What Do Elevated Liver Enzymes Mean for Your Health?

What Are Liver Enzymes?

The liver plays a vital role in many processes, including metabolism, digestion, detoxification, and elimination of substances from the body. Liver enzymes are proteins that speed up chemical reactions in the liver, which supports the liver in carrying out these functions.

Types of Liver Enzymes

Some of the common liver enzymes are listed below. Elevation of these liver enzymes can be caused by liver injury.

• Alanine transaminase (ALT): ALT is a liver enzyme that is needed to convert proteins into energy within the liver. When there is liver damage or liver injury, liver cells release more ALT, causing elevated ALT levels in the bloodstream. ALT may also be referred to as alanine aminotransferase or serum glutamic-pyruvic transaminase (SGPT). 

• Aspartate transaminase (AST): AST is a liver enzyme that helps the body metabolize amino acids. While mainly found in the liver, AST is also present in the brain, heart, kidneys, and muscles. Elevated AST can be a sign of liver disease, such as alcohol-related fatty liver or cirrhosis. AST may also be referred to as aspartate aminotransferase or serum glutamic- oxaloacetic transaminase (SGOT).

• Alkaline phosphatase (ALP): ALP is an essential liver enzyme that is required to break down proteins in the body. It is also found in bones. An elevated alkaline phosphatase level can be a sign of liver damage or bone disease.

• Gamma-glutamyl transpeptidase/transferase (GGT): Gamma-glutamyl transferase (GGT) can be elevated in people with liver disease, bile duct damage, and problems with certain other tissues in the body. GGT may also be referred to as gamma-glutamyl transferase.

In addition to the above common liver enzymes, the following tests can be used with the overall clinical picture to evaluate a person's liver health and determine the underlying causes: bilirubin, albumin, total protein test, prothrombin time (PT), and L-lactate dehydrogenase (LD). 

What Does It Mean If My Liver Enzymes Are High?

Elevated liver enzymes (high levels of liver enzymes) in your blood mean you might have a medical condition that is causing inflammation, injury, or damage to your liver. Damaged liver cells can leak liver enzymes into your blood vessels and bloodstream, causing you to have higher-than-normal levels of these enzymes on blood tests.

Your doctor may discover elevated liver enzymes on routine blood testing. Abnormal liver enzymes are more common than you think; in fact, they are found in about one in three people. In most people, the elevation in liver enzymes is mild and temporary and does not signal a longstanding or serious liver problem; in these cases, liver enzymes usually return to normal levels in two to four weeks. However, raised levels of liver enzymes can sometimes be a sign of serious liver disease.

Possible Causes of Abnormal Liver Enzymes

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

Liver Disease

• Fatty liver disease, including alcoholic liver disease associated with heavy alcohol use and nonalcoholic fatty liver disease (NAFLD)

• Viral infections, including hepatitis A, hepatitis B, hepatitis C, and Epstein-Barr virus (EBV)

• Inflammatory conditions such as alcoholic hepatitis 

• Autoimmune disorders such as autoimmune hepatitis

• Cirrhosis of the liver

• Primary biliary cirrhosis (scarring of the bile ducts)

• Biliary atresia (problems with bile flow)

Drug-Induced Liver Injury

Certain medicines can cause liver damage and elevated levels of liver enzymes, for example:

• Acetaminophen (Tylenol)

• Cholesterol-lowering drugs (statins)

• Anti-seizure drugs such as valproic acid

• Mineral and vitamin supplements such as iron and vitamin A

• Herbal supplements such as comfrey tea and chaparral

Other Common Causes That Can Raise Liver Enzymes

• Metabolic syndrome (a collection of conditions that increase the risk of heart disease, heart attack, stroke, and diabetes)

• Thyroid disorders

• Hemochromatosis (too much iron in red blood cells)

• Hemolysis (breakdown of red blood cells)

• Primary sclerosing cholangitis (inflammation and scarring of bile ducts)

• Alpha-1 antitrypsin deficiency (a genetic condition that causes lung and liver damage)

• Celiac disease (a condition caused by an immune reaction to dietary gluten)

• Polymyositis (an inflammatory disease of the muscles)

• Wilson disease (a genetic disorder in which there is too much copper in the body)

• Cancer

Symptoms of Elevated Liver Enzymes

Many people with elevated liver enzymes don’t have any symptoms. However, people with more severe liver damage may have symptoms such as:

• Stomach pain

• Nausea, vomiting

• Fatigue (tiredness)

• Itching

• Jaundice (yellowing of the skin or eyes)

• Dark-colored urine 

• Light-colored stools 

• Loss of appetite

Learn more: Is My Liver Healthy? Find out on our blog.

Diagnosis and Tests

How Are Abnormal Liver Enzymes Detected?

Abnormal liver enzymes (higher than normal levels of liver enzymes) can be detected with blood tests called liver function tests (LFTs) or a liver panel. 

In addition to the liver enzymes—alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (GGT)—liver function tests also include other tests such as total protein, bilirubin, lactate dehydrogenase (LDH), and prothrombin time (PT). 

A liver panel can give your doctor important information about possible liver problems. It can also provide clues about the underlying condition causing elevated liver enzymes, which can help your healthcare provider decide on further tests.

Liver Function Test Results Explained

The typical/normal range for liver function tests in adult men is listed below. Note that the normal values can vary from laboratory to laboratory and may be slightly different in women and children. 

• ALT: 7 to 55 units per liter (U/L)

• AST: 8 to 48 U/L

• ALP: 40 to 129 U/L

• GGT: 8 to 61 U/L

• Total protein: 6.3 to 7.9 grams per deciliter (g/dL)

• Albumin: 3.5 to 5.0 g/dL

• Bilirubin: 0.1 to 1.2 milligrams per deciliter (mg/dL)

• Lactate dehydrogenase (LD): 122 to 222 U/L

• Prothrombin time (PT): 9.4 to 12.5 seconds

Your healthcare provider will help you understand the results of your liver function test and tell you if you need more tests. 

They will use this information to diagnose your condition or decide on the treatment plan. You may need to undergo further testing, including other liver tests, more blood tests, imaging tests, and/or a liver biopsy to help your doctors make a diagnosis. 

If you have been diagnosed with liver disease, the results of your liver function tests will help your healthcare provider determine how your disease is progressing and whether you are responding to treatment.

Treatment Options: How Are Elevated Liver Enzymes Treated?

How Do You Fix Elevated Liver Enzymes?

Elevated liver enzymes are more common than you think, affecting 10% to 30% of Americans. Among those affected, less than 5% of people will have severe liver conditions. In those benign cases where elevated liver enzymes are due to temporary health issues, abnormal liver chemistries normalize in 2-4 weeks. 

If you continue to have elevated liver enzymes, your primary care physician may refer you to a gastroenterologist or hepatologist (specialist in liver diseases). The treatment will depend on the underlying cause of your abnormal liver test.

Lifestyle Changes, Dietary Recommendations, and Preventative Measures

It is not always possible to prevent some medical conditions that can raise liver enzymes. But you can take the following steps to maintain liver health:

• Avoid drinking alcohol or drink in moderation.

• Eat a healthy diet.

• Get regular exercise.

• Keep your weight in a healthy range.

• Avoid sharing needles or other items that may be contaminated with blood and can put you at risk of infections.

• Get the hepatitis A and B vaccine.

• Manage blood sugar levels if you have diabetes.

• Check with your healthcare provider before taking any over-the-counter medications, dietary supplements, and herbal products.

What Foods Should You Avoid If You Have High Liver Enzymes?

It’s a good idea to avoid or limit the following foods if your blood test measures elevated liver enzyme levels: 

• Alcohol

• Fried and fatty foods

• Processed and ultra-processed packaged foods and snacks

• Sugary foods and beverages

• High-salt foods

• Red meat and processed meats

• Refined grains

Can Dehydration Cause Elevated Liver Enzymes?

Yes, dehydration can cause elevated liver enzymes. The liver needs plenty of fluids to function properly. Dehydration (lack of enough fluids in the body) can increase the risk of liver damage and elevated liver enzymes.