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Alanine

Immunology & Autoimmune

AlaAlanine amino acidL-AlaL-Alanine

Review status

Currently under review

Pending specialist review and validation.

What it shows

Alanine is an amino acid found in your blood, spinal fluid, and urine. Testing can measure how much alanine is present in a specific specimen, and urine results may also be reported relative to creatinine to account for dilution. These measurements help show how your body is using and recycling proteins and energy.

Some laboratories also use the term alanine when they are reporting the activity of alanine aminotransferase, a liver enzyme measured in blood. The specimen type and the unit on your report show which form was measured in your case.

Why it matters

Alanine as an amino acid is part of normal protein and energy metabolism. Measuring it can help evaluate inherited or acquired metabolic conditions, nutritional problems, and the effects of illness or catabolism. It is often ordered with a broader amino acid profile to look for characteristic patterns that guide diagnosis and treatment decisions.

When the test refers to alanine aminotransferase, it helps assess liver cell health. Clinicians may order it if you have risk factors, symptoms, or medications that can affect the liver, or as part of routine panels. Interpreting alanine together with your history, diet, and other labs gives a clearer picture than any single result alone.

Understanding your results

First, check the specimen type and the unit on your report, because interpretation differs for blood, spinal fluid, urine, and for enzyme activity. A result outside the expected interval does not automatically mean disease. Diet, recent illness, vigorous exercise, and medicines can shift results for a short time.

If your alanine amino acid result is unexpected, your clinician may confirm fasting status, repeat the test, or review the full amino acid profile. Persistently unusual results can lead to targeted testing for metabolic conditions or nutrition support. If your result refers to alanine aminotransferase, your clinician will consider other liver tests, imaging when appropriate, a medication and supplement review, and a follow-up plan. Discuss any changes to diet or medicines with your care team before making them.

Reference ranges

62 – 220 umol/g cr
All sexes
0 days – 1 month
0 – 23 U/L
Female
0 days – 1 year
0 – 23 U/L
Male
0 days – 1 year
38 – 78 umol/L
All sexes
0 days – 2 years
5 – 20 umol/L
All sexes
0 days – 150 years
49 – 391 umol/g cr
All sexes
1 month – 6 months
107 – 367 umol/g cr
All sexes
6 months – 1 year
57 – 314 umol/g cr
All sexes
1 year – 2 years
0 – 19 U/L
Female
1 year – 13 years
0 – 19 U/L
Male
1 year – 13 years
80 – 306 umol/g cr
All sexes
2 years – 4 years
39 – 65 umol/L
All sexes
2 years – 6 years
43 – 260 umol/g cr
All sexes
4 years – 7 years
40 – 61 umol/L
All sexes
6 years – 14 years
35 – 159 umol/g cr
All sexes
7 years – 10 years
28 – 146 umol/g cr
All sexes
10 years – 13 years
0 – 17 U/L
Female
13 years – 18 years
0 – 18 U/L
Male
13 years – 18 years
27 – 120 umol/g cr
All sexes
13 years – 150 years
47 – 74 umol/L
All sexes
14 years – 150 years
6 – 45 U/L
Female
18 years – 150 years
6 – 45 U/L
Male
18 years – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Alanine

  • Fasting and diet

    Recent meals, high protein intake, fasting, or ketogenic diets can shift alanine amino acid levels. Follow any fasting instructions and tell your clinician about your usual diet.

  • Specimen type and timing

    Serum or plasma, cerebrospinal fluid, and urine have different expected intervals. First-morning urine can reduce dilution effects, and consistent timing improves comparison.

  • Medications and substances

    Drugs that affect the liver or protein metabolism, such as valproate, isoniazid, statins, or high-dose niacin, and alcohol use can alter results, especially for liver enzyme activity.

  • Exercise and acute illness

    Strenuous activity, fever, and catabolic states temporarily change amino acid handling and liver enzyme release. Testing during recovery may give a clearer baseline.

  • Renal function and hydration

    For urine alanine reported relative to creatinine, kidney function and hydration influence the ratio. Dehydration or impaired filtration can skew results.

  • Specimen handling

    Delayed processing, improper storage, or hemolysis can affect amino acid stability and some enzyme measurements. Proper handling reduces pre-analytic error.

  • Age, growth, and pregnancy

    Expected intervals vary with age, growth stage, and pregnancy. Reference intervals matched to your situation improve interpretation.

2026

References

  1. McGill University Health Centre. (2015, February 04). Alanine (Task CD 693127). Laboratory reference ranges.
  2. McGill University Health Centre. (2015, July 02). Alanine (Task CD 315870). Laboratory reference ranges.
  3. Kwo, P. Y., Cohen, S. M., & Lim, J. K. (2017). ACG clinical guideline: Evaluation of abnormal liver chemistries. The American Journal of Gastroenterology, 112(1), 18–35.
  4. Dietzen, D. J., Rinaldo, P., Whitley, R. J., & Bennett, M. J. (2017). Guidelines and recommendations for laboratory analysis in the diagnosis and management of patients with primary amino acid disorders. Genetics in Medicine, 19(8), 1–15.