Elevated Liver Enzymes -- Top 10
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October 12, 2017

By Ariadne Weinberg, Featured Columnist




Do you find yourself yawning a lot during the day? It could
be a sign of a little-known but serious problem with your
liver, called "elevated liver enzymes".  How many minutes a
day do you spend thinking about just how elevated your
liver enzymes are? Unless you have a kidney condition or
work in the medical profession, I would wager between zero
and five minutes.

However, elevated liver enzymes are the diagnostic marker
for a whole heck of a lot of terrible things, not only liver
disease. So you might want to give them a bit more thought.

Not to make you scared or anything but here goes. Let’s
throw out some objective statistics. How many people have
elevated liver enzymes in the U.S.?  The American
Gastroenterological Association (AGA) claims that 1 to 4
percent of the asymptomatic population may have elevated
liver enzymes, meaning that up to 4% of us could be walking
around with elevated liver enzymes and not know it.

That’s right. Some of us who are out there not thinking
about our liver enzymes because we don’t have a disease,
have altered ones. This is not the most significant number,
but more statistically significant than I would have expected.

What Is a Normal Level for Liver Enzymes?

So, how do you know what is a normal level for liver
enzymes? If you go in for lab tests, know that your
aspartate transaminase should be between 10 and 40 units
per liter. Your alanine aminotransferase should be between 7
and 56 units per liter.

Usually, of course, you may not get these tests unless
something strange is going on. Read on to find out about
some diseases correlated with elevated liver enzymes.






























1.
Non-alcoholic Fatty Liver Disease
    
Non-alcoholic
fatty liver disease is a weird one because the
condition is often asymptomatic unless your liver enzyme
levels are actually tested.

The recognizable sign of non-alcoholic fatty liver disease is
hepatic steatosis, when fat exceeds 5% of liver volume.

Increased levels of transaminases and alanine
aminotransferase, exceeding those of aspartate
aminotransferase will be the laboratory result that your liver
enzymes are too elevated, according to a 2014 report from
Naveed Sattar from the University of Glasgow. There is a
significant correlation between non-alcoholic fatty liver
disease and
Type II diabetes, so as a diabetic, you would be
particularly smart to go in for testing.

2.
Alcoholic Liver Disease

Alcohol is often delicious and the party drug of choice for
many. However, the socially-acceptable liquid is also
unfortunately hepatotoxic.

Booze can also be fatal.  Alcohol-related liver injuries due to
excess use of alcohol are one of the top five risk factors of
death. While there is no single diagnostic test that confirms
alcoholic liver disease, we can again look to liver enzyme lab
findings.

As in non-alcoholic fatty liver disease, if the transaminase
levels with aspartate aminotransferase are greater than
alanine aminotransferase, you are in trouble. Cara Torruellas
from the University of California confirms in her 2014 report
that apart from looking at liver enzymes, imaging and liver
biopsies can be other diagnostic tools for alcoholic liver
disease, depending on your case.

3.
Mononucleosis

This was more affectionately referred to as “mono” when I
was a kid, not to be confused with the Spanish word for
monkey. There is nothing cute about the disease though.
With mono, your white blood cells with a single nucleus
increase and the symptoms consist of a fever, sore throat,
and swollen lymph glands.

In a 2006 study, L. Hu and researchers from the University
of Science and Technology collected liver function data from
54 mononucleosis patients in the Union Hospital, between
March 2002 and March 2005.

As a control, data was also obtained from 40 healthy people.
The elevated enzyme activity of transaminase was especially
noted in those with mononucleosis. Many scientists and
physicians look to liver enzymes as one diagnostic marker of
infectious mononucleosis.

4.
Over-the-counter Pain Relievers, Especially
Acetaminophen

Check that you are taking moderate doses of painkillers in
the long-term, especially acetaminophen (the active
ingredient in Tylenol).

Even if you don’t already have liver conditions, painkillers
containing acetaminophen could make them worse.
According to a 2011 report from Robert C. Oh from the
Tripler Army Medical Center Family Medicine Residency
Program in Hawaii, even doses of 4 grams of acetaminophen
for 5-10 days have caused liver enzyme elevations in up to
58% of healthy, non drinkers.

The active painkiller ingredient has even been associated
with life-threatening hepatotoxicity after an overdose.
Remember not to drink alcohol if you do take
acetaminophen, and ask your doctor about adverse reactions
with other medications.

5.
Undiagnosed Diabetes

Diabetes can be closely linked with non-alcoholic fatty liver
disease.

The disease is especially dangerous when undiagnosed. In a
2013 report  CY Jeon and scientists from the University of
California, Los Angeles detailed results from 2,246 patients
with clinical diabetes, studied between 1999 and 2008.

Using elevated alanine aminotransferase and aspartate
aminotransferase as markers of liver injury, they discovered
that undiagnosed diabetes was more closely correlated with
elevated enzyme levels and liver injury.

6.
Wilson’s Disease

Wilson’s Disease is a strange one, a disorder that has a
strong correlation with elevated liver enzymes.

The pathology involves a malfunction of copper transport.
With Wilson's disease, copper accumulates in the liver, brain,
and other organs. When copper builds up in the liver, this
leads to cirrhosis. Dr. C.H. Cho and researchers from the
Pusan National University in Yangsan confirmed in 2011 that
the disease generally presents with at least mildly elevated
liver enzymes.

7.
Celiac Disease

Celiac disease is becoming all too common worldwide.
Unfortunately, the condition has a myriad of side effects,
including but not limited to elevated liver enzymes.

In 2011, Dr. AR Rahimi from the Tehran University of Medical
Sciences in Iran looked at 316 patients with non-alcoholic
fatty liver disease. The average age of the patients was 41.

Celiac disease was confirmed in 7 patients (2.2%) and was
more common in those with a body mass index below 27
kilograms. This number tends to be higher in the United
States, where celiac disease is more common. Regardless of
where you live, getting diagnosed for and treating celiac
disease is a good idea.

8.
Hepatitis  

Hepatitis, inflammation of the liver, will often come along
with, you guessed it, liver enzymes all out of whack.
Especially in acute viral hepatitis, the aminotransferase levels
will peak.

However all kinds of hepatitis, A, B, C, D, and E, will cause a
marked increase in aminotransferase enzymes, according to
a 2005 report by Edoardo G. Giannini from the University of
Genoa in Italy. Hepatitis C, however, will be more moderate
in terms of liver enzyme elevation.

9.
Sleep Apnea Hypopnea Syndrome

Do you yawn a lot during the day? Sleep apnea occurs when
breathing becomes shallow and paused frequently. This can
lead you to fall into a light sleep instead of deep sleep,
causing daytime sleepiness in the most moderate of cases.

However, the disease has myriad health complications,
including elevated liver enzymes, as confirmed by a 2015
report from J. Li and researchers from the Second Affiliated
Hospital of Soochow University in Beijing, China. They
conducted a study between June 2011 and November 2014,
with 540 patients. 42.3% of those subjects had elevated
liver enzymes.

10.
Cytomegalovirus Infection

The cytomegalovirus infection is a potentially mortal
complication. The condition is often associated with liver
conditions.

In 1993, R.M. Marinelli and researchers from the Policlinico
Umberto I in Rome, Italy, studied more carefully the
correlation of risk factors with liver disease. They studied 56
subjects.

Results confirmed that patients with positive
cytomegalovirus results had elevated aminotransferase
activity in addition to a significant incidence of chronic
hepatitis and active cirrhosis.
















































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Daytime sleepiness can be a sign of elevated liver
enzymes.