Liver Enzymes High, Low, Tests & Symptoms

The human liver is one of the most complicated and multi-functional organs in the body, surpassed, perhaps, only by the brain. Among its many functions are detoxification (cleansing the blood of toxic substances), synthesis of proteins, and production of substances necessary for digestion, especially of fats.

There is no way to survive long-term without the functions of the liver, although it is possible to replace some of its functions in the short term through periodic dialysis. The liver produces chemical substances called enzymes in the course of its activities, and elevated or (less commonly) low levels of liver enzymes in the blood can be a symptom of liver problems of varying severity.

Elevated Enzymes

Liver disease often has no symptoms and a person can have mild forms of liver disease for years without ever suffering any ill effects. Nevertheless, elevated liver enzymes are always considered a cause for concern and a reason to watch and conduct further periodic tests. Elevated liver enzymes can indicate the presence of fatty liver disease (a condition in which globules of fat form in the liver), alcohol consumption, various metabolic liver diseases such as hemachromatosis, a side-effect of anti-cholesterol medication, or a serious and potentially life-threatening liver condition such as hepatitis or cirrhosis of the liver.

The detection of elevated liver enzymes is therefore cause for further testing and elimination of possible causes, as treatments will vary widely depending on the underlying condition.

Tests

Liver functioning is tested by an array of blood tests rather than a single test, measuring the levels of albumin, bilirubin, liver transaminases, and other enzymes in the blood. Since even very serious liver conditions do not have symptoms in the early stages, it is important to detect them early on. The tests are also useful in evaluating progress in the treatment of liver disease.

Low Enzymes

Although elevated liver enzymes are the more common “positive” test result, the presence of low enzymes is also a cause for concern. As with elevated enzymes, there are many different reasons why someone might have low enzyme levels, including: liver diseases ranging from cancer and cirrhosis to fatty liver; hypothyroidism; adrenal fatigue; malnutrition, especially a protein-poor or nitrogen-poor diet; severe diarrhea; pregnancy; kidney disease; excessive fat intake. Some of these are cause for more concern than others, obviously.

Symptoms

In most cases, regardless of the underlying cause, elevated and low liver enzymes produce no symptoms. When they do, it usually means that a disease is quite serious or has progressed to the point where it has become dangerous.

Some symptoms include: pain in the upper-right quadrant of the body (where the liver is located) or abdominal pain; abdominal swelling or bloating; abdominal tenderness in the region of the liver; jaundice (skin and whites of the eyes turning yellow); loss of appetite, nausea, and vomiting.

If symptoms are present, the indication is that a fairly severe liver condition may also be present, requiring aggressive treatment up to and including a liver transplant.

Alcohol

One common cause of elevated liver enzymes which is not necessarily an indicator of liver disease is high levels of alcohol consumption. While this can cause elevated liver enzymes in the absence of liver disease, it can also be a cause of liver disease ranging from the minor to the very severe. One of the first things a doctor will look for when liver enzymes are elevated is excessive alcohol consumption. Abstinence from alcohol will usually be recommended, and the tests repeated to eliminate this cause of the problem.