Elevation of liver enzymes is common, occurring in one to four percent of asymptomatic people, according to the American Gastroenterological Association. The two main liver enzymes, alanine aminotransferase, or ALT, and aspartate aminotransferase, or AST, may be elevated in people with hepatitis or other forms of liver disease, who take certain medications, or who consume alcohol in excess.
Hepatitis
Both acute viral hepatitis and chronic forms of Hepatitis B and C can cause liver enzyme elevation. Testing for antibodies to hepatitis virus can identify people who have acute or chronic types of infection.
Liver Disease
While there are many different types of liver disease, the two most common types that cause liver enzyme elevation are cirrhosis and steatohepatitis, according to Dr. Paul Giboney in the March 2005 issue of American Family Physician. Cirrhosis is defined as gradual deterioration and dysfunction of the liver resulting in scar tissue replacing healthy liver tissue and inability of the liver to perform its normal functions. Steatohepatitis, also called non-alcoholic fatty liver disease or non-alcoholic steatohepatitis, is fatty infiltration of the liver. People with steatohepatitis may not have any symptoms and are commonly diagnosed as a result of elevated liver enzyme testing.
Medications
Giboney identifies a number of medications that may cause liver enzyme elevation. One of the most common medications that can cause liver damage is acetaminophen. People who take certain herbal supplements, certain antibiotics, blood pressure medications, anticonvulsants, and nonsteroidal anti-inflammatory medications also are at risk for liver enzyme elevation.
Alcohol Use
Alcohol is a direct liver toxin. While most people who drink alcohol in moderation do not have liver enzyme elevation, people who drink excessive amounts of alcohol can experience alcoholic hepatitis or cirrhosis, both of which can cause liver enzyme elevation.
References
- AGA Medical Position Statement on Liver Chemistry Tests
- National Digestive Diseases Information Clearinghouse: Cirrhosis
- National Digestive Diseases Information Clearinghouse: NASH
- "American Family Physician"; Mildly Elevated Liver Transaminase Levels in the Asymptomatic Patient; Paul T. Giboney, MD; March 2005
