Why do we have high transaminases?

As part of regular blood tests, diagnostic tests are performed to assess the function of the largest organ, and one of the most important in the body, the liver. Transaminases are a family of liver enzymes, acting on intracellular metabolism, responsible for regulating and mediate the catalysis of a series of typically hepatic reactions, some of which are also carried out in other tissues in different areas of the body. Among the other organs of the body where the intracellular activity of transaminases is expressed are the heart, kidneys and muscles.

Types of transaminases

The number given by the transaminase value in the blood count reflects the state of health of the liver and the suitability of their duties. In blood tests, these values ​​provided by the transaminase test are usually reflected under the acronyms:

  • The ALT (alanine aminotrase), equivalent to TGP, GPT or SGPT (glutamate-pyruvate transferase)
  • The AST (aspartate aminotransferase), or by its alternative acronyms TGO, GOT or SGOT (glutamate-oxalate transferase)

Its alteration, by the elevation above the values ​​considered as standards normal tests, indicates that there is deviations in liver function on which to act. Of these two enzymes, elevated alanine aminotransferase (ALT) is the most effective indicator of potential liver problems.

Normal values ​​and altered values

Transaminases are considered in normal concentration if their value in the serum test oscillates in slightly different values ​​between men and women, and enter the calibrated value for ALT and AST, as follows:

  • For ALT, normal values ​​are between 10 and 40 IU / ml (IU = International Units) in men and between 7-35 IU / ml in women. Values ​​above this range are considered altered and are indicative of an inflammatory process or of toxicity in the liver with apoptotic destruction of hepatocytes (liver cells).
  • For AST, values ​​in the normal range are between 8 and 40 IU / ml, in men, and between 6 and 34 IU / ml for women.

By way of example, the alteration of transaminase levels in the blood product of hepatitis A or a dengue process, can rise above levels that throw serum values ​​greater than 3000 IU / ml, indicating the inflammatory process and cell apoptosis (cell death) that develops as a consequence of attack of both viruses on hepatocytes (liver cells).

Elevated transaminase levels in the blood

  1. The increase in serum transaminase levels does not in itself constitute a diagnostic element of liver disease, since the transitory action of a temporary treatment with certain drugs, or the transitory effect of a circumstantial toxic to which we have been exposed, for example, can also temporarily raise blood transaminase levels.
  2. Therefore, it is convenient repeat the analysis as a serial test with a few days of distance from each other, in addition to complementing said test with analysis of levels of bilirubin, albumin, and of the enzymes alkaline phosphatase and gamma-glutamyl transferase.
  3. Apart from the above conditioning factors, there may also be certain elements of the diet, as well as the consumption of alcohol, drugs and a stressful lifestyle, that can influence the moderate to significant elevation of serum transaminase values.

Diseases that raise the level of blood transaminases

By action of pathogens

  • Viral hepatitis A and E (from contact or ingestion of contaminated food)
  • Hepatitis B, C and D (from the exchange of blood or infected bodily secretions)
  • Epstein-Barr mononucleosis
  • Cytomegalovirus
  • Salmonellosis
  • Parvovirus
  • Toxoplasmosis
  • Herpes
  • Adenovirus
  • Varicella zoster

By the action of chemical agents

  • Cytotoxic hepatitis (from ingestion or exposure to chemicals harmful to hepatocytes)
  • Medicated hepatitis (it is a particular type of cytotoxic hepatitis), particularly common because it is associated with the effect of some anti-inflammatories, antibiotics and antineoplastic drugs
  • Drug addiction (can be considered a particular form of cytotoxic hepatitis)
  • Alcoholism (may be considered a special form of cytotoxic hepatitis)

Characteristic hepatobiliary diseases

  • Cholestasis
  • Neonatal intrahepatic cholestasis
  • Biliary atresia
  • Alagille syndrome
  • Common bile duct cyst

Diseases of different organic origins

  • Autoimmune hepatitis
  • Systemic thyroid disease (both hypo and hyperthyroidism, and Hashimoto’s thyroiditis)
  • Ischemic hepatitis
  • Fatty liver (hepatic steatosis)
  • Cirrhosis
  • Cystic fibrosis of the pancreas
  • Gallstones (gallstones)
  • Hemolytic anemia
  • Hemochromatosis (excessive accumulation of iron)
  • Collagenosis
  • Macrotransaminasemia
  • Α1 antitrypsin deficiency (A1AT)
  • Wilson’s disease
  • Budd-Chiari syndrome
  • Gaucher disease
  • Nieman-Pick disease
  • Neoplasms (tumor growths such as hepatoblastoma and neuroblastoma)
  • Metabolic pathologies (porphyria, galactosemia, glycogenosis, etc.)
  • Myocardial infarction
  • Myopathies
  • Muscle injuries
  • Kidney injuries
  • Celiac Disease
  • Obstetric trauma during childbirth
  • Chromosomopathies (phenotypically expressed chromosomal abnormalities)
  • Intolerance to milk proteins (particularly cow)
  • Parenteral nutrition for prolonged periods

Recommendations to reduce blood transaminase levels

Are all those healthy lifestyle actions that help lighten the purifying function of the liver, avoiding congestion and inflammation, with the consequent risk of cell death and elevation of transaminases:

  1. Moderation in the consumption of alcoholic beverages
  2. Moderate smoking
  3. Perform physical activity, at least moderate
  4. Avoid obesity
  5. Drink at least 2 liters of water a day (contributes to the hydration and purifying action of the liver)
  6. Avoid processed foods
  7. Avoid excessive fat consumption
  8. Moderate the consumption of salt and sugars
  9. Increase your intake of fruits and vegetables, particularly raw
  10. Cook preferably steamed, boiled or grilled
  11. Avoid fried foods
  12. Consume beneficial infusions for liver purification (boldo, milk thistle)

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