Memphis Gastroenterology Group, PC

A blood sample is used for tests.

It’s not easy to understand the significance of lab results or doctor’s reports, especially when it comes to the liver. What does it mean if enzymes are elevated? A basic understanding can go a long way.

What are the liver enzymes?

ALT and AST are enzymes located in liver cells. ALT is thought to be a more specific indicator of liver inflammation since the AST may be elevated in diseases of other organs such as the heart and muscle.
Mild or moderate elevations of ALT or AST are nonspecific and may be caused by a wide range of liver diseases, so really, no correlation exists between the degree of elevation of ALT or AST and the degree of liver injury or symptoms.

In acute injury the ALT and AST may be elevated over a thousand. In chronic hepatitis or cirrhosis these enzymes may be minimally elevated.

The alkaline phosphatase and GGT are elevated in a large number of disorders that affect the drainage of bile such as gallstones or tumor blocking the common bile duct, or alcoholic liver disease or drug-induced liver disease either prescribed by a doctor or over the counter or from health food stores. (Be sure to tell your doctor about all medications especially over the counter and herbal medicines.) For this reason the GGT is utilized as a supplementary test to be sure that the elevation of alkaline phosphatase is indeed coming from the liver or the biliary tract. Mild or moderate elevation of GGT in the presence of a normal alkaline phosphatase is difficult to interpret. Most liver panels do not include a GGT.

What is Bilirubin?

Bilirubin is the main bile pigment in humans that, when elevated, causes the yellow discoloration of the skin and eyes called jaundice. Elevated bilirubin can be caused by liver disease, destruction of red blood cells or both. The bilirubin may be elevated in many forms of liver or biliary tract disease, and thus, it is also relatively nonspecific.

What about Albumin and Prothrombin?

The only liver tests that indicate “true” liver function are albumin and prothrombin. Albumin is a major protein formed by the liver and chronic liver disease causes a decrease in the amount of albumin produced. The prothrombin, which is also called the PT, is a test that is used to assess blood clotting. Blood clotting factors are proteins made by the liver. The prothrombin time is also a useful test of liver function.

Here are key points to remember

• No correlation between degree of liver test elevation and severity of disease
• Tell your doctor about all medications, especially over the counter or herbal medications
• Tests should be followed until they are normal or a diagnosis is made.

Memphis Gastroenterology Group’s mission is to provide the highest quality, most cost-efficient gastroenterology services to our patients. To accomplish this goal, we will have physicians of unsurpassed ability, an endoscopy center equipped with the finest state-of-the-art equipment, a clinical staff delivering the highest quality care in a comfortable, safe, and confidential environment; and an office staff who will offer helpful and compassionate services with patient satisfaction as their first priority.