Liver Enzymes
Liver Enzymes, also called Liver Function Tests (or LFT's) are proteins produced in the liver. Their job is to accelerate certain types of chemical reactions in the liver. They help the liver do its job. These enzyme levels are measured on routine blood tests that your doctor may do in his office. The two main tests are SGOT (also called AST) and SGPT ( also called ALT). 

Liver enzyme elevations are an extremely common phenomena. A doctor with a busy practice may come across a patient with this abnormality almost every day.

What does it mean if my liver enzymes are elevated?

Liver enzyme elevations can be caused by many things. The list below is long but by no means complete. Because there are so many things that can cause the enzymes to go up, it is one of the most common abnormalities discovered on routine blood tests. Most things that cause liver enzyme elevations are self resolving conditions or very mild illnesses, but some conditions can have more significant health implications.
Some Causes of Liver Enzyme Elevations
  • Fatty Liver
  • Viral Hepatitis  (Hepatitis A, B, or C)
  • Other Viruses ( CMV, Mono, and many others)
  • Alcohol
  • Medications - see list at right
  • Tumors
  • Hemochromatosis
  • Nutritional Supplements
  • Herbal Remedies
  • Thyroid Disease
  • Liver Abscess
  • Wilson's Disease
  • Alpha-1-Antitrypsin Deficiency
  • Primary Biliary Cirrhosis
  • Autoimmune DIseases
Although the list of things that can cause liver enzyme elevations is very long some of these conditions are extremely rare. Wilson's disease and alpha-1-antitrypsin deficiency are conditions that a physician may never see in his or her entire career. Viral Hepatitis, medications and alcohol are much more common causes, but far and away the most common cause is a condition known as Fatty Liver. This condition causes close to 50% of the cases of liver enzyme elevation seen in my practice. It is primarily due to diets high in carbohydrates and an excess of calories. Alcohol also can contribute to this. Click Here to read more about Fatty Liver.

So what do I do now?

First, don't panic. As stated above, this is a common problem and usually not a serious one. The first thing we always do is repeat the test. This is done for several reasons. First, the test could be wrong. Errors can and do occur in lab testing. It is unavoidable. Second, as stated above, many of these problems are self resolving.  The problem may cure itself by the time your the blood work is retested.  It's very important to avoid alcohol, drugs, herbal remedies, and nutritional supplements in the week leading up to the test.

If your repeat test is still abnormal your doctor will order additional blood work to rule out some of the causes listed above and if necessary, a sonogram may be ordered as well to look for things like tumors and abscesses.  The sonogram is also the best way to diagnose fatty liver which causes many if not most cases of liver enzyme elevation.

Helpful Links

  • Acarbose (Precose)
  • Acetaminophen
  • Allopurinol (Zyloprim)
  • Amiodarone
  • Baclofen (Lioresal)
  • Bupropion (Wellbutrin)
  • Herbal preparations containing kava kava (Piper methysticum) and germander (Teucrium chamaedrys)
  • Highly active antiretroviral therapy
  • Isoniazid
  • Ketoconazole
  • Lisinopril (Zestril)
  • Losartan (Cozaar)
  • Methotrexate
  • NSAID's - Nonsteroidal anti-inflammatory drugs
  • Omeprazole (Prilosec)
  • Pyrazinamide
  • Rifampin
  • Risperidone (Risperdal)
  • SSRI's - Selective serotonin reuptake inhibitors
  • Statins
  • Tetracyclines
  • Trazodone
  • Valproic acid (Depakene)

This is only a partial list. Check with your physician to determine if any of your medications may be elevating your liver enzymes