Elevated Liver Enzymes - Common Enzymes, Tests & Causes

Enzymes are the heroes of your body - they work behind the scenes to keep everything running smoothly. For example, without them your body wouldn’t be able to break down food into energy or copy DNA.

Your liver plays a key role in digestion as it produces important enzymes and fluids such as bile. This helps break down fats in your small intestine to allow proper absorption.

It also helps your liver release important enzymes such as alanine transaminase (ALT) and aspartate transaminase (AST).

When the enzyme levels rise it may be seen as a sign of something wrong in your liver. This affects your digestion as well as overall health.

So, what do elevated liver enzymes indicate? The following sections will help you understand it better.

Common Liver Enzymes & Causes for Elevation

Think of enzymes as your liver’s helpers as they kickstart and speed up important biochemical reactions. Without them your liver might not excel at doing its job.

During liver damage, the enzymes often leak into your blood and show up in blood tests. That is why your doctor checks the following key liver enzymes that can reveal the real problems:

i. Alanine Transaminase: ALT, sometimes called SGPT, is one of the hardest working liver enzymes! It converts proteins into energy for your liver cells. But when liver tissues get stressed SGPT leaks into your blood. It may be due to hepatitis, fatty liver and damage from heavy alcohol consumption.

Healthy range: 10 to 40 U/L (men) and 7 to 35 U/L (women.) If there are high levels in your blood test, your liver might be sending out an SOS.

ii. Aspartate Transaminase: Sometimes known as SGOT, AST puts in the extra hours by working in your muscles too. Fun fact, when your blood test results comes back with high AST levels, doctors suspect either liver or muscle damage.

Normal range is between 10-40 U/L for men and 9-32 U/L for women.

iii. 5'-Nucleotidase: Your liver makes this enzyme to chop up nucleotides (the building blocks of your DNA, by the way). If blood tests show too much of this floating around, there’s some serious damage for example, cirrhosis, viral hepatitis, and alcoholic liver disease.

Normal level is 2-17 U/L.

iv. Alkaline Phosphatase: It is found in your liver and bones and has an important role in breaking down proteins. Thus, elevated levels of ALP indicate reduced bile flow or bone disorders.

Normal level is in the range 44-147 U/L (adults) and 130-320 U/L (children and adolescents.)

v. Gamma-glutamyl Transferase: GGT is involved in amino acid transport and detoxification. Elevated GGT levels indicate bile duct problems or liver disease.

Normal levels are 5-40 U/L.

vi. Lactate Dehydrogenase: It is present in many tissues and plays an important role in producing energy. Thus, elevated levels can indicate liver damage.

Normal levels are between 140-280 U/L.

An abnormal level of these enzymes can hint at some damage or disease. When the liver cells are damaged or inflamed, these enzymes “leak” out into the blood; which leads to the “high levels” in your blood tests.

Here are a few common causes of the indicative “liver damage”:

• Alcoholic liver disease

• Non-alcoholic fatty liver disease

• Hepatitis

• Autoimmune disorder

• Medications and toxins

Can Stress Cause Elevated Liver Enzymes? Find Out Here

If you find yourself thinking, “Can stress cause elevated liver enzymes?” Well, the findings are confusing. Some evidence suggests stress alone does not lead to elevated levels of liver enzymes.

While others suggest that stress can modulate the liver blood flow, increase cortisol levels, and trigger a release of natural killer cells. These NKCs can harm the liver cells.

Chronic stress can also push you to take on bad lifestyle habits such as alcohol abuse which can worsen liver health.

Tests That Determine Elevated Enzymes

The increased liver enzymes can show up in a collective test called liver function tests. LFTs help determine the levels of different enzymes, such as those listed above.

With the help of this test, you can understand the condition of your liver. Your doctor can help simplify the test findings. Some other tests include

• PT/INR, or prothrombin time, a longer PT/INR indicates reduced liver function.

• Lower albumin on the LFT is also indicative of poor liver function.

• The alpha-fetoprotein test helps monitor liver cancer.

Clinical Significance of Elevated Liver Enzymes

Now that you know which tests help indicate liver damage, here’s a list of every clinical significance the test results have:

• Liver damage can be clear by associating elevated ALT and AST levels (SGPT/SGOT.) This may be due to drug-induced liver injury, viral hepatitis, and alcohol-related liver disease.

• Cholestasis is clearly indicated through test results with elevated ALP and GGT. This is when bile flow from the liver is blocked or reduced.

• These test results are helpful in monitoring liver function, thus helping assess the severity of hepatic damage. Moreover, these help check the effectiveness of treatments.

Symptoms of Liver Damage

If you experience any of the following symptoms and observe these signs recently, maybe it's time to visit a hepatologist. A liver doctor can help you understand the root of the following signs:

• Yellowing of the skin (more advanced liver damage that causes jaundice)

• Fatigue

• Abdominal pain

• Swelling in feet and legs

• Loss of appetite

• Nausea and vomiting

• Dark urine

Nearly one-third of people with elevated enzymes of this organ have normal enzyme levels within 2-4 weeks. If your enzymes stay high, there may be more blood tests that get ordered.

It is important that you follow your health provider’s recommendations when resolving these symptoms.

What Would Cause My Liver Enzymes to Be Elevated?

Your liver enzymes may be elevated due to any of the following reasons:

• Drinking alcohol excessively

• Heart failure, as the heart does not pump blood as well as it should

• Hepatitis A, B, C.

• Consuming drugs without a prescription can lead to this issue.

• Shared needles or items with contaminated blood.

• Eating unhealthily.

• Not managing your blood sugar when you have diabetes.

Note From Yapita Health

Elevated enzymes may be due to several reasons, such as medication and liver disease. These are temporary and can be brought down to normal levels with the help of a liver specialist or a hepatologist.

If you’re looking for a hepatologist or a GP who can help you resolve all your queries related to your liver, get in touch today.

Yapita Health’s vast network of established and skilled liver doctors around the world can help you get peace of mind quickly. We’re here to get you connected.