Raised Liver Enzymes: What an Abnormal Liver Test Means
Liver enzymes turn up raised on a health check in someone who feels well, and the finding is common, usually mild, and worth taking seriously: fatty liver, alcohol, medicines and viral hepatitis are the usual causes, and each is treatable or preventable. At Smart Care Polyclinic in Deira, an internal medicine specialist works the result up in the order the guideline sets out, with the tests done on site and ultrasound by referral.
For: abnormal ALT, AST, ALP, GGT or bilirubin on a blood test
Takes: a 30-minute consultation; bloods on site; ultrasound by referral
Price: consultation AED 125
Book the internal medicine specialistor call +971 (0) 4379 3562
What it is
The pattern points to the cause. Raised ALT and AST mean liver cell injury; raised ALP and GGT point to the bile ducts; bilirubin is about clearance. The American College of Gastroenterology guideline sets out how an abnormal result is interpreted and what to test next, and its first step is often simply to repeat it, because a mildly raised enzyme frequently normalises.1
Fatty liver is the commonest cause in Dubai, tied to weight, diabetes, high triglycerides and inactivity, and it is reversible in its early stages with weight loss. Alcohol is the next. Medicines and supplements — including some bodybuilding and herbal products, and paracetamol in excess — are the ones people forget. Viral hepatitis B and C are tested for because they are common in the region and treatable, and hepatitis B is vaccine-preventable.
The work-up is stepwise: a repeat with the full liver panel, hepatitis B and C serology, iron studies, blood sugar and lipids, an honest alcohol and medicine history, and an ultrasound. Rarer causes — autoimmune hepatitis, iron overload, Wilson disease, coeliac disease — are tested for where the first round does not explain it. Referral to a hepatologist follows where the picture is more than fatty liver.
Fatty liver, honestly
It does not cause symptoms, and it is not harmless. A proportion progresses to inflammation and scarring over years, and the risk is highest with diabetes and obesity. Weight loss of 7 to 10% reverses fat and inflammation in most people, which makes fatty liver one of the strongest medical reasons to address weight; the medical weight-management programme is available where that is the right route.
The consultation, and what follows from it
Internal medicine consultation
Assessment, examination and a plan with every cost stated before anything further is done.
AED 125 was AED 200
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Questions patients ask
Most often fatty liver, alcohol, medicines or supplements, and viral hepatitis. A mildly raised result often normalises on repeat. The specialist works through the causes in order and arranges an ultrasound where indicated.
It is common and usually mild, but a proportion progresses to inflammation and scarring, particularly with diabetes and obesity. It is reversible with weight loss in its early stages, which is why it is worth finding.
Bring everything you take to the consultation. Some bodybuilding, herbal and weight-loss products cause liver injury, and stopping the culprit is the treatment.
This guide is general information, not advice about you. Long-term conditions are managed on your own results and history, which is what the specialist consultation is for.
References
- Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. The American Journal of Gastroenterology. 2017;112(1):18-35. PMID 27995906. doi:10.1038/ajg.2016.517The American College of Gastroenterology guideline on what a raised liver enzyme actually means and how an abnormal result should be worked up.
Sources are listed for the specific statements they support. They are published research and guidance, not a substitute for a consultation — what applies to you is decided by a doctor who has assessed you.