Having elevated liver enzymes could mean you have an inflammation or damage to cells of liver. Whenever there is injury or inflammation occurring in liver, the cells can leak higher amounts of substances like enzymes, which enter the bloodstream resulting to slightly elevated enzymes found in blood tests. The common liver enzymes are alanine transaminase (ALT) and aspartate transaminase (AST). In most cases, elevation of liver enzymes is usually discovered when routine blood tests are being conducted. Most of the liver enzymes levels may be temporarily or mildly elevated. In such a situation, it does not signal any major or chronic liver problem.
Causes of slightly elevated liver enzymes
There are a plethora of diseases and conditions, which are linked to increased levels of liver enzymes. A doctor may determine the possible cause by conducting various tests and reviewing your medical history and any signs you might have. The common causes are use of prescription drugs like statins, drinking alcohol, hepatitis, obesity, autoimmune hepatitis, cirrhosis, and heart attack.
In primary care, mild elevations of liver enzymes are found commonly in asymptomatic patients. There is limited evidence that can help in guiding the diagnosis of elevated liver enzymes, therefore, if the medical and physical investigation of a patient does not suggest any possible cause, there may be need to conduct stepwise evaluation pegged on diseases that are believed to cause mild elevations of these enzymes.
The commonest of the causes of increased transaminase levels is nonalcoholic fatty liver disease. This disease affects a large population and is mainly detected in people who have slight increase in liver enzymes. An injury of the liver associated with medication may also cause this situation. When drugs such as statins used to treat cholesterol levels in body are taken by a patient, they may cause side effects like damage of liver cells. This could contribute to the increases levels of transaminase.
Viral hepatitis such as hepatitis B and C are also linked to such elevations. A virus that attacks the livers causes damage to cells thereby resulting in the increment of liver enzymes. There are also less common causes, which may include autoimmune hepatitis where the body attacks its own cells through the immune system. Wilson disease is also associated with the condition. In Wilson disease, a patient does not have the ability to excrete copper from the body meaning that a lot of this metal is stored in body.
Inflammation of the pancreas or pancreatitis may also affect the liver, which causes the enzymes to increase in blood. Analyzing the pattern of elevations of the liver enzymes in blood may indicate specific kind of diseases or conditions. Alanine transaminase is primarily found within the liver but aspartate transaminase can be found in other locations like erythrocytes and skeletal muscles. This means that if you have elevations of alanine transaminase, it is more associated with hepatic injury.
When the ratio of AST to ALT is greater than 2, it suggests a condition like alcoholic liver disease. A ratio of AST to ALT that is less than 1 is usually associated with nonalcoholic fatty liver disease. A ratio exceeding 1 may indicate a disease like Wilson disease.
A genetic disease known as hemochromatosis is linked to elevated liver enzymes. This disease is has to do with iron metabolism. It can cause asymptomatic elevation of the transaminase enzymes in liver due to deposition of iron in liver. A gene mutation which cause hemochromatosis is common is some groups of people.
What do liver enzyme tests indicate?
Generally, liver blood tests are conducted to detect if there is an injury or inflammation to liver. The liver enzymes AST, ALT, and others such as alkaline phosphatase are referred to as liver enzymes not because they help determine the function of the liver but due to the fact that they help detect an injury or damage to the liver. Although these different tests such as AST test, ALT test, alkaline phosphatase test, and bilirubin tests are collectively referred to as liver function tests, this term is considered misleading since alkaline phosphatase and aminotransferases do not reflect the functioning of liver.
The tests that can be referred to as a true liver function tests are the tests for glucose, bilirubin, albumin, and blood coagulation panel. The tests are conducted in different situations such as in routine screening of a patient, evaluation of abdominal pain, or investigating a suspected liver disease like cirrhosis or hepatitis.
The liver blood tests are only conducted as part of a larger and broader comprehensive metabolic panel tests, which include kidney function test and electrolyte levels. When the liver transaminase levels increase and they remain elevated despite having treatment and making modification on lifestyle, there is need for further diagnosis. An elevation of liver enzymes that lasts for more than six months and does not subside even after treatment, it should be considered seriously and a liver biopsy may be conducted to help determine the exact cause.