Is an ALT of 218 bad?

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It's not a good result. The normal range of ALT is 7 to 55 U/L for males, and 7 to 45 U/L for females. A high level indicates liver damgae, lead poisoning, exposure to carbon tetrachloride, necrosis, mononucleosis. It could be also due to some medicinal use, including statins, antibiotics, chemotherapy, aspirin, narcotics or barbiturates.