How to Lower AST Levels

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Co-authored by Dan Hickey Medically reviewed by Luba Lee, FNP-BC, MS

Last Updated: December 6, 2024 Fact Checked

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Aspartate aminotransferase (AST) is an enzyme normally found in your liver, heart, pancreas, kidneys, muscles, and red blood cells. Very little AST is normally circulating in your blood (between 0–42 U/L), but levels become elevated when your organs or muscles are damaged from things like liver disease, a heart attack, or car accident, for example. An AST blood test is often done in conjunction with other enzymes tests (such as alanine aminotransferase, or ALT) to determine whether your liver or another organ or tissue has been damaged. It's possible to reduce elevated AST levels from liver damage with lifestyle changes, herbal supplements, and certain medications.

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Part 1

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Lowering AST Levels Naturally

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1. 1
   Limit your alcohol intake. Chronic alcohol use will lead to an increase in AST levels because ethanol is actually toxic to the liver cells and damages them. Occasionally drinking an alcoholic beverage (wine, beer, or cocktails) will not impact AST or other liver enzymes significantly, but moderate long-term usage (more than a couple drinks per day) or binge drinking on the weekends will definitely impact enzyme levels.

   • If you are a moderate-to-heavy or binge drinker and have elevated AST levels in your blood, then cutting back or stopping alcohol consumption will likely lower your enzyme levels. It might take a couple of weeks or longer to see results on a blood test.
   • Mild alcohol consumption (less than one drink daily) has been linked to reduced risk of cardiovascular disease, but any ethanol consumption is at least a little injurious to liver and pancreas cells.
   • AST and ALT are the most useful measures of liver injury, although AST levels are less liver-specific than ALT levels.
2. 2
   Lose weight via a low-calorie diet. There are many reasons to lose weight, such as reduced risk of heart attack and stroke, but slimming down by reducing your daily caloric intake is also linked to lower AST levels. Researchers believe it's a combination of less body mass and fewer refined sugars, saturated fats, and preservatives to process that reduces the liver's workload and allows it to recover, which is eventually reflected in lower AST levels. Low-calorie diets typically consist of eating less saturated fats and refined sugars and switching to lean meats, fish, whole grains, and fresh fruits and veggies.

   • AST and other liver enzyme concentrations constantly decrease in men on low-calorie diets, whereas women on the same diets sometimes show an initial increase in AST levels before seeing a noticeable reduction a few weeks later.
   • For most women, eating less than 2,000 calories each day will lead to some weight loss every week (a pound or so), even if you're only a light exerciser. Most men will lose weight when they regularly consume less than 2,200 calories daily.
   • Losing weight by vigorously exercising and lifting weights has many health benefits, but AST levels may rise due to constant low-level damage to muscles.
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3. 3
   Add some coffee to your diet. Research conducted in 2014 concluded that drinking moderate amounts of regular or decaffeinated coffee on a regular basis may benefit liver health and lower circulating liver enzymes such as AST. This suggests that chemical compounds in coffee other than caffeine seem to help protect or heal liver cells. Scientists aren't certain, but they suspect it's the antioxidants within coffee that are helpful to the liver and other organs.

   • It was the participants who drank three or more cups of coffee daily who had lower liver enzyme levels compared to those who didn't drink any coffee.
   • Previous research has found that moderate coffee consumption may also help lower the risks of diabetes, cardiovascular disease, and liver diseases such as cirrhosis and cancer.
   • If you're hoping to lower AST levels and recover from a liver issue, then decaffeinated coffee is likely the better choice due to the side effects associated with moderate-to-high caffeine consumption (sleep disruption, nervousness, gastrointestinal upset, and others).
4. 4
   Consider taking milk thistle supplements. Milk thistle is an ancient herbal remedy used for numerous ailments including liver, kidney, and gallbladder problems. Several scientific studies conclude that compounds in milk thistle (particularly silymarin) help protect the liver from toxins and stimulate healing by growing new liver cells. Silymarin also has strong antioxidant and anti-inflammatory properties. However, the extent to which silymarin can reduce AST and other liver enzyme levels in the blood is not clear as research is conflicted. Due to its relative lack of side effects, milk thistle is likely worth experimenting with if you're looking for a natural remedy to help treat liver disease, even if it doesn't have a dramatic effect on AST levels.

   • Most milk thistle supplements contain 70-80% silymarin and are available as capsules, extracts, and tinctures at most health food and botanical stores.
   • A typical dosage of milk thistle for someone with liver disease is 200–300 mg, 3 times daily.
   • Liver diseases such as viral hepatitis (A, B, and C), alcoholic cirrhosis, congestion, and toxic hepatic injury are the most common causes of moderate-to-severe elevations of AST in the blood.
5. 5
   Try supplementing with turmeric powder. Turmeric powder is the most clinically tested herb because it's a powerful anti-inflammatory and antioxidant that helps numerous organs in the body heal, including the liver. The most medicinal compound in turmeric is curcumin, which has been shown to reduce high liver enzyme levels (ALT and AST) in both animals and humans. The amounts required to make a significant impact on liver enzymes are about 3,000 mg daily for up to 12 weeks.

   • Turmeric (curcumin) is also linked to reduced risk of cardiovascular disease, Alzheimer's, and numerous cancers.
   • Curry powder, which is widely used in Indian and Asian cuisine, is rich in turmeric/curcumin, which gives curry its rich yellow color.
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Part 2

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Getting Medical Help for Lowering AST Levels

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1. 1
   Consult with your doctor. Most people get AST and ALT blood tests because they have symptoms with their livers. Common symptoms related to liver inflammation/injury/damage/failure include yellowing of the skin and eyes (jaundice), dark-colored urine, upper right abdominal swelling and tenderness, nausea, vomiting, loss of appetite, weakness/fatigue, disorientation or confusion, and sleepiness. Your doctor will take into consideration your liver enzyme levels in addition to your symptoms, a physical exam, positive diagnostic tests (ultrasound, MRI), and possibly a liver biopsy (tissue sample) before arriving at a diagnosis.

   • Acute liver failure from a variety of causes can develop very quickly (within days) in an otherwise healthy person and become life-threatening, so high AST and other enzyme levels should be taken seriously.
   • In addition to the above-mentioned signs and symptoms, a liver panel (looking at all the liver enzymes in the blood) may be ordered routinely for people who are on long-term medication, heavy drinkers or alcoholics, those with previous bouts of hepatitis, diabetics, and those who are obese.
2. 2
   Ask your doctor about stopping certain medications. Virtually all medications have the potential to damage the liver and increase blood liver enzymes (including AST), but it's usually a matter of dosage and how long you've been taking them. Like alcohol, all medications are metabolized (broken down) in the liver, so there is potential to be overworked. Having said that, some drugs (or their breakdown products) are naturally more toxic to the liver than other compounds. For example, statin medications (used to lower blood cholesterol levels) and acetaminophen (Tylenol) negatively impact the liver more than most drugs.

   • If your AST levels are high and you are on statins and/or acetaminophen, talk to your doctor about alternative medication or remedies to deal with high cholesterol and/or chronic pain. At the very least, your dosages should be reduced.
   • When you stop taking drugs that have an especially toxic effect on the liver, your AST levels will naturally reduce over the course of a few weeks or so.
   • Too much iron accumulation in your body (called hemochromatosis) can lead to elevated levels of liver enzymes, too. This may be an issue if you're taking iron supplements or getting iron shots from your doctor to combat iron-deficiency anemia.
   • Acetaminophen in the setting of normal liver function, with normal recommended doses, is not toxic to the liver. Always follow dosage instructions and recommendations from your physician.
3. 3
   Take medications to fight liver disease. As noted above, there are numerous liver diseases (and other conditions) that elevate AST and other enzyme levels in the blood. However, there are a limited number of drugs that can help combat liver diseases such as viral infections (hepatitis A, B and C), cirrhosis (fat accumulation and dysfunction from alcohol abuse), and cancer. Ask your doctor about your treatment options, which may ultimately include a liver replacement if your liver fails completely. Make sure to get an understanding of the expected side effects from taking such powerful drugs.

   • Hepatitis B is typically treated with the drugs lamivudine and adefovir dipivoxil, whereas hepatitis C is treated with a combination of peginterferon and ribavirin.
   • Diuretic drugs are used to treat cirrhosis (to remove edema), as well as laxatives (such as lactulose) to help absorb toxins from the blood and take the workload off the liver.
   • There are a number of chemotherapy medications (oxaliplatin, capecitabine, gemcitabine) used to fight liver cancer, including very targeted therapies such as injecting the drug sorafenib (Nexavar) directly into tumors.
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• Healthcare providers are more prone to having increased AST levels because they are more prone to getting hepatitis B via contact with blood and fluids from an infected person. For this reason, hepatitis B vaccination is recommended.
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• More than 4.5 million Americans suffer from chronic liver diseases or cirrhosis, and it’s suspected that many more Americans are unaware they have any liver problems.
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• AST levels seem to be highest in response to acute liver damage from toxins, alcohol, or drugs.
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