Liver enzymes are proteins the liver produces. The amount of these proteins in your blood is a good indication of your liver’s overall health. But elevated liver enzyme levels do not always mean serious liver damage or disease.
Sometimes, factors such as hormonal changes or reactions to medications can cause temporarily elevated liver enzyme levels. Elevated levels caused by these factors will generally return to normal in about 2 to 4 weeks without treatment.
Your liver makes proteins called liver enzymes that help your body perform necessary functions. For instance, liver enzymes help your body:
- fight infections
- make coagulation proteins that are necessary for blood clotting
- break down the food you eat
- break down toxins
Your liver makes several liver enzymes, including:
- Aspartate transaminase (AST)
- Alkaline phosphatase (ALP)
- Alanine transaminase (ALT)
- Gamma-glutamyl transferase (GGT)
These liver enzyme levels are a good indicator of how well your liver is functioning. A liver panel test checks liver enzyme levels in your blood.
A healthcare professional might order this test as part of routine blood work, as a way to monitor you if you’re at risk for liver disease, or as a diagnostic test if you have symptoms of liver disease or liver damage.
There are many reasons liver enzyme levels can change. Some causes are temporary and will resolve on their own. Other causes are more serious and will require medical treatment.
Temporary causes of changes in liver enzyme levels include:
- Hormones: Fluctuations in your liver levels can occur during your menstrual cycle and pregnancy.
- Certain medications: Some medications, including acetaminophen, antibiotics, and some cholesterol-lowering medications, can elevate your liver enzyme levels.
- Herbal supplements: Supplements such as iron, vitamin A, comfrey, and chaparral can elevate liver enzyme levels.
- Alcohol: Heavy drinking can raise your liver enzyme levels.
Causes of elevated liver enzyme levels that are more likely to be chronic include:
- Fatty liver disease: Heavy alcohol use, obesity, and a range of other factors can cause fatty liver disease. No matter the cause, fatty liver disease raises your liver enzyme levels.
- Hemochromatosis: Hemochromatosis is a rare condition that occurs when your body builds up too much iron. Elevated liver enzyme levels can be a symptom of the condition.
- All types of hepatitis: Any type of hepatitis, including hepatitis A, hepatitis B, hepatitis C, autoimmune hepatitis, and alcoholic hepatitis, causes liver inflammation and elevated liver enzymes.
- Cirrhosis: Cirrhosis is chronic liver damage. This damage causes elevated levels of liver enzymes.
- Liver cancer: Cancer that impacts your liver will also affect your liver enzyme levels.
- Hemolysis: Hemolysis is a type of anemia that occurs when your red blood cells are destroyed. It’s sometimes seen with alcohol-related liver diseases, and it can cause changes to liver enzyme levels.
- Thyroid disease: Hyperthyroidism can sometimes cause high levels of liver enzymes.
- Metabolic syndrome: Metabolic syndrome is a term that refers to a group of conditions that raise your risk of diabetes, heart disease, and stroke. These conditions include high blood pressure, high cholesterol, high blood sugar, and carrying excess weight around your midsection. People with metabolic syndrome may also have elevated liver levels.
The exact threshold for what is considered an elevated level or a typical level depends on your age, gender, health goals, and the values used by the specific lab. You can see some standard thresholds below.
- AST: under 36 U/L
- ALP: between 20 and 140 U/L
- ALT: under 25 U/L for women or under 33 U/L for men
- GGT: between 5 and 40 U/L
A liver function test might also measure:
- Albumin: between 35 and 50 U/L
- Bilirubin: between 0.1 and 1.2 mg/dl
These values are not enzymes, but they’re also important chemicals made by your liver.
A liver function test is a standard blood draw. It can be done during a regular office visit. You don’t generally need any special preparation before a liver function test, although a doctor might ask you to fast for 12 to 24 hours before the blood draw. You can read more about liver function tests here.
The treatment for elevated liver enzymes depends on the cause. In many cases, liver enzyme levels return to normal on their own within about a month. You might need to switch medications, stop taking a supplement, or cut back on drinking if you drink, but you will not need a treatment plan.
In other cases, your doctor might need to treat the condition that’s raising your liver enzyme levels. They might order more tests, such as imaging tests, to get a better look at your liver or blood tests. They might also order a liver biopsy. Depending on your results, you might be referred to a specialist. Treatment will depend on your final diagnosis.
If you’re concerned your liver enzyme levels might be elevated, you might consider making some lifestyle changes at home, such as:
- reducing or eliminating alcohol from your diet
- being cautious about the medications and supplements you take
- staying active, including exercising regularly
- trying to add liver-friendly foods to your diet
- maintaining a moderate weight
Liver enzyme levels are an important indication of your liver’s health. When your enzyme levels are too high, it can be a symptom of liver damage or disease.
Some causes of elevated liver levels, such as hormonal changes or certain medications, are temporary and might resolve without treatment. Other causes are more serious and can include conditions such as cirrhosis, hepatitis C, and liver cancer.
Treatment for high liver enzyme levels depends on the cause.