Elevated Liver Enzymes

What does elevated liver enzymes mean?

Having elevated liver enzymes means that certain enzymes from your liver are higher than normal.

Liver enzymes are inflammatory markers produced by your liver cells. Common liver enzymes include:

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

If your liver is injured or damaged, it releases enzymes into your blood. This causes enzyme levels (usually ALT or AST) to rise.

High liver enzyme levels can be temporary or they may be a sign of a serious liver condition, like viral hepatitis, metabolic liver disorders or cirrhosis. Certain medications can also cause elevated liver enzymes.

Your healthcare provider checks your liver enzyme levels with a liver function test (LFT) or liver panel. They may recommend this blood test if you have symptoms of liver problems or if you have risk factors for liver disease.

What are the symptoms of elevated liver enzymes?

You don’t always have symptoms of elevated liver enzymes. If liver damage is the cause, you may have some symptoms like:

• Abdominal pain
• Dark-colored pee
• Fatigue
• Itching
• Yellowing of your skin or eyes
• Light-colored poop
• Loss of appetite
• Nausea or vomiting
• Swelling or fluid retention in your stomach or legs

What causes elevated liver enzymes?

Liver diseases, medical conditions, tumors, medications and infections can cause elevated liver enzymes.

Common causes for elevated liver enzymes include:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) including alcohol-related and non-alcohol-related types
• Certain medications like statins and acetaminophen
• Hepatitis A, B and C
• CMV or HSV Hepatitis or alcoholic hepatitis
• Herbal supplements and vitamin supplements, like chaparral, comfrey tea, iron and vitamin A
• Cirrhosis
• Metabolic syndrome
• Liver stones

Less common causes include:

• Autoimmune hepatitis
• Hemochromatosis
• Celiac disease
• Thyroid disease
• Broad spectrum antibiotics
• Ischemia (liver injury due to poor blood flow)
• Certain types of cancer

What are the risk factors for elevated liver enzymes?

Factors that put you at risk include:

• Alcohol use
• Diabetes
• Obesity
• Rapid weight loss or weight gain
• Family history of liver disease
• Autoimmune hepatitis or exposure to infectious hepatitis
• Pregnancy

How are elevated liver enzymes treated?

Healthcare providers usually find elevated alanine transaminase (ALT) and aspartate transaminase (AST) on a blood test. Your healthcare provider will order tests to find out why your levels are high. Then, they’ll recommend treatment.

Tests you may have include:

• Blood tests to check for infections or other medical conditions (like diabetes or thyroid disease)
• Imaging tests, like an abdominal ultrasound, CT scan or MRI, to look for liver disease or bile duct issues

Treatment depends on what’s causing the elevated liver enzymes. For example, you may need to change or stop certain medications, or limit or avoid alcohol.

Your healthcare provider may repeat blood tests after a few weeks to see if your levels have improved. This is important because elevated liver enzymes can lead to serious liver damage if not treated.

Can elevated liver enzymes be prevented?

Some medical conditions that raise liver enzymes can’t be prevented. But you can take these steps to help keep your liver healthy:

• Avoid alcohol.
• Don’t share needles or items contaminated with blood.
• Manage blood sugar if you have diabetes.
• Tell your provider about any medications, herbs and supplements you take.
• Manage your weight.
• Exercise regularly.

When should I see my healthcare provider?

See your provider if you have risk factors for liver disease or have symptoms of liver problems. They may recommend that you have your liver enzyme levels checked. Early detection is the best way to avoid serious liver damage.