Who is this especially useful for?
- ✓People with metabolic syndrome or insulin resistance
- ✓Those concerned about fatty liver disease (NAFLD/MASLD)
- ✓Anyone with elevated triglycerides or central obesity
- ✓People taking medications metabolized by the liver
ALT is a screening marker — elevated values warrant further investigation with your healthcare provider.
Your lab report says your ALT is "normal." But is it really? Traditional lab ranges were established from populations where fatty liver disease is epidemic.
That's exactly what our ALT Evaluator addresses. It uses research-based thresholds that can detect liver fat accumulation — often years before standard ranges flag a problem.
The Problem with 'Normal' ALT Ranges
Standard lab ranges were established from population averages — including millions with undiagnosed fatty liver:
- 30-40% of adults have some degree of fatty liver disease
- 79% of NAFLD patients have ALT within "normal" range
- 19-30 U/L is the threshold where liver fat begins accumulating (research)
A "normal" ALT doesn't mean your liver is healthy — it means you're average in a population where fatty liver is epidemic.
What is ALT?
ALT (alanine aminotransferase), also known as SGPT, is an enzyme found primarily in liver cells. When liver cells are damaged or inflamed, ALT leaks into the bloodstream.
ALT is considered more specific to the liver than AST (which is also found in heart and muscle). This makes ALT particularly useful for detecting liver problems, especially non-alcoholic fatty liver disease (NAFLD) — now called metabolic dysfunction-associated steatotic liver disease (MASLD).
The critical issue: standard laboratory reference ranges are too wide. They were established from population averages that included people with undiagnosed fatty liver. Research shows that "normal" ALT levels may still indicate significant liver fat accumulation.
Why Standard Ranges Miss So Many Cases
Your lab report says your ALT is "normal." But is it really? Traditional lab ranges were established from populations where fatty liver disease is epidemic.
The Prati et al. study (2002) examined truly healthy populations — excluding anyone with metabolic risk factors — and found optimal thresholds are significantly lower:
- Men: < 30 U/L (not < 40)
- Women: < 19 U/L (not < 35)
This explains why 79% of people with confirmed fatty liver have "normal" ALT by standard criteria.
How to Test
💡 Pro tip: A single elevated ALT may be transient. If persistently elevated, imaging (ultrasound) can assess liver fat accumulation.
🔍Where to find your result
ALT is included in standard metabolic panels (CMP) and liver function tests (LFT).
How Different Paradigms Interpret This
Different health paradigms interpret ALT thresholds differently:
ALT Interpretation by Paradigm (Male)
Ranges shown are for adult males. Evaluator → Use the evaluator for personalized interpretation based on your gender, age, and health context.
Each paradigm has different thresholds and clinical focus:
Standard Medical
Research Consensus
Metabolic Optimization
What Causes Elevated ALT?
Metabolic Causes (Most Common)
NAFLD/MASLD
Non-alcoholic fatty liver disease — the leading cause
Insulin resistance
Drives liver fat accumulation
Visceral obesity
Central obesity strongly predicts fatty liver
Type 2 diabetes
Often coexists with fatty liver
High triglycerides
Marker of metabolic dysfunction
Lifestyle Factors
Alcohol consumption
Even moderate drinking stresses liver
High fructose intake
Soda, fruit juice directly fatten liver
Excess carbohydrates
Converted to liver fat when overconsume
Sedentary lifestyle
Reduces liver's ability to clear fat
Rapid weight loss
Temporarily elevates ALT
Medications & Other
Statins
Common, usually mild elevation
Acetaminophen
Hepatotoxic at high doses
NSAIDs
Ibuprofen, naproxen can elevate
Viral hepatitis
B and C should be ruled out
Intense exercise
Temporary elevation for 24-48 hours
How to Lower ALT
The good news: fatty liver is reversible. ALT often improves significantly with targeted lifestyle changes.
Diet Interventions
Reduce refined carbs and sugars
Primary driver of liver fat accumulation
Eliminate fructose
Soda and fruit juice directly fatten liver
Mediterranean or low-carb diet
Both proven to reduce liver fat
Coffee (2-3 cups daily)
Protective for liver — reduces ALT
Lifestyle Changes
Weight loss 5-10%
Reduces liver fat by 40-80%
Exercise regularly
Aerobic and resistance both help
Limit alcohol
Even moderate drinking stresses liver
Avoid hepatotoxins
Limit acetaminophen use
Supplements (Discuss with MD)
Vitamin E
800 IU shown to improve NASH
Omega-3 fatty acids
May reduce liver fat
Milk thistle (silymarin)
Traditional liver support
Berberine
May improve metabolic markers
2-4 weeks: Initial ALT response to dietary changes. 8-12 weeks: Significant ALT reduction with sustained lifestyle changes. 3-6 months: Major liver fat reduction visible on imaging. 6-12 months: Potential reversal of early fibrosis; normalized enzymes.
Key Takeaways
- 1'Normal' lab ranges miss the majority of fatty liver disease cases
- 2Research-based thresholds: < 30 U/L (men), < 19 U/L (women) indicate truly healthy liver
- 3ALT is an early warning system — elevations precede symptoms by years
- 4Fatty liver is REVERSIBLE with diet and lifestyle changes
- 5Weight loss of 5-10% can reduce liver fat by 40-80%
- 6Coffee is protective — 2-3 cups daily associated with lower ALT