It's normal to feel a little scared when you see 'liver enzymes' high, or elevated liver enzymes, on a blood test. You might think, "Oh my, is something wrong with my liver?" But don't worry. Most of the time, this is a temporary condition. Let's talk about this in simple terms today.
What are these liver enzymes?
Simply put, liver enzymes are special proteins found inside our liver. They help our bodies perform many important functions, like factory workers.
Some of the main functions of these enzymes are:
- Helps produce bile.
- They make things needed for blood clotting.
- Things like the food and medicine we eat are broken down in a way that the body can absorb.
- It breaks down and removes toxins that enter the body.
- Helps fight infections.
There are several main types of liver enzymes that we typically see in blood reports:
- Alanine transaminase (ALT)
- Aspartate transaminase (AST)
- Alkaline phosphatase (ALP)
- Gamma-glutamyl transferase (GGT)
Think of our liver as a balloon. These enzymes are inside that balloon. If there is any damage to the liver, such as an injury or infection, the balloon will leak a little and the enzymes will leak into the blood. That's when a blood test will show that the level of these enzymes is elevated.
Why is the doctor testing these?
Your doctor may order a liver function test (LFT) during your regular annual check-up, especially if you are at risk for liver damage (for example, alcohol abuse, diabetes) or if you have symptoms of liver disease.
But remember, elevated enzymes do not always mean there is a serious illness. Sometimes this can be temporary .
What are the main reasons for these enzyme levels to rise?
There are many reasons why liver enzymes can be elevated. Some are very minor, while others are more serious . Let's take a look at the main causes.
| Reason | A simple explanation |
|---|---|
| Fatty Liver Disease | This is a very common cause these days. It can be caused by alcohol consumption as well as non-alcoholic causes (obesity, diabetes). |
| Some medications | Things like cholesterol-lowering medications (e.g. statins), painkillers (e.g. taking too much paracetamol), some antibiotics, and epilepsy medications can cause enzymes to rise. |
| Hepatitis infections | Inflammation of the liver caused by various types of viruses. Examples: `Hepatitis A`, `Hepatitis B`, `Hepatitis C`. In addition, there is a condition called `Alcoholic Hepatitis` caused by alcohol and `Autoimmune Hepatitis` caused by a problem in the body's own immune system. |
| Alcohol use | Excessive or prolonged alcohol consumption directly damages the liver. |
| Some vitamins and herbal supplements | Taking certain herbal products without medical advice, such as vitamin A or iron in excess, can also be harmful to the liver. |
Are there any other reasons besides this?
Yes, there could be a number of other reasons. They are a bit less common, but it's important to be aware of them.
- Hemochromatosis: Excessive iron accumulation in the body.
- Cirrhosis: The liver becomes almost completely hardened, scarred, and loses function.
- Cancer status: Cancer that occurs in the liver or the spread of cancer from elsewhere to the liver.
- Celiac disease: An allergy to the protein gluten.
- Wilson disease: Excessive accumulation of copper in the body.
- Thyroid disease.
- Muscle conditions.
What are the symptoms of this condition?
The important thing here is that many people do not experience any symptoms . Elevated liver enzymes are only discovered when a blood test is done for another reason.
However, if the cause of these enzyme elevations is liver damage, the following symptoms may occur.
| Symptom | Description |
|---|---|
| Jaundice | Yellowing of the whites of the eyes and skin. |
| Dark-colored urine | Taking on a dark color similar to the color of tea. |
| Pale-colored stools | Becoming pale, like the color of clay. |
| Stomach pain | Feeling pain, especially on the right side of the abdomen, under the ribs. |
| Frequent fatigue | Feeling tired all the time for no reason. |
| Itching | Itching on the skin surface. |
| Loss of appetite, nausea, and vomiting | Loss of appetite and nausea. |
What should I do now? What are the treatments?
If your blood test shows elevated enzymes, the first thing your doctor will do is ask you about your complete history. He'll ask about everything, including the medications you take, supplements, and alcohol habits.
The good news is that about a third of people with elevated enzymes return to normal within two to four weeks, without any treatment.
So, your doctor may tell you to get another blood test in a few weeks. If your enzyme levels are still high, they will order more tests to find the cause.
- Other blood tests: To look for things like hepatitis viruses.
- Scans: An abdominal ultrasound scan, a CT scan, or an MRI.
- Referral to a specialist: You may be asked to see a doctor who specializes in liver diseases, aka a 'Hepatologist'.
Treatment depends entirely on the underlying disease that caused the enzyme elevation. If the cause is a medication, the medication will be changed. If the cause is Fatty Liver, lifestyle changes (weight loss, exercise) will be advised. Therefore, treatment will vary from person to person.
What can we do to keep the liver healthy?
While we cannot prevent some diseases, there are many things we can do to protect this precious organ called our liver.
- Avoid alcohol consumption or limit it as directed by your doctor.
- Eat a balanced, healthy diet . Reduce foods high in oil, sugar, and flour.
- Exercise regularly. Even walking for 30 minutes a day is a great thing.
- Control your body weight. Obesity is a major cause of Fatty Liver.
- If you have diabetes, control your blood sugar levels well .
- Do not use any medication, vitamin, or herbal product without your doctor's approval. Tell your doctor about everything you are taking.
- Get vaccinated for Hepatitis A and B.
- Do not use needles, razors, etc. that have been used by others.
Take-Home Message
- Don't panic when you see elevated liver enzymes on your blood test. In most cases, it's a temporary condition.
- Elevated enzymes can be caused by various factors, such as medications, diet, and viral infections.
- Many people do not experience any symptoms.
- The most important thing is to talk openly about this with your doctor. He or she will give you the guidance you need.
- Following a healthy lifestyle is the best way to protect your liver.
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