The liver, being the largest glandular organ in the human body, plays a vital role in processing various substances that are ingested. It filters toxins, metabolizes drugs, and aids in the digestive system.

The liver has the unique property of regenerating itself, but prolonged exposure to harmful substances like alcohol, excessive medications, or viruses such as hepatitis can cause liver damage. Elevated liver enzymes or transaminases in a blood test is usually the first indication of liver damage.

What Are Transaminases?

Transaminases are enzymes that occur naturally in all cells of our body, but they are more concentrated in the liver. These enzymes, also known as aminotransferases, are released into the bloodstream when liver cells are damaged.

The two most common transaminases measured in a liver function test (LFT) are alanine transaminase (ALT) and aspartate transaminase (AST).

What Causes Elevated Transaminases?

The most common causes of elevated transaminases are alcohol consumption, drug-induced liver injury, obesity, and viral hepatitis.

However, elevated transaminases may also be seen in other medical conditions, such as non-alcoholic fatty liver disease (NAFLD), autoimmune hepatitis, and metabolic disorders.

Signs and Symptoms of Elevated Transaminases

Elevated transaminases typically cause no symptoms, and the condition may only be detected during a routine blood test. In some cases, symptoms of liver disease may be present, such as:.

Jaundice (yellowing of the skin and eyes)
Abdominal pain and swelling
Fatigue
Nausea and vomiting
Dark urine and pale stools

Diagnosis of Elevated Transaminases

The diagnosis of elevated transaminases is usually made during routine blood work. Elevated ALT levels of more than three times the upper limit of normal, and/or elevated AST levels, may indicate liver injury.

However, these enzyme levels can also be elevated in conditions, such as muscle injury or inflammation.

If elevated transaminases are found, your doctor may recommend further tests to determine the cause. This may include:.

FibroScan or ultrasound to determine if liver damage is present
Blood tests to rule out hepatitis A, B and C, and other liver diseases
A liver biopsy, where a small sample of liver tissue is removed and examined under a microscope to look for liver disease and damage

Treatment for Elevated Transaminases

The treatment for elevated transaminases depends on the cause of the liver damage. If the elevated transaminases are due to alcohol consumption, reduction or cessation of alcohol consumption is recommended.

If drug-induced liver injury is suspected, discontinuation of the medication is recommended if possible. For viral hepatitis, antiviral medications may be prescribed.

If obesity is causing elevated transaminases, losing weight by following a healthy diet and exercise plan can often help improve liver function. In some cases, surgery may be recommended to address fatty liver disease.

In cases of severe liver damage, liver transplantation may be necessary.

Prevention of Elevated Transaminases

Prevention of elevated transaminases involves avoiding exposure to known hepatotoxic substances like alcohol, drugs, and toxins. Vaccination for viral hepatitis A and B can significantly reduce the risk of contracting these infections.

Following a healthy lifestyle that includes a balanced diet and regular exercise can help in preventing obesity and its related metabolic disorders.

It is also essential to maintain a healthy weight and avoid rapid weight loss as these can lead to the development of fatty liver disease.

Conclusion

Elevated transaminases are usually the first indication of liver damage, and timely intervention can help prevent further liver disease progression. It is essential to monitor liver function periodically, especially if you are at risk for liver disease.

Adopting a healthy lifestyle, avoiding harmful substances, and undergoing routine health screenings can help maintain liver health and prevent liver disease.