Can Fatty Liver Cause Elevated ALT Levels?

Fatty liver disease is one of the common causes of elevated alanine aminotransferase (ALT), also known as SGPT. In most cases, the increase ranges between 1 to 5 times the normal level, with 2 to 3 times being the most common. Mild or simple fatty liver usually does not lead to elevated ALT levels and often presents without noticeable symptoms. It is typically discovered during routine health checkups when a liver ultrasound reveals an enlarged liver or signs of fatty infiltration.

However, in moderate to severe cases, fatty liver may progress to non-alcoholic steatohepatitis (NASH) or liver fibrosis. At this stage, ALT levels rise significantly, and patients may also experience elevated AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase), blood sugar, and lipid levels. Common symptoms include fatigue, abdominal bloating, and discomfort or pain in the upper right quadrant of the abdomen.

The treatment of fatty liver involves a comprehensive and long-term approach. For alcoholic fatty liver disease, complete abstinence from alcohol is essential. For non-alcoholic fatty liver disease (NAFLD), lifestyle modifications are the cornerstone of management. This includes adopting a balanced diet, quitting smoking and alcohol, engaging in regular physical activity, and managing body weight and waist circumference. A weight loss of 7% to 10% can significantly reduce ALT levels and improve liver health.

Currently, there are no FDA-approved specific medications for fatty liver. However, certain supplements such as silymarin (milk thistle extract), reduced glutathione, and bicyclol may help reduce liver inflammation and lower ALT levels. These should be used under medical supervision as part of an overall treatment plan.