Elevated liver enzymes are generally a sign of liver disease or inflammation. As a result of inflammation or injury to the liver, high levels of certain chemicals, including liver enzymes, are released into the bloodstream.
Enzymes from the liver are proteins that accelerate chemical reactions in the body. These chemical reactions include the production of bile and chemicals that aid in blood clotting, the breakdown of food and toxins, and the fight against infection. Several common liver enzymes include the following:
- Alkaline phosphatase (ALP).
- Alanine transaminase (ALT).
- Aspartate transaminase (AST).
- Gamma-glutamyl transferase (GGT).
Elevated liver enzymes could be detected with normal blood tests. In most situations, liver enzyme levels are only moderately and temporarily raised. Most of the time, elevated liver enzymes don’t signify a chronic, serious liver condition.
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Causes of Elevated Liver Enzymes
Liver diseases, medical conditions, medications, and infections can cause elevated liver enzymes.
Common causes for elevated liver enzymes include:
- metabolic syndrome
- hepatitis
- alcohol or drug use disorder
- cirrhosis
- autoimmune hepatitis
- celiac disease
- infection with the Epstein-Barr virus, a type of herpes
- liver cancer
- hemochromatosis, when the body absorbs too much iron
- mononucleosis
- sepsis
- Wilson’s disease
- polymyositis, which involves inflammation of the muscles
- certain medications, including some pain relievers and statins
Symptoms of Elevated Liver Enzymes
- Abdominal pain.
- Dark urine
- Fatigue
- Itching.
- Jaundice
- Light-colored stools
- Loss of appetite.
- Nausea and vomiting.
Tests for Elevated Liver Enzymes
Elevated liver enzymes can be detected with a blood test. The blood test looks for elevated levels of the enzymes AST and ALT, which the liver produces when it is inflamed or damaged.
If a doctor discovers that a patient’s AST or ALT levels are elevated, they would generally order additional testing to ascertain the underlying cause.
Different AST/ALT ratios may reflect a variety of underlying reasons.
Treatment of Elevated Liver Enzymes
After two to four weeks, approximately one-third of persons with increased liver enzymes will have normal liver enzyme values. If your liver enzymes remain elevated, your provider may recommend additional blood tests or imaging tests such as an ultrasound, computed tomography scan, or magnetic resonance imaging (MRI). Additionally, they may refer you to a hepatologist. The treatment will be determined by the cause of the high liver enzymes.