What is the significance of an Alanine Transaminase (ALT) level of 36?

From the Guidelines

An ALT of 36 is within the normal range, indicating no liver damage or disease, and therefore, no specific treatment or medication is needed. According to the study published in the Journal of the American College of Radiology 1, normal ALT levels are 29 to 33 IU/L in men and 19 to 25 IU/L in women, but it's essential to note that reference ranges may vary slightly between laboratories. The severity of abnormal aminotransferase can be classified, but in this case, an ALT of 36 does not indicate any significant liver damage. Some key points to consider include:

• ALT elevations are specific for liver injury owing to low concentrations in skeletal muscle and kidney 1
• Maintaining a healthy lifestyle with balanced nutrition, regular exercise, limited alcohol consumption, and avoiding hepatotoxic medications will help preserve liver health
• Regular monitoring of liver function tests may be recommended if you have risk factors for liver disease such as diabetes, obesity, or if you're taking medications that could affect the liver
• If you have other abnormal liver tests or symptoms like jaundice, abdominal pain, or fatigue, further evaluation would be warranted despite this normal ALT value. It's also important to understand that ALT is an enzyme primarily found in liver cells that is released into the bloodstream when liver cells are damaged, and an ALT of 36 indicates normal liver function 1.

From the Research

ALT Levels

• The normal range for ALT levels can vary depending on the population and geographical location, with values ranging from 19 IU/L to 55 IU/L 2.
• A study found that the upper limit of normal (ULN) for ALT was significantly diverse across various geographical locations and sexes 2.
• Another study suggested that the normal range of ALT be redefined, taking into account regional differences, methods used in ALT measurements, and ULN determination 2.

Vitamin E Supplementation and ALT Levels

• Vitamin E supplementation has been shown to reduce ALT levels in patients with non-alcoholic fatty liver disease (NAFLD) 3, 4.
• A meta-analysis found that vitamin E supplementation reduced ALT levels by -7.37 IU/L (95% CI: -10.11 to -4.64) compared to placebo 4.
• Another study found that vitamin E supplementation reduced ALT levels by 46% in patients with hepatitis C 5.

Healthy Ranges for ALT Levels

• A study found that updated upper limits for ALT levels (30 U/L for men and 19 U/L for women) were lower than current limits and showed superior sensitivity in identifying participants with HCV viremia 6.
• The study suggested that revision of normal limits for ALT level is advisable in patients with chronic HCV infection or nonalcoholic fatty liver disease 6.

ALT Value of 36

• An ALT value of 36 is above the suggested upper limit of normal for women (19 U/L) but below the suggested upper limit of normal for men (30 U/L) 6.
• However, the normal range for ALT levels can vary depending on the population and geographical location, and an ALT value of 36 may be considered normal or elevated depending on the specific context 2.