AST/ALT ratio calculator
Work out your AST/ALT ratio — the De Ritis ratio — from two liver enzymes on a standard panel. The pattern between AST and ALT is a clue to what's driving a liver result. It's a plain number (AST ÷ ALT), so units don't matter.
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Educational reference only — not medical advice. The De Ritis ratio is a pattern clue read with the actual AST and ALT, GGT, and your clinical picture — not a diagnosis on its own. Reference ranges vary by lab.
## What the ratio means
| AST/ALT ratio | How it's usually read |
| --- | --- |
| < 1 | Common; with raised enzymes often fatty liver (NAFLD) or viral hepatitis (ALT > AST) |
| ~1–2 | Read with the enzyme levels; can appear as chronic liver disease progresses |
| > 2 | Classically associated with alcohol-related liver disease (especially with high GGT) |
These bands are a **rough orientation, not thresholds** — a ratio only carries meaning next to the actual AST and ALT values. A perfectly healthy person can sit below 1; the ratio earns attention when the enzymes themselves are raised.
## The formula
- **AST/ALT ratio = AST ÷ ALT** (both in U/L). The result is unitless — same number in any unit system.
- Also called the **De Ritis ratio** (De Ritis, 1957). The classic teaching points are a ratio around **1** and around **2**: a low ratio leans toward NAFLD/viral hepatitis, a very high ratio toward alcohol-related liver disease.
## The rest of your liver panel
The ratio is only a pointer — read it with the enzymes it comes from:
- **AST & ALT** — what raised liver enzymes actually mean: [elevated liver enzymes (ALT & AST) explained](/blog/elevated-liver-enzymes-alt-ast-meaning/).
- **ALP** — the other main liver enzyme; see [what your ALP blood test means](/blog/what-your-alp-blood-test-means/).
- **Albumin** — the liver's synthetic marker; see [albumin & the metabolic panel](/blog/albumin-alp-metabolic-panel-explained/).
- On the same metabolic panel? Correct calcium for albumin with the [corrected calcium calculator](/tools/corrected-calcium-calculator/).
## Track your liver markers over time — privately
A single ratio is a snapshot; the value is in the **trend**. [Quanome](/) pulls your labs, Apple Health, and even your DNA into one private timeline on your device — parsed locally, never uploaded — with an AI coach that reads your liver panel over time.
Track your liver markers over time, privately
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