Elevated Liver Enzymes

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.

What causes elevated liver enzymes?

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

Common causes for elevated liver enzymes include:

• Certain medications, such as cholesterol-lowering drugs (statins) and acetaminophen.
• Fatty liver disease, including alcohol-related and non-alcohol-related conditions.
• Hemochromatosis.
• Hepatitis A, hepatitis B, hepatitis C, alcoholic hepatitis and autoimmune hepatitis.
• Herbal supplements and vitamin supplements, like chaparral, comfrey tea, iron and vitamin A.

Other causes of elevated liver enzymes include:

• Alpha-1 antitrypsin deficiency.
• Cancer.
• Celiac disease.
• Cirrhosis of the liver.
• Hemolysis.
• Metabolic syndrome.
• Muscle conditions, like polymyositis.
• Thyroid disease.
• Wilson disease.
• Primary sclerosing cholangitis.
• Primary biliary cirrhosis.

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

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

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:

• Abdominal (stomach) pain.
• Dark urine (pee).
• Fatigue (feeling tired).
• Itching.
• Jaundice (yellowing of your skin or eyes).
• Light-colored stools (poop).
• Loss of appetite.
• Nausea and vomiting.

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.