Elevated Liver Function Tests: Causes and Concerns - Internal Medicine

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Elevated liver function tests (LFTs) can be a source of concern for many individuals, especially when the results are consistently high over time. In your case, with a liver function index of 85, it is essential to understand the potential causes and implications of these elevated levels.

Firstly, liver function tests typically measure enzymes and proteins in the blood that indicate how well the liver is functioning. The most common enzymes measured include AST (aspartate aminotransferase) and ALT (alanine aminotransferase). Normal ranges for these enzymes can vary slightly depending on the laboratory, but generally, ALT levels above 40 U/L and AST levels above 37 U/L are considered elevated.

The causes of elevated liver enzymes can be numerous and varied. While your doctor mentioned alcohol consumption and excessive fatigue as potential causes, there are several other factors to consider:
1. Non-Alcoholic Fatty Liver Disease (NAFLD): This condition is increasingly common and is associated with obesity, diabetes, and metabolic syndrome. It occurs when excess fat builds up in the liver without significant alcohol consumption.

2. Viral Hepatitis: Hepatitis A, B, and C can lead to elevated liver enzymes. Even if you do not have symptoms, it is crucial to get tested for these viruses, especially if you have risk factors such as unprotected sex or sharing needles.

3. Medications and Supplements: Certain medications, including over-the-counter pain relievers like acetaminophen, can cause liver damage if taken in excess. Herbal supplements can also affect liver function.

4. Autoimmune Liver Diseases: Conditions like autoimmune hepatitis can lead to inflammation and damage to liver cells, resulting in elevated enzyme levels.

5. Hemochromatosis: This genetic disorder causes excessive iron accumulation in the body, which can damage the liver and lead to elevated liver enzymes.

6. Wilson's Disease: A rare genetic disorder that leads to copper accumulation in the liver, causing liver dysfunction.

7. Muscle Disorders: Elevated AST can sometimes be due to muscle injury rather than liver issues, as AST is also found in muscle tissue.

Given that you do not consume alcohol excessively and do not feel overworked, it would be prudent to undergo further testing to identify the underlying cause of your elevated liver function tests. This may include:
- Viral Hepatitis Panel: To check for hepatitis A, B, and C.

- Ultrasound: To assess liver structure and look for fatty liver or other abnormalities.

- Liver Biopsy or FibroScan: In some cases, these tests may be necessary to evaluate liver damage or fibrosis.

- Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP): To assess overall health and liver function.

In terms of management, it is crucial to maintain a healthy lifestyle. This includes:
- Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while avoiding processed foods and sugars.

- Exercise: Regular physical activity can help reduce liver fat and improve overall health.

- Avoiding Alcohol: Even if you do not drink heavily, it may be wise to limit alcohol consumption to allow your liver to recover.

- Regular Monitoring: Follow up with your healthcare provider to monitor your liver function tests regularly.

In conclusion, while elevated liver function tests can be alarming, understanding the potential causes and taking proactive steps can help manage your liver health. It is essential to work closely with your healthcare provider to determine the underlying cause and develop an appropriate management plan.