I am worried as my enzymes are now normal, but my ast is always higher than alt. Like 16 and 11. I read many people say that if the numbers are in range it does not mean cirrhosis. I have not had any scans since I originally had elevated enzymes many years ago. Keep keep saying it only matters if you’re out of range on your enzymes but I keep finding this online. The below quote seems to say it even in healthy individuals it means I would possibly have cirrhosis. Has anyone found some thing that definitely says it does not mean anything if your levels are normal?
“The AST:ALT ratio in a healthy individual would be around 1.15. If the ratio is more than 2.0 (up to 6.0), this denotes alcoholic liver disease. And if the ratio is between 1.4 and 2.0, it suggests cirrhosis.
I have not asked yet. I juts recall others posting here about the ration so I looked it up and found that quote online. Had you ever been told the ratio does not matter if the numbers are normal?
Unfortunately a lot of the literature about the De Ritis ratio does not explicitly state that its importance is clinically relevant ONLY within the larger picture of one’s medical history, other test results and blood levels, imaging tests etc. That lack of clarity causes much fear and worry when anxious patients zero in on it. It seems many people recently have been drawn by some posts here and had their fears exacerbated due to a poster who convinced himself he had cirrhosis due to the ratio and spent many weeks arguing about it, inaccurately and selectively citing studies and research articles etc. There are many knowledgeable patients and carers here with firsthand experience and I hope you will find some reassurance in their responses. If you have a risk history it is always a good idea to be vigilant and follow up with additional testing and surveillance, especially if you are also having symptoms, but the De Ritis ratio on its own is absolutely no reason to worry yourself. Take good care ♥️
Ah thank you! I missed this response somehow. So, others in normal range have worried needlessly when the ratio was high as well? and it was all ok in the end for them? Wow so it really is ONLY important if the numbers are out of range HIGH? I once had my ALT low by one and the doc said that no big deal. Normal was 10 mine was 9. Said he sees that often in women and now the range has no bottom at our lab. . Every other time both were in range 11 or higher. . I did read one article saying the ratio can be skewed if the patient has low ALT and then doesn’t hold the same prognostic at all, but that all I could find.
It can be relevant in assessing the cause of liver disease in already-diagnosed patients. It is not used as a screening tool for patients who don’t have any other flags for liver problems among the many other reliable diagnostic tests.
Oh really? So it means nothing if my numbers are normal?
Those are almost my number exactly! My doc said she is not worried and it doesn’t matter as my numbers are normal. Did you have other tests that made you think you had liver disease or just read about the ratio at some point? I found the ratio as my husband has liver disease and I read too much . What made you look into the AST being higher? Also are you female, I read females have a slightly higher ASt often. Is your ast always like 4 higher than ALT. Sorry for all the questions it’s nice, I know though unfortunate, to see someone else with the same numbers as myself. We are told they are fine though. I also have ridges in my nails that go length wise, not width and so does most of my friends LOL I think they’re more common than we think.
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AST/ALT Ratio
Ast:alt ratio
ALT higher then AST
Reversal of ALT & AST RATIO
Ast 61 Alt 41 everything else in perfect range.... 
