What does your result mean?
This is your AST/ALT (De Ritis) ratio.
If you are:
- In range (about 0.8–1.2): Your AST and ALT are in a typical balance. Maintain liver-friendly habits: limit or avoid alcohol, keep a balanced diet, stay active, and review medications/supplements as advised in your routine care.
- Below range (<0.8): ALT predominance can occur with metabolic fatty liver or viral/inflammatory liver stress. Focus on metabolic health (weight management, regular physical activity, Mediterranean-style eating), limit alcohol, avoid hard workouts for 48–72 hours before repeat testing, and review meds/supplements that can affect liver enzymes.
- Above range (>1.2): AST predominance may reflect alcohol-related liver injury, advanced fibrosis/cirrhosis, or muscle-related enzyme release after strenuous exercise. Avoid alcohol, allow 48–72 hours recovery from intense exercise before retesting, ensure good hydration and nutrition, and review medications (e.g., statins) and supplements if you have muscle symptoms.
Note: Results are guides, not medical advice. Adjust based on your symptoms or conditions (e.g., recent intense exercise, alcohol intake, new medications, abdominal discomfort, dark urine, or jaundice).
How is this calculated?
Evidence baseline:
The De Ritis ratio is AST (U/L) divided by ALT (U/L). Typical interpretation uses broad patterns: ratios near 1 are non-specific; ratios <1 indicate ALT predominance often seen in metabolic or viral liver stress; ratios ≥2 can suggest alcohol-related liver injury. The result is dimensionless.
Sized to you:
The ratio is unitless and not scaled to body size, age, or sex. It is inherently personalized by your measured AST and ALT; context (age, sex, medical history) informs interpretation rather than the math.
Activity adjustment:
Recent vigorous exercise or muscle injury can raise AST more than ALT, pushing the ratio higher. Alcohol intake can also elevate AST relative to ALT. Some drugs and supplements (e.g., statins, acetaminophen, certain antibiotics or botanicals) may shift enzymes.
Environment & day-to-day:
Intercurrent illness, heat stress with heavy exertion, or sample issues (e.g., hemolysis) can alter AST more than ALT. Minor day-to-day biological and lab variability is expected.
Why a range?
Liver enzyme patterns overlap across conditions, and values vary with timing, activity, alcohol, and lab variability. Interpretation bands around the ratio provide a more realistic view than a single cut-off.
Backed by leading scientific literature
Based on established scientific principles.
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