De Ritis Ratio (AST/ALT)
The De Ritis ratio divides AST by ALT and helps clarify the cause of elevated liver enzymes. Ratios above 2 suggest alcoholic liver disease, while ratios below 1 are more typical of viral hepatitis or nonalcoholic fatty liver disease. Very high ratios can also accompany cirrhosis, ischemic hepatitis, and muscle injury since AST is also found in muscle.
Optimal range: who says what
Institutions, researchers and practitioners draw the line in different places. Each position is listed with who holds it and, where a document states it, a link. How we verify ranges.
- Institution or study0.8-1.2 with both enzymes normalThe ratio only carries meaning when an enzyme is elevatedAST-dominant patterns above 2 suggest alcohol-related injury
- Lab reference interval0.8-1.0 normalWhat a lab report flags against. A lab interval is not an optimal target.
3 providers include this
Liver Function
Why De Ritis Ratio (AST/ALT) matters
Compares two liver enzymes to distinguish between liver disease types. Ratio above 2 often suggests alcoholic liver disease; below 1 suggests viral hepatitis. Helps guide diagnosis and treatment decisions.
Which Providers Test De Ritis Ratio (AST/ALT)?
Empirical Health is both the cheapest ($190/year) and the most comprehensive (100+ biomarkers) panel that includes De Ritis Ratio (AST/ALT).
3 panels that include it, cheapest first
| Provider | Annual Cost | Total Biomarkers | $/Biomarker |
|---|---|---|---|
| $190 | 100+ | $1.90 | |
 Superpower | $349 | 100+ | $3.49 |
| $349 | 75+ | $4.65 |
$/Biomarker is annual cost divided by the panel's advertised biomarker count, not the price of this one test. We track 23 blood test providers (32 plans); 21 of those plans are itemized marker by marker. Compare all of them.
18 itemized panels do not include De Ritis Ratio (AST/ALT)
WHOOP Advanced Labs · Labcorp OnDemand · Life Extension Elite · Everlywell · Mito Health · InsideTracker · Function Health · Marek Health Base · Marek Health Comprehensive · Marek Health Complete · Marek Health Executive · Blueprint · Oura Health Panels · SiPhox Health · Healthspan · Vitality Blueprint Standard · Vitality Blueprint Elite · Ultrahuman Blood Vision Annual
11 providers not itemized in our matrix
We have not itemized these marker by marker (some sell tests one at a time), so this page cannot say whether they offer De Ritis Ratio (AST/ALT). Check with them directly.
Life Extension Standard · Quest Health · Ultrahuman Blood Vision · Lifeforce · Hundred Health · Personalabs · Walk-In Lab · HealthLabs · WHOOP Specialized Panels · Marek Health Essential · Vitality Blueprint Upload
Frequently Asked Questions
What is the optimal range for De Ritis Ratio (AST/ALT)?
Published position: 0.8-1.2 with both enzymes normal (The ratio only carries meaning when an enzyme is elevated). Lab reference interval: 0.8-1.0 normal. That is what a lab report flags against, not an optimal target.
Which blood test providers include De Ritis Ratio (AST/ALT)?
3 of the 21 blood testing panels we itemize marker by marker include De Ritis Ratio (AST/ALT) in their panels. This biomarker has limited availability.
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Medical Disclaimer
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
Last reviewed Sep 3, 2026 · First published Nov 30, 2025