It is estimated that 1 to 9 percent of people who do not show symptoms have elevated levels of liver enzymes. When extensive evaluation of the abnormal test results is done, it could expose many patients to unexpected risks and expenses but on the other hand, failing to evaluate the minor liver enzymes may mean missing an early diagnosis of possible treatable disorders that may be potentially dangerous when left untreated.
Slightly elevated liver enzymes could indicate damage or inflammation of liver cells though at times, the elevations may occur when the liver is functioning properly. In this case, the elevation of liver enzymes is caused by other factors and not necessarily a damaged or inflamed liver.
When the liver is injured or inflamed, its cells may leak higher amounts of certain chemicals such as the liver enzymes into the blood streams. This may result to increased levels of the enzymes as detected in blood tests. Two of the commonly found enzymes in liver are alanine transaminase (ALT) and aspartate transaminase (AST).
What do slightly elevated liver enzymes indicate?
While there are many different types of enzymes of the liver, the common ones are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Others are such as lactate dehydrogenase and alkaline phosphatase. These enzymes are proteins that are made by liver and they are measured in blood.
At times, elevations of these enzymes may be temporary but in other cases, they can be long term. The most used measures of cell injury or damage of liver are ALT and AST, although the former is regarded less liver specific when compared to the latter. Mild degree of elevated levels of ALT may be seen when there is skeletal muscle injury or after one has had vigorous exercise.
Elevated enzyme levels in liver may be detected during routine blood tests and in most cases, the levels are only mild and temporary. Most of the times, the mild elevations do not indicate chronic and serious liver problem. Similarly, elevations may occur if there is an infection, damage, or blockage to the liver. If there is blockage to gall bladder and common bile duct by conditions like an infection, tumors, and gallstones.
Certain medications may also cause damage to liver, which causes enzyme levels to increase. In other times, even when there is no damage to liver, there may be elevated enzymes. This may happen due to damage of bones.
Symptoms of mild elevated liver enzymes
Mild levels are considered to be around 2 to 3 times higher than the expected normal range. In some cases, the elevations can be as high as hundreds in range. The normal levels of enzyme ALT and AST could vary slightly based on reference levels of an individual laboratory tests. The typical range reported for usual ASL is between 10 to 40 units in a liter and for ALT it is between 7 to 56 units in a liter. The symptoms of mild to moderate liver enzyme elevations may vary but the common ones are;
Yellowing skin or jaundice
Symptoms of mild elevated levels of liver enzymes may be specific such as liver enlargement. This is one common symptom that accompanies elevated liver enzymes. The common cause of liver enlargement or hepatomegaly is inflammation of liver or hepatitis. Alcohol liver disease, lymphoma, leukemia, and cancers may also cause hepatitis. Jaundice is the yellowing of skin, lips, and whites of eyes. This condition arises from accumulation of a substance known as bilirubin that is produced by liver. If the liver cells are damaged, the liver may not get rid of excess bilirubin, and this substance accumulates in tissues causing jaundice.
People who have slight elevated levels of liver enzymes may also show nonspecific symptoms, which are not specific to liver disease. These are such as abdominal pain, nausea, and poor appetite. Celiac disease may also cause the levels to increase.
Another condition, polymyositis, which is a condition associated with inflammation of muscles may increase liver enzymes and cause other symptoms like muscle weakness, shortness of breath, fatigue, and difficult speaking.
Not all people who have a single isolated case of mild elevated liver enzymes may have underlying liver disease. These people may not require being subjected to extensive evaluation but there are factors that may be considered when deciding to do an evaluation. These factors include the overall health of a patient including chronic illnesses, the duration as well as the pattern of elevations, and the patient characteristics including family history of liver, neurologic disease, or lung disease.
The age and risk factors for having viral hepatitis needless to mention the amount of alcohol consumed may also determine whether an evaluation is needed. Other factors that may be considered are such as the risks associated with taking additional evaluation and the costs inherent.