What Level of Liver Enzyme Should I be Concerned With?
Are you having ongoing slight elevations in your liver enzymes?. Maybe you were told it is perfectly normal and you shouldn't worry about it. In this article we go into some of the details of why that may or may not be appropriate for you. We look at what the optimal levels of liver enzymes are for males and females, so you can better understand what to do for your own health.
If you want to know what level of liver enzymes you should be concerned with keep reading.
The Level Of Liver Enzymes To Be Concerned With
What level of liver enzyme should I be concerned with? Mainly we are looking at this from the perspective of getting a blood test back that shows you have elevated liver enzymes. This could be the AST, the ALT or the GGT. AST is usually written out as as aspirate amino transferase. ALT is written out as alanine amino transferase. Most of the time the GGT isn't done, but sometimes if you are looking specifically at a liver function test, the GGT will be included. There are a few other liver tests that may be included in a liver specific test. These are the three that are of most importance for assessing liver function.
In other articles we mentioned why these levels might be high. Also some other testing you might want to consider when you have elevated levels of these liver enzymes. These enzymes do come from your liver, but they can be found to a lesser extent in some other tissues as well. With all that being said, at what level should you start to be concerned when your liver enzymes are high? How high is too high?
The reference range for your liver enzymes will be slightly different from one lab to the next. Typically the level for the AST or aspirate amino transferase will be reported as between 10 and 40 units per liter. Alanine amino transferase will be between 7 to 56 units per liter. These are the reference ranges. If you fall within those parameters, you will not get flagged as high or low. Mild elevations are generally considered to be one or two times the normal limit. Moderate elevations are two to three times the reference range. Severely high levels are in the thousands. Then the question is, what do you do when your levels are in the sixties, seventies, or even fifties? Are these really a problem? Should you be concerned if your liver enzymes are on the upper end of normal or slightly above?
It is actually pretty common where to see the lab not flagging the results, but the level is slightly high. I see this very commonly in my practice. There is usually a good reason for it, but that doesn't mean the level is actually in the optimal range. Optimal or a true healthy range for ALT is a range between 29 and 33 units per liter for males and slightly lower for females 19 to 25 units per liter. Levels consistently above this, meaning multiple tests that are higher than this, should be investigated. We' are not getting into the causes here because there's other articles on that topic.
The same approximate ranges can be used for the AST and GGT to make things simple and straightforward. I usually use 25 as a general reference range for both males and females. If it's above that, that could be a problem. Of course, there's some leeway depending on if you are a male or female and which tests we are actually looking at. That's a rule of thumb that I usually go off of. Now, transient elevations, like one test above 25 is nothing to be concerned about. It is the consistent elevations, much more than 25, like 50, or even 30 that could be a problem. The level will really tell you what the next steps should be.
When it's slightly above, it's not really something to be concerned about. However, when the levels start to get into the upper end of the reference range like the fifties, that's when you should start looking a little deeper. Especially if they are like that after multiple tests. So if you want more details on elevated liver enzymes, check out this videos. There's also a very detailed paper that goes into a lot more detail on why we are establishing 25 as a normal, healthy, optimal liver enzyme range. The basis is, if you take a sick population and try and create a reference range from that, you get a sick reference range. The paper goes into a lot more detail.
That should give you a better understanding of what what level of liver enzymes should I be concerned with. If you have questions about the content in this article, please ask it in the comment section below.
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