Liver function is vital for biotransformation, i.e., transforming substances that enter our body (medicines or toxins) into forms that are not harmful to our systems. For instance, excessive alcohol consumption affects the liver in a way many can't imagine. The liver gets overwhelmed by elevated amounts of toxins, so it can no longer perform its function. These substances can be transformed in the liver into less toxic or water-soluble substances that will be easier to get excreted through the kidneys or pancreas from our body. However, the bio-transformation of alcohol, medicines, and other toxins damages the liver.
During the process, toxic metabolites often produce free radicals (O2, HOO). They are highly reactive and quickly cause peroxidation of lipids, most often lipids of the cell membrane, which causes damage and death of liver cells. Ultimately, high levels of toxicity to the liver will lead to a condition we call liver cirrhosis. At this point, the liver cells are extensively damaged and must replenish themselves. The process of self-repair is only possible when the cause is halted temporarily, if not permanently. A person can stop the use of a certain steroid if it is the one causing liver damage. Alternatively, they can change to a mild steroid that does not affect their liver negatively.
The liver has numerous enzymes it releases into the blood when they damage you, such as AST and ALT. These enzymes reach maximum value in blood when acute liver damage occurs. Blood tests determine or confirm liver damage/illness, i.e., to evaluate the existence and severity of liver cell damage, or cholestasis, when illness attacks pancreas cells.
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AST and ALT are liver enzymes that indicate liver (cells) damage. Their value rises proportionally to liver damage, i.e., the higher the value of these enzymes, the more significant liver damage. They can show different health issues, but their value often indicates intoxication with medicines (such as steroids, some antibiotics, and painkillers) or alcohol.
AST or Aspartate transaminase: Serum glutamic-oxaloacetic transaminase is a liver enzyme that usually tests in blood to determine and follow liver cell damage. AST is present in:
Blood is usually present in low concentrations. When alcohol, steroids, or other substances damage liver cells, AST is released in the blood in a larger volume. To determine liver cell damage, the body generates AST, which we generally test with ALT because ALT is more specific and will be present in blood at an elevated value only when liver cells are present. AST can indicate other illnesses besides liver cell damage. Therefore, sole AST testing for liver cell damage is limited. That means we need to run more tests using different techniques to ascertain the level of damage.
Scientists now know that after intensive workouts, AST values can triple. In this case, you should do a repeat test after the period of rest to determine if they're actual liver damage. With acute liver damage, levels of AST and Alt can increase up to 100 times above the reference value. That is quite dangerous and would damage the liver permanently. Most of the time, the doctor will recommend a complete cessation of steroid or alcohol use. If the levels of AST and Alt keep rising, a liver transplant may be necessary to save your life. That tells you just how vital these chemicals are to the human body.
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The reference value of AST is 8 to 38 U/L.
ALT, serum glutamate pyruvate transaminase (SGPT), or alanine aminotransferase, is an enzyme primarily present in the liver and kidneys but can also be located in the heart and muscles. In blood, it is present in low values. Its value will increase in blood after cell damage. ALT testing is okay to discover and track liver cell damage, and you can test along with AST. The reference value of ALT is 10 to 48 U/L. Regarding the liver, this enzyme can have adverse effects on the organ if its level increases, as we shall discuss below.
The liver has excellent regeneration ability and can function effectively, with only half of the liver tissue healthy. However, liver illnesses often don't express symptoms until too late. It is the main reason most victims are older people with a history of substance use. Mostly, liver damage occurs due to excessive alcohol, steroid, and sometimes cigarette use. Liver damage can be acute or chronic, and when it's sensitive, it usually has limited effect, and the liver will recover quickly with appropriate health treatment. However, the liver can heal itself naturally, even without treatment. You only go to the doctor if all other remedies, such as withdrawal from the substance, fail.
In some cases, blood tests that show elevated AST or ALT will show average values after it repeats, which indicates that blood tests for liver damage are the only indicator of a possible problem and can't be taken into account solely without additional testing. More tests may require additional funding and specialization to ascertain that the tests are accurate. After it has been proven beyond a reasonable doubt, you need to take appropriate action, such as detoxing the liver. In a worst-case scenario, the doctor might recommend an organ transplant, but don't let it get to that point.
Generally, AST and ALT blood tests cannot determine liver damage. The elevated value of AST and ALT will be only a starting point for further testing to confirm possible liver damage and determine appropriate therapy for treating liver damage. Anabolic steroids can cause liver damage inappropriately. In this case, treatment will be necessary to enable liver regeneration.
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