ALT is the more liver-specific of the two. Mildly elevated values usually fall as body composition and the alcohol cap improve. Hard or unfamiliar lifting can raise AST, ALT, and CK for several days, so the draw comes after 72 hours with no hard lifting. Executive Health Edge draws both on the comprehensive metabolic panel at month 0, 6, and 12 and coaches body composition, alcohol, and carbohydrate; any value the lab flags, any persistent elevation, and any supplement or medication question goes to the program physician.
What the numbers are
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes found inside liver cells. When those cells are stressed or damaged, the enzymes leak into the blood. ALT is mostly liver; AST is also found in muscle and heart. Executive Health Edge draws both on the comprehensive metabolic panel at month 0, 6, and 12, alongside glucose, kidney markers, protein, and electrolytes.
Reference ranges vary by lab. Your physician decides what any value means for you.
Why they matter in this demographic
The common finding in a man over 40 who is not ill is a mildly elevated ALT that nobody mentioned at his physical. In this population it most often reflects fat accumulating in the liver, which is driven by the same things that drive visceral fat: surplus calories, alcohol, and refined carbohydrate. It is one of the clearest lab signals that the nutrition side of a man’s life needs a standard, and it usually improves across the program because those inputs are exactly what the program changes.
Why AST is read with creatine kinase
Muscle releases AST when it is damaged, and hard training damages muscle on purpose. Hard or unfamiliar lifting can raise AST, ALT, and CK for several days, for reasons that have nothing to do with the liver. The draw instructions ask for no hard lifting in the 72 hours before the panel, and the program reads AST next to CK to tell the two apart.
What moves them
- Body composition. Visceral fat loss is a major lever on liver fat and on ALT.
- Alcohol. Directly. The weekly cap gets a number and honest reporting.
- Refined carbohydrate and fructose. Surplus becomes liver fat. The carbohydrate range and its timing are the tool, not elimination.
- Training timing before the draw. For AST and ALT both.
- Supplements and medications. Some raise liver enzymes. This is the physician’s lane; tell him everything you take.
What the research says
- Mild elevations usually mean liver fat. In a US national survey, 69% of elevated liver enzymes were not explained by alcohol, hepatitis, or iron overload; they tracked with waist size, triglycerides, and fasting insulin and likely represent fatty liver (Clark et al., American Journal of Gastroenterology, 2003).
- Lifting raises both enzymes for days. One hour of weightlifting raised AST, ALT, and CK in 15 healthy men, and they stayed raised for at least 7 days (Pettersson et al., British Journal of Clinical Pharmacology, 2008).
- Supplements are a growing cause of liver injury. Supplement-related liver injury has risen over three decades and now makes up 20% of drug-induced liver injury cases in a US registry, with anabolic steroids, green tea extract, and ashwagandha among the agents (Halegoua-DeMarzio and Navarro, Liver International, 2025).
What goes to the physician
Any value the lab flags, any elevation that persists after six months of body composition and alcohol work, any supplement or medication question, and anything with symptoms route to the program physician in writing. The coach does not diagnose liver conditions.
This page is coaching information, not medical advice. Questions about medication, hormones, or peptides go to the program physician.