Elevated liver enzymes may mean a person’s liver is not working properly. Common causes include fatty liver disease and cirrhosis. Managing these conditions will help treat high enzyme levels.
Doctors test people for elevated liver enzymes if they have symptoms of conditions that typically cause liver damage.
In this article, learn about the causes of elevated liver enzymes, as well as the symptoms and treatment of each of these conditions.
Liver enzymes is an umbrella term for a
- alanine transaminase (ALT)
- aspartate transaminase (AST)
- alkaline phosphatase (ALP)
- gamma-glutamyl transferase (GGT)
- serum bilirubin
Liver enzyme testing typically focuses on ALT and AST levels.
If a person’s blood test results show elevated liver enzymes, a doctor will investigate possible underlying causes. They may do further tests in addition to asking about a person’s lifestyle and dietary habits.
There are many different causes of elevated liver enzyme levels.
Below are the common causes of elevated liver enzymes, as well as their symptoms:
Fatty liver disease
Fatty liver disease occurs when fats build up in the liver. If this buildup is due to alcohol consumption, it is called alcoholic fatty liver disease. When alcohol is not a causative factor, the buildup of fat in the liver is called nonalcoholic fatty liver disease (NAFLD). People with metabolic syndrome are at a higher risk of NAFLD.
Metabolic syndrome is a group of symptoms that increase the risk of heart disease. These symptoms include:
The doctor may test people with one or more of these symptoms for elevated liver enzymes.
Hepatitis is a virus that leads to liver inflammation and damage. There are several different strains of hepatitis, which are called A, B, C, D, and E. The symptoms of all of the strains are similar.
Common hepatitis symptoms include:
The doctor may test a person with symptoms of hepatitis for elevated liver enzymes.
Alcohol or drug use disorder
Drinking too much alcohol or using illegal drugs may lead to liver inflammation or damage.
Liver inflammation due to alcohol consumption is called alcoholic hepatitis. When drugs are the underlying cause, doctors call it toxic hepatitis.
The symptoms of alcoholic and toxic hepatitis are similar to those of other strains of hepatitis.
Cirrhosis symptoms include fatigue and skin itching. People are at risk of cirrhosis if they do not receive treatment for hepatitis or fatty liver disease.
If a person has cirrhosis symptoms, the doctor may check their liver enzyme levels.
Other conditions that less commonly cause elevated liver enzymes include:
Elevated liver enzymes are a symptom of many different conditions rather than a condition themselves. People should seek help if they exhibit symptoms of fatty liver disease, cirrhosis, or other conditions listed above.
Liver enzyme levels may return to normal quickly if a person follows the doctor’s recommended treatment plan for the underlying condition.
Testing for elevated liver enzymes
A blood test can show elevated liver enzymes. The blood test checks for raised levels of AST and ALT, which are enzymes that the liver releases when it becomes inflamed or damaged.
If a doctor finds that a person has raised AST or ALT levels, they are likely to carry out further tests to determine the underlying cause.
The treatment for elevated liver enzymes will focus on managing the underlying condition causing the increased levels.
The treatments for some common causes of raised AST or ALT levels include:
Fatty liver disease
People can work with their doctor to treat NAFLD with weight loss. The doctor may advise a person to make lifestyle changes to lose weight, such as:
Speaking with a nutritionist or even a personal trainer can help someone stay on track with their weight loss plan.
If a person has fatty liver disease due to alcohol consumption, the doctor will support them in reducing their alcohol intake.
Treatments for metabolic syndrome include:
- losing weight
- exercising more
- eating a healthful, balanced diet
- managing blood sugar levels
Treatments for hepatitis depend on whether it is acute or long-term. A doctor may recommend the following treatments for acute hepatitis:
- bed rest
- plenty of fluids
- avoiding alcohol
Treatment for long-term hepatitis usually includes antiviral medication to manage the condition’s symptoms and progression.
Alcohol or drug misuse disorder
Treatments for alcohol or drug use disorder
- behavioral therapies
- support groups
Anyone who feels as though their alcohol or drug use is causing health problems or interfering with their everyday life should speak to their doctor.
Treatments such as a modified diet, weight loss, and reduced alcohol consumption can all reduce the risk of further liver damage. The prompt diagnosis and treatment of conditions that affect the liver can help prevent cirrhosis.
Elevated liver enzyme levels are a symptom of an underlying condition, and as such, prevention will focus on these causes rather than enzyme levels themselves. Following an active, healthy lifestyle can help support liver health and function and can reduce the risk of several conditions, such as fatty liver diseases and metabolic syndromes.
This may include eating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats while limiting saturated fat, salt, and alcohol intake.
Elevated liver enzymes are themselves asymptomatic, but the underlying conditions responsible for them may cause symptoms.