ALT · high result
What does a high ALT mean?
Short answer
ALT is the most liver-specific of the routine enzymes. Mild elevations (up to about 2–3 times the upper limit) are most often fatty liver, alcohol, medications or supplements, and recent strenuous exercise; higher levels point to viral hepatitis, drug injury or other active liver disease. A repeat in a few weeks plus a hepatitis B and C screen and an ultrasound are the standard first steps.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
When does this result need same-day care?
- ALT many times the upper limit with jaundice, confusion or easy bleeding — same-day care
What is the normal range for ALT?
- Male, age 18+: 7.00 – 55.0 U/L
- Female, age 18+: 7.00 – 45.0 U/L
Often reflects fatty liver, alcohol use, viral hepatitis, or muscle injury. Some medications also raise ALT.
Full reference table, citations and testing options: ALT biomarker page.
What are the common causes of high ALT?
- Non-alcoholic fatty liver disease (the most common cause in the US)
- Alcohol
- Medications and supplements: statins, acetaminophen, antibiotics, anti-seizure drugs, bodybuilding and weight-loss supplements
- Viral hepatitis (B, C, acute A, mononucleosis)
- Strenuous exercise or muscle injury (ALT also lives in muscle)
- Autoimmune hepatitis, hemochromatosis, celiac disease, thyroid disease
What symptoms go with high ALT?
- Usually none
- Fatigue, right-upper abdominal discomfort
- Jaundice, dark urine, itching when the liver is more significantly affected
What do clinicians usually check next?
- Repeat ALT with AST, GGT, bilirubin and albumin in 2–4 weeks
- Hepatitis B and C serology
- Liver ultrasound
- Ferritin and iron saturation, celiac screen, TSH when the picture isn't explained
Follow-up tests available at TestWell: TSH (Thyroid Stimulating Hormone) ($26.99), TSH + Free T4 ($27.99), Ferritin ($24.99), GGT (Gamma-Glutamyl Transferase) ($19.99).
How do you recheck ALT?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| General Wellness Panel | Panel · 4 tests | $89.99 | Yes | 1–3 business days |
| Kidney Health Panel | Panel · 4 tests | $64.99 | Yes | 2–4 business days |
| Gut Health Panel | Panel · 5 tests | $129.99 | No | 3–7 business days |
| Comprehensive Metabolic Panel | Test · 14 biomarkers | $22.99 | Yes | 1–3 business days |
Common questions
What ALT level is concerning?
Above the reference range (roughly 40–55 U/L depending on lab and sex) warrants a repeat and an explanation; above about three times the upper limit prompts a faster workup; above ten times suggests acute injury and same-day evaluation.
Can exercise raise ALT?
Yes — muscle releases ALT and AST after hard training, with CK rising too. Rest 48–72 hours and repeat.
Sources
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.