If a person’s blood test results show elevated liver enzymes, a doctor will investigate possible underlying causes. They may do further tests in addition to asking about a person’s lifestyle and dietary habits.
The most common cause of elevated liver enzymes is fatty liver disease. Research suggests that 25-51% of people with elevated liver enzymes have this condition.
Other health conditions that typically cause elevated liver enzymes include:
- metabolic syndrome
- hepatitis
- alcohol or drug use disorder
- cirrhosis, which is liver tissue scarring
Other conditions that less commonly cause elevated liver enzymes include:
- autoimmune hepatitis
- celiac disease
- infection with the Epstein-Barr virus, a type of herpes
- liver cancer
- hemochromatosis, when the body absorbs too much iron
- mononucleosis
- sepsis, or blood poisoning
- Wilson’s disease
- polymyositis, which involves inflammation of the muscles
Certain medications, including some pain relievers and statins, can also cause elevated liver enzymes.
Elevated liver enzymes are themselves asymptomatic, but the underlying conditions responsible for them may cause symptoms.
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Below are the common causes of elevated liver enzymes, as well as their symptoms:
Fatty liver disease
Fatty liver disease occurs when fats build up in the liver. If this buildup is due to alcohol consumption, it is called alcoholic fatty liver disease.
When alcohol is not a causative factor, the buildup of fat in the liver is called nonalcoholic fatty liver disease (NAFLD). People with metabolic syndrome are at a higher risk of NAFLD.
Fatty liver disease may sometimes cause tiredness and pain on the right side of the abdomen, but it often causes no symptoms.
A doctor may test someone with alcohol use disorder or metabolic syndrome for elevated liver enzymes to check for fatty liver disease.
Learn about what to eat to help manage fatty liver disease here.
Metabolic syndrome
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Metabolic syndrome is a group of symptoms that increase the risk of heart disease. These symptoms include:
- high blood sugar
- high blood pressure
- being overweight
- high cholesterol
The doctor may test people with one or more of these symptoms for elevated liver enzymes.
Hepatitis
Hepatitis is a virus that leads to liver inflammation. There are several different strains of hepatitis, which are called A, B, C, D, and E. The symptoms of all of the strains are similar.
Common hepatitis symptoms include:
- fatigue
- muscle soreness
- joint pain
- nausea
- loss of appetite
- stomach pain
- fever
- dark urine
- skin itching
- yellowing of the eyes and skin (jaundice)
The doctor may test a person with symptoms of hepatitis for elevated liver enzymes.
Alcohol or drug use disorder
Drinking too much alcohol or using illicit drugs may lead to liver inflammation or damage.
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Liver inflammation due to alcohol consumption is called alcoholic hepatitis. When drugs are the underlying cause, doctors call it toxic hepatitis.
The symptoms of alcoholic and toxic hepatitis are similar to those of other strains of hepatitis.
If a person is experiencing symptoms of alcohol or drug use disorder, the doctor may check their liver enzyme levels and offer various forms of treatment and support.
Cirrhosis
Cirrhosis is a type of liver damage. A person with cirrhosis has permanent scarring of the liver, which can prevent it from working properly. Cirrhosis may eventually lead to liver failure.
Cirrhosis symptoms include fatigue and skin itching. People are at risk of cirrhosis if they do not receive treatment for hepatitis or fatty liver disease.
If a person has cirrhosis symptoms, the doctor may check their liver enzyme levels.
