Alanine aminotransferase (ALT) is a liver enzyme, and high levels can indicate liver damage. Dietary and lifestyle steps to lower ALT levels may help the liver recover.

This article looks at what ALT levels are, what it means when they are high, and eight natural and lifestyle tips for reducing ALT levels. It also discusses target levels.

While natural methods can complement medical treatment, anyone with high ALT levels will need medical attention.

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ALT, or alanine aminotransferase, is one of several liver enzymes. Enzymes help the body carry out the chemical reactions they need to function properly.

ALT is essential for:

  • filtering toxins from the blood
  • storing nutrients
  • producing bile

When liver cells become damaged, unusual levels of ALT can enter the bloodstream. For this reason, if a blood test shows high ALT levels, a doctor will likely investigate if there is liver damage.

In the past, doctors referred to ALT as SGPT, or serum glutamic-pyruvic transaminase, and the test to assess levels was an SGPT test. Now, they talk about ALT tests.

Damage or inflammation to the liver causes the liver to release ALT enzymes into the bloodstream. This can lead to high ALT results in a blood test.

The main causes of high ALT levels include:

  • non-alcoholic fatty liver disease (NAFLD)
  • hepatitis
  • non-alcoholic steatohepatitis (NASH)
  • medication or supplement use
  • celiac disease
  • Wilson’s disease
  • various genetic factors

An ALT blood test can show whether ALT levels are within the acceptable range or are too high. In some cases, they may indicate liver damage before a person has symptoms.

Some natural remedies can help boost liver health, which may be reflected in lower ALT levels. However, anyone with liver damage or significantly high levels will need medical attention to prevent complications and long-term problems.

Drinking coffee may help lower ALT levels. A 2021 review found evidence of a link between drinking coffee and lower ALT levels, although more studies are needed to explain this link.

Regular exercise may help improve liver health, and research suggests physical activity may help manage liver disease.

One article recommends a regular exercise program as part of treatment for chronic diseases, such as cirrhosis.

People with obesity are more likely to have NAFLD and NASH. Some statistics suggest that around 50% of people with obesity have both high ALT levels and NAFLD.

In one study, 140 people with obesity and NAFLD joined either an intensive weight-loss program or a control group to see how weight loss would affect liver function. ALT levels improved significantly in 66.7% of those on the weight loss program, compared with 18.2% in the control group.

People with low levels of folate may have a higher risk of NAFLD.

In a 2023 study, 66 people with NAFLD took either 1 milligram (mg) per day of folic acid or a placebo for 8 weeks. Those who took folic acid experienced a drop in ALT levels compared with those who took the placebo. The findings suggest that taking folic acid supplementations may help lower ALT levels in people with NAFLD

Foods that are high in folate include:

One small, older study from 2013 looked at how switching lunch options for 1 month affected ALT levels in 10 males.

Compared with previous measures, participants had 20.3% lower ALT after switching to lunch options that contained:

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

For a healthy liver, the American Liver Foundation recommends 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 total cholesterol levels and high blood levels of liver enzymes — such as ALT — in adults in the United States.

Tips to help reduce high cholesterol levels include:

  • exercising regularly
  • reducing meat intake
  • avoiding unhealthy fats
  • increasing dietary fiber
  • increasing intake of omega-3 fatty acids

The use or overuse of certain drugs and supplements can damage the liver.

The authors of a 2016 study noted that 20% of liver poisoning in the United States stemmed from the use of herbal and dietary supplements and particularly:

  • anabolic steroids
  • green tea extract
  • multi-ingredient supplements

Many prescription and over-the-counter medications can also lead to liver damage.

Always:

  • check first with a doctor before taking any new drug or supplement
  • ensure the doctor knows about any drugs already in use
  • let the doctor know if you experience adverse effects from a drug
  • follow the instructions for using any type of medication or supplement

Some lifestyle habits that can help prevent liver damage include:

  • avoiding or limiting alcohol intake
  • quitting smoking, if relevant
  • avoiding exposure to second-hand smoke
  • avoiding exposure to chemical toxins, where possible

A blood test can show if a person has high ALT levels. A doctor will take blood from the arm and send the sample off for testing at a laboratory.

A typical range for ALT levels in the bloodstream is 7–56 units per liter.

However, this can vary depending on:

  • the laboratory
  • the time of day, as levels tend to be lower at 4.00 in the morning and higher at 4.00 in the afternoon
  • sex, as males tend to have higher levels than females, possibly due to hormonal factors
  • recent extreme physical exertion, which can raise levels

A doctor will look at the results together with the results of other tests. Having done this, they can explain if a person’s ALT levels are appropriate or if they need to take steps to address them.

Here are some questions people often ask about ALT levels.

Is 70 a high ALT level?

A typical ALT level is 7–56 units per liter of blood, but various factors can affect this. A doctor can advise an individual on what their ALT levels mean.

What should I do if my ALT is high?

High ALT levels can be a sign of liver disease. A doctor may recommend further tests, lifestyle changes, or a treatment plan to address underlying issues.

How can I lower my ALT naturally?

Lowering ALT levels will depend on what is causing the elevation. In some instances, a person may lower ALT levels naturally by managing their weight, increasing their activity levels, and making diet changes.

However, when high ALT levels result from more serious underlying conditions, medical treatment may be necessary to reduce levels.

Can ALT levels return to normal?

With proper treatment and lifestyle modifications, elevated ALT levels can return to a normal baseline.

High levels of the liver enzyme ALT can be a sign of liver damage. Some natural remedies — such as weight management, dietary choices, and avoiding exposure to toxins — can help boost liver health and prevent high ALT levels and liver disease.

ALT levels typically fall between 7 and 56 units per liter of blood, but a doctor must interpret the results, as various factors can affect the levels.

The doctor may need to carry out further tests before recommending a treatment plan.