Abnormal Liver Enzymes
Abnormal liver enzymes reflect liver injury or damage and could indicate the presence of chronic liver disease. If undiagnosed or left untreated, they can lead to progressive liver damage, the development of liver fibrosis (scarring) and even cirrhosis over many years.
When liver cells are inflamed or damaged, they release higher levels of these enzymes into the bloodstream, which can be detected with a simple blood test. Liver disease is sometimes referred to as a silent killer as there are often no symptoms until very late in the course of the disease. For this reason, the detection of abnormal liver enzymes should prompt further investigation to determine the cause of the abnormalities and to exclude the presence of chronic liver disease.
The liver enzymes include:
Abnormal liver enzymes can in some cases be a temporary finding, but additional tests are indicated to determine if these liver enzymes are persistently elevated. Continuously elevated liver enzymes are likely to reflect an underlying liver disease and further tests are required to establish a diagnosis. A medical history is also important to identify other risk factors for liver disease and to exclude the use of certain medications or over the counter remedies which can cause abnormal liver enzymes.
How are abnormal liver enzymes detected?
Abnormal liver enzyme levels can be detected with routine blood tests, also referred to as liver function tests (LFTs). The levels of these liver enzymes, in addition to albumin (a protein produced in the liver) and bilirubin are used to determine the health of your liver.
Liver function tests are standard blood tests and do not generally need special preparation beforehand. The detection of abnormal liver enzymes may indicate underlying liver disease, while abnormal levels of albumin (low) and bilirubin (high) may reflect impaired function and further investigation is required.
Causes & Symptoms
Abnormal liver enzyme levels do not indicate one specific disease or condition, but instead they reflect liver inflammation or liver injury, which can be caused by many different conditions, thus abnormal liver enzymes require appropriate investigation and management.
Potential conditions include:
- Alcohol-related liver disease
- Viral hepatitis
- Steatotic (Fatty) liver disease
- Autoimmune liver disease (immune-mediated liver diseases)
- Toxic or drug induced liver injury
- Hyperferritinemia ( elevated ferritin levels) and haemochromatosis (iron overload)
- Cirrhosis
- Liver cancer
- Liver lesions (requiring further investigation/characterisation)
- Gallstones and biliary disease
- Pancreatic lesions and cancer
- Gallbladder and bile duct cancer
- Coeliac disease
There are also many other possible causes for abnormal liver enzyme levels. While receiving abnormal liver function tests can be concerning, we are here to help you understand exactly why your liver enzymes could be elevated and what the appropriate management should be.
Additionally, some people with abnormal liver enzymes will have no identifiable cause and, in many cases, may not require treatment.
Abnormal liver enzymes often cause no symptoms, but in some cases individuals can present with the following symptoms:
- Fatigue
- Abdominal pain
- Jaundice (yellowing of the eyes and skin)
- Itching
- Nausea and vomiting
- Loss of appetite
- Dark urine
- Change in stool colour
Liver disease is often described as a silent killer, as many people will be have no symptoms even with persistently elevated liver enzymes, thus abnormal LFTs may only be detected during routine blood tests.
Treatment & Prevention
The detection of abnormal liver enzymes should be the springboard to visit a specialist, so that they can conduct further tests to determine the cause and the best course of action. There may be cases where the abnormal liver enzyme levels are due to a temporary infection or even related to medication use, which in some cases means no treatment will be necessary.
However, if you and/or your healthcare provider have concerns about your abnormal liver enzymes, additional tests will be employed to determine the cause and plan any treatment if required.
Identifying the cause of abnormal liver enzymes will be carried out through additional blood tests, usually referred to as a liver disease screen, imaging such as ultrasound scan, CT or magnetic resonance imaging (MRI) scans, in addition to Transient Elastography (Fibroscan), which is a simple non-invasive test performed in the clinic to quantify liver fibrosis (scarring) and steatosis (fat). Finally, a liver biopsy may be indicated if there remains diagnostic uncertainty.
Some recognised risk factors for abnormal liver enzymes include:
Lifestyle interventions to improve liver health
There are steps you can take to keep your liver healthy and functioning well, including eating a balanced healthy diet, exercising regularly, drinking alcohol in moderation with consecutive alcohol-free days each week, optimising blood sugar control if you have diabetes mellitus (or pre-diabetes) and making sure you are vaccinated against viral hepatitis (type A and B).
When to see a specialist
If you experience any symptoms of liver disease, such as jaundice, nausea and vomiting, abdominal pain, dark urine/pale stools, itching or fatigue, it is vital to contact your healthcare provider.
Alternatively, if you have already received abnormal liver function tests and you would like to know what the best treatment options are, you should contact a liver specialist to discuss appropriate investigations and management of your condition.
Professor Kennedy has created an online platform which offers consultations with liver specialists within 24 hours. The specialists are dedicated to overseeing the entire scope of a patient’s care from start to finish.
All treatment will be handled by a highly specialised team, ranging from experienced liver nurses and administrative staff to being supported by leading radiologists, oncologists and surgeons. The team of specialists will oversee investigation, diagnosis and management of patients who have received abnormal test results or abnormal imaging.
We prioritise a quick turnaround time for individual diagnosis and discussing treatment pathways. Additionally, the platform is served by a multidisciplinary team to discuss challenging cases and where necessary appropriate onward referral will be made without delay. Leaders in Liver Health are dedicated to providing a comprehensive personalised clinical pathway for every individual’s case.
