Reviewed By: Pramod Kerkar, MD, FFARCSI

How Long Does It Take To Lower Liver Enzyme Levels?

It does not exist a specific time to achieve a liver enzymes diminishment due to certain pathological processes. It depends on a series of factors such as the severity of the condition and its causes. Only if the patients follow the doctor`s recommendations (medications, proper diet and exercises) it can be a fact to get the liver back in a month or two.

The liver is an important gland because there not only protein synthesis is performed, but also the detoxification of a series of compounds that must be eliminated from our body. It contains a large number of enzymes, but the ones with the greatest interest are transaminases, alkaline phosphatase, gammaglutamyltranspeptidase and 5'ND.

Transaminases are enzymes that carry out transamination reactions (it consists of the transfer of the amino group from a donor amino acid to a ketoacid acceptor, the donor amino acid becoming a ketoacid and the ketoacid acceptor into an amino acid) giving rise to amino acids and keto acids different from the original ones. In the liver have been detected no less than 60 transamination reactions, but the only transaminases with clinical value are GOT and GPT.

How Long Does it Take to Lower Liver Enzyme Levels?

These enzymes are not specific to the liver and are also found in muscle, heart, pancreas and brain. The GOT is constituted by two isoenzymes, one cytoplasmic and other mitochondrial, while GPT is exclusively cytoplasmic. The normal concentrations of these enzymes in plasma translate the normal destruction of the cells that contain them, the normal ratio GOT / GPT is about 1.3.

In all liver diseases that present with cell necrosis, there is hypertransaminasemia, the more intense the more acute the lesion. Viral and toxic hepatitis, and more rarely sudden onset heart failure and shock liver, often produce levels more than 10 times higher than normal.

The finding of a moderate elevation of transaminases (less than 10 times the normal values) is more difficult to interpret and can correspond to acute or chronic hepatitis, to the regression phase of acute hepatitis, but also to cirrhosis, biliary disease or many other processes. A GOT / GPT ratio greater than one unit with moderate hypertransaminasemia suggests an alcoholic or neoplastic liver disease.

Gammaglutamyltranspeptidase: The richest tissue in this enzyme is the kidney, followed by the pancreas, liver, spleen and lung. It is located in the membranes cells, mainly of the smooth endoplasmic reticulum, in the microsomes, in the soluble fraction of the cytoplasm and in the bile ducts. γGT normal serum values differ in both sexes, being higher in males than in females. γGT increases in most liver diseases, so its specificity is poor. The γGT is a highly sensitive enzyme, it increases to a lesser or greater degree in all hepatobiliopathies, the highest increases are seen in obstructive or neoplastic processes, it is also increased in hepatitis. The most important increases are observed in tumoral processes, in intrahepatic or extrahepatic cholestasis due to proliferation of bile ducts, in addition its synthesis is induced by alcohol and also by barbiturates.

The γGT is a very useful parameter for the control of alcoholic patients, although they can also translate the exposure to industrial toxins. The interruption of alcohol consumption, in the absence of other causes of enzymatic induction is followed by an immediate reduction of the γGT plasma levels, until normalization completely after 6-8 weeks.

Alkaline phosphatase: This enzyme has several origins (liver, kidney, placenta, intestine, bones, leukocytes), although the most important sources are the liver, bones and intestine. During the growth, the serum levels are high due to the increase of the bone fraction, which translates the osteoblastic activity in the bone.

The same happens during pregnancy, especially in the third trimester, in which the elevations are due to alkaline phosphatase of placental origin.

The increase in alkaline phosphatase of hepatic origin reveals biliary obstruction intra or extrahepatic, with jaundice (yellowing of skin and mucous membranes, produced by the increase of bilirubin above 2 mg/dl) or without it, or the existence of an expansive, infiltrative or nature-type hepatic granulomatous process.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 26, 2018

This article does not provide medical advice. See disclaimer

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