Abnormal Liver Enzymes

Overview

When your blood includes more liver enzymes than normal, you have elevated liver enzyme levels. Elevated liver enzymes mean high liver enzyme levels. Increased levels of liver enzymes may signal the existence of a medical condition like hepatitis or liver disease, or they may be the cause of the problem. A variety of medications may also induce a rise in liver enzymes.

Elevated liver enzymes are often linked with liver inflammation or cell damage. When liver cells are inflamed or injured, they release more chemicals into the bloodstream, including liver enzymes, resulting in a rise in liver enzyme levels on blood tests.

Routine blood testing may reveal increased levels of liver enzymes. The vast majority of the time, liver enzyme levels will be modestly elevated and transient. High liver enzyme levels are not necessarily symptomatic of chronic or severe liver disease.

Liver enzymes are proteins that help to accelerate the chemical reactions that occur in the body. Chemical processes include the creation of bile and chemicals that assist in blood clotting, the breakdown of food and toxins, and infection defense. The following are important liver enzymes:

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

When your liver is damaged, it secretes enzymes into the circulation. The most commonly secreted liver enzymes are ALT and AST.

Transaminitis, also known as hypertransaminasemia, is a disease characterized by high levels of transaminases, which are particular liver enzymes, in the blood. When your liver produces an abnormally large quantity of enzymes, they begin to circulate throughout your body. Nonalcoholic fatty liver disease develops when a significant quantity of fat accumulates in the liver of people who do not use a lot of alcohol. It is one of the reasons for elevated liver enzymes.

To assess the levels of liver enzymes in your blood, your healthcare provider may suggest a “Liver Function Test” (LFT) or a liver panel. LFT is one of many kinds of blood tests. If you are at risk of liver damage or illness, or if you have symptoms of liver impairment, your doctor may suggest a liver function test at a regular appointment.

Prevalence of Abnormal Liver Enzymes:

Abnormal liver enzyme levels are standard and can occur in people of all ages. Elevated liver enzyme levels vary according to age, gender, lifestyle, and risk factors such as alcohol consumption or viral infections. While minor and transitory increases in liver enzymes can arise due to many variables, such as drugs or dietary choices, persistent and severe abnormalities frequently suggest an underlying liver problem. Early detection and treatment are critical for preventing further liver damage and consequences. Regular medical exams and liver function testing can aid in detecting and managing liver enzyme problems.

Causes

A physician will examine a patient’s blood test results that show increased liver enzymes to identify the cause of the elevated enzymes. Healthcare providers may conduct further testing on a person in addition to questioning them about their lifestyle and eating habits.

Fatty liver disease is one of the most common causes of elevated liver enzymes. The incidence of this illness in people with elevated liver enzymes is estimated to be between 25% and 51%.

Some health conditions that can lead to high liver enzymes are:

• Hepatitis
• Hemochromatosis
• Drug use disorder
• Metabolic syndrome
• Alcohol use disorder
• Cirrhosis (scarring of liver tissue)
• Fatty liver disease
• Liver cancer

A variety of medications, including statins and pain relievers, may induce a rise in liver enzyme levels. Among the medicines that may damage the liver include those used to treat ADHD, antibiotics, anticonvulsants and over-the-counter products. The majority of the time, drug-induced liver damage is mild, although it may sometimes be severe, causing abnormal levels of liver enzymes.

Stress can also cause elevated liver enzymes as the stress damages the liver leading to high liver enzymes.

While abnormal levels of liver enzymes are asymptomatic, the underlying illnesses that cause them may show it as a symptom. Elevated liver enzyme symptoms include jaundice, abdominal pain, and loss of appetite.

After two to four weeks, about one-third of individuals with elevated liver enzymes will have normal liver enzyme values. If your liver enzymes remain high, your doctor may order further blood tests or imaging tests such as an ultrasound or MRI. It is likely that they will also refer you to a liver specialist. Your treatment plan will be determined by the reason for your high liver enzymes. High liver enzyme treatment involves the management of the underlying disease that is producing the high levels.

Symptoms

Abnormal liver enzyme levels do not always manifest as distinct symptoms. Normal blood tests usually discover them. However, when liver enzyme abnormalities are connected with an underlying liver ailment, the following abnormal liver enzymes symptoms may occur:

• Fatigue: Excessive tiredness and weakness.
  

• Jaundice: A yellowing of the skin and eyes.
  

• Abdominal Pain: Pain or discomfort in the upper right abdomen.
  

• Nausea and Vomiting: Nausea, vomiting, and appetite loss.
  
  
• Unexplained Weight Loss: Significant weight loss cannot be explained.

Diagnosis

Diagnosing the cause of abnormal liver enzyme levels involves a multi-step process:

• Blood Tests: Standard blood tests usually detect elevated liver enzymes. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are two enzymes that are frequently examined.
  

• Imaging: Ultrasound, CT scans, or MRI may be used to determine the size, shape, and structure of the liver. These can aid in detecting tumors, fatty liver disease, and bile duct obstructions.
  

• Liver Biopsy: In some circumstances, a liver biopsy may be recommended to directly examine liver tissue, diagnose disorders such as cirrhosis, and estimate the extent of liver damage.

• Additional Blood Tests: Additional blood tests may be performed to detect the underlying cause of abnormal liver enzymes, such as viral hepatitis, autoimmune illnesses, or metabolic diseases.

Treatment

Abnormal liver enzyme treatments are individualized, involving lifestyle changes such as a healthy diet and exercise, medications for specific liver conditions, weight management in cases of fatty liver disease, addressing the underlying condition, and, in severe cases, considering a liver transplant. The treatment plan is highly personalized, emphasizing regular monitoring and follow-up with healthcare professionals to check progress and liver function.

When To See A Doctor

If a blood test reveals that your liver enzymes are elevated, you should consult with your doctor, as consulting a doctor is crucial to understanding what this means. To determine the root reason of your elevated liver enzyme levels, your doctor may suggest further tests and treatments to you. Increased (excessive) liver enzyme levels are a red flag that something may be causing organ damage. This may happen for a variety of reasons. Additional testing is likely to be needed to pinpoint the exact cause. Thus, it is crucial to see a doctor on an immediate basis to prevent further damage. 

Summary 

Abnormal liver enzymes arise while the liver releases more enzymes into the bloodstream than normal, indicating inflammation or cell damage. According to Medical News Today, approximately 25% to 51% of people with elevated liver enzymes have fatty liver disease. Common causes include conditions like hepatitis, affecting over 296 million people globally, and alcohol use disorder, which is a leading cause of liver disease in the U.S. Stress also can contribute to elevated liver enzyme levels. The condition is frequently asymptomatic, however underlying issues may cause symptoms such as jaundice, fatigue, abdominal pain, and unexplained weight loss.

Routine blood assessments and liver feature tests (LFT) often detect elevated enzyme levels. ALT and AST are the number one enzymes tested. Imaging checks like ultrasounds or MRIs, as well as liver biopsies, may be used to diagnose liver conditions further. Treatment includes addressing the underlying cause, which may include lifestyle modifications, medicine, or more invasive procedures in excessive cases.

Abnormal liver enzyme levels are not unusual and are no longer constantly a sign of severe liver disease, but chronic elevations should be evaluated by a healthcare provider. Early detection and treatment can also prevent liver damage. 

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about abnormal liver enzymes or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.