What Are the Causes of Elevated Liver Enzymes?

Elevated liver enzymes indicate damage to liver cells. Doctors order a liver test panel in new patients during annual physicals and when prescribing certain medications that have the potential for liver damage, according to WebMD. Other reasons for liver test panels include patients showing signs of bile disease or the excessive use of alcohol.

According to Mayo Clinic, many conditions contribute to elevated liver enzymes. Patients with any form of hepatitis show an elevation in enzymes. Obesity, over-the-counter pain relievers and heart failure also increase these levels. Other causes are hepatitis, alcohol consumption, nonalcoholic fatty liver disease and heart failure. Conditions such as celiac disease, associated with gluten’s effect on the small intestine, and dermatomyositis, characterized by skin rash and muscle weakness, both cause elevated liver enzymes. Viral infections are a common cause of abnormal liver tests and include Epstein-Barr and cytomegalovirus. Other reasons for elevated liver enzymes include myocardial infarction, hypothyroidism, cancer of the liver, pancreatitis, toxic hepatitis, gallbladder disease and mononucleosis. Both Wilson’s disease, where the amount of copper in the body exceeds normal levels, and hemochromatosis, which results from excessive iron, elevate liver enzymes. When the test reveals elevated liver enzymes, the patient should speak with his doctor about the meaning of the test results.

WebMD reports that an elevation in the ALS and ALT enzymes in the blood or muscles indicates damaged liver cells are leaking the enzyme. An elevation in the alkaline phosphatase, 5′ nucleotidase and GGT levels indicate problems with the bile flow due to problems with the liver, gallbladder or the duct that connects the two.

WebMD indicates the true liver function test also checks the liver’s production of proteins essential for clotting the blood, albumen production and bilirubin levels. The liver produces bilirubin as it breaks down red blood cells, and the body normally excretes it. However, if there is a problem with bile production and bilirubin levels increase, they cause yellowing of the skin and eyes, or jaundice. High bilirubin levels indicate severe liver disease or a problem with the gall bladder.

Enzyme levels do not always correlate with liver damage, notes MedicineNet. High numbers do not necessarily indicate the prognosis. An example is the very high levels of liver enzymes found in hepatitis A patients. Once the infection resolves, the liver tests return to normal with no lasting liver damage.