Liver is one of the most important organs in the human body with over 500 functions including protein synthesis, blood clotting, destruction of old RBCs, detoxification and metabolism of chemicals and drugs along with hormone regulation and digestion of fats assisted by the production of bile, to name a few. When the liver is not functioning optimally due to various reasons, the signs can be seen as elevated liver enzymes. There are two types of liver enzymes commonly found; serum aspartate aminotransferase (ALT or SGOT) and serum alanine aminotransferase (AST or SGPT). ALT is found mostly in the liver that helps in the metabolism of protein; whereas, AST helps with the metabolism of alanine amino acid. ALT and AST levels are normally low in the body, but in case of damage, their levels are increased in the blood stream. Normal level of enzyme for ALT in adult male is 7 to 55 units per liter while for AST, it is 8 to 48 units per liter. The normal levels may slightly differ for women and children.
Causes of Elevated Liver Enzymes
The various causes of elevated liver enzymes include alcohol consumption, hepatitis A, hepatitis B, hepatitis C, obesity, non-alcoholic fatty liver disease, liver cirrhosis, heart failure, certain medications (Tylenol, statins), autoimmune hepatitis, alcoholic hepatitis, cytomegalovirus infection, celiac disease, Epstein-Barr virus, hemochromatosis, liver cancer, mononucleosis, thyroid disorder, pancreatitis, polymyositis, sepsis, toxic hepatitis, Wilson’s disease, adrenal insufficiency, alpha 1 antitrypsin deficiency, diabetes, muscle disorders, liver or bile duct tumors. It can also be caused due to excessive herbal supplements such as kava, pennyroyal, comfrey and skullcap.
Alcohol abuse is the most common cause of liver enzyme elevation leading to liver damage as metabolism of alcohol takes a toll on liver over time. Chronic alcoholism can lead to fatty liver, fibrosis, cirrhosis, liver failure, and even death.
Non-alcoholic fatty liver disease is one of the most common causes of liver enzyme elevation. Fatty liver, not only occurs due to excessive alcohol consumption, but also due to unhealthy lifestyle leading to excess fat deposition in the liver. It is mostly seen in obese people and requires lifestyle modification to reverse the condition.
What is The Best Treatment for Elevated Liver Enzymes?
The treatment of elevated liver enzymes include treating the underlying cause of enzyme elevation and treating the symptoms too. For example, antiviral medications are given for hepatitis C, corticosteroids and pentoxifylline are given to reduce liver inflammation, ursodeoxycholic acid is used to treat primary biliary cirrhosis and penicillamine is used to treat Wilson’s disease. Alcohol related liver damage is managed by abstaining from alcohol. Along with treating the cause, it is also imperative to make dietary modifications too, so that there is less strain on liver to process foods. It is best to eat liver friendly foods and avoid foods such as fatty foods and alcohol that put extra strain on liver.
Foods that are good for liver are green vegetables and fresh fruits and juices that provide more minerals and roughage for proper motility of the toxins to be flushed out of the body. They help detox the liver by lowering bilirubin and flushing heavy metals out of the body and promoting increased bile production, stimulation of lymphatic flow and restoration of pH in the body. These include burdock roots, dandelion, cilantro, oregano, beets, carrots, grapefruits, kale, celery, ginger, orange, cranberry juice, milk thistle, broccoli, spinach, brown rice, whole grains, bitter gourd, mustard greens and chicory. It is best to eat eggs and lean meat and avoid turkey, beef and red meat. Drinking a lot of water also, helps flush out toxins from the body.
The foods that should be avoided are refined carbohydrates and processed foods and drinks such as white breads, pasta, biscuits, pastries, desserts, carbonated drinks, alcohol, artificial sugars and also restrict deep fried foods and butter. It is also advised to lose weight if one is obese to reduce elevated liver enzymes and to follow up with doctor regularly for routine liver function tests.
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