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Liver

AST value and your medication: statins and muscle pain

If you take medication, AST is probably on your report to monitor that medication. AST is an enzyme from your liver and your muscles, which explains why it comes up alongside muscle complaints. On older reports it is called SGOT. A raised value does not mean you should stop your medicine, and that decision is not yours alone in any case. There is something else few people know: as you lose muscle over the years, your baseline drops with it, which makes a normal result less reassuring than it looks.

Doctor's Assessment Included

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Your reference range
u/l
12 53 u/l
Reference ranges by group, in u/l
Male · 1–5 years 24–53 u/l
24 53
Male · 6–12 years 19–42 u/l
19 42
Male · 13–18 years 14–39 u/l
14 39
Male · 19 years and older 14–43 u/l
14 43
Female · 1–5 years 23–49 u/l
23 49
Female · 6–12 years 15–46 u/l
15 46
Female · 13–18 years 12–33 u/l
12 33
Female · 19 years and older 13–38 u/l
13 38
12 53 u/l

Source: NVKC Reference population: Nederlandse huisartsenpopulatie (NUMBER, n=7.574.327)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

AST (Aspartate Aminotransferase): what this test measures

The test measures how much AST is in your blood, in u/l. Does your report say SGOT? That is the same measurement under its old name, which you mostly meet on older forms.

The AST enzyme belongs inside your cells. If it reaches your blood, cells have been damaged somewhere. The word "somewhere" matters here. AST comes not only from your liver, but also from your skeletal muscle, your heart muscle, your kidneys and your red blood cells.

That is exactly why AST is so often mentioned in the same breath as muscle complaints. Do your muscles ache and is your AST raised? Then the enzyme may be coming from those muscles rather than your liver.

To separate the two, your GP looks at the values beside it. ALT is far more concentrated in your liver. If your AST is higher than ALT, that points more towards muscle. Gamma-GT responds to your bile flow, but not to muscle damage. Alkaline phosphatase belongs to that same group. And creatine kinase, shortened to CK, comes almost exclusively from muscle tissue.

Do you have muscle complaints with a raised AST? Then ask your GP to measure CK alongside. That is the test that answers the question. Ask straight away when AST should be checked again.

AST (Aspartate Aminotransferase): why this value matters

If you take medication, AST is mainly a monitoring value. Your GP looks at it to see whether a drug is burdening your liver.

Statins and muscle complaints. Cholesterol-lowering drugs can cause muscle aches. With muscle damage not only CK rises but also AST, because this enzyme sits in muscle tissue. Do you have muscle pain and are both AST and CK raised? Then discuss that combination with your GP. There are different statins and different doses, and there are also other causes of muscle pain later in life.

Important: do not stop your cholesterol-lowering drug yourself. It was prescribed for a reason. Stopping on your own because of a single blood value carries a risk you cannot assess. Call your GP and discuss what you see and what you feel.

Other medicines. Some medicines burden your liver straight away. Certain medicines only do so after weeks, even once a course has finished. Think of painkillers, antibiotics and drugs for epilepsy or fungal infections. Herbal preparations and non-prescription supplements belong here too.

So a raised AST has several different causes. Besides medication, unaccustomed physical exertion, heavy alcohol use and fatty liver disease play a part. Look at the magnitude as well. A mildly raised value fits muscle, alcohol or medication. A markedly raised value, more than ten times the upper limit, almost always indicates acute viral hepatitis. In conditions of the liver, such as hepatitis, ALT also usually sits higher than AST.

And then the age nuance. Part of your AST comes from muscle tissue. If you lose muscle as you get older, your baseline drops with it. A result inside the normal range is then slightly less reassuring than the same number in a thirty-year-old carrying plenty of muscle. More change fits inside it before anything stands out. So look at your own trend across the years.

AST (Aspartate Aminotransferase): how to prepare

  1. No hard training beforehand

    Required

    No heavy training, long endurance sessions or anything that leaves you out of breath in the 48 hours before the draw. Normal walking is fine.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

AST (Aspartate Aminotransferase): when is testing worthwhile?

If you take medicines that can burden your liver, your GP decides when and how often your liver values are checked. Often that happens when starting a drug and periodically thereafter.

There is one preparation point that surprises people: do no unaccustomed physical exertion in the 48 to 72 hours before your blood draw. That does not have to mean a gym. A day of heavy gardening, a house move, a long walk or DIY can already load your muscles enough to lift your AST.

Do you have muscle complaints? Mention it beforehand and ask whether CK can be measured alongside. Without CK the question "is this from my muscles or my liver" stays unanswered, and that is precisely the question you want resolved.

You do not need to fast for AST itself, but if glucose or cholesterol are also on your form, fasting may be needed for those. Check with your GP or the draw point.

Is your result abnormal? Discuss it with your GP before changing anything about your medication. What usually follows first is a repeat with ALT and gamma-GT alongside.

AST (Aspartate Aminotransferase): symptoms of a high or low value

Low Levels

A low AST causes no symptoms and needs no action. There is no illness that begins with an AST that is too low, and there is nothing you should be supplementing or raising.

Still, there is one thing worth understanding later in life. This enzyme comes partly from muscle tissue. As your muscle mass declines over the years, something that happens to almost everyone, your baseline drops with it.

That has a consequence not everyone spots. If your baseline has fallen from 22 to 13 u/l through muscle loss, then a result of 28 is a substantial rise for you, while it sits comfortably within the normal range and is therefore not flagged as abnormal.

So keep your old results. Your own trend across the years says more than whether you are inside the limits.

High Levels

You notice nothing from a raised AST yourself. The symptoms that go with it come from the cause.

With muscular causes: muscle pain, stiffness, weakness or heavy legs. With statin use it is often symmetrical pain in the large muscle groups, such as thighs and shoulders. Loss of strength that makes stairs or rising from a chair harder belongs in this list too, and is a reason to get in touch.

With liver causes: fatigue that rest does not clear, reduced appetite, nausea, a pressing feeling in the upper right of your abdomen. With clear liver problems, yellow eyes or skin, dark urine and pale stools join them. Those are symptoms to discuss with your GP within a week.

One situation is urgent. Do you have severe muscle pain with swollen muscles, and is your urine dark and cola-coloured? Muscle tissue may be breaking down on a large scale and your kidneys are at risk. Call the out-of-hours GP service immediately or go to an emergency department. Do not wait for a blood result in that case.

AST (Aspartate Aminotransferase): what to do about an abnormal value

Male

If Low

Normal AST indicates healthy liver and heart function. Maintain healthy lifestyle habits.

If High

Elevated AST may indicate liver or heart muscle damage. Consider further evaluation including imaging and additional liver tests.

Female

If Low

Normal AST indicates healthy liver and heart function. Maintain healthy lifestyle habits.

If High

Elevated AST may indicate liver or heart muscle damage. Consider further evaluation including imaging and additional liver tests.

AST (Aspartate Aminotransferase): lifestyle and this value

There is more to gain here from good arrangements than from lifestyle rules.

Keep an up-to-date medication overview. Put your supplements, herbal preparations and over-the-counter painkillers on it too. Go through that list once a year with your GP or pharmacist. Many unexplained rises in liver values are sitting on it.

Schedule your blood draw on a quiet day. Not after a day of heavy gardening, DIY or a house move. That is muscle loading too, and 48 to 72 hours of rest beforehand gives a cleaner result.

Report muscle complaints actively. Do not wait until someone asks. Muscle pain with a raised AST is a concrete reason to have CK measured alongside.

Change nothing about your medication yourself. Do not stop, do not halve, do not skip because a number displeases you. Call your GP; there are often alternatives within the same group.

Keep moving. Preserving muscle mass is valuable later in life, and that holds regardless of any number. Build new activity up gradually, and the effect on your result stays limited.

Alcohol counts. Regular drinking raises both your AST and gamma-GT.

AST (Aspartate Aminotransferase): frequently asked questions

Can my statin raise my AST?

It can, through two routes. Statins can mildly burden the liver, and they can cause muscle complaints in which AST rises because this enzyme also sits in muscle tissue. Which of the two applies to you shows in CK and the other liver values. Discuss a raised result with your GP before changing anything.

What does a low AST mean at my age?

Nothing alarming in itself. But your baseline does drop as muscle mass declines, and that happens to almost everyone over the years. As a result, a value inside the normal range can still be a substantial rise relative to your own baseline. Keep your old results and you will see that difference.

Which other medicines raise AST?

Besides cholesterol-lowering drugs, some painkillers, certain antibiotics and drugs for epilepsy or fungal infections can lift your liver values. Herbal preparations and non-prescription supplements belong on the list too. Go through your full list with your GP or pharmacist; that is often where an unexplained rise comes from.

Should I stop my cholesterol-lowering drug if my AST is raised?

No, not on your own initiative. Your medicine was prescribed for a reason, and stopping carries a risk you cannot assess from a single blood value. Call your GP and discuss the result together with your symptoms. There are often alternatives or adjustments within the same group.

I have muscle pain and a raised AST. Is it the statin?

That is a real possibility, but not the only one. Ask your GP to measure CK alongside, because that value comes almost exclusively from muscle tissue and makes the distinction. Symmetrical pain in the thighs or shoulders and difficulty rising or climbing stairs are complaints to report actively.

What does SGOT mean on my report?

SGOT is the old name for exactly the same measurement as AST. You still meet it on older forms and on results from abroad. If you see both SGOT and AST listed, these are not two different tests but one value under two names.

Test Products

This marker is included in the following test panels.

Heart & Metabolism

GLP-1 Extended Panel

The 6-month measurement: everything from the check-in plus insulin, ApoB and your nutrients — especially relevant if you have been eating much less for a while.

Insulin (Fasting) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides
€196,-
Heart & Metabolism

GLP-1 Baseline Panel

Your starting point before the first injection: blood sugar, cholesterol, pancreas, liver, kidneys, thyroid and nutrients in one measurement.

Insulin (Fasting) ALT (Alanine Aminotransferase) TSH (Thyroid Stimulating Hormone) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) Bilirubin (Total) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides Bilirubin (Direct) Bilirubin (Indirect)
€214,-

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Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
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AST (Aspartate Aminotransferase)

€9,-