Elevated Liver Enzymes - Causes, Risk Factors, Symptoms, Diagnosis, and Treatment

What Are the Enzymes That Mostly Get Elevated?

These elevated liver enzymes can be discovered during a routine blood test. However, in most cases, these liver enzymes are only mildly elevated and would not signal long-term liver disease.

The most commonly elevated liver enzymes are:

• Alanine transaminase (ALT).

• Aspartate transaminase (AST).

• Alkaline phosphatase (ALP).

• Gamma-glutamyl transpeptidase (GGT).

What Are the Causes of Elevated Liver Enzymes?

The causes can be attributed to various factors, such as the medications the patient takes, the signs and symptoms of the disease, and infections. In some cases, the reason may be because of the tests and procedures.

The etiology of elevated liver enzymes includes:

• Over-the-counter medications, especially Acetaminophen.

• Certain prescription medications, which include statin drugs used in controlling cholesterol levels.

• Alcohol consumption.

• Heart failure.

• Hepatitis A, B, C.

• Non-alcoholic fatty liver disease.

• Obesity.

• Alcoholic hepatitis (inflammation of the liver caused by excessive alcohol consumption).

• Autoimmune hepatitis (inflammation of the liver caused by an autoimmune disorder).

• Celiac disease (inflammation of the small intestine caused by gluten consumption, usually found in barley, cereals, and wheat).

• Cytomegalovirus infection.

• Epstein Barr virus.

• Hemochromatosis (increased amount of iron in the blood).

• Liver cancer.

• Mononucleosis.

• Polymyositis (an inflammatory disease that causes weakness of the muscles).

• Sepsis (an infection that uses neutrophils, a type of white blood cell, faster than they could be produced in the bloodstream).

• Disorders of the thyroid gland.

• Toxic hepatitis (inflammation of the liver caused by drugs or toxins).

• Wilson's disease (an excessive amount of copper stored in the body).

Elevated liver enzymes are found predominantly in the following conditions:

1. Fatty Liver Disease:

• This disease occurs when fat builds up in the liver. If this build-up is because of alcohol consumption, then it is termed alcoholic fatty liver disease.

• This disease can sometimes cause tiredness and pain on the right side of the abdomen.

Treatment options for this include:

• The doctor will recommend the patient to exercise more.

• Have a healthy balanced diet.

• Individuals should try to burn more calories than they eat.

• If the patients have fatty liver disease because of alcohol consumption, they should stop taking alcohol.

2. Hepatitis:

It is a virus-borne disease that leads to inflammation of the liver. There are different strains of hepatitis which include A, B, C, D, and E. The symptoms of all the strains are similar, which include:

• Fatigue.

• Muscle soreness.

• Joint pain.

• Nausea.

• Loss of appetite.

• Stomach pain.

• Fever.

• Dark-colored urine.

• Itching of the skin.

• Yellowing of skin and eyes.

Treatment Options:

The treatment depends upon whether the inflammation is short-term or long-term. The doctor will recommend the following treatment options which include:

• Bed rest.

• Intake of plenty of fluids.

• Avoiding alcohol.

• Antiviral drugs for long-term hepatitis.

3. Metabolic Syndrome:

It is a group of diseases that increases the risk of heart disease. These symptoms include:

• High blood pressure.

• High blood sugar.

• Overweight.

• High cholesterol.

Treatment for metabolic syndrome includes:

• Regular exercise.

• Losing weight.

• Eating a healthy balanced diet.

• Managing sugar levels in the blood.

• Managing stress by doing meditation, yoga, relaxing, and reducing commitments.

4. Alcohol or Drug Use Disorder:

• Drinking too much alcohol or use of illicit drugs.

• Liver inflammation can be due to the use of alcohol.

• When drugs are the underlying cause, it is called toxic hepatitis.

• If the person is experiencing the symptoms of alcoholic liver disease, then the doctor will check the level of liver enzymes and give the treatment accordingly.

Treatment for an alcoholic or drug disorder includes:

• Support groups.

• Rehabilitation centers.

• Behavioral therapies.

• Medications for alcohol addiction.

5. Cirrhosis of the Liver:

It is a type of liver damage where there is irreversible damage to the liver. This condition can prevent the liver from functioning correctly, which may eventually lead to liver failure. The symptoms of this condition include itchy skin and fatigue. People are at greater risk of getting this disease if they do not get treatment for hepatitis. If a patient's symptoms of liver disease occur, the doctor will check the liver enzyme levels to help with the diagnosis and treatment plan for that particular patient. The treatment options for cirrhosis include:

• Following a healthy diet which includes fruits, green leafy vegetables.

• Reduced intake of drugs.

• Reduced alcohol consumption.

• Weight loss.

What Are the Risk Factors for Elevated Liver Enzymes?

The risk factors of elevated liver enzymes include:

• Use of alcohol.

• Use of certain medications, herbs, and vitamin supplements.

• Diabetes.

• Familial history of liver disease.

• Hepatitis (inflammation of the liver).

What Are the Symptoms of Elevated Liver Enzymes?

Most people who have elevated liver enzymes do not display any symptoms. However, if the injury of inflammation to the liver is the cause, then the patient will have the following symptoms which include:

• Pain in the abdomen.

• Dark-colored urine.

• Feeling tired.

• Itching.

• Jaundice (yellowish discoloration of eyes and skin).

• Light-colored stools.

• Loss of appetite.

• Vomiting.

• Nausea.

How Are Elevated Liver Enzymes Diagnosed And Treated?

The elevated liver enzymes will return to normal in one-third of the people in about two to four weeks. However, if the liver enzyme levels stay high, the laboratory technician may take blood tests or imaging tests such, as ultrasound (a procedure in which sound waves are used to produce images of the structures present inside the body), computed tomography (an imaging procedure that uses special X-ray equipment to create detailed images of the body), magnetic resonance imaging (uses a magnetic field and compute generated radio waves to produce clear images of the organs and tissues in the body) to check for any possible conditions. They may also refer the patient to a liver specialist. The doctor will provide treatment based on the cause of the elevated liver enzymes. Most of the time, the alanine transaminase (ALT) and aspartate transaminase (AST) enzymes are elevated when there is liver damage.

Can Elevated Liver Enzymes Be Prevented?

Some medical conditions that raise liver enzymes cannot be prevented. But the individual can take some preventive measures to maintain a healthy liver. The preventive measures include:

• Avoid drinking alcohol.

• Follow a healthy balanced diet.

• Get hepatitis A and B vaccines.

• Manage the level of blood sugar if the patient has diabetes.

• The patients should tell the doctor about the medications they are taking.

• The individual must check the weight regularly.

• The individual must also make sure to exercise regularly.

Conclusion:

Elevated liver enzymes are a temporary condition and do not always have to be an indication of a disease. However, it would be good to get an opinion from a doctor and discuss with the doctor when the patient has elevated levels of liver enzymes. The liver enzyme levels can return to normal if a person sticks to the treatment plan suggested by the physician for the condition which caused the elevated liver enzyme levels.