M LFT

• For magnitude of rise <5X ULN, testing should assess for, among other disorders, hepatitis B and C, alcoholic liver disease, and NAFLD, and for >15X ULN or a massive elevation of ALT > 10,000 IU/L, testing should assess for acetaminophen toxicity and ischemic hepatopathy (shock liver).
• A ratio of AST to ALT exceeding 3:1 further increases the likelihood of alcoholic liver disease. This ratio largely reflects the relatively lower serum activity of ALT compared with AST, driven by the pyridoxine deficiency observed in patients with alcoholic liver disease.^[2]