Elevated Liver Function Tests: Causes and Symptoms Explained - Gastroenterology and Hepatology

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Elevated liver function tests (LFTs) can be concerning and often indicate underlying liver issues. In your case, with AST (aspartate aminotransferase) at 195 and ALT (alanine aminotransferase) at 317, these values are significantly elevated compared to normal ranges, which typically are around 10-40 U/L for AST and 7-56 U/L for ALT. Such high levels suggest that there is likely some form of liver injury or inflammation occurring.

1. Possible Causes of Elevated Liver Enzymes:
The elevation of liver enzymes can be attributed to various factors, including:
- Viral Hepatitis: Hepatitis A, B, or C can cause significant liver inflammation, leading to elevated enzyme levels.

- Alcoholic Liver Disease: Excessive alcohol consumption can damage liver cells and elevate enzymes.

- Non-Alcoholic Fatty Liver Disease (NAFLD): This condition is increasingly common and is associated with obesity, diabetes, and metabolic syndrome.

- Medications and Toxins: Certain medications, herbal supplements, and toxins can lead to liver damage.

- Autoimmune Liver Disease: Conditions like autoimmune hepatitis can cause inflammation and damage to the liver.

- Hemochromatosis or Wilson's Disease: These genetic disorders can lead to excessive iron or copper accumulation in the liver, respectively, resulting in liver damage.

Given your elevated enzyme levels, it is crucial to follow up with a healthcare provider for further evaluation. This may include additional blood tests to check for viral hepatitis, autoimmune markers, and imaging studies like an ultrasound to assess liver structure and rule out fatty liver or other abnormalities.

2. Symptoms Related to Liver Dysfunction:
You mentioned experiencing symptoms such as nausea ("想吐") and unexplained anxiety ("無故緊張"). While these symptoms can be associated with liver dysfunction, they are not specific to liver issues. Nausea can occur due to a variety of reasons, including gastrointestinal disturbances, anxiety, or even medication side effects. Anxiety can also stem from various sources, including stress, mental health conditions, or physical health issues.

If your liver is not functioning optimally, it can lead to a buildup of toxins in the body, which may contribute to feelings of malaise, nausea, and even anxiety. However, these symptoms can also arise from other conditions unrelated to the liver, such as gastrointestinal disorders, anxiety disorders, or even thyroid issues.

3. Next Steps:
- Consult a Specialist: It is advisable to see a gastroenterologist or a hepatologist who specializes in liver diseases. They can provide a comprehensive evaluation and determine the underlying cause of your elevated liver enzymes.

- Lifestyle Modifications: Regardless of the cause, adopting a healthy lifestyle can support liver health. This includes avoiding alcohol, maintaining a balanced diet, exercising regularly, and managing stress.

- Monitoring: Regular follow-up blood tests will be necessary to monitor liver function and assess the effectiveness of any interventions.

In conclusion, elevated liver function tests warrant further investigation to determine the underlying cause and appropriate management. Symptoms like nausea and anxiety may or may not be related to liver function, and a thorough evaluation is essential to address your concerns effectively.