Barbell Medicine Podcast Episode #389: Your Liver Enzymes Are Elevated — But It Might Not Be Your Liver
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Mar 9, 2026 
Dr. Austin Baraki, physician and clinical expert on lab interpretation, explains why elevated liver-associated enzymes often come from muscle. Short cases and clear rules unpack ALT/AST, GGT, timing of changes, and how pre-test exercise triggers false alarms. Practical advice on what labs to add and what to tell your clinician is presented in punchy, actionable segments.
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ALT and AST Come From Muscle Too
- ALT and AST are liver-associated enzymes not exclusive to the liver.
- Austin Baraki explains they are present in skeletal muscle and leak into blood after muscle microtrauma from resistance training.
Resistance Training Predictably Raises Liver Tests
- Resistance training reliably raises AST and often ALT with eccentric loading causing microtrauma and enzyme leakage.
- A study showed 100% of men lifting 1 hour at 70% 1RM had AST/ALT bumps, larger in untrained individuals.
Timing Matters For Postworkout Enzyme Peaks
- Exercise-induced AST/ALT peaks slowly and normalize over days to weeks, not instantly.
- AST/ALT can rise up to 48–120+ hours and may take 10–12 days to return to baseline after hard workouts.