Elevated Liver Enzymes

Overview

What does it mean to have elevated liver enzymes?

If you have high levels of liver enzymes in your blood, you have elevated liver enzymes. High liver enzyme levels may be temporary, or they may be a sign of a medical condition like hepatitis or liver disease. Certain medications can also cause elevated liver enzymes.

What are liver enzymes?

Liver enzymes are proteins that speed up chemical reactions in your body. These chemical reactions include producing bile and substances that help your blood clot, breaking down food and toxins, and fighting infection. Common liver enzymes include:

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

If your liver is injured, it releases enzymes into your bloodstream (most commonly ALT or AST).

Why does a healthcare provider check liver enzymes?

Your healthcare provider may check your liver enzyme levels with a liver function test (LFT) or liver panel. A liver function test is a type of blood test. Your provider may order an LFT during a regular checkup if you’re at risk for liver injury or disease or if you have symptoms of liver damage.

Possible Causes

What causes elevated liver enzymes?

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

Common causes for elevated liver enzymes include:

Other causes of elevated liver enzymes include:

What are the risk factors for elevated liver enzymes?

Factors that put you at risk for elevated liver enzymes include:

  • Alcohol abuse.
  • Certain medications, herbs and vitamin supplements.
  • Diabetes.
  • Family history of liver disease.
  • Hepatitis or exposure to hepatitis.

What are the symptoms of elevated liver enzymes?

Most people with elevated liver enzymes don’t have symptoms. If liver damage is the cause of elevated liver enzymes, you may have symptoms such as:

Care and Treatment

How are elevated liver enzymes treated?

About one-third of people with elevated liver enzymes will have normal liver enzyme levels after two to four weeks. If your liver enzymes stay high, your provider may order more blood tests, or imaging tests such as ultrasound, CT scan or MRI. They may also refer you to a liver specialist (hepatologist). Treatment will depend on what’s causing the elevated liver enzymes.

Can elevated liver enzymes be prevented?

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

  • Avoid alcohol or drink in moderation, depending on your provider’s advice.
  • Don’t share needles or items contaminated with blood.
  • Eat a healthy diet.
  • Get the hepatitis A and B vaccine.
  • Manage blood sugar if you have diabetes.
  • Tell your provider about any medications, herbs and supplements you take.
  • Watch your weight.
  • Exercise regularly.

A note from Cleveland Clinic

Elevated liver enzymes have a variety of causes, including liver disease and medication. Elevated liver enzymes may also be temporary. If your blood test shows high levels of liver enzymes, talk with your provider. They’ll work to figure out the cause.

Last reviewed by a Cleveland Clinic medical professional on 06/28/2021.

References

  • American College of Gastroenterology. Medications and the Liver. (https://gi.org/topics/medications-and-the-liver/) Accessed 7/8/2021.
  • American Family Physician. Elevated Liver Enzymes. (https://www.aafp.org/afp/2011/1101/p1010.html) Accessed 7/8/2021.
  • American Family Physician. Mildly Elevated Liver Transaminase Levels: Causes and Evaluation. (https://www.aafp.org/afp/2017/1201/p709.html) Accessed 7/8/2021.
  • Cancer Advisor. Elevator Liver Enzymes. Hepatitis. (https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/hospital-medicine/elevated-liver-enzymes-hepatitis/) Accessed 7/8/2021.
  • ClinLab Navigator. Most Common Causes of Elevated Liver Enzymes. (http://www.clinlabnavigator.com/most-common-causes-of-elevated-liver-enzymes.html) Accessed 7/8/2021.
  • HepMag. Symptoms of Hepatitis. (https://www.hepmag.com/basics/hepatitis-a-basics/symptoms-hepatitis-a) Accessed 7/8/2021.
  • Merck Manuals. Liver Blood Tests. (https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/diagnosis-of-liver,-gallbladder,-and-biliary-disorders/liver-blood-tests) Accessed 7/8/2021.
  • Merck Manuals. Overview of Liver Disease. (https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/overview-of-liver-disease/) Accessed 7/8/2021.
  • U.S. Department of Veterans Affairs. Liver Enzymes. (https://www.hepatitis.va.gov/basics/liver-enzymes.asp) Accessed 7/8/2021.
  • U.S. National Library of Medicine. ALT Blood Test. (https://medlineplus.gov/lab-tests/alt-blood-test/) Accessed 7/8/2021.
  • Holstege, A. Elevated Liver Enzymes. (https://pubmed.ncbi.nlm.nih.gov/27824421/) Dtsch Med Wochenschr. 2016 Oct;141(22):1640-1646. Accessed 7/8/2021.
  • Giannini EG, Testa R, Savarino V. Liver Enzyme Alteration: A Guide for Clinicians. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC545762/) CMAJ. 2005;172(3):367-379. Accessed 7/8/2021.
  • Lala V, Goyal A, Bansal P, Minter, DA. Liver Function Tests. (https://www.ncbi.nlm.nih.gov/books/NBK482489/) StatPearls. Updated July 4, 2020. Accessed 7/8/2021.
  • Hall P, Cash J. What Is the Real Function of Liver ‘Function’ Tests? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609680/) Ulster Med J. 2012; 81(1):30-36. Accessed 7/8/2021.

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