High ALT (GPT) liver enzymes: what your blood test means
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 21 October 2026
High ALT or AST (GPT, GOT) on a Spanish blood test: what the liver enzymes show, common causes, when a mild rise is repeated, and warning signs.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Liver enzymes are part of many routine blood tests. In Spain, ALT is often printed as GPT and AST as GOT. A raised value is common and is often mild. This guide explains what the numbers show, the usual causes and what tends to happen next.
- ALT (GPT) and AST (GOT) are enzymes inside liver cells. When cells are irritated, more of them leak into the blood.
- A mild rise is common. Fatty liver, alcohol, some medicines and recent hard exercise are frequent causes.
- A mild rise is usually checked again, with a few extra tests. One result is rarely a diagnosis.
- Yellow skin or eyes, dark urine with pale stools, or confusion need urgent care. In an emergency, call 112.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What the liver tests show
A "liver function test" is really a group of tests. On a Spanish report they may appear under perfil hepático. The main ones are:
| Name in English | Name on a Spanish report | What it mainly shows |
|---|---|---|
| ALT | GPT or ALT | Irritation of liver cells |
| AST | GOT or AST | Liver cells, and also muscle |
| GGT | GGT | Bile ducts; often raised by alcohol and some medicines |
| ALP | Fosfatasa alcalina | Bile ducts, and also bone |
| Bilirubin | Bilirrubina | How well bile is cleared; high levels cause yellow skin |
ALT and AST are called transaminasas in Spanish. Each lab sets its own range, shown next to your result, in U/L.
How high is high?
Doctors often think of the rise compared with the top of the lab range:
- Mild: up to a few times the upper limit. This is by far the most common.
- Marked: many times the upper limit. This needs a prompt check.
The size of the rise does not always match how serious the cause is. Long-term liver disease can show normal or only mildly raised enzymes. That is why your doctor looks at the whole picture.
Common causes of a mild rise
- Fatty liver (MASLD). Linked to weight around the waist, high blood sugar and high blood fats. It is one of the most common causes. Our guide on fatty liver and weight loss explains more.
- Alcohol, even at amounts some people think of as normal.
- Medicines and supplements, including some pain relievers, antibiotics, cholesterol medicines and herbal products.
- Hard exercise in the days before the test. This mainly raises AST, from muscle.
- Viral hepatitis, such as hepatitis B or C. A simple blood test can check for these.
- Coeliac disease and thyroid problems, less often.
- Rarer causes, such as iron overload or autoimmune liver disease.
Have a liver test result you are not sure about?
You can book a video visit to go through the results you already have with a GP licensed in Spain, in English or Spanish.
What usually happens next
If you feel well and the rise is mild, the usual step is to repeat the test. It is often done with a few extra tests to look for a cause. UK guidance from NICE uses a similar approach. Common steps are:
- Review every medicine and supplement you take, including herbal ones.
- Ask honestly about alcohol. Many labs show a rise that falls when people cut down.
- Avoid hard exercise for a few days before the repeat test.
- Check hepatitis B and C, blood sugar, cholesterol and iron levels.
- Arrange a liver scan (ultrasound) if the cause is not clear, or the rise stays.
Do not stop a prescribed medicine on your own because of a liver result. Ask the doctor who prescribed it first.
Warning signs that need urgent care
Go to an emergency department or call 112 if you have:
- Yellow skin or yellow whites of the eyes (jaundice).
- Very dark urine with pale stools.
- Vomiting blood, or black, tarry stools.
- Confusion or great drowsiness.
- Severe pain in the upper right side of the belly, with fever.
- A large paracetamol overdose, even if you feel well. Do not wait for symptoms.
Going through your results by video
Dr. Yelamo is a GP licensed in Spain. He can go through results you already have, by video, for adults. Visits run every day, 07:30–20:30 (Spain time). In the visit he will:
- Read the full report, with units, dates and the lab's range.
- Compare it with past results, including ones from other countries.
- Ask about alcohol, medicines, supplements, exercise and symptoms.
- Explain what the numbers suggest and what is usually checked next.
- Tell you if you need a test, a scan or an exam in person.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
See how the Urgent Care video visit works (15 minutes, €50), or read about fatty liver care.
Frequently asked questions
What is GPT on a Spanish blood test?
GPT is the Spanish name for ALT, a liver enzyme. GOT is AST. Both are called transaminasas. Your lab's range is printed next to the result.
Is a slightly high ALT serious?
Usually not. A mild rise is common and often comes from fatty liver, alcohol, medicines or recent exercise. It is normally repeated, with a few extra tests to find the cause.
Can exercise raise liver enzymes?
Yes. Hard exercise in the days before the test can raise AST, and sometimes ALT, because these enzymes are also found in muscle. Avoid heavy training before a repeat test.
When are high liver enzymes an emergency?
When they come with yellow skin or eyes, dark urine and pale stools, vomiting blood, confusion, or after a paracetamol overdose. Call 112 or go to an emergency department.
Can an online GP go through my liver results?
Yes. Dr. Yelamo can go through results you already have by video, for adults. He explains them and tells you if you need a scan, a test or an exam in person.
Sources
- NHS: Non-alcoholic fatty liver disease (NAFLD)
- NHS: Liver disease
- NHS: Jaundice
- NHS: Hepatitis C
- NICE guideline NG49: Non-alcoholic fatty liver disease, assessment and management
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
