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What causes high liver enzymes, and how do you treat them?

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Possible causes of elevated liver enzymes include nonalcoholic fatty liver disease, dietary supplements, certain medications, and more. Treatment can depend on the underlying cause.
Medically reviewed by Darragh O'Carroll, MD
Written by Amy McLean
Updated on

Liver enzymes, or proteins, have many roles in the body. In general, they regulate chemical reactions that help keep you healthy. For example, they influence how quickly you make the substances that help you fight infection or your blood to clot. They also assist your body in breaking down food and toxins.

A doctor may discover that you have elevated liver enzymes if they order a liver function test. The tests can monitor liver enzymes such as:

  • alkaline phosphatase (ALP)
  • alanine transaminase (ALT)
  • aspartate transaminase (AST)
  • gamma-glutamyl transferase (GGT)

The doctor may order additional tests to identify the cause of elevated liver enzymes. They can also recommend treatments or steps to take to reduce high liver enzymes. This might include medications and lifestyle changes.

Causes of elevated liver enzymes

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There are many possible causes behind elevated liver enzyme levels. These include:

Nonalcoholic fatty liver disease and alcohol-related liver disease

The most common causes of elevated liver enzymes are nonalcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ARLD).

The conditions refer to too much fat buildup in your liver. Over time, they can lead to liver damage and even scarring of the liver (cirrhosis).

Neither NAFLD nor ARLD may cause any symptoms until the conditions advance. If a doctor detects elevated liver enzymes, they may order additional tests to check for signs of liver disease.

Dietary supplements and vitamins

Your liver filters everything you consume. This includes dietary supplements and vitamins. Over-the-counter supplements may contribute to or cause elevated liver enzymes.

Supplements are not always regulated as prescription medications are. High dose vitamins or certain herbs can cause harm. It is best to inform your doctor about any dietary supplements or vitamins that you are taking.

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Certain medications

Some medications can cause elevated liver enzymes. These include statins that help lower cholesterol, such as atorvastatin (Lipitor) and simvastatin (Zocor).

It may not be necessary for a person with existing liver dysfunction to avoid taking statins. Your doctor can advise on whether they recommend statins.

Other medications can cause liver damage that may affect your enzyme levels. These can include:

It is best to contact a doctor for advice if you have concerns about the potential side effects of medications you are currently taking.


Elevated liver enzymes may be due to hepatitis.

Hepatitis refers to an inflamed liver. It most often happens as a result of a virus. The most common types of viral hepatitis in the United States are hepatitis A, hepatitis B, and hepatitis C.

Some people with hepatitis do not have any symptoms. It is best to contact a doctor to assess your risk and whether you should receive regular screening for hepatitis.

Effective vaccines are available to help prevent hepatitis A and hepatitis B. Treatments can help manage hepatitis.

Bone disorders

Your bones also produce the enzyme ALP. If you break a bone, it can raise the ALP enzyme levels in your blood.

Other bone disorders, such as Paget disease of bone, can also raise your ALP levels.

Celiac disease

Celiac disease is an autoimmune condition where gluten causes an immune response and damages the small intestine.

About 5–10% of people with unexplained high liver enzymes have celiac disease.

It is unclear why there may be a link between celiac disease and high liver enzymes. However, the inflammation can allow more substances to pass through the small intestine, so toxins and other chemicals may enter your bloodstream, reaching the liver and causing damage over time.

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Heart failure

Heart failure may cause elevated liver enzymes.

When you have heart failure, your body can have difficulty meeting the needs of your organs, including the liver.

Over time, low blood flow can starve the liver of oxygen. In some cases, blood has difficulty pumping back up to the heart. Fluid can build up in the liver, which can cause damage.

Learn about the surprising signs of heart failure. You can also learn about some easy ways to save on heart failure medication.

Treatment for elevated liver enzymes

Treatment for elevated liver enzymes can depend on the underlying cause. If it’s due to supplements or vitamins, then stopping these can help.

A doctor may recommend medication changes if they believe your current prescription medication is affecting enzyme levels. It is important to continue to take your medication until your doctor advises on any changes.

Treating NAFLD or ARLD can help lower high liver enzymes. Treatments for liver disease can include:

  • maintaining a moderate weight
  • avoiding alcohol consumption
  • taking medication for any infection, such as hepatitis

Your doctor can advise on the suitable steps you can take to reduce high liver enzymes, as well as recommend any medications to manage conditions that may be the cause.

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Frequently asked questions

Here are some common questions about elevated liver enzymes and liver damage.

Are elevated liver enzymes a problem?

Elevated liver enzymes may be temporary if they are due to certain supplements or medication. Stopping taking them on a doctor’s advice can help lower liver enzymes. But, in some cases, high liver enzymes may be due to a serious condition such as NAFLD. A doctor can recommend suitable treatments.

What are 4 warning signs of a damaged liver?

There are numerous possible signs and symptoms of liver damage. Some people may not notice any symptoms in the early stage of liver damage. As the condition progresses, you may experience symptoms such as itchy skin, jaundice, swelling, changes in urine, and more.


There are several possible causes of elevated liver enzymes. The most common are NAFLD and ARLD.

Other conditions can elevate liver enzymes. These include hepatitis, celiac disease, and heart failure. Certain supplements, vitamins, and medications may also affect your enzyme levels.

If your doctor detects elevated enzyme levels during a liver function test, they may order additional tests to help identify the cause. They can also advise on ways to reduce elevated liver enzymes, which might include lifestyle changes and managing the underlying cause.

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