Your Health

Common Reasons for a High Liver Enzyme Count

Jeff Hayward

Published on November 22, 2017 Updated on July 15, 2019

So your doctor has told you that you have a high liver enzyme count…now what? It could be associated with a disease or another health problem, but a doctor will be the one to assess the symptoms and rule out the possible causes.

In some cases, further tests will be needed to pinpoint the exact reason behind the elevated count. It can be something relatively minor that can be easily adjusted, or it can be something more serious that requires further medical supervision. Here are seven things to know if you have a high liver enzyme count, in no particular order…

1. Pain Pills

Over-the-counter pain relievers, including Tylenol in particular, can cause the liver count to be high. Aside from non-prescription painkillers, prescription drugs for cholesterol (statin drugs) can also be the culprit.

Meanwhile, Livestrong.com explains that acetaminophen (the active ingredient in Tylenol) can stress your liver “at nearly any dose.” Ibuprofen (Advil) can also cause stress on the liver at even the recommended dose, while aspirin’s effect on the liver is directly related to dosage, adds the source.

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2. Heart Failure

This is a more concerning cause of a high enzyme count, because it means your heart isn’t pumping blood the way it should be, notes the Mayo Clinic. Certain conditions – such as coronary artery disease – can stress the heart and make it too weak to pump efficiently, notes the source.

“Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer,” it adds. While the doctor may be able to trace the cause of your heart problems (such as congestive heart failure), elevated liver enzymes aren’t always traced to the heart.

3. Nonalcoholic Fatty Liver Disease

Cleveland Clinic says Nonalcoholic fatty liver disease is among the most common causes of chronic liver disease, which can range in severity. The disease is “mostly silent,” but it can be discovered through tests for liver enzyme levels, adds the source.

Although the disease often sits in the background as a benign condition until it’s discovered (often for a test for another health problem), it can be serious if it’s in the form of nonalcoholic steatohepatitis (NASH), adds the source. “NASH can progress to fibrosis and lead to end-stage liver disease,” it warns.

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4. Hepatitis

MedicineNet.com explains testing for liver enzyme counts is one of 3-ways that doctors use to evaluate patients with hepatitis. “If the liver is injured (as in viral hepatitis), the liver cells spill the enzymes into the blood, raising the enzyme levels in the blood and signaling that the liver is damaged,” it notes.

Hepatitis is commonly caused by a viral infection, and there’s an autoimmune form of the disease that causes your system’s antibodies attack your otherwise healthy liver. There are a number of types of hepatitis, each with its own possible causes.

5. Alcoholic Liver Disease

The National Institute on Alcohol Abuse and Alcoholism says that a history of heavy drinking may be responsible for your high liver enzyme count. However, alcoholic liver disease (ALD) can sometimes be a challenge for doctors to diagnose because patients often downplay their alcohol consumption, notes the source.

Medical diagnosis then relies on lab tests of 3-liver enzymes – gamma–glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Doctors will look for AST levels that are significantly higher than the ALT levels – the source explains that studies have shown in about 80-percent of cases of alcoholic liver disease, the AST level is more than 2-times that of the ALT level. GGT is another indicator of excessive drinking, “but GGT is present in many organs and is increased by other drugs as well,” it adds.

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6. Celiac Disease

This is a condition where the digestive system is sensitive to gluten found in some grain products, causing a host of unpleasant symptoms. It can also cause your liver enzyme count to be out of whack, notes University of Chicago Medicine.

The source also points out that your enzyme levels should go back to normal soon after cutting out gluten products (from a month to a year). If they don’t, then you may have another problem on your hands. Doctors may have to perform a liver biopsy if changing diet doesn’t drop the enzyme levels and no other cause is obvious, says the source.

7. Thyroid Problems

Hypothyroidism in particular is when the thyroid gland doesn’t produce enough thyroid hormones that are responsible for a number of functions in your body (including liver function), notes EveryDayHealth.com.

The liver and thyroid are pretty closely connected, it adds. “Not only does the liver play a role in the chemical process that develops thyroid hormones, but untreated hypothyroidism can cause problems in liver function over time,” it explains. The doctor may perform a liver panel test to look for things like irregular GGT liver enzyme levels to determine a course of treatment.