Do you need to fast to test for transaminases? If you are testing for transaminases alone, you can skip the fasting. Aminotransferases include alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which are found mainly in hepatocytes, and AST, which is found in tissues other than hepatocytes, such as cardiac muscle, skeletal muscle, kidneys, brain, and red blood cells. Elevated aminotransferase suggests that liver cell damage may be present. Hemolysis, myositis, thyroid disease, and strenuous exercise may also cause elevated aminotransferase. However, eating does not cause elevated transaminases, and fasting may not be necessary if the test is simply for transaminases.