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How often should AAT levels in the blood be checked?

It usually is not necessary to have more than one AAT level checked during an Alpha’s lifetime, just as it usually is not necessary to have an Alpha’s phenotype or genotype checked more than once in a lifetime. Having said this, however, there are some exceptions that should be noted. When the initial diagnosis is made, it is reasonable to recheck it, preferably at a reference laboratory with experience in testing for Alpha-1.

Some individuals with unusual phenotypes and evidence of lung disease may have their levels rechecked to evaluate whether their baseline level is low enough to cause concern. It is not recommended that levels be checked following institution of augmentation therapy. It is also important to know that phenotype tests will be inaccurate in individuals receiving augmentation therapy.

How often should AAT levels in the blood be checked?Big Fat Reference Guide

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

Some doctors think they should monitor your alpha-1 antitrypsin (AAT) levels and adjust your dose based on these
levels. We don’t recommend this dosing approach at the present time.

That’s because AAT levels found in your lungs after longterm augmentation therapy tend to be much more stable and consistent than the levels found in your blood. Adjusting your dose based on blood levels may not have the desired effect on your lungs.

The FDA’s recommended doses promote a consistent protective level of AAT within your lungs. They won’t stop the progression of lung disease entirely. But so far, no study has found a dose that can do that. So, we suggest sticking with the FDA-approved dose of 60 mg/kg of body weight once a week.

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