The liver enzyme AST is elevated. Biochemical blood test for liver enzymes. Useful plants are

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 constancy in the body, acting in a way that is 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 the synthesis and action, all liver enzymes are divided into several groups:

Indicator. These enzymes show the presence of an organ pathology in the form of destruction of its cells. These include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase), GDH (glumatate dehydrogenase), LDH (lactate dehydrogenase). The first two enzymes are most commonly used for diagnostic processes.
Secretory (cholinesterase, prothrombinase). Participate in the support of the blood coagulation system.
Excretory (representative - alkaline phosphatase). It is found in bile components. During research, this enzyme shows the work of the biliary system.

ALT and AST

These are microsomal liver enzymes, the level of which is controlled 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 the enzyme in the blood indicates the development of the disease, even if there are no visible symptoms yet.

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

Reasons for the increase

An increase in liver enzymes can be insignificant, arising from the intake of a number of drugs or the accumulation of toxic substances in the body, or pronounced, appearing with 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, Paracetamol. Provoking factors may be the intake of alcoholic beverages and the abuse of 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 is elevated, 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 bruising, nosebleeds.

Excretory and secretory enzymes

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

Together with these enzymes, the rate of bilirubin, which is a bile pigment, is evaluated. Clarification of its numbers is important for cholecystitis, cholelithiasis, cirrhosis, giardia, vitamin B12 deficiency, poisoning with alcohol, 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 the general condition, but also in laboratory parameters.

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 overshoot, which is not considered a problem, since the load on the liver during this period becomes maximum.

GGT indicators - up to 36 U / l. It may increase slightly from 12 to 27 weeks of pregnancy, which is the norm. The level increases strongly 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 delivery causes an increase in the numbers of the enzyme. The level of alkaline phosphatase changes against the background of taking large doses of ascorbic acid, antibacterial drugs, with calcium and phosphorus deficiency.

Norm

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

Patient management

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

It is important to increase the amount of vegetables in the body. Spinach, kale, greens, lettuce, dandelion greens are considered especially useful. You also need to increase the amount of foods consumed, which include 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 contribute to the normalization of the biliary system. Fiber rich foods:

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

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

Taking herbs and supplements

Phytotherapy favorably affects the state of the liver and reduces the pathological parameters of enzymes. Treatment consists in the use of teas based on herbal ingredients. It is important to consult with your doctor about the possibility of such events.

Useful herbal ingredients:

In food, you need to add turmeric, which reduces the manifestations of inflammatory processes, and garlic, which has an antitumor effect. With the permission of a doctor, you can use nutritional supplements rich in antioxidants.

Treatment of diseases

If during the diagnosis a pathological process is detected, which was the reason for the increase in liver enzymes, it must be treated. A qualified specialist will select a therapy 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, the proper functioning of which depends on the well-being and health of a person. Enzymes - liver enzymes that are involved in the 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;
development of pathologies is observed.

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

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

Secretory - some of them are involved in the process of cholinesterase and blood clotting. With pathologies, their concentration decreases.
Excretory are allocated with bile. With violations in the work of the body, their level increases.
Indicators perform intracellular functions, are located in mitochondria (AsAT, GDH), cell cytosol (ALAT, LDH, AST). Their concentration in the blood serum with liver damage increases. The norm of AlAT is 5-43 U/l, and AsAT is 5-40 U/l. The value of the first indicator can increase by 20-100 or more times in acute parenchymal hepatitis. AST activity increases slightly.

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

Physicians, conducting a liver examination, take into account the indicators of ALT and AST. Norm of the first:

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

The concentration of this substance increases with damage to hepatocytes. ALT and AST indicators are a diagnostic method called the de Ritis ratio (DRr). Doctors determine their ratio for the selection of 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 values are up to 38 U/l (in women) and up to 55 U/l (in men). An increase in concentration of more than 10 times is observed in diabetes and diseases of the biliary tract. Norm GdG - up to 3 U / l (in women) and up to 4 U / l (in men). The concentration increases with severe poisoning, oncology, infectious processes. Norm LDH - 140-350 U / l.

ALP (alkaline phosphatase) is involved in the process of digestion, excreted in the 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 no reason to panic. After making a diagnosis, the doctor prescribes treatment, taking into account the characteristics of the course of the disease and the patient's body. One of the drugs that are prescribed to normalize enzymes is Galstena. You can not self-medicate by taking medicine without consulting a qualified specialist. Folk remedies are used on the recommendation of the attending physician.

Transaminases are microsomal enzymes found in all cells and essential for aminotransferase. Thanks to them, nitrogen-containing compounds are exchanged with carbohydrates. ALT transaminase 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 level of bilirubin is normal, but the concentration of transferases is increased. 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, and with angina pectoris, their concentration does not change. The number of aminotransaminases in the blood can temporarily increase with gout, extensive muscle injuries, myopathies, burns, myositis, diseases associated with the breakdown of red blood cells.

Indications DR (de Ritis ratio) help in the diagnosis of the following pathologies:

viral hepatitis - DR up to 1;
chronic hepatitis or liver dystrophy - DR 1 and above;
alcoholic liver disease (hepatitis, fatty degeneration or cirrhosis of the liver) - DR 2 and above, 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;
concentration of liver enzymes;
whey protein content.

bilirubin (1.7-17 µmol/l);
SDG (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 with cirrhosis of the liver. 3 indicators are taken into account (measured in µmol / l):

direct fraction (norm - up to 4.3);
indirect fraction (norm - up to 17.1);
the sum of fractions (the norm is 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), albumins (normal - up to 50 g / l). It is recommended to carry out a coagulogram (special test). The liver synthesizes a large number of proteins that affect blood clotting. Patients predisposed to liver pathologies need to know:

To normalize the level of enzymes allows the elimination of the causes that led to an increase in the concentration of the former. Additional tests may be required for cirrhosis of the liver and other pathologies. Which tests you need to pass, is determined by the attending physician.

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

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

Timely tests for liver cancer allow you to quickly start treatment.

In an advanced state, the disease can lead to death. Having found the symptoms of cirrhosis, you can not self-medicate. It is recommended to seek help from a doctor, pass the necessary tests for liver cancer. This condition is dangerous during pregnancy. During this period, the patient should be under constant medical supervision (examination of the liver). If necessary, the expectant mother will need to lie down for preservation or a medical abortion is performed.

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Questions and answers on: liver enzymes are elevated

2014-10-28 06:24:39

Elena asks:

Hello. I really need your help in making a diagnosis, since there are very big problems with the liver, time is running out, and only bicyclol and ursosan are the only treatment options.
In 2011, I entered into a second marriage (it was both a second marriage and a second sexual partner), which soon broke up. After a short period of time, I learned from strangers. that the person has had hepatitis in the past. he had a hepatic coma, at the time of his acquaintance he was absolutely healthy (although he drank a little. He had contact with toxic substances at work), but had no complaints about the liver. In 2012, I passed the tests not for hepatitis B and C. For hepatitis C, everything was negative. Hepatitis B was positive only
Anti-HBc(sum) positive 1.08
Anti-HBe positive. 1.54. The rest of the tests were negative. According to the analyzes, ALT was slightly increased. and 3 times increased GGT. I went to the Infectious Diseases Hospital, and received an answer that I do not have hepatitis B. so there are only antibodies to it, but there is no Australian antigen and virus DNA. Although, according to information obtained on the Internet, the absence of Anti-HBs and the presence of low Anti-HBe indicate chronic hepatitis B.
After that, it was negative for 1.5 years three times by PCR (the sensitivity of the PCR system is from 30 copies). I did not receive treatment.
Spring 2014
years, with random blood tests, an increase in Alat up to 180 was revealed (the norm is up to 31). GGt up to 300 (norm up to 31). I was hospitalized at the Institute of Gastroenterology in the city of Dnepropetrovsk. Infectionists again said not our diagnosis. As of April 2014, the analyzes are as follows:
Anti-HBe - 1.44 positive (norm less than 1)
Anti-HBc (sum) - 1.05pos. (norm less than 1)
Anti-HBs are negative.
HBsAg - 0.566 negative (norm less than 0.9)
HBe - 0.094 negative (norm less than 1)
PCR - negative (sensing system 30 copies).
According to ultrasound, the enlargement of the liver in the right lobe is 181 mm. left - 91 mm., the spleen is a little enlarged.
The diagnosis of autoimmune hepatitis was questioned. According to the analysis of antibodies to smooth muscles. soluble antigen of the liver and pancreas. antinuclear antibodies. liver and kidney microsomes were negative. AMAs were positive in general, with repeated AMAs they were already negative. Primary biliary cirrhosis was called into question. A liver biopsy was made - a complete answer: Diagnosis on the Mrtavi scale: severe widespread fatty hepatosis without signs of fibrosis (F 0). with weak activity (A1). According to the fibroscan at admission, there is no fibrosis. after biopsy - possibly weak fibrosis F 1 (6 units). The diagnoses of autoimmune hepatitis and primary biliary cirrhosis were dropped. She was treated with Gepadif, Reasorbilact. phosphogliv.heptral. Liver parameters decrease slightly, after the biopsy they increased. She was discharged with a diagnosis of steatohepatosis.
After discharge, she felt an increasing intoxication - hot flashes. sweating. On an outpatient basis, she again underwent a course of reasorbilact droppers, intravenous phosphogliv. By the way, phosphogliv helps me a lot, but tableted heptral does absolutely nothing. It is possible that there is an antiviral effect in phosphogliv, and heptral is more for drinking people. Considering her biopsy to be uninformative, she turned to the 3rd city hospital in Zaporozhye, the department of liver surgery. A second biopsy was taken and the biopsy was examined for hepatitis B virus DNA and hepatitis C virus RNA.
The results of PCR studies of Hep B DNA and Hep RNA. C not found. The pathomorphological diagnosis is very brief, although Professor Valery Alekseevich Tumansky was made by an experienced doctor.
The biopsy itself is detailed - Steatohepatitis with predominantly macrovesicular (partial microvesicular) fatty degeneration of approximately 90 percent of hepatocytes. This is the whole analysis. Well, the preparations are stained with hematoxylin and eosin. Wag-Gison method. Massson's three-color method.
Not a word about fibrosis, about the activity of the process. As far as I understand, the preparations were not dyed for the study of hepatitis B. maybe because I'm not being diagnosed, or the lab doesn't test for HBc in liver tissue.
The ultrasound picture worsened: the portal vein - 14 mm. splenic vein - 9 mm. Liver right share 183 mm. left - 81 mm. Spleen - 131 x58 mm. An ultrasound is used to diagnose portal hypertension.
After the biopsy, at my request, hepamerz was again instilled with 2 pcs. .gepadif -4 pcs. reasorbilact.
At the moment, ALat 52 (the norm is up to 31). GGT 137 (norm up to 31). At the indicator of 137 GGT, it seemed to freeze. lower in any way, although the alat jumps.
According to other analyzes, the proteinogram is all normal. protein is normal. triglycerides are normal. cholesterol levels are normal. erythropoietin is normal. ferritinin increased to 179 (normal up to 150).
For four months of treatment, it was not possible to normalize ALT (jumps). and especially GGT - 137. The stomach is enlarged. the liver is baking. I am taking bicyclol. phosphogliv. ursosan.
I was diagnosed with fatty degeneration even before contact with hepatitis B. I personally believe that I have chronic hepatitis B, my immune system is not able to cope with such a formidable virus. besides, at the time of contact with the virus, he was already diagnosed with fatty degeneration. Liver parameters are elevated and not stabilized. because something causes hepatitis. I think the diagnosis of steatohepatitis with fatty degeneration is too sweet for my clinical picture.
I beg you to help me (I really trust your professionalism)
1. Make the correct diagnosis. Although I personally assume that I have advanced chronic hepatitis B, and infectious disease specialists say that there is no DNA of the virus in the blood and in the liver biopsy, there is no Australian antigen itself, and there is no virus either. But the liver that already decently hurts.
2. Clarify the need for antiviral therapy. Although bicyclol is improving liver performance. But I do not quite trust this Chinese pill, which can only be obtained through the Internet and is very expensive.
3. Tell me, perhaps it is still necessary to pass some tests, although it is dangerous to do a liver biopsy for the third time within 4 months, I think. And why are the biopsy results so modest. Perhaps 90 percent of the fat covered the entire histological picture. A mess, of course, but three years of infection and two years of unsuccessful attempts to make a correct diagnosis do not add to the mind.
Concerning alcohol it is negative. never used drugs. Although she was often ill throughout her life, she took many antibiotics. female sex hormones, took immunomodulators (Allokin Alpha) never treated the liver. According to the doctors, I myself planted the liver with drugs, although at the time of infection all liver enzymes were normal. I have no contact with toxins at work.
Thanks in advance for your reply. Perhaps at least you will help to understand my confused clinical picture.

Responsible Sukhov Yuri Alexandrovich:

Hello, Elena. I hope you yourself understand that according to the fragmentary information provided by you, a full-fledged consultation will not work. I would suggest the following algorithm: an additional examination by an infectious disease specialist, a consultation with a gastroenterologist. council. Regards, Yu Sukhov.

2011-09-29 16:57:09

Natalia asks:

Hello dear doctors! 2 weeks ago, after the flu, I passed the tests. The blood is normal. All liver enzymes are normal. Billirubin is increased up to 20 for 6 years. Urine is normal. The doctor said that I had a borderline reaction to hepatitis b. I feel good. Sometimes it hurts. It is the left side, at the bottom of the ribs. I go in for sports, I do not observe any special deviations. But from that day on, I'm in a panic. maybe so and what to do? thanks in advance for your reply. Sincerely, Natalia

Responsible Medical laboratory consultant "Synevo Ukraine":

Good day, Natalia. In order to decide on the presence or absence of hepatitis B, it is necessary to take tests for markers of hepatitis B and the DNA of this virus. And so you need to additionally conduct an ELISA blood test for HBsAg, IgM and IgG to HBsAg, antibodies to HBeAg and HbeAg itself, IgG to HBcAg and IgM to HBcAg, PCR to conduct a blood test for DNA of the hepatitis B virus. With the results of the tests, please contact advice, we'll figure it out. Be healthy!

2010-12-27 15:12:00

Catherine asks:

Good afternoon doctor! please help me figure it out. Pregnancy 37 weeks. Deadline for DA is January 21st. On December 3, everything began to itch terribly: arms, hands, legs completely, stomach. Has handed over analyzes on hepatic enzymes have been exceeded in 2 times. My doctor in the antenatal clinic sent me to the hospital. I was in bed for 10 days, now I am in the maternity hospital at a day hospital with a diagnosis of cholestatic hepatosis of pregnant women. I passed all the necessary blood tests (hepatitis, jaundice), feces, ultrasound of the abdominal cavity, urine. No pathology was found.
As to results of a blood on hepatic enzymes. Bilirubin, ALT, AST still remain elevated, but do not get worse, i.e. from normal values exceeded 2 times. But alkaline phosphatase (AP) in the following dynamics with reference indicators of the laboratory of the maternity hospital up to 98 units:
- On December 9, the AP was 198 units.

In the hospital, they told me that their laboratory considers an alkaline phosphatase level of up to 98 units to be normal.
Treatment: 3 tab. Ursosan per day. One tablet at 20 pm, the rest at 22 pm.

Question: is the last ALF result of December 24 critical for pregnant women, based on laboratory parameters? It turns out that my alkaline phosphatase is now increased by 2.7 times from the normal value. And if not, what indicator should be considered critical? By how many times should ALP be increased for emergency delivery?

Responsible Selyuk Mariana Nikolaevna:

Good afternoon, Catherine!
We are not talking about emergency childbirth with an increase in the level of alkaline phosphatase. Since the serum level of alkaline phosphatase during pregnancy increases as a result of the formation of a placental isoenzyme by the third trimester. There are reports of significant increases in alkaline phosphatase levels during pregnancy, but this is uncommon. Alkaline phosphatase levels return to baseline by the end of the first postpartum month. An increase in the level of alkaline phosphatase during pregnancy has no clinical significance for assessing the health of the mother or fetus. . But, it must be remembered that the determination of the level of alkaline phosphatase, placental alkaline phosphatase and their ratio are one of the modern methods for assessing the state of the placenta.

2010-11-26 15:42:55

Valeria asks:

Good afternoon. I was diagnosed with hepatitis C in 2008, genotype 1b. In the spring of 2010, I gave birth, the whole pregnancy ALT, AST were normal, PCR was a plus. In the summer I passed biochemistry - liver enzymes turned out to be elevated. Then I was prescribed bicyclol and choleretic preparations. Bicyclol seems to make me sick. Maybe start drinking hepatoprotectors? Thanks for the answer.

Responsible Medical consultant of the portal "site":

Good afternoon, Valeria. Bicyclol is not a first-line drug for the treatment of viral hepatitis and may well cause side effects such as nausea. Hepatoprotectors are not part of antiviral therapy, although in some cases their use is justified by the desire to protect liver cells in conditions of viral infection and aggressive therapy. Currently, the best treatment option for viral hepatitis C is treatment with pegylated interferons. However, to start therapy, you need the help of a specialist. Find a hepatologist, get examined and, if there are no serious contraindications, plan standard antiviral therapy. If necessary, the doctor will recommend you hepatoprotectors. Be healthy!

2016-04-25 18:47:14

Anna asks:

Responsible Stadnitskaya Svetlana Valerievna:

Hello Anna! When diagnosing allergies, one determination of the IgE (immunoglobulin E) value is not enough. Specific antibodies of the IgE group should be established. To identify the causative allergen in modern laboratory conditions, it is possible to determine the immunoglobulin E in the blood to more than 600 allergens that cause allergic reactions in the human body. With a disease of the pancreas, itching is a frequent symptom, due to the fact that bile enters the bloodstream, there may also be "jaundice" of the skin. Therefore, to determine the diagnosis, I recommend that you contact a specialist gastroenterologist in combination with consultations of a Dermatologist and an Allergist, in order to exclude other diseases.

2010-08-13 02:24:09

Zoryan asks:

Hello, I am 32 weeks pregnant. When I was registered with a gynecologist at about 8-9 weeks, they took tests from me, including a biochemical blood test, and everything was like a "soldier". After 3-4 weeks, I changed the doctor and for some reason he decided to take all the tests again when you register and in the biochemical analysis showed too high ALT and AST levels (everything else was within the normal range). The doctor sent me to check the liver and its diseases, but I didn’t have hepatitis, and for 3 months the doctor took tests and these indicators fell, eventually reached the norm. But he insisted on going to a gastroenterologist, which I did a week ago (since I live in the USA and I had to wait in line for up to two months for public insurance) and I was very scared, because the doctor sent me to test for the Einstein-Barr virus (I never heard of him). My question is this: if AST and ALT transaminases are elevated, can we unambiguously talk about this virus or has it not yet been finally confirmed? I am very worried now, since it is already time to give birth, and here you have a torch infection that can affect the development of the fetus with a variety of consequences? And from what else can these enzymes rise? all other liver tests are normal, ultrasound-all organs (liver, pancreas, urinary) are within size.??? The child has. Should I be worried that the baby might not be born healthy? I also double checked the amniotic fluid and everything is ok.

2009-02-12 14:36:10

Roma asks:

He completed the treatment of hepatitis C. He treated with Pegasis and Raferon and Copegus. Liver tests:
Billir.-11.0
Thymol.-3.7
ALT-1.52
AST-0.12
Phosphotase-1660.
Why elevated ALT enzymes after the end of treatment?
It is possible to judge by the analyzes that the virus is active in the oven?

Responsible Bondar Alexander Evgenievich:

Good afternoon. The effectiveness of antiviral treatment can be judged by the result of the PCR HCV RNA test. The increase in ALT may be due to other reasons.

The liver is one of the main organs of our body. Its activity is hardly noticeable, and disturbances in the functioning of this organ are extremely rarely manifested by any pronounced changes in well-being, unless we are talking about the development of a serious pathology or an advanced stage of some disease. However, some malfunctions in the liver may be manifested by changes in the results of laboratory tests. For example, a biochemical blood test may unexpectedly show an increase in liver enzymes, the causes and symptoms of which we will now discuss, and also talk about what to do if liver enzymes have increased.

Causes of elevated liver enzymes

In fact, a slight increase in liver enzymes in the blood is a completely natural phenomenon, which may be due to medication or the accumulation of toxins in the body. After all, the liver is a real biochemical laboratory in our body, it is able to respond both to the state of the environment and to the ingestion of insufficient quality foods or water.

However, it should be noted that quite often an increase in the amount of liver enzymes in the blood indicates the presence of some diseases, among which are serious disorders represented by hepatitis, etc.

An increase in liver enzymes can be explained by many pathological conditions. Only a doctor can determine which factor led to a change in normal parameters, which were recorded by biochemical blood tests.

So in some cases, a similar clinical picture can be observed when taking certain medications. An increase in liver enzymes often occurs during treatment with painkillers or statins, designed to get rid of excess cholesterol in the blood (“bad” cholesterol, otherwise low-density cholesterol). Excessive alcohol consumption or obesity can also increase the amount of these substances in the body.

If the tests performed show a significant increase in ALT (alanine aminotransferase), it can be triggered by damage to the liver and pancreas - hepatitis, pancreatitis, alcohol intoxication (alcohol poisoning). In addition, such a clinical picture is characteristic of some oncological ailments.

With an increase in AST (aspartate aminotransferase), the doctor may suspect damage to the skeletal muscles or myocardium. Such test results are observed in patients with myocardial infarction, infectious myocarditis and myopathy.

The simultaneous increase in AST and ALT levels is usually caused by taking a number of drugs or herbal preparations. A similar situation is typical for people using the already mentioned statins, cordarone, amiodarone, sulfonamides and paracetamol. As for herbs, an increase in liver enzymes can be observed if alexandria leaf (senna herb), ephedra and skullcap are used.

What indicates an increase in liver enzymes, what are the symptoms of this?

An increase in the level of liver enzymes may not manifest itself at all and does not disturb the general well-being of a person. In some cases, if the change in indicators is caused by liver diseases, the patient may be disturbed by excessive fatigue and weakness, abdominal pain of incomprehensible localization and loss of appetite. Specific manifestations of liver diseases are also possible: skin itching, jaundice (staining of the skin and sclera in a characteristic yellowish color), a violation of blood clotting (decrease), which makes itself felt by the rapid appearance of hematomas.

Violations in the activity of the pancreas can also be manifested by painful sensations, including quite pronounced ones. Sometimes the patient is only concerned about not very pronounced problems in the activity of the digestive tract: dyspeptic symptoms, increased gas formation in the intestines (flatulence), the appearance of undigested particles in the feces and the specific "fatty" of feces.

If an increase in liver enzymes is detected - what to do?

This phenomenon should be considered solely as a symptom requiring further diagnosis. The doctor is able to determine the cause of the increase in the level of enzymes and select the appropriate measures to correct it.

Therefore, if you passed a biochemical blood test and found abnormal liver enzymes, make an appointment with a therapist as soon as possible. The doctor will tell you what other studies need to be done to identify the cause of such a violation.

In most cases, patients with an increased amount of enzymes are immediately advised to adhere to a diet: eat fractionally, in small portions, and only wholesome food. Fatty, smoked, salty and spicy dishes should be excluded from the diet. In addition, you must stop taking alcoholic beverages, coffee and soda. Organic food and dairy products will benefit.

In addition to drugs aimed at correcting the underlying disease, patients with elevated liver enzymes are usually prescribed hepatoprotectors. Such drugs quite effectively restore the affected liver cells and help protect them from further aggressive influence. In addition, these drugs are able to facilitate the activity of this body and help it perform a number of functions. However, you should not make a decision on their use on your own.

Folk recipes

You can also cope with many factors that can cause an increase in liver enzymes using traditional medicine. Of course, the appropriateness of their use should be discussed with the attending physician.

So an excellent effect on hepatitis and some other liver diseases is given by a collection prepared from equal proportions of such components: corn stigmas, medicinal herb St. licorice. Chop and mix all ingredients. Brew a tablespoon of the resulting collection with a glass of boiling water and leave for two hours to infuse. Strain the finished medicine and dilute with warm, pre-boiled water to an initial volume of one glass. Drink it in a third of a glass about fifteen to twenty minutes before a meal three times a day.

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

The presence of liver enzymes in the blood is constant. They are indispensable to humans. If the human body is affected by some kind of pathology, then enzymes show 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 it is. What plasma enzymes are generally secreted. Enzymes are used by the human body to carry out metabolic processes. Contains enzymes in the hepatobiliary system. Due to the presence of microsomal liver enzymes on a permanent basis, 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; in part, excrement components, such as bile, are used for excretion.

Blood biochemistry is able to determine the performance of a particular enzyme. You can perform such biochemical studies 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 their decrease can be observed. Since the liver performs a variety of functions, it is not surprising that enzymes are different. Three options can be distinguished, varying in the field of activity:

secretory;
excretory;
indicator.

Speaking of 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 is determined during folding. If the plasma enzymes of this type are lowered, you should pay attention to possible problems with the liver, gallbladder or its ducts.

Only alkaline phosphatase can be attributed to the second type. These enzymes are released along with bile, which means that the output is carried out in the form of a stool. When alkaline phosphatase is increased, it is worth considering checking the bile ducts.

Blood enzymes of the indicator type can rise sharply against the background of 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 such variants as AST, ALT, GGT, LDH and GlDH. 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 rate of these substances can tell a lot about the state of affairs. An 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 severe cases, a hepatic puncture may be required.

When some liver enzyme is elevated, but the norm is not seriously exceeded, and biochemistry has found a single deviation, there is no question of any terrible diagnosis. Perhaps you recently ate something of poor quality or drank alcohol. If there is a regular drug treatment, it affects the liver, affecting the level of the enzyme. You need to start worrying if a very high indicator is revealed by the results of the study.

Why Enzymes Grow

An increase in liver enzymes can be due to many reasons. Doctors speak of a small increase as a fluctuation that is natural, which 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 intake of low-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. Due to biochemical studies, doctors can more accurately isolate the factor that provoked the corresponding changes.

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

If, after passing the tests, a significant increase in alanine aminotransferase, indicated by a reduction in ALT, is indicated as a result, then we can talk about improper hepatic or pancreatic glandular work. 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 the doctor about problems with the skeletal muscles or myocardium. Patients often come with a corresponding mark in the test results, who have survived myocardial infarction, myocarditis of an infectious nature, or myopathy.

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

What pregnant women need to know

When liver enzymes are elevated during pregnancy, indicators are not always 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 at the same time, then in the period from 28 to 32 weeks there is an increase in these numbers. Usually the first two trimesters now and then show a slight overstepping, but this is not considered a problem. All due to the increased load on the liver.

In this case, GGT indicators can reach up to 36 U / l. In the period from 12 to 27 weeks of pregnancy, there is some 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 units. At the same time, against the background of active fetal growth, which starts from the 20th week until the moment of delivery, there is a slight increase in numbers. A serious change in the level of alkaline phosphatase is observed when taking a large amount of ascorbic acid, antibacterial drugs, with a lack of calcium and phosphorus in the body.

What to do when you get promoted

An increase in any of the liver enzymes can only be considered as a symptom, and not as a direct 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 passed blood biochemistry as a preventive measure, and it showed 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 his nutritional diet. The main task of such a therapeutic diet is to reduce the load on the liver, reduce the level of body fat in it, remove toxins and toxins.

For a liver diet, an increased amount of vegetables is important. You can make salads from spinach, kale, greens. It is important to adjust the amount of foods that contain antioxidants. Add avocados and some nuts to your usual diet, the liver will be grateful to you.

The daily menu should contain at least 50 grams of dietary fiber. It's about fiber. With the help of such substances, the body is able to eliminate "bad" cholesterol and normalize the functioning of the biliary system. A lot of fiber contains fruits, nuts, cereals, legumes.

As part of the treatment, it is important to get enough protein. The fact is that it is the substances of the protein order that are considered the necessary basis, which allows you to restore damaged hepatocytes. However, the doctor must deal with the definition of a specific protein norm. It is important to adhere to the correct drinking regime during the treatment process. Drink up to two liters of fluid per day.

Transaminases, or transferases, are enzymes that catalyze the chemical reactions of nitrogen metabolism, whose main task is to transport amino groups to form new amino acids. Biochemical processes requiring their participation are carried out mainly in the liver.

The transit movement of transaminases in the blood normally does not affect the result of the tests; in quantitative terms, their concentration for women and men, respectively, is up to 31 and 37 U/l for ALT and 31 and 47 U/l for AST.

Hepatic transferases determined during standard laboratory tests:

alanine aminotransferase, or alanine transaminase (ALT);
aspartate aminotransferase, or aspartic transaminase (AST).

If necessary, ELISA (enzymatic immunoassay) is performed to search for antibodies to hepatitis viruses or PCR (polymerase chain reaction) to determine the DNA or RNA of viruses.

The test for the determination of transaminases is sensitive to changes in the liver, so it can be used to assess the effectiveness of therapy in combination with other laboratory and instrumental methods.

Enzyme groups

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

Indicator. These enzymes show the presence of an organ pathology in the form of destruction of its cells. These include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase), GDH (glumatate dehydrogenase), LDH (lactate dehydrogenase). The first two enzymes are most commonly used for diagnostic processes.
Secretory (cholinesterase, prothrombinase). Participate in the support of the blood coagulation system.
Excretory (representative - alkaline phosphatase). It is found in bile components. During research, this enzyme shows the work of the biliary system.

ALT and AST

Reasons for the increase

If the blood test for liver enzymes is elevated, 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 bruising, nosebleeds.

Excretory and secretory enzymes

Indicators during pregnancy

Norm

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

Patient management

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

Taking herbs and supplements

Phytotherapy favorably affects the state of the liver and reduces the pathological parameters of enzymes. Treatment consists in the use of herbal teas. It is important to consult with your doctor about the possibility of such events.

Useful herbal ingredients:

astragalus;
dandelion;
thistle.

In food, you need to add turmeric, which reduces the manifestations of inflammatory processes, and garlic, which has an antitumor effect. With the permission of a doctor, nutritional supplements rich in antioxidants can be used.

Treatment of diseases

If a pathological process is detected during the diagnosis, which was the reason for the increase in liver enzymes, it must be treated. A qualified specialist will select a therapy 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.

01 The essence of the problem

The liver produces the following enzymes: secretory, indicator and excretory. When liver enzymes exceed the permissible norm, or their level becomes less than normal, this indicates that either there is a pathology in the body or the liver is damaged. According to a blood test, doctors can determine what pathologies occur in the body, and with some additional studies they can make an accurate diagnosis.

For example, if hepatic enzymes of the secretory group are increased or decreased, then there are likely to be pathologies of blood clotting. If the work of the organ is disrupted, then the level of excretory enzymes increases, and the indicator ones are responsible for the processes inside the cell, if the liver is damaged, their level increases, the increase in the level occurs with parenchymal hepatitis.

02 Classification of enzymes

When examining the liver, the indicators of AST, ALT, GGT, LDH and alkaline phosphatase are most often considered:

gamma-glutamyltransferase - GGT;
lactate dehydrogenase - LDH;
alkaline phosphatase - alkaline phosphatase.

The most informative are the indicators of AST, ALT. The norm of AST and ALT in women should not exceed 31 units, in men ALT - 45 units, AST - 47 units. We must not forget that the rate of indicators will change in accordance with the age of the patient, so the above indicators are very conditional. As for children, in this case the age of the child also matters in determining the norm. Deciphering blood tests should be carried out by a competent specialist.

03 Symptoms of elevated readings

If a high level of liver enzymes is found in the blood, then the patient may not feel it at all. Sometimes, with liver diseases, a person may be disturbed by weakness, abdominal pain, loss of appetite, severe fatigue. There may be itching and a yellow tint of the skin, the sclera of the eyes may also turn yellow. With a decrease in blood clotting, hematomas of uncertain origin may occur.

If violations occur in the pancreas, a person may experience pain, sometimes the patient complains of dyspeptic disorders - an increase in the formation of gases, undigested pieces of food are observed in the feces, the feces become more fatty.

04 What measures should be taken?

An increase in the blood levels of liver enzymes should alert a person. Such a phenomenon must be considered solely as a symptom that requires additional diagnostic measures. Therefore, having found high enzymes in the analysis, it is necessary to consult a therapist.

Most often, doctors recommend following a diet, food should be fractional, portions should be small, food should be healthy. It is necessary to give up salty, fatty, smoked, spicy, you should refrain from coffee, carbonated drinks and alcohol. It is advisable to consume more dairy products and organic food. You can take any drugs and hepatoprotectors if they are recommended by a doctor. These drugs restore damaged liver cells well and help the organ perform its functions.

How to eat with liver damage? Fatty and heavy foods adversely affect the liver, this body needs a lot of greens - lettuce, spinach. Inflammatory processes in the liver reduce walnuts, avocado helps to remove harmful substances from the body. Useful in garlic and dairy products.

It is advisable to introduce into the diet foods with a high content of fiber - legumes, fruits, berries, cereals. Due to the fact that the liver processes a large amount of fats, its condition may worsen, foods that are rich in fiber enhance the work of the gallbladder, and more bile is secreted, which significantly reduces the burden on the liver during the breakdown of fats. It is recommended to use foods that contain vitamin C - rose hips, citrus fruits.

You also need to consume more fluids, water helps to remove toxins from the liver, so you need to drink at least 2 liters per day. You can drink clean water, or you can brew herbal teas, for example, from milk thistle, dandelion root, astragalus. Green tea is also very beneficial for the liver.

If the doctor recommends taking medications - hepatoprotectors, then it is very important to heed this recommendation and purchase Allohol, Essentiale, Phosphoglyph or Galstena - they will help bring enzyme levels back to normal and restore damaged organ cells.

Role in the body

An increase in the level of these enzymes occurs due to cell death in the internal organs and indicates the presence of abnormalities in the body. There are two types:

AST (ASpartanine-Transferase) - a specific enzyme, sensitive to changes in the heart muscle, liver, brain. As long as the cellular structure of these organs is not disturbed, the level of AST in the blood will be within the normal range.
ALT (ALanine-Transferase) is an enzyme that is the main indicator of liver disease.

The most simple and accessible about liver markers in the video below

Analysis

Indications for analysis

The reason for donating blood to identify transaminases can be symptoms of a disease that causes an increase in the level of ALT and AST enzymes. For example, hepatitis, heart attack, diseases of the gastrointestinal tract. The attending physician will definitely send for analysis if the following symptoms are detected:

Pain in the chest on the left side and irregular heart rhythm.
Pain in the right side of the abdomen (in the hypochondrium).
Weakness, fatigue.
Discoloration of the skin (jaundice).
Enlargement of the abdomen in the baby.
Long-term use of medications that can have a negative effect on liver function.
Suspicion of trauma to internal organs.
Evaluation of the effectiveness of treatment.
Toxic poisoning.

Preparation for analysis

To obtain a reliable result, the following rules must be observed:

Blood is given on an empty stomach, preferably in the morning.
It is allowed to drink only ordinary boiled water.
Do not take medications 10 days before the test.
For a couple of days, you need to exclude junk food (fried, sweet, salty) and alcohol from your diet.
Recommended minimize physical activity.

Norms of indicators

The indicators differ depending on gender and age:

Causes of elevated enzyme levels: ALT and AST

ALT and AST levels rise in the blood when the tissue of the organ for which they are responsible is damaged, mainly the liver, gastrointestinal tract and heart muscle. A more detailed list of causes of increased enzyme levels is presented below:

Hepatitis of any etymology (the main diagnostic indicator is ALT).
Oncological diseases of the liver.
Benign tumors of the liver.
Diseases associated with damage to the heart muscle (for this reason, there is also a simultaneous increase in ALT and AST).
During pregnancy, the level of ALT in the blood slightly increases, such deviations should not cause concern. But if during pregnancy there is a simultaneous increase in the level of ALT and AST, then a diagnosis of liver function is necessary.
Advanced form of pancreatitis (ALT rises).
Taking medications: warfarin, paracetamol, hormonal drugs (this can cause increased rates)
Congenital pathologies of the liver in infants (increased GGT and ALT).

How to reduce indicators

It is possible to reduce the amount of ALT and AST enzymes in the blood only by eliminating the underlying disease that caused the deviation from the norm. When the damaged organ fully restores its functions, it will stop releasing transaminases into the blood. Traditional medicine can help the sick organ to cope with the pathology faster, to treat it.

Nutrition recipes for the normalization of the liver and heart:

Dissolve half a teaspoon of turmeric and a tablespoon of honey in a glass of water. Take three times a day.
Oatmeal with milk will help cleanse the liver of accumulated toxins.
Juice from freshly squeezed beets.
A delicious dessert made from boiled pumpkin and honey will help to remove cholesterol.

What are liver tests

Liver tests combine types of laboratory tests aimed at identifying possible liver diseases.

Include determining the amount of liver enzymes and bilirubin in the blood:

ALT (alanine aminotransferase).
AST (aspartate aminotransferase).
GGT (gamma glutanyl transferase).
ALP (alkaline phosphatase).
total bilirubin.

Prevention

You can prevent liver diseases by a special diet that includes foods rich in vitamin D in your diet: milk, eggs, apples, sea fish, caviar, buckwheat and oatmeal. By eating wholesome plant foods, you will help the liver become more disease resistant and remove dangerous toxins. Eliminate fatty and salty foods from your diet so as not to overload the liver beyond the norm.
Give up bad habits: alcohol and smoking.
Avoid exposure to toxins. They can easily penetrate the body, having a detrimental effect on the liver.
Do not self-medicate. Uncontrolled intake of antibiotics may not bring the indicators back to normal, but, on the contrary, significantly weaken liver function.

What are the different groups of liver enzymes?

Liver enzymes are usually differentiated into groups. Allocate:

secretory substances. These include prothrombinase and cholinesterase. These molecules carry the function of blood clotting. If a patient has noticed their insufficiency, then there are deviations in the work of the gallbladder, its ducts and liver.
Indicator blood molecules. They are compounds such as: AST, ALT, LDH. Such substances are an integral part of blood cells. If the organs do not function properly, their values in the blood are increased.
Excretory group or alkaline phosphatase. This liver enzyme is produced in the gallbladder and its ducts. When the process of bile secretion has a pathology, the content of enzymes of this group increases.

What are the most commonly used in research?

According to liver enzymes, modern medicine diagnoses many diseases.

The amount of substances contained in the liver is quite large. However, to identify diseases, it is enough to examine only some of them. The most common for research are such biochemical signs as:

alanine transaminase (AST);
alanine aminotransferase (ALT);
gammalutamyl transpeptidase (GGT);
lactate dehydrogenase (LDH);
alkaline phosphatase (AP).

Each of the above components can indicate the presence of certain diseases. After the analysis has been carried out, the results are evaluated by the attending physician and a diagnosis can be made. The assessment takes place in accordance with the established general standards of content. Each result has certain units of measurement: units/l, µmol/l, mol/l.

Transaminase ratio

AST is a substance that is produced in the cells of the liver and in some other organs of the body. These include: lungs, brain, pancreas, heart muscle and muscle fibers. ALT is produced in the blood by hepatocytes. If there are pathologies in the functioning of any of these components, their content in the blood increases. To identify deviations in the early periods of the development of ailments, a biochemical study is carried out. This will make it possible to correctly identify the disease and prescribe effective treatment.

A change in these indices may indicate a violation of the function of both the liver and the heart. To make an accurate diagnosis, use the de Ritis coefficient. If the signs of transaminases are normal, its calculation is useless. However, if the activity of liver enzymes fluctuates, its value will help to correctly assess the patient's condition. Such a coefficient is calculated by determining the partial ratio of these two indices. A result in the range of 0.9-1.8 is considered normal. When the upper limit is increased, this indicates cardiac abnormalities. If the indicator is lower, these are symptoms of liver disease.

To obtain more accurate data in the detection of liver diseases, the ratios of the level of transaminases in the de Ritis coefficient with the processes occurring in the body were studied. The following interpretation of the results emerged:

1 - indicates the development of viral hepatitis;
1-2 - degeneration of the hepatic gland or a chronic form of jaundice;
more than 2 - destructive processes in the liver due to alcohol abuse.

Norms for adults and children

To identify existing deviations, it is important to know the general norms of AST ALT activity. There are different methods of laboratory research using different reagents. The main methods that detect insufficiency in the liver are optical and the Reitman-Frenkelal reaction. The results vary according to the sex and age differences of the patients. In optical biochemistry, the following values are used: men - 40-41 IU, women - 34-35 IU, babies - 50 IU. For the RF reaction: men - 0.1-0.5 h / ml, women 0.1-0.4 h / ml, babies - 0.2-0.5 h / ml.

When no significant violations were detected during biochemical analysis, they talk about the healthy and proper functioning of the heart muscle and biliary system. If there are strong index fluctuations, it is recommended to study the data in relation to other markers. In particular, to determine the de Ritis coefficient.

What tests need to be done

The most common analysis to determine the presence of the disease is blood biochemistry. It is prescribed for suspicion of any pathology in the human body, as well as for prevention. The doctor pays attention to the levels of AST and ALT in the human blood and to the level of alkaline phosphatase. These enzymes are measured in U/L (international unit per litre).

In the male and female half of the population, the indicators of enzymes differ slightly:

For men, 10 to 40 U/l ALT and 15 to 30 U/l AST are considered normal.
For women, the ALT norm is from 12 to 32 U / l and from 20 to 40 U / l AST.
With an increase in AST levels, damage to the liver cells (mechanical or necrotic) is considered.
An elevated ALT level indicates the development of an infectious process in the body.

Enzymes such as glutamate dehydrogenase and lactate dehydrogenase are also considered important indicators of liver enzymes. GDH in women should not exceed 3 U / l, and in men 4 U / l. The level of LDH is normal - 140-350 U / l. A significant excess of these enzymes indicates the development of infectious processes, oncological neoplasms, intoxication with toxic substances and degeneration of the parenchymal organ (liver).

A very important indicator in a biochemical blood test is the level of alkaline phosphatase. For the male population, this substance should not exceed 120 U / l; in women, alkaline phosphatase should be less than 90 U / l. If this enzyme is exceeded by 3-4 times the norm, this indicates problems with the outflow of bile (inflammatory process of the bile ducts, gallstones, etc.).

The ratio of AST and ALT

In a biochemical blood test, the AST and ALT indicator is always taken into account, the deviations of these enzymes make it possible to clarify the violations occurring in a particular organ:

AST is present in all tissues of the human body, but the heart muscle (myocardium) contains the most of this enzyme. That is why the excess of this substance indicates diseases of the heart.
The ALT enzyme is found in the highest quantities only in the liver, so a significant excess of its norm indicates a violation of the work of this parenchymal organ.

The ratio of AST and ALT in the medical language is called the de Ritis coefficient, therefore, with a biochemical blood test, it is possible to determine which organ is affected. With heart problems, the level of AST increases up to 8-10 times more than normal, while ALT increases by only 1.5-2 times more. With such indicators, the patient is diagnosed with a heart muscle infarction.

In liver diseases, such as hepatitis, the picture is reversed:

ALT rises up to 8-10 times, and AST only up to 2-4 times.
In most cases, the de Ritis coefficient has a lower figure, since the ALT enzyme increases in values more often than AST.
But in some diseases (alcoholic hepatitis, cirrhosis of the liver, damage to muscle tissue), it is the level of AST that rises, which makes it possible to differentiate one pathology from another.

In a healthy person, the de Ritis coefficient does not exceed 0.91-1.75. If the coefficient exceeded the permissible norm, a person is diagnosed with problems with cardiac activity. With a heart muscle infarction, the de Ritis coefficient (the ratio of AST to ALT) will be more than 2. If the coefficient is below the norm, the patient is diagnosed with a violation of the liver (for example, with hepatitis A or B, the ratio of AST to ALT will be from 0.55 to 0.83) .

Any person, even considering himself absolutely healthy, needs to regularly take a biochemical blood test for liver enzymes. The parenchymal organ does not have nerve endings, so very often the liver may not get sick and not bother a person for a long time. Only a blood test for liver enzymes is able to detect the presence of serious diseases, which will allow the patient to start as early and effective treatment of the pathology as possible.

You can also, by watching this video, find out which three tests you need to take in order to prevent many liver diseases in time.

Enzyme groups

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

Indicator. These enzymes show the presence of an organ pathology in the form of destruction of its cells. These include AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase), GDH (glumatate dehydrogenase), LDH (lactate dehydrogenase). The first two enzymes are most commonly used for diagnostic processes. Secretory (cholinesterase, prothrombinase). Participate in the support of the blood coagulation system. Excretory (representative - alkaline phosphatase). It is found in bile components. During research, this enzyme shows the work of the biliary system.

ALT and AST

Reasons for the increase

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

viral inflammation of the liver (hepatitis); cirrhosis; fatty hepatosis of the liver; primary malignant liver tumor; secondary tumor processes with the formation of metastases in the gland; inflammation of the pancreas; myocardial infarction; infectious myocarditis; heart failure.

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 bruising, nosebleeds.

Excretory and secretory enzymes

Indicators during pregnancy

Norm

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

Patient management

fruit; nuts; cereals; berries; legumes; leafy green vegetables.

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

Taking herbs and supplements

Useful herbal ingredients:

astragalus; dandelion; thistle.

Treatment of diseases

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 one of the most important human organs, cleansing the body of toxic substances and helping the digestion process. But at the same time, it is unpretentious, can withstand fairly large loads and is able to recover quickly.

Liver health affects the general condition of a person, his appearance and even the psyche. In everyday life, this organ is subject to serious stresses that harm it even before any symptoms appear. Elevated liver enzymes just indicate the presence of an excessive load on this biochemical laboratory of the human body.

Reasons for the increase

A slight increase in the level of liver enzymes in the blood is a fairly common phenomenon. This may be the result of medication or the accumulation of toxins. After all, the liver reacts to the state of the environment and to low-quality products, and to water. If discomfort is felt in the right hypochondrium, it is worth going for a consultation with a doctor in order to identify the causes. The results of liver enzyme tests will help specialists identify possible diseases. Increased activity of liver enzymes may indicate serious diseases, such as hepatitis.

Many diseases can affect the increase in liver enzymes. After studying and analyzing the symptoms and signs that accompany the increased level of enzymes taken by drugs, the specialist will be able to identify the cause of this.

Quite often, the value of liver parameters is increased due to the intake of certain medications. For example, painkillers or statins used to control cholesterol levels. Alcohol abuse or obesity can also affect the amount of enzymes in the blood.

Of course, the most common causes are certain diseases. Among them are hepatitis A, B and C, and heart failure, cirrhosis and liver cancer, mononucleosis and inflammation of the gallbladder, pancreatitis and hypothyroidism, and many others.

Identification of the content of liver enzymes in the blood

The fact that liver enzymes are elevated is most often detected during a preventive blood test. In many cases, this is a temporary minor increase that does not signal serious problems. In addition, it should be remembered that the norm may differ slightly from person to person and depends on gender, height and weight.

A significant deviation from the norm indicates inflammation or destruction of liver cells, which provokes the release of certain chemicals into the blood, including liver enzymes. A routine biochemical blood test will indicate an increase in the level of a particular enzyme.

The most common increase in blood enzymes is alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Alanine aminotransferase is an enzyme that promotes the production of alanine, which is necessary for the formation of proteins in the body. ALT is present in trace amounts in most cells of the body. In the case of liver damage, its level is greatly increased. It can be used to determine the activity of the inflammatory process in the liver.

Aspartate aminotransferase is involved in amino acid metabolism. The enzyme is present in the nervous tissue, skeletal muscles, in the tissues of the heart and kidneys. AST is most active in the liver, and the presence of hepatitis C is diagnosed by its level.

When diagnosing diseases and assessing the level of elevated liver enzymes, not only the indicators of each of them are important, but also the ratio of ALT and AST activity.

With viral damage to the liver or with excessive death of red blood cells, bilirubin may increase, which is accompanied by yellowing of the skin and eye sclera.

To control other enzymes that may be needed to more accurately determine the causes of any changes, it is necessary to take specific liver tests.

Treating elevated enzyme levels

Since an increase in the level of liver enzymes is a consequence of its inflammation or damage, the doctor first of all tries to find the cause of this condition, from which it is necessary to get rid of. That is, the treatment is not aimed at reducing the level of enzymes in the blood as such, but at eliminating the disease that caused such a reaction in the body.

In addition to drugs that treat the disease directly, hepatoprotectors are also prescribed. These drugs repair already damaged liver cells and protect them from further damage. In addition, they facilitate the work of this body, helping to perform some of its functions. But do not forget that any drugs should be prescribed by a specialist. It is not uncommon for cases when self-treatment and taking drugs to cleanse the liver lead to opposite consequences.