5 Liver Enzymes Levels Charts & Infographics (Normal & High, for Men & Women).
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1. What are liver enzymes?
Liver enzymes (or liver biochemical tests) are a group of blood tests that help assess your liver function.
The most common liver enzymes are alanine transaminase (ALT) and Aspartate transaminase (AST).
The liver enzymes are generally produced by the cells of the liver and the biliary system inside the liver.
The liver enzymes are detectable at small levels in healthy individuals.
In liver diseases such as liver inflammation and liver cirrhosis, the cells release excess amounts of liver enzymes. In addition, the inflamed or injured liver cells release the excess enzymes into the bloodstream.
So, we use these liver enzyme levels to indicate liver diseases.
The table below illustrates the complete list of liver functions. Note that not all liver tests are liver enzymes.
Serum albumin, bilirubin, and prothrombin time are not liver enzymes, but they measure liver functions.
|Liver enzyme tests.||Oher liver tests (not enzymes)|
|1. Alanine aminotransferase (ALT).||1. Billirubin (total & direct).|
|2. Aspartate aminotransferase (AST).||2. Serum albumin.|
|3. Alkaline Phosphatase (ALP).||3. Prothrombin Time (PT).|
|4. Gamma-glutamyl transferase (GGT).|
|5. Lactate dehydrogenase (LDH)|
The four most commonly used liver enzymes include:
- Alanine aminotransferase (ALT, previously called SGPT).
- Aspartate aminotransferase (AST, previously called SGOT).
- Alkaline Phosphatase ( ALP).
- Gamma-glutamyl transferase (GGT).
2. Normal liver enzyme levels chart for women and men.
Normal levels of liver enzymes in adults vary from laboratory to laboratory. Therefore, the best way to check if your liver enzymes are within the normal range is to check your lab reference.
The table below shows the common reference ranges of liver enzymes for both men and women for one hospital (reference).
|Liver enzyme||Normal levels in men (U/L)||Normal Levels in Wormen (U/L)|
IMPORTANT: Check your lab or hospital reference ranges as the normal liver enzyme levels differ from lab to lab.
Any elevation above the normal levels is considered high liver enzymes and should be investigated. But bear in mind that these liver enzymes are not completely specific to the liver.
For example, The Enzyme (AST) is also released from skeletal muscles, the heart, and the brain. Also, The enzyme alkaline phosphatase (ALP) is released from bones (reference).
So, the elevations in these enzymes don’t necessarily mean liver damage or inflammation.
3. Normal liver enzymes levels according to age (in children & adults).
Liver enzyme levels also vary with age. Therefore, children (boys and girls) may have slightly different reference ranges for liver enzymes, especially ALT levels.
The table below is an example of the ALT liver enzyme levels according to age and gender (reference).
|Gender||Age range (years)||ALT levels (U/L)|
|18 or more||<33|
|18 or more.||<45|
4. High liver enzyme levels chart
A. Slightly elevated liver enzymes.
Your doctor should investigate any above-range liver enzyme levels. However. The degree of elevation matters.
Most cases of high liver enzyme levels are only slightly elevated (often ALT and AST levels below 100).
The most common causes of slightly elevated liver enzymes include:
- Fatty liver (nonalcoholic fatty liver diseases).
- Medications such as statins, some antibiotics, and others.
- Some toxins and herbal supplements.
- Alcohol abuse.
- Chronic viral hepatitis (such as chronic hepatitis B and C).
- Hemochromatosis (A common genetic disease affecting mainly people of European descent).
- Liver congestion (as in people with chronic chest or heart diseases).
- Wilson’s diseases (copper overload inside the body, including the liver).
B. Moderately to highly elevated liver enzymes.
Moderate to highly elevated liver enzymes are often referred to as ALT and AST levels five times or more above the upper limit of normal (ULN).
The table below illustrates the possible causes of moderately to highly elevated liver enzymes (reference).
ALT & ASt liver enzymes degree of elevation
|Alcoholic liver disease||2-15 ULN (upper limit of normal)|
|Acute cholangitis or bile duct obstruction||5-10 ULN.|
|Autoimmune hepatitis||2-10 ULN or more.|
|Acute viral hepatitis||5-10 or 20 times ULN.|
|Ischemic or toxic liver injury||Up to 50 times ULN.|
5. Low liver enzyme levels.
The lower reference for liver enzymes varies from hospital to hospital and from lab to lab.
Furthermore, Some labs have no lower reference range (the lower level of liver enzymes is zero).
For example, the famous Labcorp laboratory in the USA has no lower reference range for ALT levels.
Liver enzymes such as ALT, AST, and ALP levels are concerning when higher than the reference range.
During your routine laboratory investigations, you may get anxious about the below-reference range liver enzymes. However, low liver enzyme levels are generally not a cause of concern.
Low liver enzyme levels (ALT and AST) in people with end-stage liver cirrhosis may indicate severe affection of the liver cells (liver cell depletion). However, this does not apply to people with a healthy liver.
Low AST Levels: Should you worry?
What are the causes of elevated bilirubin with normal liver enzymes?