Abnormal Liver Function: Causes, Concerns, and Solutions

Liver dysfunction

Hello Doctor: I visited the clinic due to onychomycosis and had blood tests done to facilitate more effective medication treatment.
The results showed my GOT at 42 and GPT at 87.
The doctor at the clinic said I have severe fatty liver disease! However, I am unsure how he made this determination without an ultrasound.
Approximately 2-3 years ago, after abnormal liver enzyme tests by a hepatobiliary and gastroenterology specialist, I had an ultrasound that confirmed fatty liver.
At that time, the specialist did not prescribe any medication but advised me to eat less and exercise, which I have been trying to do until now without any serious issues.
My fasting blood sugar is normal, but I understand that abnormal liver enzymes indicate liver inflammation! However, I do not know why this is happening.
I tend to stay up late and do not exercise, resulting in my weight increasing from 66 kg to 74 kg! After gaining weight, I find myself eating even more! Since I have not been tested for hepatitis B or C, I am unaware if I have those conditions.
I really cannot lose weight! After doing household chores, I feel hungry again, so I eat...
I am also unsure if I should return to the hepatobiliary and gastroenterology specialist for a consultation.
I am currently taking psychiatric medication.
How should I eat wisely and stay active? My work hours are from 5 PM to 1 AM, but I often have trouble sleeping, staying awake until noon after work without being able to sleep.
I know that irregular sleep can contribute to weight gain, but I truly cannot find a way to lose weight naturally! What should I do? Thank you for your response, Doctor!

Jason, 30~39 year old female. Ask Date: 2017/02/07

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, it is quite common for psychiatric medications to cause obesity and fatty liver.
We need to discuss the possibility of changing your medication and managing your caloric intake.
Changhua Hospital is concerned about your health.
Best regards, Chen Shih-Dian.

Reply Date: 2017/02/07

More Info

Understanding abnormal liver function is crucial for maintaining overall health, especially given the rising prevalence of liver diseases such as fatty liver disease, hepatitis, and cirrhosis. Your recent blood test results indicate elevated levels of GOT (AST) at 42 and GPT (ALT) at 87, which indeed suggest liver inflammation or damage. The interpretation of these results, along with your lifestyle factors, can provide insight into your liver health and guide you toward appropriate actions.

Causes of Abnormal Liver Function
1. Fatty Liver Disease: The most common cause of elevated liver enzymes in individuals who are overweight or obese is non-alcoholic fatty liver disease (NAFLD). This condition occurs when excess fat builds up in the liver, leading to inflammation and potentially progressing to more severe liver damage.

2. Lifestyle Factors: Your mention of late-night habits, lack of exercise, and weight gain (from 66 kg to 74 kg) are significant contributors to liver health. Poor dietary choices, high-calorie intake, and sedentary behavior can exacerbate liver issues. Additionally, sleep deprivation can lead to metabolic disturbances that further complicate weight management and liver function.

3. Medications: You mentioned taking psychiatric medications. Some medications can have hepatotoxic effects, meaning they can cause liver damage. It’s essential to discuss your medication regimen with your healthcare provider to ensure that they are not contributing to your liver issues.

4. Potential Viral Hepatitis: Although you have not been tested for hepatitis B or C, these viral infections can also lead to elevated liver enzymes. It would be prudent to get tested for these viruses, especially if you have risk factors such as a history of intravenous drug use or unprotected sex.

Concerns Regarding Your Liver Health
Given your elevated liver enzymes and lifestyle factors, there are several concerns:
- Progression of Liver Disease: If left unaddressed, fatty liver disease can progress to non-alcoholic steatohepatitis (NASH), which can lead to fibrosis and cirrhosis.

- Metabolic Syndrome: Your weight gain and sedentary lifestyle may place you at risk for metabolic syndrome, which increases the risk of cardiovascular disease and type 2 diabetes.

- Mental Health and Lifestyle: The impact of your work schedule on your sleep and overall well-being cannot be overlooked. Chronic sleep deprivation can lead to weight gain and exacerbate liver issues.

Recommendations for Improvement
1. Consult a Specialist: It would be wise to return to a hepatologist or gastroenterologist for a comprehensive evaluation. They may recommend imaging studies, such as an ultrasound, to assess the degree of fatty liver and rule out other liver conditions.

2. Lifestyle Modifications:
- Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing sugar and saturated fat intake can help manage weight and improve liver health.

- Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity each week. Incorporating strength training can also be beneficial.

- Sleep Hygiene: Establish a regular sleep schedule. Aim for 7-9 hours of sleep per night. Consider relaxation techniques or sleep aids (under a doctor’s guidance) to improve sleep quality.

3. Regular Monitoring: Regular follow-up blood tests to monitor liver enzymes and overall liver function are essential. This will help track your progress and make necessary adjustments to your treatment plan.

4. Mental Health Support: Since you are on psychiatric medications, it’s important to have ongoing support for your mental health. Discuss any concerns with your psychiatrist, especially regarding how your medications may affect your liver.

In summary, while your liver function tests indicate some level of concern, proactive management through lifestyle changes, regular medical follow-up, and potential further testing can significantly improve your liver health and overall well-being.

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