Ratio questioning.

[FThomp]

Hello all. I’ve heard conflicting things on ratios or that they only matter when out of range. My question is if I have an ast of 12 and an alt of 14 could that be an issue? Considering they are both within the reference range of their own groups?

[AyrshireK]

Taken in isolation of all other test the De Ritis ratio means nothing and doctors won't even look at it unless your figures are way in excess of upper limit of normal or you have other symptoms or tests that prove the liver is in trouble. Not only are your numbers completely normal they are the correct way round i.e. AST is lower than your ALT. De Ritis ratio comes into play when AST is so many times higher than ALT.

[Ruggerhead]

ok, I also had a problem with this as i didnt fully understand, so I asked my consultant who is a leading expert on Liver disease etc. She said more or less the same as Ayrshire. That unless they are elevated well above normal it does not matter. AST and ALT levels fall and rise with every thing we do, eat, breath etc they are supposed to, and if you had them checked tmw they may be different. So yours are not only the correct way around they are well below the normal upper cut off, these would seem actually perfect. They are also read with the company they keep, if you want a better snapshot of how well your liver is working for you, look at your other markers, ie protein, GGT, Bilirubin, Alburin etc if these levels are too high or too low they can give you a better idea if your liver is working well. AST is not even 100 percent specific to the liver, ALT is more specific. Best advice from me is at some stage get a fibroscan, reasonably inexpensive, uninvasive way to screen for liver fibrosis.. Hope this puts you more at ease,