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Do You Have High Liver Enzymes or a Fatty Liver?
If your doctor delivers news of high liver enzymes or a fatty liver, make sure you understand what that means.
A routine doctor visit is an opportunity to discuss nagging health concerns, whether or not they seem important. Patients complaining of fatigue, aches and general malaise are frequently ordered to undergo blood panel or imaging tests in an effort to rule out any major health issues. Much to the patient’s chagrin, a liver-related result “out of the normal range” can surface. Thanks to the modern physician’s ability to analyze seemingly vague symptoms with lab test findings, many people are learning that their health woes are due to high liver enzymes and/or a fatty liver.
- Liver Enzymes
- High Liver Enzymes
- Fatty Liver
- Stages of Fatty Liver Disease
- High Enzymes and Fatty Liver Are Reversible
- Nine Key Components of Supporting Liver Health
Liver Enzymes
High liver enzymes are one of the more frequent findings at a routine doctor visit. Potentially indicating liver damage, high liver enzymes are detected by a simple blood test. While liver enzymes are usually found in the liver, damage to this important organ causes the enzymes to leak into the bloodstream.
The two liver enzymes that are the most straight-forward to test for and evaluate are aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Normal, or healthy ranges for these liver enzymes are:
- AST = 5 to 40 units per liter of serum
- ALT = 7 to 56 units per liter of serum
High Liver Enzymes
High liver enzymes could indicate many different types of conditions – some are mild, temporary and unimportant; others are high, chronic and hazardous. The following are some potential reasons for high liver enzymes:
- Fatty liver
- Consequence of taking a medication – prescription or over-the-counter
- Casual or problematic alcohol use
- Exposure to toxins
- Hepatitis A, Hepatitis B or Hepatitis C
- Heart failure
- Obesity
- Celiac disease
- Cirrhosis
- Hypothyroidism
- Wilson’s disease
- Mononucleosis
Although the list above is not exhaustive, a fatty liver is by far the most common culprit of high liver enzymes.
High Liver Enzymes and Your Cancer Risk
High liver enzymes can be a sign of both liver cancer and pancreatic cancer. While fatty liver is a much more likely diagnosis, you should be alert for the signs and symptoms of cancer, especially if tests for fatty liver come back negative. Discuss your health history with your doctor, and either suggest a cancer screening or seek a second opinion if you’re not sure. This is especially important if you are overweight, as doctors can be prone to assuming the cause is obesity when, in reality, something else is going on beneath the surface.
Learn more about liver cancer here.
If you don’t have cancer but do have high liver enzymes, breathe a sigh of relief, but start considering cancer prevention. One way to help your liver resist cancer is by using Clinical Liver Support, which helps to eliminate inflammation and free radicals which can lead to precancerous conditions.
Fatty Liver
While a little bit of fat in the liver is normal, livers containing 5 to 10 percent of their weight in fat is considered fatty liver, the first stage of non-alcoholic liver disease. A fatty liver could be due to alcohol abuse or other diet and lifestyle factors. Between 90 and 100 percent of the 15 million alcoholics in the U.S. have a fatty liver.
Even if you do not drink to excess, you may still have a fatty liver and not know it.
The Centers for Disease Control (CDC) estimates that up to 30% of the U.S. population has a fatty liver, which can affect liver function and lead to more serious liver and health issues. The CDC also reports, that approximately 50% of the U.S. population is overweight – and over 25% is obese. Ninety percent of these two groups have liver issues starting with a fatty liver.
Stages of Fatty Liver Disease
There are two basic stages of non-alcoholic fatty liver disease: steatosis and steatohepatitis. Steatosis is the earlier stage, characterized only by liver fat accumulation. If steatosis persists and worsens, steatohepatitis can develop. Steatohepatitis is characterized by liver fat accumulation and inflammation. Referred to by its full name, non-alcoholic steatohepatitis – or NASH – this condition can lead to cirrhosis, a severe health condition defined by irreversible, advanced scarring of the liver.
High Enzymes and Fatty Liver Are Reversible
In and of itself, test results indicating high liver enzymes or a fatty liver don’t mean your quality of life will be affected. As long as severe, permanent damage to your liver has not occurred, both are reversible. Being proactive in supporting liver health with healthy nutrition and supplementation has been shown to normalize liver enzyme levels and reduce liver fat accumulation.
Nine key components of supporting liver health include the following:
- Losing weight if overweight or obese.
- Eating a nutritious, low-fat, low-glycemic, high-fiber diet.
- Getting daily aerobic exercise.
- Avoiding alcohol and unnecessary medications.
- Minimizing exposure to chemicals and toxins.
- Increasing consumption of antioxidant-rich foods, like blueberries, pomegranates, grapefruit, kale and carrots. In addition to blueberries, find out 5 more anti-inflammatory foods for your liver.
- Taking probiotics or other dietary supplements containing healthy live bacteria. Natural Wellness’ Ultra Probiotic Formula contains 35 billion viable cells per capsule.
- Supplementing with substances that support the liver’s functions, like milk thistle and Alpha Lipoic Acid.
- Supplementing with substances that support the liver’s ability to metabolize fat, like green tea and curcumin. Turmeric 95 is powerful! It contains 95% curcuminoids (or curcumin), the highest level on the market today. Moreover, Natural Wellness’ Clinical LiverSupport contains green tea extract and Curcumin C3 Complex®
Also important is following a doctor’s orders to treat other health conditions which can aggravate the liver, like diabetes, high cholesterol or hypertension.
Although not a reason to celebrate, finding out you have high liver enzymes or a fatty liver is not the end of the world. Luckily, routine doctor visits can help many people detect these issues before they progress to severe liver damage. The good news is that the nine liver support practices described above can help normalize liver enzymes and reduce liver fat accumulation so that you can return to optimum health.
http://health.usnews.com/health-news/family-health/diabetes/articles/2009/04/10/nonalcoholic-fatty-liver-disease-5-tips-for-treatment-prevention, Nonalcoholic Fatty Liver Disease: 5 Tips for Treatment, Prevention, January W. Payne, Retrieved October 28, 2012, US News & World Report, LP, 2012.
http://www.ccjm.org/content/77/3/195.full, When and how to evaluate mildly elevated liver enzymes in apparently healthy patients, George Aragon, MD, et al, Retrieved October 28, 2012, Cleveland Clinic Journal of Medicine, March 2010.
http://www.mayoclinic.com/health/elevated-liver-enzymes/MY00508, Elevated Liver Enzymes, Retrieved October 28, 2012, Mayo Foundation for Medical Education and Research, 2012.
http://www.webmd.com/hepatitis/fatty-liver-disease, Fatty Liver Disease, Retrieved October 28, 2012, WebMD, LLC, 2012.
http://www.cancer.ca/en/cancer-information/cancer-type/liver/diagnosis/?region=on, Diagnosis of Liver Cancer, Canadian Cancer Society, Retrieved July 5, 2018.
https://www.medicinenet.com/pancreatic_cancer_the_silent_disease/views.htm, Pancreatic Cancer, the Silent Disease, Lee, Dennis, MD., Retrieved July 5, 2018, MedicineNet.com.
About the Author
Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.
I have non alcoholic fatty liver. I have hypothyroidism but my T4 and T3 are under control by taking medicine. Last month I did my blood test and found my AST 38 (13-39) and ALT is 51 ( 5-52) are within the range. I did ultrasound today and technician ( not doctor said yet) said I still have fatty liver. I am 5’9″ and weigh only 140lb and my waist is 30″. Not a over weight. I am a thin guy.
I found fatty liver last November and since then I started taking Milk thristle, proper diet and started aerobic exercise but still my fatty liver is not going away. Why?
I also do not have Dietetics, cholesterol. I check for these every year and they are normal. I have take Tylenol or Advil only one time in whole year, no liquor and totally veggie.
My GI doctor told me that due to thyroid, you have fatty liver and once it is under control, you will be fine. But since last 6 months my T4, T3 and TSh are normal. My LFT are normal then why my fatty liver is not going away.
What should I do to get rid of fatty liver? Please help
Thanks
Try exercise. Walking about half a hour daily.
Some rat studies show what’s going on…the liver needs enough choline to flush fats out via VLDL particles, so if its intake is insufficient, fat gets stuck.
So, you might want to try supplementing choline (as choline bitartrate) 1000 mg/day for a time, to correct any underlying deficiency, plus BCM-95 curcumin to stop inflammation and help bringing liver enzymes down. Watch out for ALT/AST ratio however: if ALT is significantly elevated over AST, even in the normal range, it usually indicates fatty liver.
As for side effects, choline slightly raises triglyceride levels, which can be countered with enough omega-3 intake.
You liver will never regain full liver function if you don’t eat the fat- if you’re on the low-fat diet that is killing you. Liver needs fat to function properly and you need saturated fat -good animal grass fed fat and coconut oil. This article is calling again for LOW-FAT! That is unbelievable. Low-fat BS and eating grains, sugars and vegetable oils caused the whole world to be obese and sick. Get rid of all grains, sugars, any dairy for now, and vegetable oils as they are highly inflammatory (gluten, lactose, casein!)and are overburdening the digestive tract, liver and damage your gut. Liver’s main function is to emulsify fats so increase fat you will recover over several months. Do you have gall bladders issues as well? Do you have Hashimoto’s thyroid? Thyroid hormones are converted in the liver so no wonder your is low as you liver function is impaired so it doesn’t convert it properly, so your GI is wrong- the cause of low thyroid is due to low-functioning liver not the opposite. Do some reading- there is tonnes of info out there. Just stay away from mainstream ‘medicine’ as you will never recover.
Sylvie, you seem to know quite a bit, could I ask you some questions as trying to navigate around the web is too much for me at the moment…I was diagnosed with FMS 8 years ago, sleeping 20 hrs out of every 24, couldn’t walk more than 3 paces due to fatigue etc., etc., then last Nov was diagnosed with Hashimotos, now my liver is painful through to my shoulder am taking MT, Serrapeptase, Magnesium, Gentle Iron, Vit C, EPO, Adrenal support and NDT, as well as my meds from doc, 2 blood pressure tabs, anti spasmodic for spasms in the liver, Nexium, Provera, and a beta blocker……because of the pain fron the FMS I have been taking 4/8 Solpadeine a day for the las t 8 years which is what I think has brought on the fatty liver, I stopped taking them a week ago but am in such pain I feel like I need to take some again…..where do I go from here? Help please 🙂
Hi Annie, if you have a way of sending me a private message I can help you 🙂
Hi Sylvie, am now on the disqus board, Thankyou for replying to my message
not sure how to send you a private message here. cant find an option 🙁
Had blood and urine tested for the first time everything was normal except my ast was 42 the range 11-41 and my alt was 69 the range was 3-63 should I be concerned about these high levels, my diet has been really poor lately and I had a really fatty meal the night before
I wouldn’t be ‘worried’ but if it were me I’d heed the warning and make sure that I am not drinking too much or eating poorly – remove all ‘crap’ food. Nothing but healthy food and sugary foods and drinks as a treat only, no more than once a week. Cardio 30 min a day, maybe weights as metabolism is tied to muscle so add a bit of weight training a couple days a week. Make sure you keep your waist (at largest spot) less than 36 in – best if around 32 inches for a man, less than 30IN for a woman. Take fish oil or find a way to get omega 3 in your diet, they help with inflammation. CoQ10 is a good antioxidant and Vit C is as well. Turmeric supplements are good for liver and quite safe since it is just turmeric but you can also just add to your foods. Read books about fructose and liver health and get your liver enzymes checked at least every year. Also, get your iron checked annually and men in general should donate blood once a year – good for heart health and over all health. Make sure to get your cholesterol checked annually and especially watch your triglycerides and LDL. If these start to rise, it is a sign of liver struggles.
Good distinctions. Mel at fattyliverdietguide
my ALT is 135 and my AST is 64; my My red cell distribution is high and so is my hemoglobin and anion gap. tests for gallbladder are okay, but now what should i do/
If you are no longer getting regular menses you may want to have your iron/ferritin checked. Hemochromatosis is a common genetic issue that impacts the liver – women don’t usually notice until they stop monthly menses due to iron lost during that time. Men usually have issues in the +40 range but if someone can’t/doesn’t want to go get the lab test – you can go donate blood!!! Go donate blood at a local blood bank, it is free and they will tell you what your iron level is. If your iron level is too high they won’t let you donate, but if it is on the boarder or normal you can donate and do your civic duty!!! 🙂 Free blood testing – kind of, they take a pint of blood 🙂
Men should donate one or twice a year as a manner of habit for heart health. I am not a crazy nut – it is well known. To confirm ask a cardio doc or call the local blood bank and ask them why would men benefit from an annual blood donation.
Sheryl – You would also likely benefit from the 3 week protein only diet as mentioned above in my reply to Shelley. You can google books about liver and fructose, basically diet is 3 weeks of nothing but protein, milk and nuts (Milk, eggs, nuts, green tea and fish/meat). Absolutely nothing else and if you can go 3 weeks with zero cheating your liver enzymes will likely improve. After the 3 weeks you can return to a normal, but low sugar and healthy diet with 30 min of cardio a day and assuming nothing else is wrong (such as iron overload) you’d likely see a perfectly healthy liver in about a year or so (liver heals itself but it takes a bit of time to recover). Also, turmeric, milk thistle and green tea are good for the liver.
Thank you, I have added turmeric to my diet as well as going to get my iron level checked. I still have pain in my right side up to just under my shoulder blade….they want to do a biopsy now.
My ALT is 158, AST is 177 and Alkaline Phosphatase is 148. I have back pain, fatigue and achy . What should my next step be?
Try this….For 3 weeks eat 100% protein – zero anything else. Milk, eggs, nuts, fish/meat, white/green tea and nothing else. It isn’t fun, cravings are hard to resist and meal time is dreaded…. but it’s only 3 weeks. If you can stick with it and not cheat at all for 3 weeks then…. Then go back to a regular – but healthy diet and 30 min of cardio a day. It worked for me and at my 3 month follow-up MD apt he was so impressed he said they don’t normally see liver disease reverse so quickly. The US showed my liver was over 3 cm smaller that it was – albeit still larger than it should be. It took a year before my US showed a normal sized liver but it is now normal. Sounds crazy but it works. There are a few books about fructose out there that may help…certainly better than cirrhosis! Try reading any books/website about fructose and liver problems. Also, milk thistle and green tea are helpful. You may also want to see a hepatologist or at least a GI doctor.
Is this all you ate for 3 weeks. Also what are the foods you should avoid while doing this?
Hi, I’m a 55 year old female. I just got results that my ast is 55 and my alt is at 59. I’m not abusing or drinking. My thought was that what diet can I do to help my liver? I have had chronic pain in the past back in 2009 to 2012. But I got over it. My liver function has always read normal until last week. I’m suffering from chronic pain again for the last 3 months.
When this new bout of chronic pain started I was over weight by 35 pounds, I’ve lost 20. I had been taking over the last three months until my doctor switched my meds after my recent abnormal liver reading, celexa 30 mg, Tylenol 3 at 2 to 3 tabs , daily, unisom 1 to 2 gel caps nightly,, over the counter leg muscle relaxers at night and during the day and a supplement called MSM. As well as several supplements. My doctor stopped all that and switched meds for my pain as stated below.
Now I want to know if milk thistle is ok to take while trying to heal liver? Plus, Is including juice of 1 beet and a chunk of ginger on a daily bases ok for the liver during this time for me? Can anyone talk to me about what would be helpful in supplements and diet for me while realizing that now at this time, I must take Prozac 20 milligrams, maloxacam 15 to 20 milligrams, and a time released tramadole 100 milligrams all daily? Thanks Mia
Mia, pls ready my comments above. You should look into AIP diet (autoimmune protocol) or at least switch 100% to ‘Paleo’ way of eating ASAP. Do some reading, many Integrative/Functional medicine drs (that went away from this scandalous mainstream drug-dealing medicine) have websites with tonnes of info. If you’re on FB there a many support groups with thousands of people sharing their path to health. Dr. Mercola, Dr. Loren Cordain, Dr.Terry Wahls and many others- read it all to understand how we get sick. But quickly here- Get rid of all grains, sugars, any dairy for now, and vegetable oils as they are highly inflammatory (gluten, lactose, casein!)and are overburdening the digestive tract, liver and damage your gut. Liver needs fat to function properly and you need saturated fat -good animal grass fed fat and coconut oil, so increase fat substantially. You will get health, and lose weight naturaly 🙂 .
I am 24, and my ALT is 460 and AST is 217. I don’t drink nor do I use any medications or have any symptoms that I’m aware of. Any suggestions? Over the last 3 years I have gained 50lbs, so that could always be a contributing factor.
Hello, received blood test and my
Ast 81 High (15-37 should be)
Alt 169 High (12-78 should be)
Is this a major concern and what should I do?
Hello, I had an ALT of 106 and an AST of 222 in Nov. had another blood test one month later. ALT went up to 222, AST went up to 333! I take simvastatin, and love my wine! Before the second test, I cut back on the wine but continued my statins. Now I have cut back considerably on the wine and have been taken off of my statins. I will be seeing a gastro dr in Jan. kinda freaking out here! Can I lower those numbers back to normal or are they too high? Is there hope?
Hello, my partner was told her increased liver enzymes (4 times normal) is caused by pressure from benign tumor.
So my question is could the higher enzymes cause weight loss by preventing the body from absorbing nutrients? She eats same if not more than me but muscles wasting away? Thanks
U got something very wrong here too. If you have fatty liver , do not take milk thistle. IT CAN KILL YOU!!! You have to first detoxify the liver. I made the mistake so I know what I am talking about. M.T. gave me horrendous liver pain. once I cleansed my liver, I was able to take milk thistle. Think about it you cannot regenerate a liver which is fatty without cleaning it first. this would be like trying to cook Thanksgiving dinner in an oven that is super greasy and has never been cleaned before. You’ll cause a fire! Another example: you would not put your antioxidant moisturizer on top of your face that has spackled, caked on makeup. You need to wash it first or it will be useless. I did not know what milk sister did when I took it. I took stupid advice from a blogger such as yourself because I thought milk thistle cleansed the liver. It does not. It merely aids regeneration of cells. M.T. is for Phase 2 liver cleanse. First you have to take care of phase one. I am surprised how someone can have a liver website and know so little. You are dangerous and can get people killed this way. Educate yourself first please. I am surprised you have not being sued yet!
so where is your doctorate that makes you so knowable of this?? what cause you happen to have a bad experience with a supplement.
Thank you so much for this information because I’m overweight, have fatty liver, trying to lose it through diet and exercise, even got a pit bull who walks with my everyday. I’ve been trying every thing, Milk thistle, green tea, turmeric, apple cider vinegar “the mother” every morning, decaf coffee, laying off the sugar, treats, bread, pasta, cheese. Thank you so much for the milk thistle examples, no wonder why my liver hurts.
low-fat?? this is a liver support website? where do you get your information? from sugar industry??
Recently had an ultrasound which showed mild fatty liver infiltration. I am not a heavy drinker nor am I obese. LDL levels are slightly elevated but not at the level where I need meds and negative for all viral serology. If I have some drinks over the weekend it seems that my liver enzymes get slightly elevated and otherwise are normal. Why would this be happening? And do I have to avoid alcohol completely now and perhaps forever?
Fatty liver is not just a problem for people that are obese. You may want to visit http://www.liversupport.com/fatty-liver/ to see the causes of Fatty Liver. Drinking alcohol when your liver is unhealthy could certainly increase liver enzymes. Speak with your doctor about what could be causing your mild fatty liver and ways to reverse it. Until that is under control, your doctor may recommend abstaining from alcohol.
Thank you for your response
Unfortunately my doctor doesn’t seem to know much about this and told me not to worry and not to change my lifestyle- kind of frustrated and anxious about finding the cause
Hi, I have had fatty liver for years now. My Liver Enzymes are ok, AFP ok, Billi Normal, yet My LDL is always in the range of 150. Recently my Ultra sound report suggested Patchy Fatty infiltration. and i have had pain in right upper abdomen. Have tried to change my eating habits but that bloating feeling and pain and heavyness doesnt go away. any suggestions?
I’m a middle aged female, and my ALT is 57 right now. It has been elevated ever since two changes were made in my meds. FIrst, I switched from occasional use (as needed) oxycodone to daily use morphene because with the recent changes in pain med prescribing it seemed like a better way to ensure my urine samples would always be positive. However this change also had a deteriorating effect on my overall health and fatigue. Not as much as daily oxy would’ve been, but still a bad effect.
The second change is, I began treatment for chronic mononucleosis using Valtrex daily. This is on top of the daily beta blocker and celebrex, both of which had no effect on my liver after years of use. Although celebrex is generic for the first time ever, it’s debatable if the difference is more than a color change in the capsules because the same manufacturer makes both.
The chronic mono makes me catch every infection that comes within miles of me. I am on 3-4 courses of antibiotics each year.
I’m glad you mentioned mono in this article and I want to know if it is the Valtrex that causes the ALT elevation, or if the herpes virus (two cause mono, epstein barr and cytomegalovirus) is actually attacking liver cells, which would make it more of a herpes – hepatitis.
Note that since 2012, officially there are I think 9 herpes viruses, but that will surely change since HHV6 is a retrovirus and different from the others. I wonder if the HHV6 Foundation notes anything about ALT, I’m going to look at that next. Thank you for the article, it helped out.