Hepatic enzyme elevated. Increased liver enzymes in the blood. Changes in enzyme activity in cirrhosis

The liver is one of the largest organs. It is directly involved in metabolism, cleanses the liquid connective tissue of toxic compounds, and also controls some biochemical processes. All these actions occur due to the production of the liver itself. Their indicators are clinically significant in the diagnosis of a disease. If this indicates the development of a pathological process in the body. Similar results of biochemical analysis are the basis for a comprehensive examination.

Enzyme groups

All enzymes produced by the liver have certain synthesizing features. The latter are the main criterion for classification.

Groups of liver enzymes:

Indicator. Their level deviates from the norm when the cells of the organ are destroyed. These enzymes include: ALT (alanine aminotransferase), AST (aspartate aminotransferase), LDH (lactate dehydrogenase), GDH (glumatate dehydrogenase), GGT (gammaglutamyl transpeptidase). The enzymes ALT and AST have the greatest clinical significance.
Secretory. Designed to maintain the blood clotting index. These include: prothrombinase, cholinesterase.
Excretory. Clinically significant is the indicator of alkaline phosphatase. When it deviates up or down, it is customary to talk about violations in the work of the biliary system.

In the conclusion of a biochemical blood test, not all enzymes are reflected, but only those that are of the greatest importance in diagnosing pathological processes.

Norm indicators

First, doctors evaluate the levels of AST and ALT enzymes. Moreover, the first is contained not only in the liver. AST can be found in skeletal muscle, myocardium, and kidneys. ALT is an enzyme found exclusively in the liver. A normal indicator of AST is one that is not less than 10 and not more than 30 U / l. For ALT, it ranges from 10 to 40 U / l.

Doctors also evaluate the ratio of alanine aminotransferase and aspartate aminotransferase levels. If the liver enzyme is equal to the level of AST, this indicates the development of acute hepatitis. When the first is 2 times greater than the second, it is customary to talk about alcohol addiction. If, on the contrary, AST is higher than ALT, this indicates the presence of cirrhosis. These are the main reasons for the increase in the blood of liver enzymes belonging to the indicator group.

The enzymes GGT, LDH, and alkaline phosphatase are also clinically significant. The norm of gamma-glutamyl transpeptidase in the blood is not more than 40 U / l. GGT is found not only in the liver, but also in the kidneys, the walls of the bile ducts and the pancreas. The enzyme is the most highly sensitive indicator, especially in children and during childbearing. For example, if AST and ALT indicators are within the normal range during toxic exposure, then GGT will definitely be increased.

The LDH enzyme is not only found in the liver. For this reason, it is additionally identified using numbers from 1 to 5. If a violation of the biliary system is suspected, a blood test for LDH-5 is indicated. The norm of the enzyme is up to 250 U / l.

Alkaline phosphatase is an enzyme also found in the kidneys, bone structures, and walls of the bile ducts. Its increase indicates a violation of the functioning of the hepatobiliary system. The norm of alkaline phosphatase - up to 270 U / l.

Causes of increased liver enzymes in the blood

Not in all cases, the deviation of indicators from the norm indicates the development of a pathological process in the body. Elevated liver enzymes in the blood are sometimes the result of being overweight or taking certain medications. Antipyretic and analgesic drugs, as well as drugs related to statins and sulfonamides, have the greatest impact on the indicators.

In addition, elevated liver enzymes in the blood sometimes indicate alcohol poisoning and the abuse of overly fatty foods. Also, the deviation of enzymes from the norm in some cases occurs against the background of alternative treatment of a disease. It is important to know that the use of products based on hay, skullcap and ephedra contributes to an increase in liver enzymes in the blood.

Other possible reasons for the deviation of indicators from the norm:

Pathologies in the form of cirrhosis, acute hepatitis, organ tissue necrosis, fatty degeneration, obstructive jaundice. In such cases, elevated liver enzymes ALT and AST.
The presence of cholestasis, neoplasms, cholangitis, alcohol intoxication. These are the reasons for the increase in the liver enzyme GGT. The indicator of this enzyme may also deviate upward against the background of hepatitis, obstructive jaundice and cirrhosis.

Levels of LDH and alkaline phosphatase increase against the background of all of the above diseases.

Clinical manifestations

The deviation of these indicators from the norm is accompanied by the appearance of a number of symptoms in a person. Against the background of an increase in liver enzymes, the following alarming signs occur:

A significant decrease in the degree of performance.
Rapid onset of fatigue.
Constant feeling of tiredness.
Appetite disorders.
Painful sensations in the abdominal cavity.
Itching and yellowness of the skin.
Bruises that appear for no apparent reason.
Jaundice of the sclera.
Frequent episodes of nosebleeds.

In some cases, an increase in liver enzymes is not associated with the occurrence of any symptoms.

Diagnostics

The level of enzymes is displayed in the conclusion of a biochemical blood test. This type of study is a laboratory diagnostic method, with the help of which a doctor can assess the degree of functioning of internal organs and obtain the most complete information regarding metabolic processes.

A biochemical blood test is a mandatory step in a comprehensive examination of a patient, even if the latter does not have clinical manifestations of any disease.

Before donating biological material (venous or capillary liquid connective tissue), some rules must be observed. Blood sampling is carried out on an empty stomach, and therefore the last meal should take place no later than 8 hours before visiting the laboratory. Psycho-emotional instability and physical overstrain can lead to false results. A day before donating blood, it is recommended to avoid any kind of exercise. Immediately before taking the biomaterial, it is advisable to sit for 15 minutes in a calm environment to normalize the psycho-emotional background.

To find out the cause of elevated liver enzymes in the blood, the doctor prescribes a series of laboratory and instrumental studies. The list of necessary diagnostic measures is compiled by a specialist based on the patient's complaints, anamnesis data and the results of a biochemical analysis.

It is important to understand that an increase in liver enzymes is a symptom of one of the diseases of the organ. Only after identifying the root cause, the doctor draws up the most effective treatment regimen.

Each of the liver diseases requires a specific approach. The treatment regimen for cirrhosis includes the following items:

Taking antiviral, immunomodulatory or hormonal drugs (depending on the etiology of the disease).
Injections or oral use of interferons ("Viferon", "Genferon", "Cycloferon").
Vitamin therapy.
Reception of hepaprotectors ("Gepabene", "Karsil", "Ursosan", "Geptral").

In addition, the doctor cancels all drugs for the use of which there are no clear indications. It is also necessary to follow a therapeutic diet and completely abandon alcohol-containing drinks.

Treatment of acute hepatitis involves the following activities:

Intravenous administration of a solution of glucose and ascorbic acid.
vitamin therapy.
Reception or administration of drugs that accelerate the release of harmful compounds from the body (with toxic hepatitis).
Hemodialysis.
Taking antihistamines ("Zodak", "Zirtek", "Fenistil").
The introduction of anti-inflammatory and desensitizing agents.

Depending on the etiology of the disease and its severity, the doctor may make adjustments to the treatment regimen.

Treatment of fatty degeneration of an organ consists of the following stages:

Reception of essential phospholipids ("Essentiale Forte", "Phospholipiale"). Preparations belonging to this group contribute to the restoration of liver cells.
Reception of the strongest hepaprotectors ("Rezalyut", "Antral", "Phosphogliv"). They have a powerful positive effect on the body.
Reception of immunomodulators ("Kogocel", "Amiksin", "Arbidol").
The use of choleretic agents ("Allohol", "Flamin").
The use of dietary supplements ("Zosterin-Ultra", "Tantal", "Silymarin").

Therapy of obstructive jaundice involves detoxification, antibacterial and infusion therapeutic measures. If they fail, surgery is indicated. In the presence of this disease, it is also necessary to follow a strict diet and completely exclude the use of alcohol-containing drinks.

The treatment regimen for cholestasis includes the following items:

Taking drugs whose active ingredient is ursodeoxycholic acid (Ursofalk, Ursodez, Ursosan).
The use of cytostatics ("Casodex", "Cisplacel").
Reception or intravenous administration of hepaprotectors.
Vitamin therapy.
Taking antihistamines.

Thus, the tactics of treating patients with elevated liver enzymes (AST, ALT, ALP, LDH, etc.) directly depends on the root cause that caused the onset of the pathological condition. In all cases, the doctor, without waiting for the results of a comprehensive examination, recommends making adjustments to the diet and diet. The purpose of following a therapeutic diet is to reduce the load on the affected organ, accelerate the removal of harmful compounds, and prevent the deposition of fat.

Recovery period: nutritional features

For liver diseases, doctors prescribe table number 5. This is a rather tough, but at the same time balanced diet. Its main principle is the exclusion from the diet of foods that contain a large amount of fat, "bad" cholesterol, purine and oxalic acid. These substances negatively affect the liver and prevent the restoration of its cells.

The basic principles of the diet:

It is necessary to grind as much as possible (it is better to grind) vegetable products rich in fiber. Meat should be cut into small pieces.
You need to eat up to 5 times a day. In this case, the size of one serving should not exceed 200 g.
Only warm food is allowed. Cold or too hot dishes are not recommended.
Products are allowed to boil, bake, steam or stew. Fried foods should be excluded from the diet.
The maximum allowable amount of salt per day is 10 g.

It is important to observe the drinking regimen. Every day you need to drink up to 2.5 liters of pure non-carbonated water.

Bread (rye or with bran).
Unsweetened cookies.
Yeast-free baking.
Rice, semolina, oatmeal and buckwheat porridge.
Pasta.
Berries.
Fruit.
Zephyr.
Marmalade.
Zucchini.
Cabbage (cauliflower and Beijing).
Pumpkin.
Beets.
carrots.
Cucumbers.
String beans.
Sweet pepper.
Dill.
Petrushka.
compote.
Skimmed milk.
I'll decoction the wild rose.
Ryazhenka.
Kefir.
Natural yogurt.
Curd.
cheese.
Lean meats and fish.
Chicken and quail eggs.
Olive oil.

During treatment and during the recovery period, it is forbidden to eat foods that irritate liver cells and increase the load on healthy hepatocytes. From the menu without fail it is necessary to exclude:

Muffin.
Yeast baking.
Puff pastry products.
Fresh bread.
Bean cultures.
Corn, barley and barley porridge.
Halva.
Seeds.
Chocolate.
Nuts.
Ice cream.
Ginger.
Olives.
Green onion.
Radish.
Mushrooms.
Petrushka.
Spinach.
Salted cucumbers.
Tomatoes.
White cabbage (not thermally processed).
Raspberry.
Grape.
Figs.
Black and green tea, as well as hibiscus.
Packaged juices.
Coffee.
Carbonated water.
Dairy products with a high percentage of fat.
Sauces.
Meat and fish of fatty varieties.

All soups should be in a weak broth. It is recommended to cook the meat separately at all, then cut it into small pieces and add to the finished dish.

Folk methods

Doctors do not prohibit turning to non-traditional methods of treatment. However, you must first consult with a specialist. This is due to the fact that some natural components can worsen the course of the underlying disease and, accordingly, further increase the level of liver enzymes.

The goal of alternative treatment is to prevent the destruction of hepatocytes. The most effective are the following recipes:

Take 150 g of oat grains and pour 1.5 liters of boiling water over them. Put the container on medium heat and cook for about 20 minutes. Allow liquid to cool. Drink the resulting decoction daily, 200 ml. The course of treatment is 20 days.
Take 200 ml of honey. Add ground cinnamon to it in an amount of 20 g. Mix the components thoroughly. Take the resulting remedy on an empty stomach twice a day (morning and evening) for 1 tsp. The duration of treatment is not limited.
Take the root of elecampane, wash it thoroughly and chop it. Pour 5 g of raw materials with boiling water in an amount of 200 ml. Let it brew for 1 hour. Filter the liquid and take the resulting remedy 4 times a day.

After a few days, the symptoms of general malaise disappear. If necessary, the course of treatment can be repeated.

Increased enzyme levels in pregnant women and children

During the period of gestation, it is necessary to take a biochemical blood test several times. If liver enzymes are elevated during pregnancy, this indicates the development of a pathological process or uncontrolled medication.

Most often expectant mothers are diagnosed with drug-induced hepatitis. During the period of bearing a child, the body experiences an increased load and a slight increase in the dosage of even a drug prescribed by a doctor leads to severe intoxication. If liver enzymes are elevated during pregnancy, it is necessary to adjust the dosing regimen or stop taking medications. Antibiotics, glucocorticosteroids, NSAIDs, anticonvulsants and anti-tuberculosis drugs, diuretics can provoke a deviation from the norm.

Elevated liver enzymes in a child can also be a consequence of taking medications (painkillers, statins, sulfonamides). In addition, eating fatty foods can provoke a deviation from the norm. To exclude serious diseases, the pediatrician prescribes a comprehensive examination. If a child has elevated liver enzymes, a hepatitis test is mandatory.

Finally

In the diagnosis of many diseases, a biochemical study of blood is important. It is possible to evaluate the functioning of the liver due to the indicators of the enzymes synthesized by it. They are divided into the following groups: indicator, excretory, secretory. Clinically significant in assessing the functioning of the body are indicators of ALT, AST, alkaline phosphatase, LDH.

If a pathological process is suspected, the doctor prescribes a series of studies and, based on their results, draws up the most effective treatment regimen. The main reasons for the deviation of liver enzymes from the norm are hepatitis, cirrhosis, obstructive jaundice, fatty degeneration, cholestasis. In pregnant women and children, an increase in enzymes is most often the result of taking medications. But at the same time, the development of dangerous pathologies cannot be ruled out.

The liver performs many important functions, from removing toxins from the body to helping with digestion, but by overworking the liver, we can cause serious damage to it. An increase in liver enzymes is a symptom of too much stress on the liver. However, they can be reduced to normal levels by changing diet and lifestyle.

Steps

Identification of liver diseases

Know what functions the liver performs in the body. In addition to the glandular function, the liver affects the functioning of other organs. It protects the body by inactivating hormones, drugs and biological substances that are not produced in our body. The liver also synthesizes cholesterol and proteins that could otherwise lead to blood clotting and inflammation. It stores vitamins, minerals and sugar, while removing harmful bacteria.

The liver is involved in several other important processes in the body, so it is easy enough to overload it.
It is very important to monitor the health of the liver, especially if the level of liver enzymes is already exceeded and the liver is overloaded.

Learn to recognize the symptoms of liver disease. Since the liver is involved in many processes, there is no single list of symptoms of liver damage. However, liver diseases not only have their own unique symptoms, but also share several common features. If you have any of the following symptoms, contact your doctor immediately:
- yellowish skin and whites of the eyes;
- abdominal pain and swelling;
- swelling of the legs and ankles;
- skin itching;
- dark yellow or reddish urine;
- discoloration of stools, tarry stools, or the appearance of blood;
- chronic fatigue;
- nausea or vomiting;
- loss of appetite;
- weight loss;
- dry mouth, thirst;
- tendency to bleed.
See a doctor for a diagnosis. Contact your doctor to have him examine you. Describe in detail your symptoms and any previous illnesses. Your doctor will ask you to donate blood for liver function tests (LFTs). FPP measures the levels of various liver enzymes and proteins. Based on this information, the doctor can make a definite diagnosis. As a rule, this analysis shows the level of the following enzymes:

Monitor your liver enzyme levels. If you have liver disease, you will likely need to have your liver enzymes tested every month or every 6 to 8 weeks. Monitor test results closely. A downward trend in values over six to twelve months indicates a positive outcome of maintenance treatment. Always let your doctor know what supplements you are taking and if there are any changes in your symptoms.

Change in diet

Eat more green leafy vegetables. Green leafy vegetables are rich in vitamins, minerals and nutrients. What is important for liver function, they help reduce the level of fatty deposits in it. Add leafy vegetables to your diet, including spinach, kale, chard, turnip greens and mustard greens, cruciferous plants (cauliflower, cabbage, broccoli, Brussels sprouts), dandelion greens, and lettuce.

Eat more foods rich in antioxidants. By itself, spinach or other green leafy vegetables will not lower liver enzymes, but they are rich in “flavonoids,” which are antioxidants that support liver function. Avocados can be beneficial because they contain a lot of vitamin E - an effective natural antioxidant. Avocados and walnuts contain glutathione, which is our body's primary antioxidant precursor.

Walnuts are also a good source of omega-3 fatty acids, which help reduce liver inflammation.
Other nuts, including brazil nuts, pecans, and almonds, are also healthy and are high in B vitamins and minerals.

Eat 35-50 grams of fiber daily. High-fiber foods reduce the absorption of cholesterol by the body, which means they reduce the amount of cholesterol the liver needs to process, and so these foods are beneficial for liver health and liver enzyme levels. Fiber also increases bile production, which improves fat digestion and prevents liver disease. Fiber-rich foods such as:
- oats, wheat, corn, rice bran;
- legumes (lima, adzuki, black, red, and white beans, pinto beans), lentils (red, brown, and yellow), and peas;
- berries (raspberries, blueberries, strawberries, blackberries, logan berries, gooseberries, cloudberries);
- whole grains (wheat, oats, corn, rye, buckwheat, brown rice);
- leafy green vegetables (turnip greens, mustard, lettuce, chard, spinach);
- nuts (almonds, pistachios, cashews, walnuts) and seeds (sesame, pumpkin, flax, sunflower seeds);
- fruits (especially those with edible skins such as apples, pears, plums, peaches and apricots).
Drink citrus juices rich in vitamin C. Vitamin C helps in tissue repair and wound healing. Drinking citrus juices or eating citrus fruits will help your liver recover and allow your liver enzymes to drop back down to normal. In addition, citruses reduce the risk of developing liver cancer. Add oranges, grapefruits, lemons and limes to your diet. When buying juices, try to choose those fortified with vitamin C.

Eat more cruciferous vegetables. Cruciferous vegetables are known to help balance the production of enzymes that neutralize carcinogens in the body. These vegetables contain a ton of vitamins, minerals, antioxidants, and fiber:
- broccoli;
- Brussels sprouts;
- cauliflower;
- radish;
- horseradish;
- swede and turnip;
- wasabi (Japanese horseradish);
- watercress.
Ask your doctor how much protein you need. Protein is generally the key to repairing damaged cells in the body, so increasing your protein intake is essential to heal the liver. But since the liver is a protein-processing organ, you can overload it by eating too many protein foods. These overloads can worsen the condition of the liver and increase the level of liver enzymes.
- Discuss with your doctor and/or dietitian how much protein you need to consume. Your doctor should provide you with a nutrition plan that is right for your body and based on your needs.
Drink more. Drinking enough water will help your liver get rid of anything else that might be stressing it out. Drink 8-10 glasses (230 ml) of water daily. It is especially important to drink water:
- when you wake up;
- before and during meals;
- before each physical activity and after it;
- right before bed.
Avoid foods that are bad for the liver. A healthy diet can support the liver, but unhealthy foods can damage it. Too much salty, fatty, or sugary foods can put undue stress on the liver. If you already have elevated levels of liver enzymes, then you need to give your liver a little rest. Avoid the following foods to lower your liver enzyme levels:

Taking herbs and supplements

Drink herbal teas that are good for the liver. Many herbs have traditionally been used to support liver function. The principle of action of these herbs has not been studied, but centuries of experience in their use has confirmed their safety. As a rule, these herbs are taken in the form of infusions and decoctions, but the dosage is not always strictly defined. Consult your doctor for dosage or follow the manufacturer's instructions on the package. The dosages indicated below should be considered as indicative.

Add garlic and turmeric to your food. These spices not only improve the taste of dishes, but are also beneficial for the liver. Add them to your food or use at least one of them daily.

Garlic also prevents the development of liver cancer and heart disease, and also improves immunity.
Turmeric has anti-inflammatory properties and therefore supports the liver by reducing inflammation that can lead to hepatitis, non-alcoholic steatohepatitis (NASH), liver cancer and cirrhosis.

Take antioxidant supplements. While there are many ways to get antioxidants from food, antioxidant supplements can be very beneficial. Alpha-lipoic acid (ALA) is an antioxidant that has been studied in patients with diabetes, cardiovascular disease, and liver disease. It supports the metabolism of sugar in the liver and prevents the development of alcoholic hepatosis. The most common dosage of this antioxidant is 100 mg three times a day. N-acetylcysteine (N-AC) works as a precursor to glutathione, which is the main antioxidant in our body. The most common dosage for liver health is 200–250 mg twice daily.

Liver function tests should be taken every 6 months, or as directed by a physician, until liver enzymes return to normal.

Warnings

Those with elevated liver enzyme levels should not take statins. Check your list of medications you are taking and discuss it with your doctor to make sure it does not include drugs in this group of medications.

Sources

http://www.nlm.nih.gov/medlineplus/liverdiseases.html
http://www.medicinenet.com/liver_anatomy_and_function/article.htm
http://www.medicinenet.com/liver_anatomy_and_function/page2.htm
http://www.mayoclinic.org/diseases-conditions/liver-problems/basics/symptoms/con-20025300
https://labtestsonline.org/understanding/analytes/liver-panel/tab/sample/
https://labtestsonline.org/understanding/analytes/ast/tab/test/
https://labtestsonline.org/understanding/analytes/alt/tab/glance
https://labtestsonline.org/understanding/analytes/alt/tab/glance

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:

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

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:

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

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:

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, 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 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.

An increase in liver enzymes may indicate inflammation or damage to the liver cells. Inflamed or damaged liver cells are manifested by laboratory elevations of certain chemicals, including liver enzymes, in the blood.
Among all liver markers, the following are most often elevated:
- alanine transaminases(ALT)
- aspartate-transaminase (AST)

Elevated liver enzymes may be detected during routine blood tests. In most cases, liver enzyme levels are elevated for some time. However, a prolonged increase in liver enzymes indicates a chronic liver pathology.

Many diseases and conditions can contribute to increased activity hepatic enzymes. Your doctor will determine the specific cause of the elevated liver enzymes. having analyzed your symptoms, and in some cases, by doing some tests and procedures.

More widespread Causes of elevated liver enzymes include:
- some prescription drugs, including statins, which used to control blood cholesterol;
- alcohol consumption;
- cardiac failure;
- hepatitis A;
- Hepatitis B;
- hepatitis C;
- hepatic steatosis and obesity;
- Painkillers, including acetaminophen (Tylenol, etc.).

Other causes of elevated liver enzymes may include:
- alcoholic hepatitis (inflammation of the liver caused by alcohol consumption);
- autoimmune hepatitis (inflammation of the liver caused by an autoimmune disease);
- celiac disease;
- cirrhosis of the liver (scarring of the liver);
- cytomegalovirus(CMV);
- dermatomyositis (inflammatory disease that causes muscle weakness and skin rash);
- Epstein-Barr virus;
- inflammation of the gallbladder (cholecystitis);
- heart attack;
- hemochromatosis (increased iron in the body);

Hypothyroidism;
- liver cancer;
- mononucleosis;
- muscular dystrophy (hereditary disease that causes progressive muscle weakness);
- pancreatitis (inflammation of the pancreas);
- polymyositis (inflammatory disease that causes muscle weakness);
- toxic hepatitis (inflammation of the liver caused by drugs or toxins);
- disease Wilson-Konovalov (level up copper in the body).

The liver acts as a protective filter in the human body. With the help of this organ, all cells and tissues are cleansed of harmful and toxic substances. The liver helps to cleanse the body of its enzymes or enzymes that are contained inside the parenchymal organ. When an organ disease occurs, substances are released from it and enter the blood in large quantities. According to the analysis of enzymes, one can judge the disease occurring in the human body.

Liver enzymes play an important role in the human body - they are needed for the metabolic process (digestion of nutrients, blood clotting function). If a blood test reveals an increase or decrease in certain enzymes, this is the first sign that a pathological process is taking place in the body, or the parenchymal organ is damaged. Liver enzymes are divided into 3 groups:

indicator- these include enzymes such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase. These substances are found inside the liver cells. When an organ is damaged, enzymes are released from the cells and enter the blood in large quantities;
Secretory- Enzymes cholinesterase and prothrombinase belong to this group. These substances are needed for the process of blood clotting, and if this function of the body is disturbed, enzymes decrease;
excretory- this group of enzymes includes such an enzyme as alkaline phosphatase. This substance is synthesized and excreted along with bile. In violation of the outflow of bile, the level of alkaline phosphatase significantly exceeds the norm.

Why enzymes can be elevated

Elevated levels of liver enzymes may indicate certain pathologies in the human body. A slight increase in enzymes in the blood is observed with the use of any medications (sulfonamides painkillers), the accumulation of toxic substances (excessive consumption of alcohol and heavy food). A pronounced excess of the norm of enzymes almost always indicates the development of diseases:

liver hepatosis (fatty);
viral hepatitis;
malignant and benign tumors;
cirrhosis of the liver;
heart failure;
infectious myocarditis;
infarction of the heart muscle (myocardium);

AST, ALT, and alkaline phosphatase levels may increase in women during pregnancy. While waiting for the baby, the female body works with a double load, especially for the liver. A slight excess of these enzymes in the blood does not pose a clear threat, however, if the level of enzymes is much elevated, this may indicate the development of gestational diabetes mellitus, inflammation of the bile ducts.

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 problems with the heart, 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 begin the earliest possible and effective treatment of the pathology.

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.