AST/ALT (De Ritis) Ratio
Advanced wellnessalso de ritis ratio
What it isA simple ratio of AST to ALT that fingerprints the type of liver injury when both enzymes are elevated.
DoesDistinguishes alcoholic liver injury (high ratio) from non-alcoholic fatty liver disease (low ratio) and tracks the progression to fibrosis.
GoodA ratio near 1.0 with both enzymes in the optimal range signals healthy liver biology.
BadA ratio >2 with elevated enzymes strongly suggests alcoholic liver disease; a ratio <1 with elevated enzymes is the fatty liver signature. A rising ratio over time suggests advancing fibrosis.
- Standard
- ~1.0.
- Optimal
- 0.8–1.1 (narrow target)
- Modifiers
- Pattern-based; meaningful only when both enzymes are elevated.
How to optimize
- Lifestyle
- Same as ALT/AST — visceral fat loss, alcohol elimination, resistance training.
- Diet
- Mediterranean pattern; cut sugar, refined carbs, alcohol; intermittent fasting.
- Supplements
- Berberine (500mg 3×/day), N-acetylcysteine (600mg 2×/day), milk thistle silymarin (200mg 3×/day), omega-3 EPA+DHA (2–4g/day).
- Peptides
- GLP-1 agonists.
- Drugs
- GLP-1 agonists, pioglitazone, resmetirom.
Reference ranges are general adult lab norms; optimal ranges are editorial picks from the longevity literature — not medical advice. Always interpret results with your physician.
within Liver & Detox