Aspartate-aminotransferase (AST, SGOT)

Other names: AST / SGOT, AST/SGOT, AST (SGOT), ASPARTATE TRANSFERASE

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What is AST?
Aspartate aminotransferase (AST)—formerly known as serum glutamic-oxaloacetic transaminase (SGOT)—is an enzyme involved in amino acid metabolism and energy production within cells. While the liver contains the highest concentrations, AST is also present in skeletal muscle, cardiac muscle, kidneys, brain tissue, and red blood cells.

What does the AST test measure?
A blood AST test measures the amount of this enzyme circulating in the bloodstream. Because AST is normally stored inside cells, only small amounts should be present in blood. When liver or muscle cells are injured, AST is released, leading to elevated levels.

Why this marker matters
AST is widely used to evaluate:

  • Suspected liver inflammation or injury

  • Alcohol-related liver disease

  • Viral hepatitis

  • Non-alcoholic fatty liver disease (NAFLD/NASH)

  • Medication- or toxin-induced liver damage

  • Muscle injury or breakdown (myopathy, rhabdomyolysis)

  • Heart or systemic tissue damage

AST results are rarely interpreted in isolation. Clinicians typically compare AST to alanine aminotransferase (ALT).

  • ALT > AST is more typical of non-alcoholic liver injury.

  • AST > ALT, especially ratios ≥2:1, may suggest alcohol-associated liver disease.

  • High AST with normal ALT may point toward muscle disorders, hemolysis, thyroid disease, or strenuous exercise rather than liver disease.

Symptoms associated with abnormal AST
Depending on the cause, people may experience:

  • Fatigue or weakness

  • Nausea, vomiting, or loss of appetite

  • Right-upper abdominal pain or fullness

  • Jaundice (yellowing of skin or eyes)

  • Dark urine or pale stools

  • Itching or abdominal swelling

  • Muscle soreness, cramps, or injury

When AST may be ordered

  • Routine health checkup (as part of CMP)

  • Monitoring known liver disease

  • Evaluating medication effects on the liver

  • Investigating unexplained symptoms, abnormal imaging, or elevated other liver markers

  • Assessing potential alcohol-related injury

  • After physical trauma, intense exercise, or muscle symptoms

Important testing considerations
AST can temporarily increase due to:

  • Strenuous exercise or heavy weightlifting

  • Recent muscle injury, surgery, or injections

  • Some medications (statins, antibiotics, anticonvulsants)

  • Alcohol use

  • Hemolysis during blood draw

  • Pregnancy

Because AST is found outside the liver, elevated values do not automatically mean liver disease—clinical history, symptoms, medications, and other labs (ALT, ALP, GGT, bilirubin, CK) are essential for interpretation.

What does it mean if your Aspartate-aminotransferase (AST, SGOT) result is too high?

 

What Does a High AST Level Mean?

Aspartate aminotransferase (AST) is an enzyme found in the liver, heart, skeletal muscles, and other tissues. When these cells are injured—most commonly in the liver, but also in muscles or the heart—AST leaks into the bloodstream. A high AST result indicates that some form of tissue damage has occurred, but the test alone cannot identify where the injury is coming from or what caused it.

Common Causes of Elevated AST

Higher AST levels are often associated with:

  • Liver conditions (fatty liver, hepatitis, cirrhosis, alcohol-related liver injury)

  • Heart problems (heart attack or other cardiac injury)

  • Muscle disorders or injury (myopathy, inflammation, rhabdomyolysis)

  • Gallbladder or bile duct disease

  • Medications or supplements that affect the liver

  • Heavy alcohol use or toxin exposure

  • Infections (viral hepatitis, mononucleosis) or iron overload

Other Reasons for High AST

AST may rise for reasons unrelated to serious disease, including:

  • Recent strenuous exercise or intense strength training

  • Minor muscle injury or trauma

  • Use of certain medicines (statins, antibiotics, antifungals)

  • Pregnancy or dehydration

  • Surgery, seizures, burns, or recent medical procedures

How Doctors Interpret AST Results

AST is rarely interpreted on its own. Your clinician will review it together with other blood markers—such as ALT, ALP, GGT, bilirubin, or creatine kinase (CK)—and your medical history:

  • AST much higher than ALT may suggest alcohol-related liver injury

  • ALT higher than AST is more typical of non-alcoholic liver inflammation

  • High AST with normal ALT may point to muscle or heart injury rather than liver disease

What Should You Do If Your AST Is High?

A mildly elevated AST does not always mean a serious problem—temporary increases can occur from exercise, medications, alcohol intake, or normal biological variation. However, if your AST is significantly elevated or remains high over time, your healthcare provider may recommend repeat testing, hepatitis screening, muscle enzyme tests, imaging, or medication review to help determine the cause and guide treatment.

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What does it mean if your Aspartate-aminotransferase (AST, SGOT) result is too low?

A low AST level is generally not considered clinically concerning and usually does not indicate disease. In rare cases, very low AST may reflect vitamin B6 deficiency or kidney disease, since AST activity depends on vitamin B6. Most of the time, low AST is simply a normal finding and does not require further evaluation unless symptoms or other labs suggest otherwise.

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