Fatty Liver Disease

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If your doctor tells you that you have elevated liver enzymes, you may find that scary, and in fact since this can be a sign of potentially serious liver disorders it is cause for concern. However, there are many possible causes of liver enzyme elevation, not all of which are any serious danger.

The liver enzymes that are most commonly found to be elevated are alanine transaminase (ALT) and aspartate transaminase (AST). (Elevation of these enzymes is sometimes referred to as "elevated tranaminases" or, more simply, "transaminitis.") In most diseases of the liver, ALT will rise higher than AST. However, in diseases caused by alcoholism or excess alcohol consumption, AST tends to rise higher and faster than ALT. There are other live enzymes that may be elevated less commonly as a result of some liver conditions. The liver produces thousands of different enzymes in the performance of its many functions.


Elevated liver enzymes can be produced by a wide range of factors, some of these being liver disorders, others not. Among the causes are: adrenal deficiency (inadequate hormones produced by the adrenal gland); alcohol abuse; diabetes; elevated triglicerides (a condition often accompanying elevated cholesterol levels); various benign and serious liver diseases, including
hepatic steatosis (fatty liver disease), cancer of the liver, and hepatitis (both viral hepatitis and steatohepatitis); obesity; thyroid disorders; medications, including cholesterol-lowering drugs, non-steroid anti-inflammatories, antibiotics, anti-seizure medications, and others; and excessive use of certain herbal supplements. Obviously, not all of these are liver conditions requiring concern or treatment.

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In most cases, elevated liver enzymes produce no symptoms. Where symptoms do occur, they are not normally caused by the enzyme elevation itself, but rather by an underlying condition. Among common symptoms of liver disorders are jaundice, itching, swelling of the abdomen, pain, nausea, and an enlarged liver. However, elevated liver enzymes are normally diagnosed not through symptoms but by blood tests, as most of the time the condition is asymptomatic.


Elevated liver enzymes are seldom treated directly through medication or other direct methods. Instead, the underlying cause of the condition is sought and treatment is tailored to that cause. If the elevated enzymes are the result of excessive alcohol, for example, the obvious treatment is to reduce or eliminate drinking; if it is the result of obesity, a program of weight loss is indicated. If a medication is the culprit, ceasing to take that medication may be in order, depending on the condition for which the medication is prescribed (which may be more serious than elevated liver enzymes) and whether or not good alternatives exist.


Elevation of some liver enzymes is normal during pregnancy. However, elevation of AST and ALT should not occur, and is a sign of something abnormal if it does. Abnormal liver enzyme elevation occurs in approximately five percent of pregnancies.

Some serious complications of pregnancy can produce elevations of liver enzymes. One of these is pre-eclampsia, which is characterized by high blood pressure and protein in the urine and sometimes occurs after twenty weeks of gestation. Pre-eclampsia can advance to eclampsia, characterized by seizures. Hemolysis, elevated liver enzymes and low platelets (HELLP) is sometimes a complication of pre-eclampsia and occurs in about one percent of pregnancies.

Acute fatty liver of pregnancy (AFLP) is a rare condition that threatens the life of both mother and infant, and also results in elevated enzymes. The treatment for AFLP, pre-eclampsia, and eclampsia is to deliver the baby immediately. The mother may need intensive care after delivery.

Elevated Liver Enzymes