High AST Levels: Causes, Treatment, and Prevention

Elevated liver enzymes like AST (aspartate aminotransferase) and ALT (alanine aminotransferase) can indicate liver damage, often caused by external factors. Lowering these enzymes and restoring liver health requires following your doctor’s recommendations, which may include lifestyle changes such as limiting alcohol intake, maintaining a healthy weight, and adopting a balanced diet. Additionally, avoiding exposure to toxins and prioritizing regular exercise can further support liver function and overall well-being.

Below, we’ll tackle all these steps to lower high AST and ALT levels. You’ll also learn about the popular home remedies for managing these elevated liver enzymes.

What Does It Mean When Your AST and ALT Are High?

AST and ALT play a crucial role in metabolizing amino acids, which are the building blocks of proteins. Damaged or inflamed liver cells trigger the release of AST and ALT into the bloodstream, raising their levels.

There are several possible specific causes of elevated AST and ALT levels, including liver diseases such as hepatitis (including hepatitis for children), fatty liver disease, and cirrhosis. Excessive alcohol consumption, certain medications, obesity, high cholesterol, and viral infections can also cause elevated levels.

Pinpointing the reason behind elevated AST and ALT often requires a combination of medical history review, physical examination, and further investigations. These may include blood tests, imaging scans, and sometimes a liver biopsy. Once the cause is determined, you can take targeted steps to address the underlying issue.

Normal ALT levels range from 0 to 44 IU/L, while AST levels must be between 0 to 44 IU/L. Some labs may have slightly different thresholds, so always check their specific reference. Beyond the upper limit, this indicates that the liver enzymes have been released in the bloodstream at an elevated amount. Thus, it requires immediate medical consultation. 

Did you know? While commonly referred to as AST, this liver enzyme also goes by the alias “serum glutamic-oxaloacetic transaminase,” or SGOT for short. This is why you’ll find a lab test called AST SGOT blood test. In addition, high AST SGOT and ALT provide insights into your liver health. Another panel blood test that evaluates how well your liver works is the hepatic function panel seven blood test.

How To Lower High AST and ALT Levels

Aside from medications and other treatments your doctor prescribes, lowering elevated AST and ALT levels requires prioritizing a holistic approach. These include lifestyle changes that actively support your liver’s health and reduce elevated enzyme levels. Specifically, they involve the actions below. 

1. Reduce alcohol consumption

Excessive alcohol consumption can damage the liver, leading to elevated ALT and AST levels, as confirmed by research like the study in the Journal of Clinical Medicine. Researchers found that drinking too much alcohol⁽¹⁾, especially hard liquor, can harm your liver and cause high ALT and AST. This damage can lead to liver fibrosis, which is when your liver starts to scar.

The study also found that the more alcohol people drank, the more likely they were to have advanced liver damage. This was true even for people who didn’t show any symptoms.

Reducing your alcohol intake allows the liver to recover and the hepatic cells to undergo repair. However, how long and well you recover depends on the extent of alcohol dependency. 

With this in mind, you should first assess other factors that could impede alcohol elimination from your lifestyle. Or better yet, work closely with a professional, especially if you plan to completely give up alcohol, along with other habits that destroy your liver. 

2. Maintain a healthy weight

For individuals with nonalcoholic fatty liver disease (NAFLD)⁽²⁾, achieving and maintaining a healthy weight is the primary approach to lower elevated ALT and AST levels and improve overall liver function.

However, when choosing a weight loss intervention method, go for something sustainable. Intensive options⁽³⁾ appear to diminish the goal of improving treatment among patients with NAFLD, according to a study published in the European Journal of Clinical Nutrition. 

Nonetheless, losing 7-10% of your body weight⁽⁴⁾ can help improve NAFLD. In addition, vitamin E and a special compound found in olives might be beneficial, especially for children with NAFLD. Scientists are also looking at new ways to treat NAFLD by targeting tiny molecules in the cells called microRNAs.

Pro tip: Your weight loss journey should include a medical assessment at the get-go to keep better track of your progress. A weight loss profile blood test, for example, allows your primary care provider to determine which type of diet and the rate of physical activity matches your needs and natural composition.

3. Avoid exposure to toxins

Keep the liver free from toxic chemicals and pollutants, like nicotine and industrial solvents, as they can cause damage to the liver, prompting the elevation of liver enzymes in the blood. Minimize exposure to these toxins by avoiding smoking, using protective gear when handling chemicals, and opting for organic produce to reduce the risk of elevated liver enzymes and potential liver damage. 

Cigarette smoking⁽⁵⁾, for instance, adversely impacts NAFLD, as presented in a review published in the Journal of Hepatology. The mechanism of such impact involves various minute effects of nicotine, including the activation of oxidative stress. 

Aside from the nicotine of cigarettes, a study from the Annals of Occupational and Environmental Medicine shows exposure to certain environmental chemicals⁽⁶⁾ might increase the risk of having elevated liver enzymes. Specifically, these chemicals include perfluorooctanesulfonate (PFOS), perfluorodecanoic acid (PFDA), mercury, and phthalates.

Pro tip: Wondering if there is a blood test for smoking? Check out the nicotine and metabolite blood test, ideal for those who keep track of how much nicotine their body has dispelled following cigarette withdrawal. 

4. Manage stress

Chronic stress negatively impacts liver health, potentially elevating AST and ALT levels. Studies suggest that prolonged stress can injure the liver and hinder its ability to function properly, highlighting the importance of stress management in maintaining liver health.

For instance, work-related stress⁽⁷⁾ due to working long hours can alter liver enzyme levels abnormally. This has been shown in a study published in the Annals of Occupational and Environmental Medicine. This is further supported by the fact that when you’re stressed, your body releases a hormone called cortisol. High levels of cortisol⁽⁸⁾, along with other stress factors in our lives, can contribute to liver disease. 

Incorporate stress management techniques such as mindful meditation, yoga, or engaging in hobbies to reduce stress levels and support liver function. Likewise, make sure to avoid overworking and maintain a healthy work-life balance.

Pro tip: When you’re working, it can be tricky to find ways to destress without frequently thinking about your tasks. Check out our guide on how to deal with stress when you’re busy. Additionally, make sure you’re destressing right by avoiding unhealthy ways of coping with stress. 

5. Consume liver-friendly foods

AST and ALT levels can be lowered by consuming certain foods that promote liver health. These include garlic, turmeric, leafy greens, cruciferous vegetables, and berries, which contain specific compounds or antioxidants that support liver function. 

Fatty fish rich in omega-3 fatty acids⁽⁹⁾ is also ideal for supplementation as it provides extra protection to the liver, especially among those with chronic liver disease. Tuna and salmon are two of the most common commercial fish you can include in your diet. These are also versatile in that you can prepare them in many ways. 

6. Increase fiber intake

Consume other fruits, vegetables, and whole grains, especially those rich in soluble fiber. Dietary fiber⁽¹⁰⁾ has been associated with liver protection and lowers the risk for NAFLD. Naturally, this allows AST and ALT to remain within the normal range.

In addition to adding healthy foods to your diet, if possible, avoid processed foods, too much red meat, and sugary drinks, as they can cause your liver to overwork itself. Plan your meals accordingly and work with a nutritionist or doctor to ensure your diet is in your favor. 

7. Stay hydrated

Adequate water intake is essential for liver health, as water plays a vital role in the detoxification process.  Insufficient hydration can hinder the liver’s ability to efficiently eliminate waste and toxins, potentially leading to elevated liver enzymes and impaired function. Prioritizing proper hydration supports optimal liver performance and overall health.

8. Do not ignore your regular checkups

Regular follow-up checkups play a significant role in managing and lowering high AST and ALT levels. These checkups allow healthcare professionals to monitor your liver health, assess the effectiveness of any ongoing treatments, and make necessary adjustments to your care plan. 

A collaborative approach between you and your doctor fosters a sense of accountability and empowers you to participate actively in your care, increasing the likelihood of successful outcomes and long-term well-being.

Natural Remedies for Lowering AST and ALT Levels

In addition to lifestyle modifications, exploring natural remedies that support liver function may help reduce ALT and AST levels. However, it’s important to consult your doctor before incorporating any organic supplements to ensure safety and maximize potential benefits while minimizing any risks.

1. Milk thistle

The herb milk thistle is known for its liver-protective properties, specifically reducing liver inflammation and supporting detoxification. However, make sure to consult with your doctor first for the appropriate dosage and form of milk thistle before adding milk thistle to your grocery list.

2. Dandelion root

Dandelion root, a traditional liver tonic, encourages healthy bile flow, assisting the body’s natural detoxification processes. You can typically find dandelion root in the form of a tea or a supplement. 

3. Green tea

Green tea is dubbed as the healthiest drink in the world. It is rich in antioxidants that can help protect the liver from inflammation and damage. Consider drinking two to three cups of green tea daily to support liver health.

4. Coffee

Coffee has shown promising potential in supporting liver health and potentially lowering AST and ALT levels⁽¹¹⁾. This is likely due to its rich antioxidant content, which helps protect liver cells from damage, and its anti-inflammatory properties, which can reduce liver inflammation. 

5. Licorice root

Licorice root contains a compound called glycyrrhizin, which possesses anti-inflammatory and antioxidant properties that can help protect the liver from damage. Studies suggest that glycyrrhizin may help improve liver function⁽¹²⁾ and reduce elevated liver enzymes like AST and ALT in individuals with certain liver conditions, including non-alcoholic fatty liver disease. 

6. Turmeric 

Turmeric, a vibrant yellow spice commonly used in cooking, contains a powerful compound called curcumin. Curcumin boasts potent anti-inflammatory and antioxidant properties⁽¹³⁾ that may help protect the liver from damage. However, it’s important to note that more research is needed to fully understand the efficacy and optimal dosage of turmeric for liver health.

7. Artichoke 

Artichokes contain compounds that can enhance liver function and promote healthy bile flow, which aids in digestion and detoxification. You can enjoy artichokes steamed, roasted, or in supplement form to potentially support your liver health.

Frequently Asked Questions

When should I worry about AST and ALT?

Elevated liver enzymes, even mildly elevated or without accompanying symptoms, warrant further consultation with a healthcare professional. This is especially true if AST and ALT levels are twice the upper limit of the normal range. Consistent elevation may indicate underlying liver issues requiring further investigation and management to prevent potential long-term complications.

What is the treatment for high AST and ALT levels?

Naturally, the treatment for elevated AST and ALT levels all depends on the cause of the imbalance. With this, your doctor may require further liver function testing. Nonetheless, you can follow through with the lifestyle improvement actions mentioned above to supplement the medication prescribed by your doctor, regardless of the primary underlying condition. 

Can you recover from high AST and ALT?

Yes, you can recover from high ALT and AST, but the rate of recovery and duration will depend on the cause. There are cases wherein the elevated levels of these liver enzymes are temporary. Hence, with proper medication and lifestyle adjustment, you can expect to return to normalcy between two to four weeks. 

However, if the condition’s underlying cause is a serious liver injury or something related, you may have to follow a particular course of treatment that will influence your recovery from elevated AST and AL.

The Bottom Line

Lowering high ALT and AST requires a combination of conscious lifestyle changes and professional direction from your healthcare provider. Before employing the steps and tips we outlined above, consult your doctor first so you can keep a good balance of natural and professional treatment. In addition, maintain activities and daily choices that improve your liver health. 

Sources 

¹ Minea H, Singeap AM, Sfarti CV, Girleanu I, Chiriac S, Muzica C, Cuciureanu T, Petrea OC, Huiban L, Zenovia S, Nastasa R, Rotaru A, Stafie R, Stratina E, Cojocariu C, Stanciu C, Trifan A. The Impact of Alcohol Consumption Pattern on Liver Fibrosis in Asymptomatic Patients. J Clin Med. 2023 Nov 29;12(23):7405. doi: 10.3390/jcm12237405. PMID: 38068457; PMCID: PMC10706981.

² Hadefi A, Arvanitakis M, Trépo E, Zelber-Sagi S. Dietary strategies in non-alcoholic fatty liver disease patients: From evidence to daily clinical practice, a systematic review. United European Gastroenterol J. 2023 Sep;11(7):663-689. doi: 10.1002/ueg2.12443. Epub 2023 Jul 25. PMID: 37491835; PMCID: PMC10493364.

³ Arora, C., Malhotra, A., Ranjan, P. et al. Effect of intensive weight-loss intervention on metabolic, ultrasound and anthropometric parameters among patients with obesity and non-alcoholic fatty liver disease: an RCT. Eur J Clin Nutr 76, 1332–1338 (2022). https://doi.org/10.1038/s41430-022-01111-8

⁴ Kosmalski M, Frankowski R, Ziółkowska S, Różycka-Kosmalska M, Pietras T. What’s New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD). J Clin Med. 2023 Feb 26;12(5):1852. doi: 10.3390/jcm12051852. PMID: 36902639; PMCID: PMC10003344.

⁵ Marti-Aguado D, Clemente-Sanchez A, Bataller R. Cigarette smoking and liver diseases. J Hepatol. 2022 Jul;77(1):191-205. doi: 10.1016/j.jhep.2022.01.016. Epub 2022 Feb 4. PMID: 35131406.

⁶ Chi Y, Park JT, Na S, Kwak K. Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018-2022. Ann Occup Environ Med. 2023 Jul 31;35:e27. doi: 10.35371/aoem.2023.35.e27. PMID: 37701484; PMCID: PMC10493370.

⁷ Song JH, Kim HR, Lee DW, Min J, Lee YM, Kang MY. Association between long working hours and liver enzymes: evidence from the Korea National Health and Nutrition Examination Survey, 2007-2017. Ann Occup Environ Med. 2022 May 13;34:e9. doi: 10.35371/aoem.2022.34.e9. PMID: 35801225; PMCID: PMC9209099.

⁸ Demori I, Grasselli E. The Role of the Stress Response in Metabolic Dysfunction-Associated Fatty Liver Disease: A Psychoneuroendocrineimmunology-Based Perspective. Nutrients. 2023 Feb 3;15(3):795. doi: 10.3390/nu15030795. PMID: 36771500; PMCID: PMC9921904.

⁹ Vell, M. S., Creasy, K. T., Scorletti, E., Seeling, K. S., Hehl, L., Rendel, M. D., Schneider, K. M., & Schneider, C. V. (2023). Omega-3 intake is associated with liver disease protection. Frontiers in Public Health, 11, 1192099. https://doi.org/10.3389/fpubh.2023.1192099

¹⁰ Zhu Y, Yang H, Zhang Y, Rao S, Mo Y, Zhang H, Liang S, Zhang Z, Yang W. Dietary fiber intake and non-alcoholic fatty liver disease: The mediating role of obesity. Front Public Health. 2023 Jan 6;10:1038435. doi: 10.3389/fpubh.2022.1038435. PMID: 36684870; PMCID: PMC9853063.

¹¹ Di Pietrantonio D, Pace Palitti V, Cichelli A, Tacconelli S. Protective Effect of Caffeine and Chlorogenic Acids of Coffee in Liver Disease. Foods. 2024 Jul 20;13(14):2280. doi: 10.3390/foods13142280. PMID: 39063364; PMCID: PMC11276147.

¹² Gao, W., Zhao, Y., Guo, L., Wang, Y., Gong, H., Zhang, B., & Yan, M. (2023). Comparative effectiveness of glycyrrhizic acid preparations aimed at improving liver function of patients with chronic hepatitis B: A network meta-analysis of 53 randomized controlled trials. Phytomedicine, 116, 154883. https://doi.org/10.1016/j.phymed.2023.154883

¹³ Anas, M., Falak, A., Khan, A. et al. Therapeutic potential and agricultural benefits of curcumin: a comprehensive review of health and sustainability applications. J.Umm Al-Qura Univ. Appll. Sci. (2024). https://doi.org/10.1007/s43994-024-00200-7

Frequently Asked Questions