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High ALT in blood test

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Ok, so I’m posting prematurely here - I’m waiting on my test results from a blood test to discover whether or not I have diabetes.

However, I had a private blood test a couple of weeks back which identified a really high ALT level which is normally a sign of excessive drinking (unlikely, I drink once a fortnight at the most), lack of excersize or bad diet (also unlikely as I’m at Crossfit 3-4 times a week and I have a qualified nutritionist), or potentially non-alcoholic fatty liver disease (NAFLD) and diabetes.

Was anyone else diagnosed as a result of high ALT? There seems to be a significant number of studies online which draw consistent results between raised ALT and type two diabetes.

The reason I even had blood tests is because I’ve been really struggling for energy in workouts at crossfit. I can’t seem to get anywhere near the same level of fitness I had, my results are spiralling rapidly. I just don’t feel as though I have half as much energy in the tank anymore. It’s really quite odd.

Thanks in advance
 
Welcome to the forum. Diabetes is diagnosed based on blood or urine glucose levels and not from ALT or any other test:

https://www.diabetes.co.uk/Diabetes-diagnosis.html

The ALT liver function test will be elevated if there is some kind of liver disease, including NAFLD. There is some correlation of NAFLD with insulin resistance/type 2 diabetes. Mine was elevated (62 U/L) at the time I was diagnosed with type 2 diabetes. Last tested it was 24 U/L (i.e. normal).

According to a paper titled "The upper limits of normal for serum ALT levels reported by clinical laboratories depend on local reference populations", they proposed that healthy upper range for ALT of 30 U/L for men and 19 U/L for women.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670191/

Just out of curiosity, what do you typically eat in a day?
 
Hi and welcome,

Yes, a high ALT is a marker for a non-alcoholic fatty liver, which in turn is a marker for insulin resistance, which in turn leads to T2 diabetes. However, it is not in itself a marker for diabetes - only the diagnostic blood tests for diabetes will tell you this.

I would lay a bet that your qualified nutritionist is advising an incorrect diet for insulin resistance and diabetes, so details of what you typically eat would help us to help you.
 
Thanks for the reply. I understand that high ALT on its own does not mean I have diabetes, its purely a possible outcome should NAFLD be present. My ALT was 90.4 so it’s pretty high.

My diet consists of the below, it’s pretty consistent over 5 days of the week. Over the weekend it can vary but I try hard not to let it slip far. It also varies depending on training season (bulking/cutting). The foundations are as below...

Breakfast
Porridge / Eggs / Whey Protein / Blueberries / Vitamin D / Omega 3

Lunch
Chicken breast / salad (tomato / peppers / beetroot / mixed leaves) / walnuts / quinoa or brown rice

Dinner
Meat or fish (turkey/beef/salmon) / broccoli / carrots / sweet corn / beans / potato or sweet potato or brown pasta
 

I'm guessing at least 50% of your calories come from carbs.

A reduction in carb intake and an increase in fat intake would likely be beneficial to address your NAFLD (assuming that's what's causing your high ALT). It certainly got mine to normal levels.

I'm assuming you're not overweight. However, there is a thing called TOFI - Thin on the outside, Fat on the Inside. In other words, a person has normal BMI and looks normal weight, but there is excess fat in and around their organs: https://www.sepalika.com/living-well/thin-outside-fat-inside-tofi/

You may also find this ("Nonalcoholic fatty liver disease and low-carbohydrate diets") to be a good read:

https://www.annualreviews.org/doi/f...d=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed&
 
There’s some interesting reading in there, thank you.

It depends on the season (and my training goals) as to how many of my calories come from carbs. Generally this can range from 35-60%. During the summer it would be lower and in the winter it’s higher.

I’m accustomed to changing and tracking calories and macros which I suppose is good news.

Correct, I’m not obese or overweight, although BMI isn’t the best indication of this (but that’s a debate for another day haha!). I may well be TOFI but my body fat will stay between 10-18% depending on whether I’m bulking or cutting.

I’ll give the reduced carbs / increased fat diet a go, I’m curious to see what the difference feels like in terms of energy output.

Thanks
 
Surfingspider said:
I’ll give the reduced carbs / increased fat diet a go, I’m curious to see what the difference feels like in terms of energy output.
Click to expand...

Fat is no more then what you get in a ribeye steak, so it is about stopping avoiding fat, not adding lots more. See the diet doctor website.

It takes a few weeks for our body to get used to a low carb diet, then the energy output etc will be OK. But you must keep the carb level low for your body to make the switch. Also it is likely you will need to increase your salt intake.

fructose is directly converted into fat on your liver, therefore advoid anything that contains it, remember that normal suger is 50% fructose and most sports drinks are high fructose.
 


There are differences in fat - as an example steak is high in saturated fat (considered un-healty) and oily fish / nuts / seeds are unsaturated (considered healthy). I don't avoid fats at present, especially not unsaturated because it's crucial from a dietary perspective whether your carbs are high or low.

The point being that if I'm removing carbs then I will need to add fat to make up the calories, unless I want to lose weight, which I don't because I'm not overweight!

Thanks for the info on fructose, I'll keep that in mind.
 

Yes, as you lower carbs so you must increase fats to replace the lost calories, or you will lose energy, and you will feel hungry.
Fruit is something to avoid, due to the fructose - which is a major contributor to a fatty liver. If you have any low fat products, bin them and replace with the full fat real stuff. Try to avoid cooking or eating anything cooked in most vegetable oils, especially sunflower and corn oils. Olive oil and cold pressed rapeseed oils are fine, although I only use solid fats for cooking (butter, lard, dripping, goose and duck fat).

Let us know how you go on with your blood tests.
 
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