Fatty Liver Labs?

Leslie gives you everything you need to know about your test results.
Question: I had blood laboratory work done with my health physical and my doctor told me I had elevated liver tests and I needed further testing. The result was a diagnosis of fatty liver. What does this mean?

Answer: The liver is one of the larger organs of your body located on the right side of your abdomen up under the lower rib cage. Its main function is to detoxify the blood that runs through it but it provides many other functions as well. The liver produces factors that help with blood clotting, makes albumin and proteins, processes medicine and nutrients as well as waste products, aids in glucose production and stores fat, cholesterol and bile.
Enzymes are used in cells of the body for chemical reactions. The presence of these enzymes in the bloodstream (detected on your blood test) indicates inflamed or injured liver cells. Typically, two different enzymes are measured; they are ALT or alanine transaminase and AST or aspartate transaminase. AST is found in many areas of the body so an elevation is not necessarily specific to the liver. AST may be elevated with a muscle injury, for example. ALT is mostly in the liver therefore elevation is a sign of liver injury. Put together, these two enzymes represent liver tests or liver enzyme blood tests. Ranges of abnormal vary by laboratory so it is best to check what “normal” levels are specific to your elevation.
Most cases of elevated liver enzymes are mild or temporary. The most common causes include:
1. Over the Counter medication use such as Tylenol or NSAID meds
2. Certain prescription medications including anti-seizure medications, antibiotics, cholesterol lowering drugs and some heart medications.
3. Hepatitis B or Hepatitis C
4. Alcohol abuse
5. Nonalcoholic fatty liver disease
Other less common causes include: alcoholic hepatitis, celiac disease, viral infections, hemochromatosis (abnormal iron storage), mononucleosis infection, and toxic hepatitis from exposure to a poison.
Diagnosis of the cause may require the additional testing that your physician ordered. A physical exam is necessary to discuss risk factors, assess medication and alcohol use as well as determine if your liver is enlarged. Additional blood tests may be ordered to determine if you have Hepatitis B or C. Please see previous article in the November 2017 issue for information on Hepatitis C. In addition, a liver ultrasound or liver CT may be ordered to determine if there are identifiable causes to the elevation. Finally, a liver biopsy may be done.
Liver disease known as Fatty Liver or nonalcoholic fatty liver is a very frequent cause of mild to moderate elevation of liver enzymes. This occurs in individuals who drink little to no alcohol and develops as a result of too much fat stored in the liver cells. This fat storage results in liver inflammation and could progress to scarring or severe damage to your liver. Research indicates this is the most common form of liver disease in the USA impacting 80-100 million Americans. Risk factors for fatty liver include obesity, diabetes as well as metabolic syndrome which is linked to increased abdominal fat, elevated Blood pressure, elevated triglyceride levels and an ineffective response to insulin resulting in high blood sugar levels.
Treatment of elevated liver function tests is based on the cause. For example, stopping a medication that is causing damage may result in a return to normal levels. Avoidance of medications such as Tylenol or Alcohol, which stress the work of the liver, may be advised. In addition, for fatty liver, your physician may recommend healthy diet and exercise with moderate weight loss, blood pressure and cholesterol control. Expect frequent monitoring of your blood enzyme levels to detect improvement or changes.
Editors Note: This month we will begin a new Health column where writer Leslie Reschly answers reader submitted questions. Please submit your health questions to editor@southportmag.com

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