From the Guidelines
To improve your liver health and reduce your elevated liver enzymes (ALT 66 and AST 60), I strongly recommend adopting a Mediterranean diet, exercising for at least 150 minutes per week, and maintaining a healthy weight through a balanced lifestyle. This approach is supported by the most recent and highest quality study 1, which suggests that a Mediterranean diet and regular physical activity can significantly improve liver enzymes and histology in patients with non-alcoholic fatty liver disease (NAFLD).
Some key lifestyle changes to focus on include:
- Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting processed foods, sugar, and saturated fats
- Reducing or eliminating alcohol consumption, as even moderate drinking can stress your liver 1
- Exercising for at least 150 minutes per week, with a combination of aerobic exercise and resistance training, to help reduce liver fat
- Staying well-hydrated by drinking plenty of water throughout the day
- Avoiding medications that can strain your liver, including excessive acetaminophen (Tylenol), and always following dosing instructions
It's also important to manage any underlying conditions, such as diabetes, high blood pressure, or high cholesterol, as these can impact liver health 1. By making these lifestyle changes, you can significantly improve your liver function and reduce the risk of further liver damage. We'll recheck your liver enzyme levels in about 3 months to monitor your progress.
From the Research
Lifestyle Changes for Elevated ALT and AST Levels
To manage elevated ALT (66) and AST (60) levels, consider the following lifestyle changes:
- Maintain a healthy weight, as obesity is a risk factor for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) 2, 3, 4
- Engage in regular physical activity to improve insulin sensitivity and reduce liver fat 2, 3
- Follow a balanced diet rich in fruits, vegetables, and whole grains, and low in saturated fats and added sugars 2, 3
- Limit alcohol consumption, as excessive alcohol use can exacerbate liver damage 5, 6
- Avoid taking unnecessary medications, especially those that can cause liver damage, and inform your doctor about all medications and supplements you are taking 6
Monitoring and Follow-up
Regular monitoring of liver enzymes and other health parameters is crucial to assess the effectiveness of lifestyle changes and detect any potential liver damage:
- Schedule regular check-ups with your doctor to monitor liver enzyme levels and adjust your treatment plan as needed 5, 6
- Undergo liver function tests, such as ALT and AST, to evaluate the severity of liver damage and monitor treatment response 2, 3, 4
- Consider undergoing a liver biopsy if serologic testing and imaging fail to elucidate a diagnosis or to stage a condition 6
Additional Considerations
Other factors that may contribute to elevated ALT and AST levels include:
- Viral hepatitis, autoimmune hepatitis, and other liver diseases, which should be evaluated and treated accordingly 5, 6
- Family history of liver disease, which may increase the risk of developing liver conditions 5
- Presence of other health conditions, such as diabetes, hypertension, and hyperlipidemia, which can exacerbate liver damage 2, 3, 4