What does elevated liver enzymes mean? What blood tests are there for liver enzymes? Types of enzymes – membrane, cytoplasmic and mitochondrial

Liver enzymes located in its cells perform cleansing, transport and processing functions. Thanks to these substances, the liver can clean up to 100 liters of blood in an hour and convert or neutralize about a million molecules in a minute. If for some reason the cells are damaged, the enzymes come out and their levels in the blood increase.

Inside the hexagonal liver cell are the enzymes ALT and AST. Their levels should not exceed a certain level of liver enzymes in the blood, otherwise this indicates the presence of the disease. If the amount of enzymes in the blood is still higher than normal, you should know that the unique organ is able to recover within 3 months, subject to the rules of nutrition and treatment.

How do you know if everything is okay with your liver?

The first signs of the disease are heaviness, pain in the right side, nausea, weakness, chronic fatigue. In order to find out what the reason is, you need to take tests for liver enzymes, as well as undergo additional examinations. An increase or decrease in readings may indicate illness.

• The level of AST (aspartate aminotransferase) in women should not exceed 31 units in 1 liter of blood, in men - 41 units in 1 liter of blood; the norm of ALT (alanine aminotransferase) is from 10 to 40 units in 1 liter of blood.
• Aminotransferases are liver enzymes that facilitate the synthesis of glycogen, the connection between protein and carbohydrate metabolism. The level of AST can increase in acute or chronic hepatitis, cancer and the initial stage of cirrhosis, ALT - in case of deficiency of lysosomal acid lipase, diabetes, viral hepatitis, due to the toxic effects of drugs.
• Elevated liver enzymes alkaline phosphatase should not be a concern during pregnancy or in children under 14 years of age. In other situations, disorders are associated with improper outflow of bile caused by hepatotoxic factors, cholestasis, and extrahepatic obstruction of the bile ducts.

Additional tests:

• Blood test for bilirubin. Normal bilirubin levels range from 3.4 to 20.5 µmol/L. Bilirubin is a breakdown product of hemoglobin, which accumulates in the gallbladder, then, together with fatty acids, is released into the duodenum. Bilirubin in bile helps process fats that are taken with food, emulsifies them - breaks them down into small particles and makes them available to digestive enzymes.
• An increased level of bilirubin is observed when the external and internal hepatic tracts are damaged, when the outflow of bile is disrupted, bilirubin is sent into the blood and leads to a yellow color of the eye whites, urine, while the feces lose their yellow color and become gray.
• A blood test for albumin, the norm of which is 35–50 g/l and reflects the liver’s ability to synthesize proteins needed by the body. Albumin maintains fluid levels in the blood and regulates blood pressure, transporting nutrients. Its decrease indicates poor nutrition, kidney or liver diseases.

An increase in liver enzymes or deviations from the norm indicate disorders in the body and require further diagnosis using ultrasound and seeking advice from a specialist.

Best Foods to Cleanse Your Liver

What are the types of diseases and their causes?

Liver enzyme levels are elevated when cells are destroyed and the following diseases are present:

• myocardial infarction;
• hepatitis A;
• cholangitis;
• cancer and cirrhosis;
• cholestasis;
• obstruction of the bile ducts;
• diabetes mellitus

These factors lead to the destruction of liver cells:

• exposure to the hepatitis virus;
• fatty hepatosis;
• poisoning with alcohol, decay products of bacteria and viruses, poor-quality food, fatty, fried, smoked, medications;
• unfavorable environmental conditions, work in hazardous industries;
• genetic predisposition;
• helminthiasis

A blood test will determine the cause of organ dysfunction, and the doctor will be able to prescribe a course of treatment and cell restoration.

What are the main enemies of the liver?

An irreplaceable organ must be carefully protected. Let's consider which factors have the worst effect on his condition:

• Alcohol has a strong toxic effect, and it is not the alcohol itself that is more harmful, but the products of its breakdown.
• An increase in liver enzymes may be associated with the presence of hepatitis A, B, C viruses, which destroy this organ and lead to intoxication of the entire body.
• Fatty, fried, smoked foods have a detrimental effect on human health. Studies have shown that the liver perceives fat as a toxic agent and tries to break it down and remove it from the cells as quickly as possible. Unhealthy eating habits place excessive stress on this organ.
• Margarine and products containing it are dangerous: baked goods, mayonnaise. Consumption of trans fats leads to fatty degeneration and damage to liver cells, resulting in the replacement of liver tissue with adipose tissue.
• Fructose and fructose syrups, which are sweeter than sugar, do not contain glucose, so the body is not saturated, and excess fat is stored. Eating these foods stimulates the release of insulin, which affects excess fat formation. This leads to inflammation and destruction of liver tissue - steatohepatitis, and then to cirrhosis and even cancer.
• A direct toxic agent for the liver is the preservative monosodium glutamate, contained in instant noodles, ready-made sauces, sausages, and chips. It is toxic to the liver and causes oxidative stress, which leads to destruction of the liver walls and scarring. As a result, the self-healing process is disrupted and serious illnesses occur.
• Sweet carbonated water with the sweetener aspartame also leads to hepatosis through the formation of fatty liver layers.

Any of these reasons destroys liver cells, as a result of which the level of liver enzymes in the blood increases.

About the signs of liver intoxication

How to keep your liver healthy?

Giving up bad habits, good food, and special medications will help in the prevention of diseases and during remission. Here is a list of foods that protect and restore liver cells:

• Turmeric contains curcumin, which stimulates the active production of bile. Thanks to this, the gallbladder is emptied faster, thus preventing stagnation of its contents and preventing the formation of stones.
• Broccoli is rich in isothiocyanates, which get rid of toxic breakdown products, thereby promoting a cleansing function.
• Persimmon has a large amount of sugar, which the liver converts into glycogen needed for energy. The fiber contained in the fruit prevents the absorption of 10–15% of fats, toxins and cholesterol, thereby reducing the load on the liver.
• Goji berries – the flavonoids they contain remove excess fat from the body, preventing its accumulation in the liver, and cleanse the bloodstream.
• Buckwheat is an irreplaceable product; a plant complex of flavonoids removes fat directly from liver cells, preventing them from being destroyed.
• Garlic contains allicin, which helps empty the gallbladder and also reduces cholesterol levels in the blood.
• Good protein foods and lecithin, which are involved in cell structure and metabolic processes.
• Cereals, vegetables and fruits.
• Essential vitamins and minerals: A, B, C, E, K, PP, selenium, zinc, lipoic acid.
• Sufficient amount of clean water (at least 1.5 liters per day).

Liver enzymes bear a heavy burden: breaking down fats, removing toxins, transporting nutrients.

The liver performs a number of important functions in the human body. A large number of different biochemical reactions take place in the liver, for which it is called the “biochemical factory of the body.” Consequently, a large number of enzymes are synthesized or work in the liver, the activity of which can be used to judge the condition of the entire organ. Determination of the activity of enzymes that are associated with liver function is called enzyme diagnostics liver diseases.

Types of changes in enzyme activity in various diseases
There are three main types of changes in enzyme activity, characteristic of all types of general pathological processes in the body:

1. increased activity of enzymes constantly present in the blood
2. decreased activity of enzymes constantly present in the blood
3. the appearance in the blood of enzymes that are normally absent

• aminotransferases (AST and ALT)
• lactate dehydrogenase (LDH)
• alkaline phosphatase (ALP)
• glutamate dehydrogenase (GlDH)
• sorbitol dehydrogenase (SDH)
• γ-glutamyltransferase (GGT)
• fructose monophosphate aldolase (FMPA)

Types of enzymes – membrane, cytoplasmic and mitochondrial

Alanine aminotransferase (ALT, AlAT) – normal, result for liver diseases

A sharp increase in ALT activity by 5-10 times or more is an undoubted sign of acute liver disease. Moreover, such an increase is detected even before clinical symptoms appear (jaundice, pain, etc.). An increase in ALT activity can be detected 1-4 weeks before clinical manifestations and appropriate treatment can be started without allowing the disease to fully develop. High enzyme activity in such acute liver disease does not last long after the onset of clinical symptoms. If normalization of enzyme activity occurs within two weeks, this indicates the development of massive liver damage.

Determination of ALT activity is a mandatory screening test for donors.

Aspartate aminotransferase (AST, AST) – norms, result in liver diseases

AST activity increases with necrosis of liver cells. Moreover, in this case there is a directly proportional relationship between the concentration of the enzyme and the degree of damage to hepatocytes: that is, the higher the activity of the enzyme, the stronger and more extensive the damage to hepatocytes. An increase in AST activity also accompanies acute infectious and acute toxic hepatitis (poisoning with salts of heavy metals and some drugs).

The ratio of AST/ALT activity is called de Ritis coefficient. The normal value for the de Ritis ratio is 1.3. With liver damage, the value of the de Ritis coefficient decreases.

For detailed information about the biochemical blood test for enzymes, read the article: Blood chemistry

Lactate dehydrogenase (LDH) – normal, result in liver diseases

In which liver pathologies is the content of isoforms increased?
Due to the wide distribution of LDH in various organs and tissues, an increase in the overall activity of LDH is not of great importance for the differential diagnosis of various diseases. To diagnose infectious hepatitis, the activity of LDH isoforms 4 and 5 (LDH4 and LDH5) is determined. In acute hepatitis, LDH5 activity in the blood serum increases in the first weeks of the icteric period. An increase in the combined activity of the LDH4 and LDH5 isoforms is detected in all patients with infectious hepatitis in the first 10 days. In cholelithiasis without blockage of the bile ducts, no increase in LDH activity was detected. During myocardial ischemia, the activity of the total fraction of LDH increases due to the phenomenon of blood stagnation in the liver.

Alkaline phosphatase (ALP) – normal, result in liver diseases

In what liver pathologies is the content increased?
With the development of obstructive jaundice, the activity of alkaline phosphatase in the blood serum increases 10 times or more. Determination of alkaline phosphatase activity is used as a differential diagnostic test specifically for obstructive jaundice. A less significant increase in alkaline phosphatase activity in the blood is also detected in hepatitis, cholangitis, ulcerative colitis, intestinal bacterial infections and thyrotoxicosis.

Glutamate dehydrogenase (GlDH) – normal, result in liver diseases

An increase in the concentration of glutamate dehydrogenase in the blood is a sign of the onset of degenerative processes in the liver, caused by endogenous or exogenous factors. Endogenous factors include liver tumors or metastases to the liver, and exogenous factors include toxins that damage the liver (heavy metals, antibiotics, etc.) and infectious diseases.

Schmidt coefficient
Together with aminotransferases, the Schmidt coefficient (CS) is calculated. CS = (AST+ALT)/GlDG. With obstructive jaundice, the Schmidt coefficient is 5-15, with acute hepatitis - more than 30, with metastases of tumor cells to the liver - about 10.

Sorbitol dehydrogenase (SDH) – normal, result in liver diseases

γ-glutamyltransferase - norms, in which liver pathologies the content is increased

The activity of γ-glutamyltransferase increases in diseases of the liver and biliary system, as well as in diabetes. The highest enzyme activity accompanies obstructive jaundice and cholestasis. The activity of γ-glutamyltransferase in these pathologies increases 10 times or more. When the liver is involved in a malignant process, the enzyme activity increases by 10-15 times, in chronic hepatitis - by 7 times. γ-glutamyltransferase is very sensitive to alcohol, which is used for differential diagnosis between viral and alcoholic liver lesions.

Determination of the activity of this enzyme is the most sensitive screening test and is preferable to determination of the activity of aminotransferases (AST and ALT) or alkaline phosphatase.
Determining the activity of γ-glutamyltransferase is also informative for liver diseases in children.

Fructose monophosphate aldolase (FMPA) – normal, result in liver diseases

In acute infectious hepatitis, the activity of fructose monophosphate aldolase increases tens of times, and when exposed to toxins in low concentrations (chronic poisoning by toxins) - only 2-3 times.

Enzyme activity in various pathologies of the liver and biliary tract

Read more about liver diseases in the following articles: Hepatitis, Cholelithiasis, Cirrhosis of the liver

So, we have looked at the main enzymes, the determination of whose activity can help in the early diagnosis or differential diagnosis of various liver diseases. Unfortunately, not all enzymes are used in clinical laboratory diagnostics, thereby reducing the range of pathologies that can be detected in the early stages. Considering the pace of development of science and technology, it is possible that in the coming years, methods for determining certain enzymes will be introduced into the practice of medical and diagnostic institutions of a wide profile.

Liver enzymes (enzymes, active protein compounds) are located inside its cells. Due to them, the organ cleanses the blood of toxins (100 liters per hour), which come from the intestines along with nutrients. The liver neutralizes poisons and removes them from the body. Leaves only compounds that are necessary for normal metabolism. When the structure of gland cells is damaged, a large number of enzymes enter the blood. This indicates pathological changes, disruption and the need for urgent treatment.

Liver enzymes and their significance

Liver enzymes are substances that enable the body to exist. Taking into account how many and what chemical reactions enzymes catalyze in the liver, they are divided into types.

Alanine aminotransferase

The enzyme is contained in the internal environment of the hepatocytes of the gland. Responsible for the production of glycogen (a form of carbohydrate storage in the body). If a developing infectious process damages the hepatocyte membrane, alanine aminotransferase leaks into the blood. The abnormal level allows us to judge the origin of problems in the organ. They can be caused by drugs, alcohol disease, etc.

A person who does not drink alcohol but has cirrhosis will have lower ALT levels than AST.

Liver enzymes in the blood increase not only for a reason. For example, their level may increase as a result of cardiac pathology. Therefore, the diagnosis is made taking into account the patient's medical history and the results of other tests.

Aspartate aminotransferase

Unlike ALT, this liver enzyme, which takes part in the metabolism of amino acids, is present in the cells of other organs (lungs, heart, kidneys, pancreas, skeletal muscles). Therefore, abnormally high transaminase activity in the bloodstream may indicate disease in one or even several of these organs.

Alkaline phosphatase

The enzyme is abbreviated as ALP. It is found in the membrane of intrahepatic cells.

The cells have thin outgrowths, due to which a border is formed, similar to eyelashes. The AP is located in this border. Once the bile ducts in the liver are damaged, this enzyme enters the bloodstream.

Alkaline phosphatase ensures the separation of phosphate substances from esters and their delivery to body tissues. Promotes the biliary process.

Gamma glutamyl transferase

A group of liver enzymes is involved in amino acid metabolism. The enzyme is located in the internal environment of hepatocytes, in their membrane and under it (in a part of the cell with an unchanged structure). An excess of the enzyme is found in diseases of the liver and pancreas.

Cholinesterase

The substance is responsible for the breakdown of choline (vitamin B4). Provides regeneration of gland cells, normalizes fat metabolism. Cholinesterase is localized in the internal semi-liquid environment of liver cells.

Deciphering blood biochemistry: norm and pathology

It is taken to clarify diseases of the organ and assess the functioning of the biliary tract:

• Aminotransferases - normal ratio according to the de Ritis coefficient is 1.3. With liver failure, the number drops. The AST norm is from 15 to 40 U/l. When hepatocytes die, enzyme activity increases 5-10 times. The normal level of ALT in the bloodstream is from 10 to 40 U/l. An increase in the volume of enzymes by 5 or more times indicates acute liver disease.
• Alkaline phosphatase - in a healthy person ranges from 30 to 90 U/l. A value that has increased by 2-3 times indicates damage to bone tissue or the onset of liver failure.
• Glutamyltransferase - an acceptable level is considered to be from 167 to 1800 nmol/l, depending on gender. Its growth of two or more times indicates an infection. This enzyme is sensitive to alcohol, which is taken into account when carrying out differential diagnosis.
• Cholinesterase - in healthy people, the level of the substance is from 5800 to 11800 U/l (different in men and women). A sharp decrease in its quantity indicates a chronic gland disease.

Reasons for increased enzymes

Liver enzymes ALT and AST increase due to the destruction of liver tissue. Such pathological changes cause oncological neoplasms, viral, and other types of cirrhosis. Aminotransferase levels also increase in myocardial infarction, muscle injury, and acute pancreatitis.

The volume of alkaline phosphatase increases with, as well as in women during pregnancy and in adolescents. Abnormal levels of the enzyme glutamyltransferase are observed with and. Without biochemical analysis, it is difficult to identify what caused the disruption of enzymatic processes. Elevated levels of cholinesterase are observed with alcohol exposure.

Why do enzyme levels decrease?

The amount of cholinesterase decreases in cirrhosis, hepatitis, and in the ducts. If microsomal liver enzymes (gamma-glutamyltransferase) decrease, it means that the patient has the most severe type of cirrhosis, the decompensated type. GGT is also reduced in women due to the use of certain birth control pills.

A reduced level of aminotransferases is not dangerous for the biochemical processes occurring in the human liver. Only high ALT and AST levels should be a cause for concern.

Additional symptoms

An increase in blood volume may indicate a violation of the antitoxic function of the liver or the development of hemolytic anemia. Growth usually indicates obstruction of the bile ducts. Because of this, the substance is not excreted in the liver secretions, but is partially absorbed into the bloodstream.

How to normalize liver function

It is impossible to restore liver function on your own. The attending physician can solve the problem. Taking into account the root cause of the disease and focusing on the results of biochemical analysis, the specialist will draw up an effective treatment regimen. For pathological levels of liver enzymes, it is usually prescribed. It allows you to relieve the digestive organs, eliminate excess fat deposits, and cleanse the body of toxins and waste. Protein is responsible for the restoration of hepatocytes, so the patient’s daily menu should contain rich sources of it.

Literature

• Kamyshnikov, V. S. Clinical laboratory tests from A to Z and their diagnostic profiles. Reference manual / V. S. Kamyshnikov. – M.: MEDpress-inform, 2007. – 320 p.
• Kozlova, N. M. Complex functional, metabolic, immunological and morphological disorders in diseases of the biliary tract and their drug correction: Dissertation for the degree of Doctor of Medical Sciences / Irkutsk State Medical University. Irkutsk, 2007.
• Ovchinnikov, Yu. A. Complete primary structure of aspartate aminotransferase / Yu. A. Ovchinnikov, A. E. Braunshtein, T. A. Egorov, O. L. Polyanovsky, N. A. Aldanova, M. Yu. Feigina, etc. . // Report of the USSR Academy of Sciences. –1972. – 728-731 p.
• Semenova, E. V. Diagnosis and complex treatment of liver damage: Dissertation for the degree of candidate of medical sciences / Research Institute named after. N.V. Sklifosofsky. Moscow, 1993.
• Fillipovich, Yu. B. Proteins and their role in life processes. A book to read on organic chemistry. A manual for students. – M.: Education, 1975. – 216-234 p.
• Tsygan V.N. Pathological physiology of the digestive system. Textbook / V. N. Tsygan, E. V. Zinoviev, A. V. Dergunov, O. Yu. Pakhalskaya. – St. Petersburg: SpetsLit, 2017. – 8-35 p.

Blood tests for liver enzymes are performed very often. This is not surprising, because the liver is one of the largest glands of the human body. It takes part in metabolic processes, cleanses the blood of toxins and poisons, and monitors the biochemical process. For the most part, such changes occur due to enzymes that are synthesized by the liver.

The presence of liver enzymes in the blood is constant. They are indispensable for humans. If the human body is affected by some pathology, then the enzymes demonstrate an increase or decrease, which is very important. Biochemistry for the presence of liver enzymes is required for differential diagnosis.

Before moving on to blood tests for enzymes, it is worth understanding what they are. What enzymes are secreted in blood plasma? Enzymes are used by the human body to carry out metabolic processes. Contains enzymes in the hepatobiliary system. Due to the constant presence of microsomal liver enzymes, the organ functions normally.

Mitochondria contain enzymes that are important for the liver in terms of energy metabolism. For the most part, enzymes can be broken down; partly, components of excrement, such as bile, are used for excretion.

Blood biochemistry is able to determine the indicators of a particular enzyme. Such biochemical studies can be performed at any time. Blood can also be checked with special rapid tests. At the moment, such biochemistry is important, since enzyme tests are needed to draw a clinical picture.

Against the background of a number of diseases, an increase in liver enzymes or a decrease in them can be observed. Since the liver performs a number of functions, it is not surprising that there are different enzymes. There are three options, varying by field of activity:

• secretory;
• excretory;
• indicator.

Speaking about the first type of enzymes, it is represented by two types. These are prothrombinase and cholinesterase. Enzymes of this group work with blood. The norm for coagulation is determined. If blood plasma enzymes of this type are low, you should pay attention to possible problems with the liver, gall bladder or its ducts.

The second type includes only alkaline phosphatase. These enzymes are released along with bile, which means they are excreted in the form of stool. When alkaline phosphatase is increased, it is worth considering checking the bile ducts.

Indicator type blood enzymes can increase sharply due to the destruction of hepatocytes. We are talking about liver cells, which, under the influence of a number of diseases, cease to exist. This type includes options such as AST, ALT, GGT, LDH and GlDG. These substances are present in the cytosol or mitochondria. AST and ALT can also be considered microsomal liver enzymes. However, not all enzymes have diagnostic value.

Most often, biochemistry determines AST, ALT, GGT, LDN and alkaline phosphatase in the blood. The level of these substances can tell a lot about the state of affairs. The analysis for pancreatic or liver enzymes should be deciphered by a doctor who, taking into account the data obtained, will immediately make a diagnosis or send you for additional examinations. Usually this is an ultrasound or x-ray, maybe a stool test. In particularly severe cases, a liver puncture may be required.

When some liver enzyme is elevated, but the norm is not seriously exceeded, and biochemistry has detected a single deviation, there is no talk of any terrible diagnosis. Perhaps you recently ate something bad or drank alcohol. If regular drug treatment is present, it has an impact on the liver, affecting enzyme levels. You need to start worrying if a very high indicator is revealed by the results of the study.

Why do enzymes grow?

Liver enzyme levels can increase for many reasons. Doctors talk about a slight increase as a natural fluctuation that can be explained by drug therapy or the use of low-quality products. The liver in the human body can be considered a kind of biochemical laboratory that immediately responds to any changes in the environment, the entry of poor-quality food or water into the body.

However, it is important to emphasize that quite often, especially if the indicators have increased several times, we are talking about the presence of some kind of liver disease. Through biochemical studies, doctors can more accurately identify the factor that provoked the corresponding changes.

It happens that people experience an increase in liver enzymes when undergoing a course of treatment with drugs that are harmful to the liver. These can be painkillers or statins, which help the blood remove excess cholesterol from the body. Alcohol is also considered a factor that increases such indicators, especially if it is consumed frequently and uncontrollably. Against the background of obesity, an increase in the corresponding substances can also occur.

If, after taking the tests, the result indicates a significant increase in alanine aminotransferase, indicated by a reduction in ALT, then we may be talking about improper liver or pancreatic function. These are hepatitis, pancreatitis, alcohol intoxication. In addition, a number of ailments of an oncological nature have such a picture.

Elevated levels of aspartate aminotransferase, or AST, can tell your doctor about problems with skeletal muscle or myocardium. Patients often come in with a corresponding mark in the test results who have experienced myocardial infarction, infectious myocarditis or myopathy.

If both indicators increase simultaneously, the reason may lie in taking a number of medications and herbal preparations. This situation is faced by people on statins, sulfonamides and paracetamol. Some plants cannot be excluded from risk factors. These are skullcap, alexandrine leaf and ephedra.

What pregnant women need to know

When liver enzyme levels are elevated during pregnancy, we are not always talking about some kind of pathology. The thing is that during the period of gestation, the female body undergoes serious changes. The mother's organs have to work on two fronts, which affects their condition.

During pregnancy, ALT and AST can reach up to 31 U/l. If toxicosis is present, then in the period from 28 to 32 weeks an increase in these numbers is observed. Usually the first two trimesters show slight deviations from time to time, but this is not considered a problem. Everything is explained by the increased load on the liver.

GGT indicators can reach up to 36 U/l. During the period from 12 to 27 weeks of pregnancy there is a slight increase, which is considered normal. With a strong increase in the level, inflammation in the liver or pathology of the biliary system may be present, and gestational diabetes mellitus is also expressed.

Speaking about the norm of alkaline phosphatase, its level can reach up to 150 U. At the same time, against the background of active fetal growth, which starts from the 20th week until the moment of birth, there is a slight increase in numbers. A serious change in the level of alkaline phosphatase is observed when taking large amounts of ascorbic acid, antibacterial drugs, or with a lack of calcium and phosphorus in the body.

What to do if you get promoted

An increase in any of the liver enzymes can be considered only as symptoms, and not as an immediate pathology that requires treatment. In most cases, the doctor can easily determine the root cause of the increase and select measures that can correct this indicator.

If you have had your blood biochemistry tested as a preventive measure, and it has demonstrated an increase in enzymes, then you should go for a consultation with a therapist. Your doctor may recommend additional tests to determine the underlying cause.

First of all, regardless of the cause, the patient will be advised to adjust their nutritional diet. The main objective of such a therapeutic diet is to reduce the load on the liver, reduce the level of fat deposits in it, and remove toxins and waste.

An increased amount of vegetables is important for a liver diet. You can make salads from spinach, kale, and greens. It is important to adjust the amount of foods that contain antioxidants. Add avocado and some nuts to your usual diet, your liver will thank you.

Your daily menu should contain at least 50 grams of dietary fiber. We're talking about fiber. With the help of such substances, the body is able to eliminate “bad” cholesterol and normalize the functioning of the biliary system. Fruits, nuts, cereals, and legumes contain a lot of fiber.

As part of treatment, it is important to get enough protein. The fact is that it is protein substances that are considered the necessary basis that allows the restoration of damaged hepatocytes. However, the doctor must determine the specific protein norm. It is important to adhere to the correct drinking regime during the treatment process. You need to drink up to two liters of liquid per day.

The liver is one of the largest glands in the human body. It participates in metabolic processes, cleanses the blood of toxic and poisonous substances, and controls a number of biochemical processes. Most of these changes occur due to enzymes synthesized by the gland itself.

Liver enzymes (enzymes) maintain consistency in the body, acting in a manner invisible to humans. With the development of pathological conditions, the level of liver enzymes changes up or down, which is an important sign and is used in differential diagnosis.

Enzyme groups

Based on the characteristics of synthesis and action, all liver enzymes are divided into several groups:

1. Indicative. These enzymes indicate the presence of organ pathology in the form of destruction of its cells. These include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyltransferase), GDH (glumate dehydrogenase), LDH (lactate dehydrogenase). The first two enzymes are most often used for diagnostic processes.
2. Secretory (cholinesterase, prothrombinase). Participate in supporting the functioning of the blood coagulation system.
3. Excretory (representative - alkaline phosphatase). Found in bile components. During research, this enzyme shows the functioning of the biliary system.

ALT and AST

These are microsomal liver enzymes, the level of which is monitored by a biochemical blood test. AST is an endogenous enzyme produced inside hepatocytes. It is also synthesized by cells of other organs, but in smaller quantities (heart, brain, kidneys, intestinal tract). A change in the level of an enzyme in the blood indicates the development of the disease, even if there are no visible symptoms yet.

ALT is produced by cells of the liver, heart muscle, and kidneys (insignificant amounts). It is determined by a blood test in parallel with the first enzyme. An important diagnostic point is to clarify the ratio of ALT and AST.

Reasons for the increase

The increase in liver enzymes can be minor, occurring due to taking a number of medications or the accumulation of toxic substances in the body, or pronounced, appearing during the development of diseases.

Enzymes can increase with long-term treatment with painkillers, statins (drugs that are used to remove “bad” cholesterol from the body), sulfonamides, and Paracetamol. Provoking factors may be drinking alcohol and consuming fatty foods. This includes long-term use of herbal medicine (ephedra, skullcap and hay grass can increase the level of liver enzymes in a blood sample).

If the blood test for liver enzymes shows elevated levels, this indicates the following pathological conditions:

Signs of elevated enzyme levels

Such manifestations may not have visual symptoms or be accompanied by a number of complaints from the patient:

• decreased performance, constant fatigue;
• abdominal pain syndrome;
• loss of appetite;
• itching of the skin;
• yellowness of the sclera and skin;
• frequent bruises, nosebleeds.

Excretory and secretory enzymes

A blood test for enzymes involves not only assessing the level of the well-known ALT and AST, but also other enzymes. Alkaline phosphatase and GGT have important diagnostic value. The level of these enzymes goes beyond normal limits in pathologies of the biliary system, for example, in cholelithiasis, tumor processes.

Together with these enzymes, bilirubin, which is a bile pigment, is assessed. Clarifying its numbers is important for cholecystitis, cholelithiasis, cirrhosis, lamblia, vitamin B12 deficiency, and poisoning with alcoholic beverages and toxic substances.

Indicators during pregnancy

During the period of bearing a child, a number of changes occur in a woman’s body. Her organs and systems begin to work for two, which is reflected not only in her general condition, but also in laboratory indicators.

The level of ALT and AST during pregnancy is up to 31 U/l. If toxicosis develops at 28-32 weeks of gestation, the numbers increase. The first two trimesters may be accompanied by a slight deviation from acceptable limits, which is not considered a problem, since the load on the liver becomes maximum during this period.

GGT indicators are up to 36 U/l. It may increase slightly from 12 to 27 weeks of pregnancy, which is normal. The level increases significantly against the background of inflammatory processes of the liver, pathology of the biliary system, and with gestational diabetes mellitus.

The norm of alkaline phosphatase is up to 150 U/l. Active growth of the fetus from the 20th week until the moment of birth causes an increase in enzyme numbers. The level of alkaline phosphatase changes when taking large doses of ascorbic acid, antibacterial drugs, and calcium and phosphorus deficiency.

Norm

Acceptable indicators of the main important enzymes are indicated in the table.

Patient management tactics

When determining elevated liver enzymes, the doctor prescribes a number of additional examinations to clarify the patient’s condition. The specialist immediately recommends that the patient begin treatment by adjusting the diet. The goal is to reduce the load on the liver, reduce the level of fatty deposits in it, and remove toxins and waste.

It is important to increase the amount of vegetables you eat. Spinach, kale, greens, lettuce, and dandelion greens are considered especially healthy. You also need to increase the amount of foods you consume that contain antioxidants (avocados, nuts).

The daily menu should contain at least 50 g of dietary fiber, in particular fiber. Such substances cleanse the body of “bad” cholesterol and help normalize the functioning of the biliary system. Fiber-rich foods:

Treatment includes the supply of a sufficient amount of protein, because protein substances are considered the necessary basis for the restoration of damaged hepatocytes. However, the doctor will tell you exactly how much of it should be present in the daily diet. It is important not to consume too much, so as not to overload the liver’s mechanism for processing proteins.

It is necessary to drink enough clean water. Every day you need to drink up to 2 liters of liquid: on an empty stomach, before each meal, before and after physical activity, before evening rest.

Taking herbs and nutritional supplements

Herbal medicine has a beneficial effect on the condition of the liver and reduces pathological enzyme levels. Treatment consists of drinking teas based on herbal ingredients. It is important to consult with your doctor about the possibility of such activities.

Useful plant components:

You need to add turmeric to your food, which reduces the manifestations of inflammatory processes, and garlic, which has an antitumor effect. Antioxidant-rich dietary supplements can be used with your doctor's approval.

Treatment of diseases

If during diagnostics a pathological process is discovered, which was the cause of the increase in liver enzymes, it must be treated. A qualified specialist will select a treatment regimen for the patient according to a specific clinical case.

Liver enzymes play a significant role in a number of processes occurring in the human body. Their diagnostic value is the ability to detect diseases and pathological conditions in the early stages.

The liver is an important organ, on the proper functioning of which a person’s well-being and health depend. Enzymes are liver enzymes that participate in biochemical processes occurring in the body.

This organ produces several types of enzymes:

The concentration of enzymes in the blood changes if:

• the organ in question is damaged;
• the development of pathologies is observed.

Biochemical blood test is one of the effective methods for diagnosing liver diseases. Many enzymes produced by this organ enter the blood. In some pathologies, the amount of some elements in the blood plasma decreases, while others increase.

A blood test for liver disease helps doctors narrow the range of pathologies,, if necessary, refer the patient for additional examination, and make a diagnosis. The method shows the concentration in the blood serum of enzymes of each of the 3 groups:

1. Secretory - some of them are involved in the process of cholinesterase and blood clotting. In pathologies, their concentration decreases.
2. Excretory excreted with bile. If there are disturbances in the functioning of the organ, their level increases.
3. Indicators perform intracellular functions and are located in mitochondria (AST, GDH), and the cytosol of cells (ALAT, LDH, AST). Their concentration in blood serum increases with liver damage. The norm for ALT is 5-43 U/l, and AST is 5-40 U/l. The value of the first indicator can increase 20-100 times or more in acute parenchymal hepatitis. AST activity increases slightly.

In the blood of liver diseases, the concentration of indicator enzymes increases:

Doctors, when examining the liver, take into account ALT and AST indicators. First rate:

In hepatitis, the concentration of ALT increases sharply before symptoms occur. Therefore, timely examination allows you to quickly begin treatment.

The concentration of this substance increases when hepatocytes are damaged. ALT and AST indicators are a diagnostic method called the de Ritis coefficient (DRr). Doctors determine their ratio to select an effective treatment regimen. ALT to AST should normally be 1:3.

If, after evaluating the results of a blood test for AST and ALT, an accurate diagnosis cannot be made, then additional tests are performed to check the liver. To do this, determine the concentration:

Normal GGT levels are up to 38 U/l (in women) and up to 55 U/l (in men). An increase in concentration by more than 10 times is observed in diabetes and biliary tract diseases. The norm for GLD is up to 3 U/l (in women) and up to 4 U/l (in men). The concentration increases in severe poisoning, oncology, and infectious processes. The LDH norm is 140-350 U/l.

ALP (alkaline phosphatase) is involved in the digestion process and is excreted in bile. Normally, its concentration in the blood serum is 30-90 U/l (in men it can reach 120 U/l). With an increase in the intensity of metabolic processes, the level of alkaline phosphatase increases to 400 U/l.

Bad blood tests are not a reason to panic. After making a diagnosis, the doctor prescribes treatment taking into account the characteristics of the disease and the patient’s body. One of the drugs that is prescribed to normalize enzymes is Galstena. You should not self-medicate by taking medication without consulting a qualified specialist. Folk remedies are used on the recommendation of the attending physician.

Transaminases are microsomal enzymes that are found in all cells and are necessary for aminotransferase. Thanks to them, the exchange of nitrogen-containing compounds with carbohydrates occurs. Transaminase ALT is active in the liver, and AST is active in muscle tissue. An increase in the level of these substances in the blood is observed in liver pathologies (viral hepatitis) and myocardial infarction.

With hepatitis, the patient may not have jaundice, the bilirubin level is normal, but the concentration of transferases increases. This may indicate the following pathologies:

• obstructive jaundice;
• tumor processes in the liver;
• cholestasis;
• acute viral, toxic or chronic hepatitis.

Due to myocardial infarction, the level of aminotransaminases can increase 20 times in a few days, but with angina pectoris their concentration does not change. The amount of aminotransaminases in the blood may increase temporarily with gout, extensive muscle injuries, myopathies, burns, myositis, and diseases associated with the breakdown of red blood cells.

DR readings (de Ritis coefficient) help in diagnosing the following pathologies:

• viral hepatitis - DR up to 1;
• chronic hepatitis or liver dystrophy - DR 1 and higher;
• alcoholic liver disease (hepatitis, fatty degeneration or cirrhosis of the liver) - DR 2 or higher, and blood albumin up to 35 g/l;
• myocardial infarction - DR above 1.3.

Diagnosis of liver cirrhosis and hepatitis C includes a biochemical blood test. With its help, doctors determine:

• bilirubin level;
• liver enzyme concentrations;
• whey protein content.

• bilirubin (1.7-17 µmol/l);
• SDH (up to 17 units);
• AST, ALT (up to 40 units);
• fructose-1-phosphate aldolase (up to 1 unit);
• urokinase (up to 1 unit).

Bilirubin increases in liver cirrhosis. 3 indicators are taken into account (measured in µmol/l):

• direct fraction (norm - up to 4.3);
• indirect fraction (norm - up to 17.1);
• sum of fractions (norm - up to 20.5).

A blood test for liver cirrhosis additionally involves determining the level of alkaline phosphatase (normal - up to 140 units), γ-GGT (normal for women - up to 36 units, for men - up to 61 units), albumin (normal - up to 50 g/ l). It is recommended to perform a coagulogram (special test). The liver synthesizes a large number of proteins that affect blood clotting. Patients predisposed to liver pathologies need to know:

The level of enzymes can be normalized by eliminating the causes that led to an increase in the concentration of the former. Additional tests may be required for liver cirrhosis and other pathologies. What tests need to be taken are determined by the attending physician.

In addition to drug treatment, patients are advised to adjust their diet:

• exclude salty, fatty, spicy and smoked foods from the diet;
• give up coffee and alcohol;
• include dairy products and organic food in the menu;
• take hepatoprotectors.

Timely tests for liver cancer make it possible to promptly begin treatment.

In its advanced state, the disease can cause death. Having discovered symptoms of cirrhosis, you should not self-medicate. It is recommended to seek help from a doctor and undergo the necessary tests for liver cancer. This condition is dangerous during pregnancy. During this period, the patient should be under constant medical supervision (liver examination). If necessary, the expectant mother will need to go into confinement or undergo a medical termination of pregnancy.

Are you protecting your liver when taking medications?

Find out the size of your liver by taking our tests.