What are the symptoms of high liver enzymes? What causes elevated liver enzymes? How can elevated liver enzymes be treated? Get the answers to these questions and more.

Understanding the Role of Liver Enzymes

Your liver is a vital organ that plays a crucial role in maintaining your overall health. It is responsible for a wide range of functions, including fighting disease, removing toxins, and converting the food you eat into energy. At the heart of these processes are enzymes, which act as chemical catalysts, enabling and accelerating the various reactions that occur within the liver.

Causes of Elevated Liver Enzymes

When the levels of these enzymes become elevated, it is a sign that your liver has sustained some form of damage or inflammation. The most common causes of high liver enzyme levels include:

• Fatty liver disease
• Hepatitis
• Drug or alcohol abuse
• Certain prescription and over-the-counter medications
• Metabolic syndrome
• Cirrhosis

While some of these conditions can be chronic and severe, elevated liver enzymes do not always indicate a serious underlying problem. In many cases, the levels are only temporarily elevated and will return to healthy levels once the underlying cause is addressed.

Symptoms of Elevated Liver Enzymes

Elevated liver enzyme levels do not typically cause any immediate symptoms to develop. However, the underlying condition that is causing the enzyme levels to rise often will. Some common symptoms of liver disease include:

• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine
• Abdominal swelling or pain
• Fatigue
• Loss of appetite
• Joint pain
• Muscle soreness
• Itchy skin

Risk Factors for Elevated Liver Enzymes

The risk factors for elevated liver enzymes are closely tied to the risk factors for developing liver disease. While some liver conditions may be hereditary or environmental, many are caused by lifestyle habits. The foods you eat and the chemicals you expose your body to can all have an effect on your liver, leading to varying levels of damage and deterioration. Some of the most common risk factors include:

• Excessive alcohol use (more than two drinks per day for men, or one for women, according to CDC guidelines)
• Overweight or obesity (generally defined as having a BMI of over 25 for adults)
• Family history of liver disease
• Prediabetes or diabetes

Diagnosing and Treating Elevated Liver Enzymes

Elevated liver enzymes are typically detected through routine blood tests that check for increased levels of specific enzymes, such as alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT). Once the underlying cause has been identified, your healthcare provider can develop an effective treatment plan. Some common treatment options include:

• Adopting a healthy diet and exercise regimen to prevent or reduce overweight/obesity and boost overall health
• Reducing or avoiding drug and alcohol intake, as these substances can be particularly harmful to the liver
• Adjusting medications that may be causing liver inflammation or damage
• Managing blood sugar levels, especially for those with diabetes or metabolic syndrome

When to Seek Medical Attention

If you have been diagnosed with elevated liver enzymes, it is important to work closely with your healthcare provider to determine the underlying cause and develop an appropriate treatment plan. Nurse Practitioners of Florida are dedicated to providing compassionate, personalized care to help you manage your elevated liver enzymes and maintain your overall health and well-being.

Elevated Liver Enzymes in Asymptomatic Patients

What should you do if you have elevated liver enzymes but no symptoms? A study published in the Scandinavian Journal of Gastroenterology in 1986 found that in a group of 149 asymptomatic patients with moderately elevated liver enzymes, the most common underlying causes were fatty liver disease, alcohol use, and viral hepatitis. The researchers recommended that these patients undergo further testing and evaluation to determine the root cause and appropriate treatment.

Another study published in the Journal of Hepatology in 2003 found that the prevalence of elevated serum aminotransferase activity in the United States in 1999-2002 was 7.9%. The researchers noted that the most significant predictors of elevated liver enzymes were obesity, diabetes, and alcohol consumption.

If you have been diagnosed with elevated liver enzymes but are not experiencing any symptoms, it is still important to work with your healthcare provider to identify the underlying cause and develop a treatment plan. Early intervention can help prevent the development of more serious liver conditions and maintain your overall health.

What Causes Elevated Liver Enzymes?

Your liver is truly a powerhouse of an organ. It helps your body fight disease and infection, removes toxins, creates energy from the foods you eat, and so much more. Behind the scenes, helping the liver perform all of these critical functions are enzymes. These chemicals enable and accelerate the chemical reactions that your liver carries out as it works to keep your body healthy. When these enzyme levels become elevated, however, it means that damage has occurred in your liver. Left unchecked, this can lead to serious — and even fatal — consequences.

Causes of High Liver Enzymes

Elevated liver enzymes is a sign that something has caused damage or inflammation to occur within your liver. The most common causes of high liver enzyme levels are:

• Fatty liver disease
• Hepatitis
• Drug or alcohol abuse
• Certain prescription and over-the-counter medications
• Metabolic syndrome
• Cirrhosis

While some of the causes of elevated liver enzymes can be chronic, severe liver conditions, that’s not always the case. Many times levels are only temporarily elevated and will return to healthy levels once the underlying cause is treated.

Symptoms of Elevated Liver Enzymes

High liver enzyme levels don’t immediately cause any signs or symptoms to develop, but the underlying condition often will. Common symptoms of liver disease include:

• Jaundice – yellowing of the skin and whites of eyes
• Dark urine
• Abdominal swelling/pain
• Fatigue
• Low appetite
• Joint pain
• Muscle soreness
• Itchy skin

Risk Factors for Elevated Liver Enzymes

The risk factors for elevated liver enzymes are really risk factors for liver disease. While some liver conditions may be hereditary or environmental, many are brought on by lifestyle habits. The food and chemicals you put into your body all have an effect on your liver, and can lead to varying levels of liver damage and deterioration. Some of the most common risk factors include:

• Excessive alcohol use – more than two drinks a day for men, or one for women, according to CDC guidelines
• Overweight / Obesity – generally defined as having a BMI of over 25 for adults
• Family history of liver disease
• Have prediabetes or diabetes

Diagnosis & Treatment for High Liver Enzymes

Elevated liver enzymes are detected through regular blood tests. These tests usually check for elevated levels of:

• Alanine transaminase (ALT)
• Aspartate transaminase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)

If your healthcare provider determines that you have elevated liver enzymes, they will probably want to run other tests to get to the root of the underlying issue. Only once that is determined can an effective treatment plan be created.

High Liver Enzymes Treatment

Lowering high liver enzyme levels will depend on the underlying cause, but in most cases these levels can be brought back within healthy limits and are not indicative of a chronic, severe liver condition. Some possible treatment options include:

• Healthy diet and exercise – this not only will help prevent or reduce overweight/obesity, it will boost your overall health, including that of your internal organs
• Reducing or avoiding drug/alcohol intake – since these substances can be especially harmful to your liver, keeping consumption levels to healthy limits (or avoiding them altogether) will certainly improve your liver health
• Adjusting medications – some prescription and over-the-counter medicines can cause inflammation of the liver. If your medication regimen is causing liver inflammation or damage, your doctor will work with you to create a safer treatment plan
• Manage blood sugar – this is especially important for diabetics and those suffering from metabolic syndrome. Keeping blood sugar within healthy levels can prevent the underlying conditions from causing additional liver damage

If You Need Blood Screenings or Help Managing Elevated Liver Enzymes, Nurse Practitioners of Florida Can Help

At Nurse Practitioners of Florida, we have a dedicated team of certified nurse practitioners who have an unwavering commitment to providing you with care and compassion. When you call any of our locations, you will be greeted by a live person who’s ready to offer acute medical care as well as preventive measures — including flu vaccines. And, above everything else, you will be treated like family.

If you need assistance, call us or fill out our online contact form.

Elevated Liver Enzymes in Asymptomatic Patients – What Should I Do?

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When the liver goes wrong: a gastroenterologist named 4 common reasons why ALT and AST are elevated in the blood

• Health

However, the growth of these main “liver” markers in the blood test does not always indicate problems.

April 25, 2022

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A biochemical blood test is considered one of the main ways to find out if the liver copes with the load of “wrong” nutrition, alcohol, and medication. This will be told by such indicators in the analysis as ALT (alanine aminotransferase) and AST (aspartate aminotransferase) – these liver enzymes are among the first to respond to malfunctions of the organ.

– If there is an increase in both ALT and AST, this means that the liver cells are destroyed and the enzymes from them enter the blood. (…) An increase in AST and ALT means that an inflammatory process is taking place in the liver and its cells are being destroyed. If the indicators are above the norm, you need to contact a gastroenterologist, – gastroenterologist Maria Lopatina wrote in her telegram channel, adding that the upper limits of the norm may differ in different laboratories and one must focus on those established where the analysis was taken.

The doctor named the 4 most common causes of increased liver values.

Chronic viral hepatitis

With an increase in ALT and AST in the blood, viral hepatitis B and C are always excluded first. This is very important, as they can be asymptomatic, while destroying the liver. Mandatory tests: HBsAg – hepatitis B and Anti-HCV – hepatitis C.

Non-alcoholic fatty liver disease

When fatty liver cells destroy them, ALT and AST in the blood rise and steatohepatitis develops.

Fatty liver disease is suspected if:

• Waist circumference ≥94/≥80 cm in men/women;

• Blood pressure 130/85 mmHg And more, or the person is taking antihypertensive drugs;

• Fasting glucose level of 5. 6 mmol/l or more, or the person is taking hypoglycemic drugs;

• Serum triglycerides more than 1.7 mmol/l;

• High-density lipoprotein (HDL) level less than 1.0/1.3 mmol/l in men/women.

Drug-induced liver injury

All drugs that we take by mouth pass through the liver. The more drugs we take, the more likely it is to be damaged. This group includes both herbal preparations and dietary supplements. Liver damage can occur immediately or after several weeks.

Alcohol

According to Russian clinical guidelines, a safe dose for the liver in women is 20 grams of ethanol per day, for men – 40 grams. Regular excess of this dose leads to the development of alcoholic hepatitis and an increase in ALT and AST.

Determining the ethanol content in 100 ml of a drink is very simple: the percentage of alcohol in the drink must be multiplied by 0.8. Thus, 100 ml of 40% vodka contains 40×0.8=32 grams of ethanol, and 100 ml of 12% wine contains 12×0. 8=9.6 grams of ethanol.

The doctor specifies that there are other reasons for the increase in ALT and AST in the blood, but these four are the most common.

Read also

When an increase in the indicator is not a cause for alarm

It happens that an increase in the level of “liver” indicators may not be associated with a problem in the work of our main “filter”. According to gastroenterologist Maria Lopatina, this may be the case if only the AST index is elevated.

– AST is found not only in the liver, but also in the heart, muscles, kidneys, brain and pancreas. If AST levels are elevated and ALT is normal, causes that are not related to damage to liver cells should be ruled out. For example, active training for all muscle groups, the doctor clarifies.

But if the liver values ​​were below normal in the blood test, in most cases this is not a cause for serious concern. According to the gastroenterologist, a decrease in their level can occur during pregnancy, starvation and a reduced content of vitamin B6.

What other indicators of a blood test can be used to understand that something is wrong with the liver, read HERE.

Signs of liver problems that can be seen in the mirror

According to doctors, the liver does not hurt in the usual sense of the word, especially at first – specific symptoms of the disease appear when things have gone too far. As the head of the MIBS outpatient department, gastroenterologist Iyri Alaya said, liver diseases are often accompanied by various digestive disorders:

• Increased flatulence;

• Feeling of fullness in the stomach;

• Rapid satiety after eating;

• Loss of appetite;

• Dryness and bitterness in the mouth;

• Attacks of nausea and vomiting;

• Constipation or diarrhoea.

And the most famous sign of liver problems is yellowness of the skin, mucous membranes and sclera, which indicates an increase in the level of bilirubin (bile pigment) in the blood.

Text author: Anastasia Romanova

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ALT and AST what is it?

ALT ( alanine aminotransferase) and AST (aspartate aminotransferase) – belong to aminotransferase enzymes involved in amino acid metabolism. They are also called liver enzymes. They are found mainly in the cells of the liver and in other organs: pancreas, heart, kidneys, muscle tissue. A small amount of ALT and AST may appear in the blood due to physiological processes. However, in case of liver diseases (infectious or toxic hepatitis, tumor), damage to the liver cells occurs, the permeability of cell membranes is impaired and a large amount of ALT and AST enzymes are released into the blood – as a result, a cytolytic syndrome develops.

ALT and AST transaminases are specific markers of liver disease. Indications for their appointment may be the following:

• Presence of symptoms: nausea, vomiting, abdominal pain, yellowing of the skin and sclera, lethargy.
• laboratory diagnostics of liver diseases: viral hepatitis A, B, C, toxic hepatitis, fatty non-alcoholic liver disease (steatohepatitis), alcoholic liver disease, cirrhosis of the liver.
• Monitoring the dynamics of therapy for liver diseases.

Norms for the content of liver enzymes in the blood:

Age	Men	Women	Units
0-1 years	13-45		U/ml
1-60 years old	10-40	7.0-35.0
60-90 years old	13.0-40.0	10.0-28.0
Over 90 years old	6. 0-38	5.0-24.0

Reasons for increasing ALT, AST (hepatic and extrahepatic)

The level of ALT in acute viral or drug-induced hepatitis can rise 50 times or more. With steatohepatitis and alcoholic liver disease, the increase in ALT is moderate – no more than 5 times.