When the total bilirubin is normal but the alanine aminotransferase is elevated, it may be caused by pathological conditions such as fatty liver or cirrhosis, the latter of which usually requires treatment. The normal range of total bilirubin is 3.4-17.1 μmol/L, and the normal range of alanine aminotransferase is 0-40 U/L. Therefore, a total bilirubin of 7 μmol/L is within the normal range, while an alanine aminotransferase of 190 U/L is elevated. Elevated alanine aminotransferase can be seen in drug-induced hepatitis, cirrhosis, viral hepatitis, hepatocellular carcinoma, and other disease states, and treatment is usually required for such conditions. Patients with ALT 190 U/L and total bilirubin 7 μmol/L should go to the hospital and cooperate with the doctor for standardized treatment.