Liver

Common Reasons for a High Liver Enzyme Count

Jeff Hayward

Published on November 22, 2017 Updated on October 5, 2020

Health Check Certified By: Dr. Gerald Morris

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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.

Pain Pills

Over-the-counter (OTC) pain relievers, including acetaminophen (Tylenol) in particular, can cause your liver enzyme count to be high. Aside from OTC pain relievers, prescription drugs for cholesterol (i.e., statin) can also be the culprit.

Meanwhile, LiveStrong explains that acetaminophen can stress your liver “at nearly any dose.” Ibuprofen (Advil), another OTC pain reliever, can also cause stress on the liver at even the recommended dose, while the effect of aspirin on the liver is directly related to dosage, adds the source. In other words, low-dose aspirin should be your go to for pain relief if your elevated liver enzyme count prevents your from taking these kinds of medications for your arthritis or other annoyances, such as headaches.

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Heart Failure

This is a more concerning cause of a high liver 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.

Non-Alcoholic Fatty Liver Disease

Cleveland Clinic says non-alcoholic fatty liver disease is one of the most common causes of a high liver enzyme count, which can range in severity. It represents the storage of extra fat in the liver. The disease is “mostly silent,” which is why it is often discovered incidentally through routine tests for another health problem (e.g., blood tests as part of your yearly physical).

Although the disease often sits in the background as a benign condition until it’s discovered, 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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Hepatitis

MedicineNet.com explains testing for liver enzyme counts is one of three ways that doctors evaluate patients with hepatitis (or inflammation of the liver). “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 own body’s immune system to attack your otherwise healthy liver. There are a number of types of hepatitis, each with its own possible causes.

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 three specific liver enzymes: gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Doctors will look for AST levels that are significantly higher than ALT levels. The source explains that studies have shown in about 80-percent of cases of ALD, the AST level is more than double 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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Celiac Disease

This is a condition where the digestive system is sensitive to gluten, which is found in grains, such as wheat, rye, and barley, causing a host of unpleasant symptoms. It can also cause your liver enzyme count to be out of whack, notes the University of Chicago Medicine.

The source also points out that your liver 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 a change in your diet (i.e., a gluten-free diet) doesn’t cause the enzyme levels to decrease and no other cause is obvious.

Thyroid Problems

Hypothyroidism (or a low-functioning thyroid gland) is when this gland doesn’t produce enough thyroid hormones, which are responsible for a number of functions in your body (including liver function), notes EveryDay Health.

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

Jeff Hayward

Jeff has more than 15 years of experience writing professionally about health, travel and the arts among other subjects. He continuously looks to improve his own overall health through exercise, diet and mindfulness. He is also a proud stay-at-home dad that loves taking photographs both professionally and as a hobby.