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Do You Have High Liver Enzymes or a Fatty Liver?


Nicole Cutler

Jan 2nd, 2013

If your doctor delivers news of high liver enzymes or a fatty liver, make sure you understand what that means.

Do You Have High Liver Enzymes or a Fatty Liver?

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 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 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:

  • 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.

Fatty Liver

While a little bit of fat in the liver is normal, livers containing 5 to 10 percent of their weight in fat could be due to alcoholic or non-alcoholic liver disease. Between 90 and 100 percent of the 15 million alcoholics in the U.S. have a fatty liver. Unfortunately, alcohol doesn’t need to play a role in liver fat accumulation. Experts estimate that 25 to 33 percent of American adults have some degree of non-alcoholic 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.

Hope for High Enzymes and Fatty Liver

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 has been shown to normalize liver enzyme levels and reduce liver fat accumulation. Nine key components of supporting liver health include the following:

  1. Losing weight if overweight or obese
  2. Eating a nutritious, low-fat, low-glycemic, high-fiber diet
  3. Getting daily aerobic exercise
  4. Avoiding alcohol and unnecessary medications
  5. Minimizing exposure to chemicals and toxins
  6. Increasing consumption of antioxidant-rich foods, like blueberries, pomegranates, grapefruit, kale and carrots
  7. Taking probiotics or other dietary supplements containing healthy live bacteria
  8. Supplementing with substances that support the liver’s functions, like milk thistle and N-Acetyl Cysteine
  9. Supplementing with substances that support the liver’s ability to metabolize fat, like green tea and curcumin

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., Nonalcoholic Fatty Liver Disease: 5 Tips for Treatment, Prevention, January W. Payne, Retrieved October 28, 2012, US News & World Report, LP, 2012., 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., Elevated Liver Enzymes, Retrieved October 28, 2012, Mayo Foundation for Medical Education and Research, 2012., Fatty Liver Disease, Retrieved October 28, 2012, WebMD, LLC, 2012.

  • DRP

    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


    • JH

      Try exercise. Walking about half a hour daily.

    • Yosako

      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.

  • Nick Armijo

    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

  • Au Naturel Mel

    Good distinctions. Mel at fattyliverdietguide