When a liver is inflamed or damaged, the injured liver cells may leak higher than normal amounts of chemicals including liver enzymes into the bloodstream, which can then be detected through blood tests.
Most of the time elevated liver enzymes do not indicate a chronic or serious liver problem, especially if the enzyme levels are only mildly or temporarily elevated. There are many different conditions that can contribute to abnormal liver tests and your doctor may suggest additional tests and procedures to determine the cause of your elevated liver enzymes.
Common reasons for abnormal liver tests:
Medications
Various types of medications can cause abnormal liver enzymes levels in some individuals including some types of pain relief medication, antibiotics, anti-seizure medications, cholesterol-lowering drugs such as statins, cardiovascular medications and other drugs such as some anti-depressants.
If the liver enzyme abnormalities have been induced due to medication use they should normalise again within weeks or months of stopping the medications, during which time the patient will be monitored by their healthcare professional.
Other conditions
Mild to moderate elevations of liver enzymes (between twice the upper limits of normal and several hundred units/litre) are common and are often seen during routine blood screening tests in otherwise healthy individuals. There are a number of possible causes for these elevations including fatty liver disease, chronic hepatitis B or hepatitis C infection, obesity and chronic or acute alcohol use.
Very high levels of liver enzymes (ten times the upper limits of normal to thousands of units per litre) are seen in disorders that cause rapid cell death of numerous liver cells (extensive hepatic necrosis). This degree of liver enzyme elevation is uncommon but may occur in conditions including acute viral hepatitis A or B, profound liver damage (e.g. caused by acetaminophen (paracetamol/Tylenol) overdose), deprivation of fresh blood to the liver and severe muscle diseases.
Less common causes of abnormal liver enzyme test results
Other potential causes of abnormal liver enzyme levels include hemochromatosis (excessive absorption of dietary iron), Wilson's disease (excessive accumulation of copper), alpha-1-antitrypsin deficiency (lack of glycoprotein alpha-1-antitrypsin), autoimmune hepatitis (liver injury due to body's own immune system), celiac disease (allergy to gluten), inflammatory bowel diseases (chronic inflammation of the intestines), viral infections including cytomegalovirus and Epstein-Barr virus infections, glycogen storage disorders, and in rare cases liver cancer and Budd-Chiari Syndrome (obstruction of blood flow in the liver).
Useful resources
Mayoclinic
MedicineNet
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