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Can my antitrypsin levels change?

Your antitrypsin levels will fluctuate a bit naturally, but do not drop with age or illness. Your levels will actually increase in times of stress or illness.

Alpha1-antitrypsin is an acute phase protein. This means that in times of stress, such as infections, other acute diseases, or after surgery, alpha1-antitrypsin levels in the blood increase. Oral contraceptive therapy also increases alpha1-antitrypsin levels in the blood. While this issue should be kept in mind, it is important to point out that individuals with severe Alpha-1 have only a minimal acute phase response of their alpha1-antitrypsin, and they never have normal alpha1-antitrypsin concentrations in the blood. Thus, the diagnosis of severe Alpha-1 is never masked by an acute phase response.

Understanding Test ResultsAlpha1 Centre

AAT can show a marked increase (up to four-fold) in a wide range of inflammatory conditions, cancer, and liver disease. Pregnancy and estrogen therapy also produce modest increases.

Genetic FactsAlpha-1 Canada

AAT is one of a group of proteins, made mostly in the liver, that is called “acute phase reactants.” This means that this group of proteins can be rapidly manufactured and released into the blood during times of stress. This stress can be an infection, an inflammatory process, surgery, or one of a host of other stresses including severe emotional stress. In individuals with normal AAT, the AAT level can more than double during a time of stress. Even individuals with severe Alpha-1 (PI*ZZ) can raise their AAT levels above baseline by 10 to 20 mg/dl (2-3 mmol). Individuals with heterozygote phenotypes (carriers) can often raise their AAT levels into the normal range during times of physical stress. Of note, individuals with a Null phenotype cannot make any AAT even under times of stress.

Big Fat Reference Guide – AlphaNet

Each person needs to be tested for Alpha-1 only once, as their genes will never change, and their AAT level will continuously change within the range for their genotype. People who test their AAT level more than once rarely get the same level result twice; but do not let this be a cause for worry, as AAT levels will never fall below the lower limit for your genotype, they don’t drop as you age, and they are not a marker for disease progression. In fact, the 2016 Alpha-1 Clinical Practice Guidelines recommend that AAT level should be tested once and not repeated. Alphas and carriers may share the guidelines with their doctors to avoid unnecessary testing, cost and worry.

What does my AAT level mean?Alpha-1 Registry, Winter 2018