Elevated ALT levels can be a sign of liver damage. Taking steps to lower ALT levels can help the liver recover.

Lifestyle changes, such as a healthful diet and regular exercise, can all help to lower ALT levels.

This article looks at eight ways people can try to reduce their ALT levels. It also discusses the ideal levels and how to measure them.

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A person may be able to lower ALT levels by drinking coffee.

ALT, which stands for alanine aminotransferase, is an enzyme in the liver. Enzymes help the body carry out chemical reactions to function properly.

ALT is essential for filtering toxins from the blood, storing nutrients, and producing bile. Damage or inflammation to the liver causes the liver to release these enzymes into the bloodstream, leading to elevated levels of ALT in the body.

Lowering ALT levels can help the liver carry out its functions. People should treat any causes of elevated ALT, such as liver damage or diabetes, with the help of a medical professional. Natural methods can complement medical treatment to help lower ALT levels.

Natural methods include:

Drinking coffee can help to lower ALT levels. A review from 2017 looks at several studies that show drinking a cup or more of coffee each day reduces ALT levels.

A study from 2015 compared the risk of liver cancer and chronic liver disease between coffee drinkers and non-coffee-drinkers in more than 200,000 people from Hawaii and California.

The study found that people who drank 2–3 cups of coffee each day had a 38% lower risk of liver cancer (hepatocellular carcinoma) and 46% lower risk of death from chronic liver disease, compared to non-coffee-drinkers.

In addition, those who drank 4 or more cups of coffee a day had a 41% lower risk of liver cancer and 71% lower risk of dying from chronic liver disease.

Researchers are unsure whether it is the caffeine in coffee that has liver protecting properties, or if it is due to the antioxidants in coffee. A study from 2014 found that both caffeinated and decaffeinated coffee lowered ALT levels.

Regular exercise may help improve liver health, and research suggests physical activity is an important factor in treating liver disease.

A 2018 article from the Journal of Hepatology recommends a regular exercise program as part of treatment for chronic diseases, such as cirrhosis.

Research has found that weight loss is an important factor in treating fatty liver disease and in preventing fibrosis of the liver. Weight loss improves insulin sensitivity and decreases inflammation. Regular exercise, along with a reduction in calories, may also reduce the risk of liver cancer.

Increasing exercise and decreasing calorie intake through a balanced diet will help people lose weight.

A folate deficiency may increase the risk of damage to the liver and potentially have a link to liver cancer. People may improve their liver health by eating foods high in folate, such as:

Taking supplements of folic acid may also help lower ALT levels. A 2011 study with 455 participants found that increased folic acid supplementation lowered ALT levels, particularly in men and those with elevated ALT levels. Researchers found that a daily dose of 0.8 milligrams (mg) folic acid may help in lowering ALT levels.

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Eating more vegetables may improve the health of the liver.

A small scale study from 2013 looked at the effect of changing lunch to a healthier option had on ALT levels in 10 males.

Compared to their previous lunches, people had 20.3% lower ALT after eating more healthful lunches for 1 month. The nutritional lunches contained:

  • more vegetables
  • less animal protein and more plant based protein
  • foods with lower energy density
  • more fiber
  • increased amounts of potassium, vitamin B6, and folic acid

A 2007 study found a diet lower in carbohydrates decreased ALT levels in adults who were obese and insulin-resistant.

For a healthy liver, the American Liver Foundation recommend eating a balanced diet that involves:

  • avoiding processed foods, especially fried foods and foods high in sugar, fat, and salt
  • avoiding raw or undercooked shellfish
  • increasing dietary fiber by eating whole grains, fruit, and vegetables

Eating organic food, where possible, may also help the liver by reducing the level of toxins entering the body.

A 2018 study found a link between higher levels of both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) and elevated levels of liver enzymes in adults in the United States.

People can reduce high cholesterol levels through regular exercise and a healthful diet that includes:

  • reducing meat and saturated fat
  • avoiding trans fats
  • increasing dietary fiber
  • increasing intake of omega-3 fatty acids

Certain drugs and supplements can cause further damage to the liver.

Acetaminophen can damage the liver if people take too much of it. If it is necessary for people with liver damage to take acetaminophen, they should take no more than 2,000 mg per day. People who regularly drink alcohol should avoid taking acetaminophen, or only have it in very small doses if necessary.

According to the American College of Gastroenterology, some herbal supplements can also increase toxicity in the liver, including:

  • chaparral
  • comfrey tea
  • kava
  • skullcap
  • yohimbe

Excess iron or vitamin A can also be harmful to the liver in high doses. People with high ALT levels should check with their doctor to ensure that any medications, supplements, or herbal remedies are safe to take.

Alcohol can increase damage to the liver, so people with high ALT levels should avoid consuming alcohol to protect the liver from further damage.

People who smoke should stop smoking, and others can try to avoid secondhand smoke to reduce the toxic load on the liver.

People can also take care to avoid high levels of chemical toxins in the air where possible and consider using an air purifier in the home to remove excess toxins.

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A person can speak to their doctor to see if they need to take steps to improve their ALT levels.

People can see their doctor for a liver blood test, which will show levels of ALT in their body. A doctor will take blood from the arm and send the sample off for testing at a laboratory.

According to a 2010 review, normal ALT levels are less than 50 units per liter (U/L).

However, some researchers have recommended lowering the accepted amount for normal. This is because more people are developing obesity and non-alcoholic fatty liver disease, and by reducing the upper threshold for normal ALT levels, doctors may be able to detect potential liver health issues earlier.

Following this recommendation, ideal levels of ALT are:

  • lower than 31 U/L for females
  • less than 40 U/L for males

Very high levels may indicate liver problems, such as hepatitis.

Very low levels of ALT may also pose health risks and increase frailty. One study found that low ALT levels in people with coronary heart disease increased the risk of long term mortality. ALT levels that are 17 U/L may predict an increased risk of frailty and increased mortality.

People can discuss their ALT results with their doctor to find out if their ALT levels are healthful, or whether they need to take steps to alter them.

High levels of the liver enzyme ALT can be a sign of liver damage. People can lower their ALT levels by making lifestyle changes, such as taking regular exercise and changing their diet.

Increasing fiber intake, reducing saturated fats and processed foods, as well as consuming a range of nutrients from fruits and vegetables may all help to lower levels.

People can see their doctor for an ALT test if they notice any symptoms of liver damage to check whether their ALT levels are within the normal range.