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Liver enzymes (ALT/AST) in Lyme Disease

Liver enzymes (ALT/AST), also described as Hepatic involvement, belongs to the functional group of Lyme Disease (Lyme borreliosis, Borrelia burgdorferi infection) markers, but reports against healthy controls point in different directions. Symptom domains tied to this marker in the source include disseminated Lyme subset. The finding is drawn from Lantos et al. 2021; it describes group-level differences, not a threshold that classifies an individual.

↕ InconsistentFunctional

Summary

Direction in Lyme Disease↕ Inconsistent — reported as both higher and lower across studies, with no consistent direction
CategoryFunctional
Also described asHepatic involvement
Compared againstHC (healthy controls)
Associated symptomsDisseminated Lyme subset
Test typeClinical or physiological test
SourceLantos et al. 2021 — doi:10.1016/j.idc.2021.05.001
Condition atlasLyme Disease Biomarker Atlas

Other conditions where ALT is reported

See the cross-condition hub: ALT across conditions.

Trials, interventions and tests

Commercial test availability

Liver Enzymes (ALT/AST) — commercial laboratory test.

Links are for reference only; availability, specimen requirements and coverage vary by location.

Related Functional markers in Lyme Disease

Full list: Lyme Disease Biomarker Atlas.

Frequently asked questions

Is Liver enzymes (ALT/AST) high or low in Lyme Disease?

Mixed. Some studies report higher and others lower Liver enzymes (ALT/AST) in Lyme Disease compared with healthy controls, so no single direction is established. Source: Lantos et al. 2021.

What symptoms is Liver enzymes (ALT/AST) associated with in Lyme Disease?

The cited literature associates this marker with Disseminated Lyme subset. These are population-level associations and do not mean the marker causes the symptoms.

Which test measures Liver enzymes (ALT/AST)?

It is measured as a clinical or physiological test. Commercial laboratories such as Quest Diagnostics, Ulta Lab Tests list an orderable assay.

Is one abnormal Liver enzymes (ALT/AST) result diagnostic of Lyme Disease?

No. No single biomarker is diagnostic of Lyme Disease. Liver enzymes (ALT/AST) findings come from group comparisons, overlap considerably between patients and controls, and vary with study design, timing and comparison group. A result should be interpreted by a clinician alongside symptoms, history and other tests.

Is Liver enzymes (ALT/AST) specific to Lyme Disease?

No. The same marker is also reported in Hepatitis C, NAFLD / MASH (Metabolic-Associated Steatohepatitis) in this atlas, so it reflects shared biology (for example inflammation or vascular stress) rather than a condition-specific signature.

Cite this page

Open Source Medicine Foundation. (2026). Liver enzymes (ALT/AST) in Lyme Disease: direction, evidence and what it means. OSMF Research Tracker. Retrieved October 7, 2026, from https://research.opensourcemed.info/biomarkers/lyme/liver-enzymes-alt-ast.html
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Last reviewed: 2026-06-29 · Page generated from lyme.json · Browse: Lyme Disease atlas · Biomarker Index · All marker pages

Disclaimer: This page is an educational synthesis of published, peer-reviewed research and is not medical advice. Biomarker findings vary across studies with case definitions, comparison groups, timing and assay methods. Direction of change reflects the predominant finding in the cited source and does not establish a diagnostic threshold. Discuss any test result with a qualified clinician.