What Does Elevated Liver Enzymes Mean?

Elevated liver enzymes indicate liver cell damage causing enzymes to leak into blood.

The Enzymes

• ALT — most liver-specific
• AST — liver, heart, muscle
• ALP — bile ducts and bone
• GGT — alcohol and bile ducts

Common Causes

• Fatty liver (NAFLD) — most common cause of mild elevation
• Alcohol
• Medications
• Viral hepatitis
• Autoimmune

Severity

• Mild (1–3×): often NAFLD — repeat in 6–8 weeks
• Moderate (3–10×): investigate
• Marked (10×+): urgent

Next Steps

• Repeat testing
• Viral hepatitis serologies
• Iron studies
• Ultrasound
• Review medications