First some context. The lab ranges are determined by your local lab that samples the community to determine what is "normal". However, where I live in San Antonio the population is disproportionally obese and diabetic, which creates a normal range that does not actually represent what is considered healthy. For most men both AST and ALT should be <30. For most women these values should be less than 20. Assuming no symptoms, the most prudent thing would be to repeat testing and see if is transient or persistent. If repeat testing continues to show elevation, then further testing could be considered. When AST/ALT ratio is >/= 2 that is very consistent with alcohol use regardless of magnitude. i.e., 20/10 vs 400/200. If you drink at all need to take a hard look at that and really be clear with your physician how much you are drinking. Best to be very exacting.