TGO and TGP: what they are, what they are for and normal values

Thus, when there is an increase in the levels of TGO alone, it is common for it to be related to another situation that is not related to the liver, because in the case of liver lesions, the lesion must be more extensive so that the liver cells break down and lead to the release of TGO into the blood.

On the other hand, TGP, known as pyruvic transaminase or "Image" (alanine aminotransferase), is produced exclusively in the liver and, therefore, when there is any change in this organ, an increase is observed. in the amount circulating in the blood. Learn more about TGP.

What they are for

The TGO and TGP exam is indicated to evaluate the functioning of the liver and/or to investigate the presence of any changes in this organ when there are symptoms such as abdominal pain or swelling, yellow skin and/or eyes, nausea, vomiting, excessive tiredness, general malaise, fever, loss of appetite, weight loss for no apparent reason, itching, pale stools or dark urine, for example. See other symptoms of liver disease.

In addition, the TGO and TGP exam can also be indicated by the doctor in cases of other diseases that can impair blood flow to the liver and interfere with its function, such as a heart attack or muscle injuries, for example.

Normal values

TGO and TGP values may vary according to the laboratory, however, in general, the values considered normal in the blood are:

TGO: between 5 and 40 U/L;
TGP: between 7 and 56 U/L.

Although TGO and TGP are considered liver markers, these enzymes can also be produced by other organs, especially the heart in the case of TGO. Therefore, it is important that the examination evaluation is carried out by the doctor who requested the examination, so that it is possible to verify if there was an alteration and, if so, to establish the cause.

What can TGO and TGP be changed

Changes in TGO and TGP levels are usually indicative of liver damage, which can happen due to hepatitis, cirrhosis or the presence of fat in the liver, and these possibilities are considered when much higher values of TGO and TGP.

On the other hand, when only the TGO is altered, for example, it is possible that it is a change in the heart, since the TGO is also a cardiac marker. Thus, in this situation, the doctor may recommend performing tests that assess heart he alth, such as troponin, myoglobin and creatine phosphokinase (CK) levels. Learn more about TGO.

In general, changes in TGO and TGP levels can be related to the following situations:

Fulminant hepatitis;
Alcoholic hepatitis;
Acute or chronic viral hepatitis;
Ischemic hepatitis;
Cirrhosis due to excessive consumption of alcoholic beverages;
Abusive use of illicit drugs;
Liver fat;
Presence of liver abscess;
Liver tumor;
Budd-Chiari Syndrome;
Hemochromatosis;
Alpha-1-antitrypsin deficiency;
Wilson's Disease;
Celiac disease;
Acute pancreatitis;
Biliary tract obstruction;
Infarction;
Heart failure;
Cardiac ischemia;
Muscle injury;
Use of medication for a long period and/or without medical advice.

In addition to evaluating the levels of TGO and TGP, to confirm the liver damage and its extent, the doctor applies the Ritis ratio, which is the ratio between the levels of TGO and TGP and that when greater than 1 is indicative of more severe lesions, and treatment should be started as soon as possible to prevent disease progression.

Drugs that alter TGO and TGP

Some medications can alter the levels of TGO and TGP in the blood, by causing inflammation or swelling in the liver, altering its functioning, the main ones being:

Analgesics, such as paracetamol;
Anti-inflammatories, such as nimesulide or acetylsalicylic acid;
Anabolics;
A contraceptive oral;
Antibiotics, such as erythromycin, ciprofloxacin, sulfamethoxazole + trimethoprim, amoxicillin + clavulanate, or isoniazid;
Antiarrhythmics, such as amiodarone;
Medicines for high cholesterol, such as statins;
Antiepileptics, such as valproic acid or phenytoin;
Antifungals, such as ketoconazole or terbinafine;
Chemotherapeutics, such as methotrexate, asparaginase, imatinib, or pazopanib;
Medicinal plants, such as comfrey, cascara sagrada, or Kava kava.

These drugs can interfere with the results of the TGO and TGP test because most drugs, supplements or medicinal plants are metabolized by the liver to be eliminated by the body and, when taken for a long time or in amounts greater than those recommended by the doctor, can promote liver inflammation and, in some cases, lead to the emergence of drug hepatitis, resulting in an increase in the concentration of these enzymes in the blood.

Furthermore, some drugs, such as paracetamol, even at normal doses, can cause drug-induced hepatitis and alter the TGO and TGP tests. Understand better what drug hepatitis is and how to treat it.