Reviewed By: Pramod Kerkar, MD, FFARCSI

About Elevated Liver Enzyme:

Elevated liver enzymes indicate damage or inflammation to the liver cells. When the inflamed or the injured liver cells leak more than normal amount of chemicals including the liver enzymes into the bloodstream, it results in the elevated liver enzyme. The elevated liver enzymes are discovered during the routine blood tests. In most of the cases, the liver enzyme levels are temporarily and mildly elevated. Mostly, these enzymes do not give a signal to any chronic liver problem. Several diseases occur due to high enzyme levels.

There are two common kinds of liver enzymes- Aspartate transaminase or AST and Alanine transaminase or ALT. AST is the liver enzyme which helps to metabolize alanine and an amino acid. An increase in the AST levels indicates liver disease or liver damage. ALT is an liver enzyme that helps in metabolizing protein. ALT levels are normally low in the blood but its levels increase if the liver becomes damaged and it gets released into the bloodstream.

Elevated Liver Enzyme

Elevated Liver Enzyme: What Does It Mean When Your Liver Function Is High?

Elevated liver enzymes levels signify some kind of hepatic injury or damage. The levels can be elevated for a short-term indicating a sudden injury to the liver or it may be elevated for a long-term or chronically indicating ongoing liver injury.

In healthy patients, the abnormal levels of liver enzyme challenge the most experienced doctors to decide the next course of a further evaluation. The easy availability of the serum liver enzyme levels due to the automated laboratory testing has led to further testing and more findings. Almost 1-9% of patients show no symptoms even with high liver enzyme levels. An extensive evaluation is costly, and risky if it leads to needless invasive procedures like a liver biopsy. Not every people with an isolated and mildly elevated liver enzyme has the liver disease. The factors which must be considered while deciding to evaluate include the following:

  • The overall health of the patient including the chronic illness
  • The pattern and the duration of the enzyme elevation
  • The characteristics of the patient including the age, personal and family history of liver, neurological and lung diseases, use of prescribed drugs, alcohol consumption or dietary supplements.
  • The costs and the risks associated with an additional evaluation.

Liver function test is the commonly used method to detect the measurement of the liver enzymes. The elevated serum liver enzymes reflect abnormalities in the liver cells and in the bile duct. Elevation of aminotransferases indicate hepatocellular injury, elevated alkaline phosphatase indicates cholestatic injury.

Diagnosis of Liver Condition When There is Elevated Liver Enzyme

The important step to evaluate the patients with elevated liver enzyme levels is by performing a thorough medical examination and by going through the medical history of the patients. All the medications, including the prescribed and the over-the-counter medications, must be noted.

Apart from the liver tests, the other tests to screen the liver function such as albumin level, blood coagulation panel, total bilirubin level, and total blood count should be also measured. A proper screening for viral hepatitis is done routinely to detect possible liver infections, acute or chronic. In some of the cases, the physician may do a liver ultrasound to assess the liver structure and the biliary tree to look for gallstones that may cause liver disease.

The symptoms of elevated liver enzymes in healthy people vary from no symptoms to general symptoms.

Several vitamins can help to detoxify the liver and may reduce the elevated liver enzymes. These medications include SAMe, anti-oxidant vitamins A, C, and E, and the B-complex vitamins. Before supplementing the vitamins, it is important to consult a doctor. Once the levels of the liver enzymes are tested high, ensure to test them again on a regular basis and monitor the levels consistently.

Conclusion

Most of the evaluations discussed here can be carried out by the primary health care providers using a systematic approach. If the initial diagnosis fails, then consulting a gastroenterologist or a hepatologist may provide the much-needed help. Patient education, systematic approach, and reassurance is helpful to identify these abnormalities and also in identifying the treatable causes of liver disease in the most cost-effective manner.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: May 23, 2018

This article does not provide medical advice. See disclaimer

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