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Do You Have High Liver Enzymes or a Fatty Liver?

19

Nicole Cutler

Jan 2nd, 2013
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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

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.

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:

  1. Losing weight if overweight or obese
  2. Eating a nutritious, low-fat, low-glycemic, high-fiber diet. Natural Wellness’ UltraNourish has 7 grams of fiber per serving and 0 grams of fat!
  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. Natural Wellness’ Ultra Probiotic Formula contains 35 billion viable cells per capsule.
  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. 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.

19 Comments
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  • 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

    Thanks

    • 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

    • SPT

      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.

  • Au Naturel Mel

    Good distinctions. Mel at fattyliverdietguide

  • Sheryl Arnett

    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/

    • SPT

      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.

    • SPT

      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.

      • Sheryl

        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.

  • Shelley

    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?

    • SPT

      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.

      • Stephanie

        Is this all you ate for 3 weeks. Also what are the foods you should avoid while doing this?

  • Mia

    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

  • Eric Arevalo

    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.

  • Scott

    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?

  • JP

    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?

  • Andy

    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

  • FACTS PLEASE

    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!