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Liver health

Aspartate Aminotransferase

Also known as: AST test, Serum glutamic-oxaloacetic transaminase (SGOT) test, Aspartate transaminase test

The AST test measures the amount of aspartate aminotransferase (AST) enzyme in your blood. AST is primarily found in the liver, but it’s also in the heart, skeletal muscles, kidneys, and brain. When cells in these organs are damaged, AST leaks into the bloodstream, making it a useful — though non-specific — marker of tissue injury.

While elevated AST levels can signal liver disease, they can also indicate muscle injury or cardiac events. For that reason, AST is typically interpreted alongside alanine aminotransferase (ALT) — a more liver-specific enzyme — to determine whether the source of elevation is hepatic or extrahepatic.

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Key takeaways

  • Sample required: Blood

  • Tests for: Levels of the AST enzyme, a marker of tissue injury, particularly in the liver, heart, and muscles

  • Typical healthy range: 5 to 30 international units per liter (IU/L) for adults (may vary by laboratory)

What can an AST test tell you?

The AST test is commonly used to:

  • Evaluate liver health. Elevated AST levels can indicate hepatitis, alcohol-related liver disease, nonalcoholic fatty liver disease, or cirrhosis.

  • Assess muscle injury or inflammation. High AST may occur in rhabdomyolysis, polymyositis, or after strenuous exercise.

  • Monitor treatment progress. AST trends help evaluate recovery from liver injury or response to medications affecting the liver.

What is being tested?

Aspartate aminotransferase, or AST, is an enzyme that helps metabolize amino acids. It is abundant in the liver’s mitochondria but also found in other tissues. When the cells in these tissues are damaged by inflammation, infection, toxins, or injury, AST enters the bloodstream.

Because AST exists in multiple organs, isolated elevation can come from non-liver sources, such as:

  • Muscle damage (exercise, trauma, myopathy)

  • Heart disease (heart attack, myocarditis)

  • Kidney injury

This is why providers often evaluate AST in the context of ALT, creatine kinase (CK), and cardiac troponin to identify the organ of origin.

Where is the AST test typically included?

The AST test is typically included in the following panels:

  • Liver function test (LFT). Measures liver enzymes, bilirubin, and albumin to assess liver health

  • Comprehensive metabolic panel (CMP). Broader assessment of metabolic health

  • Muscle or cardiac panels. Measure other biomarkers to identify non-liver injury 

Who should get an AST test?

Your provider may recommend an AST test if you have symptoms or risk factors of liver, muscle, or heart conditions, such as:

  • Fatigue or weakness

  • Abdominal pain or swelling

  • Jaundice (yellowing of the skin or eyes)

  • Unexplained muscle pain or tenderness

  • Dark urine or pale stools

  • History of alcohol use, hepatitis, or high cholesterol

It is also recommended for people taking medications that can affect liver function (e.g., statins, acetaminophen, certain antibiotics).

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Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

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What causes changes in AST levels?

Elevated (high) AST levels may be due to acute or chronic liver diseases, alcohol-related liver injury, nonalcoholic fatty liver disease, drug-induced liver injury (from medications or supplements), muscle injury (e.g., trauma, rhabdomyolysis, strenuous exercise), heart attack, or myocarditis (inflammation of the heart muscle).

Decreased (low) AST levels may be caused by a vitamin B6 deficiency or advanced liver failure.

A typical healthy range is 5 to 30 IU/L for adults, though this may vary by laboratory.

Is fasting required for this test?

No. The AST test does not require fasting unless it’s part of a comprehensive metabolic panel.

How long do results take?

Typically 24 to 48 hours, depending on the lab.

Can exercise affect AST?

Yes — vigorous exercise or muscle injury can temporarily raise AST levels.

What if both AST and ALT are elevated?

Combined elevation often points to liver injury. The AST-to-ALT ratio helps distinguish between alcohol-related disease (AST > ALT) and viral or fatty liver disease (ALT > AST).

Does insurance cover the test?

Yes, typically. It’s a routine part of liver and metabolic panels used for screening and diagnostic purposes. Insurance is not required with lab testing through Hims. 

What tests are related to this biomarker?

Alanine aminotransferase (ALT)

Alkaline phosphatase (ALP)

• Gamma-glutamyl transferase (GGT)

Bilirubin

• Comprehensive metabolic panel (CMP)

• Creatine kinase (CK)

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

See all biomarkers

Alanine Transaminase (ALT)

Alanine transaminase (ALT) is an enzyme found in liver cells that helps process amino acids. This enzyme is a key marker that shows if your liver cells are healthy and working normally.

Learn more about Alanine Transaminase (ALT)

Alkaline Phosphatase (ALP)

Alkaline phosphatase (ALP) is an enzyme that reflects bile flow and liver function. A healthy level indicates proper bone metabolism and that your liver and gallbladder are functioning without signs of stress.

Learn more about Alkaline Phosphatase (ALP)

Albumin

Albumin is a protein made by the liver that helps carry hormones, vitamins, and nutrients through the blood. It also helps to keep fluid in your blood vessels.

Learn more about Albumin

Total Bilirubin

Bilirubin is a waste product made when old red blood cells break down. Your liver helps remove bilirubin from your blood, so normal levels usually mean your liver is clearing waste efficiently.

Learn more about Total Bilirubin

Total Protein

Total protein measures the combined levels of albumin and globulin proteins that support fluid balance, hormone and drug transport, and the immune system. Healthy levels mean that your body is currently maintaining a good balance of these important proteins.

Learn more about Total Protein

Globulin

Globulins are a group of proteins in your blood that include antibodies, which help your body fight infection, and other proteins that carry hormones and nutrients. Healthy levels suggest your immune system and liver are working well.

Learn more about Globulin

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Reviewed by Lynn Marie Morski, MD

Published 11/19/2025