From the Guidelines
To reduce ALT and AST liver enzymes, focus on lifestyle modifications including maintaining a healthy weight, limiting alcohol consumption, and following a balanced diet low in processed foods and sugar, as recommended by the most recent study 1 from 2023. The key to reducing liver enzymes is to address the underlying causes of liver damage, such as fatty liver disease, viral hepatitis, and other conditions.
- For patients with fatty liver disease, losing 3-5% of body weight through a combination of calorie reduction (500-1000 calories less per day) and regular exercise (150 minutes of moderate activity weekly) can help decrease liver enzymes 1.
- Avoiding medications that can stress the liver, including excessive acetaminophen (staying under 2000mg daily), is also crucial 1.
- For those with viral hepatitis, antiviral medications prescribed by a healthcare provider are essential, as noted in the study 1 from 2023.
- Managing underlying conditions like diabetes (maintaining HbA1c below 7%) and high cholesterol is also important, as highlighted in the study 1 from 2019.
- Regular monitoring of liver enzymes every 3-6 months is recommended to track improvement, as suggested by the study 1 from 2019.
- Additionally, supplements like milk thistle (140mg of silymarin three times daily), vitamin E (800 IU daily), and N-acetylcysteine (600mg twice daily) may help some patients, though evidence varies, as noted in the study 1 from 2020. These approaches work by reducing inflammation, decreasing fat accumulation in the liver, and supporting liver cell regeneration, ultimately leading to improved liver health and reduced morbidity and mortality.
From the FDA Drug Label
Abnormalities in liver enzymes have not been associated with Ursodiol therapy and, in fact, Ursodiol has been shown to decrease liver enzyme levels in liver disease. However, patients given Ursodiol should have SGOT (AST) and SGPT (ALT) measured at the initiation of therapy and thereafter as indicated by the particular clinical circumstances
Reduction of ALT and AST can be achieved with Ursodiol therapy, as it has been shown to decrease liver enzyme levels in liver disease 2.
- Ursodiol may help reduce ALT and AST levels.
- Patients should have SGOT (AST) and SGPT (ALT) measured at the initiation of therapy and thereafter as indicated by the particular clinical circumstances.
From the Research
Reducing ALT and AST Levels
To reduce ALT and AST levels, several treatment options have been studied, including the use of ursodeoxycholic acid (UDCA) and vitamins E and C. The evidence suggests that:
- UDCA can significantly decrease ALT levels 3, 4, 5, 6
- The combination of UDCA and vitamin E can improve liver function tests, including AST and ALT levels 4
- Vitamin E and C combination therapy can also decrease serum AST and ALT levels, although the difference compared to UDCA was not significant 7
- UDCA treatment can significantly decrease ALT levels, particularly in people from Europe, those older than 50 years, and in longer durations 6
Treatment Options
The following treatment options have been studied:
- Ursodeoxycholic acid (UDCA) 3, 4, 5, 6
- Vitamin E and C combination therapy 7
- Combination of UDCA and vitamin E 4
Key Findings
Key findings from the studies include:
- UDCA can improve liver function tests, including AST and ALT levels 3, 4, 5, 6
- Vitamin E and C combination therapy can decrease serum AST and ALT levels 7
- The combination of UDCA and vitamin E can improve liver function tests, including AST and ALT levels 4
- UDCA treatment can significantly decrease ALT levels, particularly in people from Europe, those older than 50 years, and in longer durations 6