You should worry about ALT (alanine transaminase) levels when they are elevated beyond certain thresholds, as this can indicate liver damage or disease. Normal ALT levels are typically up to about 40 U/L for men and 35 U/L for women, though some experts recommend keeping levels below 30 U/L for men and 25 U/L for women for optimal health. Here's a rough guide on when to be concerned:
- Mildly elevated ALT (41-120 U/L): May indicate early liver stress; consider lifestyle changes and retesting in 3-6 months.
- Moderately elevated ALT (121-400 U/L): Likely indicates liver disease; prompt medical evaluation is needed.
- Severely elevated ALT (>400 U/L): Suggests acute liver injury; requires immediate medical attention.
You should seek medical attention promptly if your ALT level is more than 3 times the upper normal limit (over 120 U/L for men, 105 U/L for women), even if you have no symptoms. Persistent elevations above 2 times normal lasting more than 6 months also need investigation for chronic liver disease. Immediate medical evaluation is warranted if elevated ALT levels occur along with symptoms such as:
- Severe abdominal pain
- Persistent vomiting
- Confusion or altered mental state
- Yellowing of skin or eyes (jaundice)
- Severe fatigue impacting daily life
- Signs of bleeding or easy bruising
Even mild to moderate ALT elevations should be discussed with your healthcare provider if they persist or if you have risk factors like obesity, diabetes, or a family history of liver disease. Early intervention can help prevent worsening liver damage. In summary, worry about ALT levels when they exceed normal ranges significantly, persist over time, or are accompanied by concerning symptoms or risk factors. Lifestyle modifications and medical evaluation can help address elevated ALT levels and underlying causes.
