Elevated liver enzymes

Updated: 2022-01-06

Definition

Elevated liver enzymes often indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, elevating liver enzymes on blood tests.

The elevated liver enzymes most commonly found are:

• Alanine transaminase (ALT)
• Aspartate transaminase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)

Elevated liver enzymes might be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated. Most of the time, elevated liver enzymes don't signal a chronic, serious liver problem.

Causes

Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the cause by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.

More common causes of elevated liver enzymes include:

• Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
• Certain prescription medications, including statin drugs used to control cholesterol
• Drinking alcohol
• Heart failure
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Nonalcoholic fatty liver disease
• Obesity

Other possible causes of elevated liver enzymes include:

• Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
• Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
• Celiac disease (small intestine damage caused by gluten)
• Cytomegalovirus (CMV) infection
• Epstein-Barr virus
• Hemochromatosis (too much iron stored in your body)
• Liver cancer
• Mononucleosis
• Polymyositis (inflammatory disease that causes muscle weakness)
• Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
• Thyroid disorders
• Toxic hepatitis (liver inflammation caused by drugs or toxins)
• Wilson's disease (too much copper stored in your body)

When to see a doctor

If a blood test reveals you have elevated liver enzymes, ask your doctor what the results might mean. Your doctor might suggest you undergo other tests and procedures to determine what's causing your elevated liver enzymes.