year

or 4 payments of $167*

Pricing for members in NY, NJ & RI may vary.

Checkout with HSA/FSA

Secure, private platform

10x more value at a fraction of the walk-in price.

10x more value at a fraction of
the walk-in price.

10x more value at a fraction of the walk-in price.

10x more value at a fraction of the walk-in price.

The information provided by Mito Health is for improving your overall health and wellness only and is not intended to provide medical advice, diagnosis, or treatment. We engage the services of partner clinics authorised to order the tests and to receive your blood test results prior to making Mito Health analytics and recommendations available to you. These interactions are not intended to create, nor do they create, a doctor-patient relationship. You should seek the advice of a doctor or other qualified health provider with whom you have such a relationship if you are experiencing any symptoms of, or believe you may have, any medical or psychiatric condition. You should not ignore professional medical advice or delay in seeking it because of Mito Health recommendations or analysis. This service should not be used for medical diagnosis or treatment. The recommendations contained herein are not intended to diagnose, treat, cure or prevent any disease. You should always consult your clinician or other qualified health provider before starting any new treatment or stopping any treatment that has been prescribed for you by your clinician or other qualified health provider.

The information provided by Mito Health is for improving your overall health and wellness only and is not intended to provide medical advice, diagnosis, or treatment. We engage the services of partner clinics authorised to order the tests and to receive your blood test results prior to making Mito Health analytics and recommendations available to you. These interactions are not intended to create, nor do they create, a doctor-patient relationship. You should seek the advice of a doctor or other qualified health provider with whom you have such a relationship if you are experiencing any symptoms of, or believe you may have, any medical or psychiatric condition. You should not ignore professional medical advice or delay in seeking it because of Mito Health recommendations or analysis. This service should not be used for medical diagnosis or treatment. The recommendations contained herein are not intended to diagnose, treat, cure or prevent any disease. You should always consult your clinician or other qualified health provider before starting any new treatment or stopping any treatment that has been prescribed for you by your clinician or other qualified health provider.

The information provided by Mito Health is for improving your overall health and wellness only and is not intended to provide medical advice, diagnosis, or treatment. We engage the services of partner clinics authorised to order the tests and to receive your blood test results prior to making Mito Health analytics and recommendations available to you. These interactions are not intended to create, nor do they create, a doctor-patient relationship. You should seek the advice of a doctor or other qualified health provider with whom you have such a relationship if you are experiencing any symptoms of, or believe you may have, any medical or psychiatric condition. You should not ignore professional medical advice or delay in seeking it because of Mito Health recommendations or analysis. This service should not be used for medical diagnosis or treatment. The recommendations contained herein are not intended to diagnose, treat, cure or prevent any disease. You should always consult your clinician or other qualified health provider before starting any new treatment or stopping any treatment that has been prescribed for you by your clinician or other qualified health provider.