What can increase ALT?

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ALT is a liver-specific enzyme found mainly in hepatocytes, and it leaks into the bloodstream when those cells are damaged. Because of this, ALT rises most prominently in hepatocellular injury or disease—conditions that directly injure liver cells, such as viral hepatitis, drug-induced liver injury, alcoholic hepatitis, or ischemic hepatitis. The other options don’t directly damage hepatocytes in a way that markedly elevates ALT: dehydration can cause mild, nonspecific changes, hypothyroidism may cause only subtle or incidental increases, and pancreatitis involves the pancreas rather than the liver, so it doesn’t characteristically raise ALT. In short, ALT elevation points to hepatocellular pathology because of its liver-specific location and release pattern.