2023-06-13 07:00:00
Transaminase levels are estimated by means of a blood sample. When their concentrations are abnormally highthis is usually a sign of a liver damage. In this case, you should quickly consult the doctor who prescribed the dosage.
Definition: what exactly is a transaminase?
“Transaminases are enzymes that reside inside the cells of certain organs”, says Dr. Delphine Jouaud. They are involved in a multitude of biological reactions. “Their dosage makes it possible to reflect the activity or, on the contrary, the destruction of the cells of the organs concerned”.
ASAT (TGO or SGOT) and ALAT (TGP or SGPT): what is the difference?
There are two types of transaminases:
- THE transaminases SO TGO (Aspartate-aminotransferase or SGOTSerum GlutamoOxaloacetate Transferase);
- THE transaminases ALAT ou TGP (Alanine-aminotransferase or SGPTSerum GlutamoPyruvate Transferase).
“These two enzymes are present in heart, liver and muscles. However, ALT transaminases are a little more specific to the liver, but also to the heart and muscles. Transaminases ASATthey are present in other organs : they are also found in the kidneys, in blood cells, in the pancreas…”, explains Dr Jouaud.
Indications: when should transaminases be measured?
“The dosage of transaminases is most commonly carried out in the face of symptoms such as abdominal pain, vomiting, jaundice… which can be indicators of a liver problem, reports the doctor. This assay is also carried out during a hepatic check, in order to follow the evolution of patients whose liver is diseased.
“We also measure transaminases in other cases: a deterioration of general conditionand unexplained fatigue reporta unexplained loss of appetite or one unexplained weight loss…”, adds Delphine Jouaud. “Some doctors can measure transaminases during a routine check-up, even if this is not an indication recommended by the High Authority for Health”.
Finally, transaminases can be assayed during monitoring of certain treatments particular (antiretroviral drugs, certain oral antifungals, etc.) with the aim of check liver tolerance of the drug.
What is a normal level of transaminases in a blood test?
The level of transaminases varies according to sex, age, body temperature and body mass index (BMI). It should also be known that when carrying out a dosage of transaminases, rates may vary slightly from one medical analysis laboratory to another.
Here are the normal values of each of these enzymes in a blood test:
- For the TOOL : the rate is considered normal if it is between 8 and 35 ;
- For the ASAT : the rate is considered normal if it is between 8 and 30.
To note : “ there is no excessively low threshold for transaminases”, says Dr. Jouaud. “If the rate is less than 8, it should not be taken seriously.”
Why are transaminases elevated? What makes them increase?
There are many possibilities for changes in ALT and AST levels. ” Many diseases or medications influence these levels – mostly liver diseases. But heart disease, muscle disease, obesity… can also lead to an increase in transaminase levels.
A sudden elevation (acute) from ALAT and from ASAT evokes an acute problem :
- Drug-induced hepatitis (for example voluntary or accidental intoxication with a toxic dose of paracetamol – the toxic dose in adults being 10 g, less for people with chronic liver disease);
- Viral hepatitis (A, B, C…);
- A gallstone (presence in the gallbladder of small stony deposits composed of elements of bile) or an inflammation of the bile ducts;
- Major heart failure (significant pulmonary embolism for example);
- Obstruction of hepatic venous flow (Budd-Chiari syndrome);
- Toxins (ingestion of ecstasy, Amanita phalloides mushroom, etc.);
- More rarely, leptospirosis (a disease caused by bacteria present in the urine of animals, mainly rodents)…
To note : you should never hide from the doctor the taking of treatments, toxins or even phytotherapy, because some plants can be poorly assimilated by the liver and present a toxic risk.
A chronic elevation ALT and AST evokes:
- A “fatty liver disease” or NASH (hepatic steatosis which corresponds to an accumulation of fat in the cells of the liver);
- High alcohol consumption (the usually recognized threshold is 50 g/d.);
- Viral hepatitis B or C in its chronic form;
- Obesity with metabolic syndrome;
- anorexia nervosa;
- An endocrine pathology (hypothyroidism, etc.);
- Hemochromatosis;
- Diabetes;
- celiac disease;
- Medicines (vitamin A, statins, fibrates, etc.)
You should know that the level of transaminases of an adult is reached in adolescence and cannot be modified by the menstrual cycle or pregnancy. On the other hand, contraception and menopause appear to increase transaminase levels by regarding 10%.
Elevated transaminases: when to worry?
“A abrupt elevation transaminase level must be a sign to take into account: this is called a acute situation. The diagnosis will then be different from that of a chronic elevation,” explains Dr. Jouaud.When the level of transaminases is doubled (twice the norm) on at least one of the two enzymes, you usually have to worry. On the other hand, if the transaminase level is above the average by only a few points (36.37, 38…), even on the two enzymes, it should not be held once morest or simply monitored”.
High level of transaminases: what to do? Can we lower it?
If your transaminase level is high, consult the prescribing doctor (who prescribed the blood test for you): he direct you to the necessary examination (ultrasound, abdominal scanner, etc.), to a specialist or to a single surveillance if the rate is slightly high. If the rate is very high, he can refer you directly to the emergency room if he deems it necessary.
There is no no specific treatment to lower AST and ALT levels in the blood. “We must treat the cause if it is an illness, or stop the cause of the intoxication (alcohol, medicine, etc.),” says Dr. Jouaud. “Then it’s the body that will take care of lowering the level of transaminases on its own.”
” You must know that liver is an organ that degrades very quickly but which also regenerates very quickly on its own, which explains why the level of transaminases can increase but also drop very quickly,” concludes the expert.
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