For years, a number sat on my blood test printout that nobody quite explained. Not dangerously high. Not normal either. Just there, in the “keep an eye on it” territory GPs don’t always flag out loud. I assumed it was one of those readings that doesn’t really mean anything. It turned out to be the tablet I was taking to protect my heart.
This is the story of my ALT, the enzyme that shows liver stress, and NHS blood tests going back to 2012 that eventually spelled it out. December 2023: 69, seventy-three per cent above the top of the range, while I was still on statins. November 2025: 10. Eighty-six per cent down. This December, a GP letter that put it in writing. Optimal.
Here’s what actually happened, and what I still don’t fully understand about it.
The Number Nobody Explained
You’ve had the blood test. You’ve seen the printout land back with a small arrow next to one of the readings, and a GP who moves straight past it because, technically, you’re still inside the guidelines for the thing they’re actually treating. That was me and ALT for over a decade.
ALT is a liver enzyme. When your GP orders liver function tests alongside your regular cholesterol check, this is one of the numbers buried in there. Most of the time nobody mentions it unless it’s badly out of range.
I was on statins from 2016. Cholesterol was the number everyone watched. It made sense at the time. High cholesterol is a recognised risk factor, my GP was following NHS guidance, and I trusted that guidance because it’s what the whole system is built on. I didn’t think to ask what else that tablet might be doing while it did its job on the number we were watching.
What ALT Actually Measures
There’s a genetic study I came across, out of Singapore and Harvard, drawing on UK Biobank data across hundreds of thousands of people. It found something I wish I’d known back in 2012: a specific gene pathway tied to both liver enzymes and LDL cholesterol. Same pathway, not two separate systems sitting next to each other by coincidence.
Which matters, because for eleven years I was on a tablet designed to move one of those numbers, cholesterol, without anyone really watching the other one.
Here’s the plain version of what that other number actually is. ALT is an enzyme your liver leaks out when its cells are under stress. Not failing. Stressed. Think of it a bit like your liver’s own smoke alarm: a low background reading is normal, a rising one means something’s irritating it.
There’s a mechanism here worth sitting with. Pharmacologist David Nutt describes what happens when a liver processes something it wasn’t built to handle as being a bit like running the wrong fuel through a diesel engine. The engine copes for a long time. It wasn’t designed for that fuel, but diesel engines are stubborn, they’ll run on the wrong stuff for years before anything visibly breaks. Every tank does a little quiet damage that adds up in the background. No warning light. Just a slowly rising number on a printout, if anyone’s reading it.
Nobody was reading mine, not with any alarm. My liver kept coping. Coping isn’t the same as fine.
I want to be honest about what I don’t know here. I’m not a hepatologist, and I can’t tell you with certainty the statin alone caused this. What changed in February 2024 wasn’t one thing. I stopped the statin, yes, but I also started 18:6 time-restricted eating and cut ultra-processed food out almost entirely, all in the same period. All three things moved at once.
The Month Everything Moved
December 2023: 69. The reference range tops out around 40. I was 73% above it, and I’d been on the statin the entire time.
March 2024, one month off the statin: 28. A 59% drop in thirty days. My GP opened the file, paused, and asked if I was back on statins. I wasn’t. He scrolled through the rest, cholesterol down, LDL down, HDL up, and said: “This is better than when you were on them. What are you doing?”
It wasn’t a straight line from there, and I’m not going to pretend it was. January 2025: it ticked back up slightly to 29. I don’t fully know why. Could be diet variation that month, could be something I didn’t track closely enough. I’m not going to invent an explanation I don’t have. April 2025: 23, the lowest I’d recorded at that point. November 2025: 10. Eighty-six per cent down from where I started.
Then, this December, a letter. Not a home ketone meter, not my own spreadsheet. A clinical letter from my GP. Optimal. Twenty months medication-free, confirmed in writing.
The Myth I Believed for Over a Decade
Here’s the belief I want to properly take apart, because I held it myself for years: elevated liver enzymes are “just borderline.” Not a big deal, so long as the number sits technically inside a range someone drew on a chart.
My GP told me in December 2023 that everything looked fine and I should stay on my medications. My cholesterol was worse than when I’d started, eleven years earlier. My ALT was at 69. “Fine” meant “controlled by the system I was already on.” It didn’t mean healthy.
I want to be careful here, because this isn’t the same story as fatty liver from diet, which has its own separate causes. What I’m describing looks more like ongoing liver stress that happened to track a medication timeline. There’s a difference, and I don’t want to blur it.
There’s an analogy from cardiologist Joel Kahn that stuck with me. Taking a cholesterol tablet without changing anything else is a bit like turning over a stained settee cushion. The stain is still there. You’ve just hidden it from whoever walks into the room next. My cholesterol number looked managed for eleven years. Whatever was actually driving it up never went anywhere. And the cushion itself might have been leaving its own mark.
What I’d Actually Do Differently
If I were starting from scratch, knowing what the data eventually showed, the one thing I’d have done earlier is ask for the actual number, not the flag. “Borderline” and “abnormal, but expected” sat on my printouts for over a decade. I never once asked my GP to say the figure out loud.
This isn’t a statin story only. If you’re on any long-term medication and there’s an ALT figure buried on a routine printout, it’s worth actually reading, whether you’ve got a diagnosis attached to it or you’re the sort of person who glances at “normal” and turns the page. The guidelines weren’t written to flag this kind of slow, quiet pattern. That’s not anyone hiding anything. Ten-minute appointments don’t leave much room for a number that’s merely drifting.
So here’s what I’d suggest, for what it’s worth. Next routine blood test, if you’re on a long-term medication of any kind, ask specifically for your ALT, not just whether it’s “in range.” Ask them to pull the last few years if your surgery has them on record. Track it across time rather than judging it off one reading; mine went 69, then 28, then ticked up to 29, then down to 23, then 10. A single test would have told a different story depending on which month you caught it.
If you’re on any statin or long-term prescription and something in this resonates, please don’t act on it alone. Speak to your GP first.
What would your own printout show, if you actually asked for the number instead of the flag? I’ll leave that with you.
🎯 Key Takeaways
- ALT is a liver stress marker, not a pass/fail test: A “borderline” reading can sit unexplained for years if nobody asks for the actual number.
- 69 to 10 in under two years: ALT dropped 86% after stopping statins, alongside fasting and cutting UPF.
- It wasn’t one variable: Statin cessation, 18:6 fasting, and non-UPF eating all started in the same period.
- The trend isn’t a straight line: One reading ticked back up before falling again. A single test tells you less than a tracked pattern does.
- A GP letter closed the loop: Twenty months medication-free, confirmed in writing as optimal.
Want to Start Tracking Your Own Numbers?
If this has made you think about what might be sitting quietly on your own printouts, the place I’d start is the same place I did: sorting your eating window and cutting back on ultra-processed food, under your GP’s supervision if you’re on any medication. The 14-Day Rhythm Reset Guide covers exactly that groundwork.
👉 Get the 14-Day Rhythm Reset Guide (free)
💪 Want ongoing support? Join Rhythm Club for £30/month (includes FREE app access, community, and weekly accountability calls)
⚠️ Important: This is educational content based on evidence and personal experience. It is not medical advice. Speak to your GP before making changes to your fasting pattern, diet, or medication.
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