A blood test that reveals elevated liver enzymes may or may not be a cause for concern. Certainly it is an early possible sign of liver disease, and the liver is a vital organ, so that damage to the liver is a serious matter. Further diagnostic testing is definitely indicated, but liver enzymes may be elevated without the underlying cause being a serious danger to health.
There are two liver enzymes which a blood test most often reveals to be elevated: alanine transaminase or ALT, and aspartate transaminase or AST. A few other enzymes may be elevated as to serum levels due to certain liver conditions, but less commonly than ALT or AST. (The liver is a very complex organ and produces literally thousands of chemical substances aiding in digestion and metabolism.) AST is of particular use in showing likely liver damage from alcohol-
Causes
A lot of different factors can cause liver enzymes to be above the normal concentration in the blood. Some of these are liver disorders, others aren’t; of the liver diseases that can produce high enzymes, some are serious conditions warranting treatment and others are not so serious and require only monitoring and possibly minor lifestyle changes.
The list of possible causes is long, and includes adrenal gland deficiency, fatty liver disease, cancer of the liver, hepatitis, obesity, several different medications including drugs to lower cholesterol, certain antibiotics, excessive use of certain herbal substances, excessive use of alcohol, and cirrhosis of the liver. Some of these causes, such as hepatitis, cirrhosis, or liver cancer, are obviously of serious concern; others may be minor liver problems, problems unrelated to the liver itself, or not really problems at all.
Symptoms
Actually, high liver enzymes are themselves a symptom, so it’s not really accurate to speak of “symptoms” of the condition; strictly speaking, elevated liver enzymes in the blood produce no symptoms. On the other hand, some of the underlying causes may produce symptoms other than high enzymes, and these can include jaundice (yellowing of the skin and the whites of the eyes), pain, nausea and vomiting, abdominal swelling, chronic pain (especially in the area of the torso over the liver), and certain other symptoms. Any of these may be noticed by a physician or a patient and lead to a recommendation of a serum liver enzyme test to confirm that the problem is liver-
Treatment
Normally, when a blood test reveals elevated liver enzymes, the next step is to identify why that is so, and treatment is prescribed for the underlying condition in cases where it is warranted. This may include reducing or eliminating alcohol consumption, a regimen of gradual weight loss, changing medications or dosages, treatment for cancer or for infectious disease, or an alteration of diet and exercise to treat diabetes. Most of the time, the only treatment prescribed is a change in behavior and lifestyle. On rare occasions when a severe disease of the liver is present, more aggressive treatment may be called for up to and including a liver transplant or chemotherapy and other treatments for cancer.
Pregnancy
Pregnancy should normally result in the elevation of some liver enzymes, but not of AST or ALT. High levels of these enzymes are a sign that something abnormal is going on, and this happens in approximately five percent of pregnancies. Sometimes high liver enzymes can be the sign of a serious complication of pregnancy such as pre-
in urine.
This is a very serious complication and can, if it advances to the acute condition known as eclampsia, result in seizures, loss of the fetus, and even death of the mother.