Calculate your AST to ALT liver enzyme ratio and get instant clinical interpretation. Used by healthcare professionals to differentiate liver conditions.
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This tool is for educational purposes. Always consult a licensed healthcare provider for medical decisions.
An AST/ALT ratio of 2 or greater — especially when both enzymes are elevated — is the De Ritis ratio, classically associated with alcoholic liver disease. It has a high specificity when the ratio exceeds 2:1 and AST is above 50 U/L.
Elevated AST with normal ALT can indicate cardiac muscle damage (myocardial infarction), skeletal muscle injury, hemolysis, or hypothyroidism, since AST is present in heart muscle, skeletal muscle, and red blood cells — not just the liver.
Yes. ALT (alanine aminotransferase) is more liver-specific than AST (aspartate aminotransferase), because ALT is found primarily in the liver while AST is also present in cardiac muscle, skeletal muscle, and kidneys.
Yes. Many medications can cause drug-induced liver injury (DILI), including statins, acetaminophen (especially in overdose), NSAIDs, some antibiotics, and antiepileptic drugs. Always disclose all medications to your doctor when evaluating liver enzymes.
A liver function test panel typically includes AST, ALT, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), bilirubin (total and direct), albumin, and total protein. The AST/ALT ratio is just one component of comprehensive liver assessment.
Mild elevations (1–3× upper normal) are common and often transient. Elevations above 3× upper normal warrant investigation. Levels above 10× normal suggest acute liver injury requiring prompt medical evaluation.