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What Causes Elevated Liver Enzymes?

author avatar Dr. Eric Berg 05/18/2024

What causes elevated liver enzymes? Unusually high liver enzyme levels can indicate various liver diseases and are often linked to excessive alcohol consumption, poor dietary habits, or obesity.

Here’s a comprehensive guide to what causes abnormal liver enzymes and the steps you can take to promote healthy liver function.  

Liver function test

What are liver enzymes?

Liver enzymes are a group of proteins produced in liver cells. They facilitate critical biochemical processes, including amino acid metabolism, digestion, nutrient storage, bile production, and detoxification.

Routine blood testing protocols commonly include liver function tests, which typically measure the concentrations of three primary liver enzymes:

  • Alanine transaminase (ALT)

  • Aspartate transaminase (AST), also referred to as aspartate aminotransferase

  • Alkaline Phosphatase (ALP)

What does it mean to have elevated liver enzymes?

Mild elevations of liver enzymes aren’t necessarily a concern and can sometimes occur due to factors unrelated to liver disease, including hypothyroidism or excessive exercise. 

However, blood tests that show persistent high liver enzymes could be linked to serious liver disease. 

Abnormal liver enzymes can be indicative of various liver issues, including:

  • Drug-induced liver injury 

  • Autoimmune hepatitis

  • Alcoholic hepatitis 

  • Fatty liver disease 

  • Hepatitis B or C infection

  • Toxic hepatitis

  • Liver inflammation 

  • Liver failure 

  • Acute hepatitis 


Watch the video below to learn more about the causes of high liver enzymes.

High Liver Enzymes [ALT & AST] What Do They Mean?

What causes high liver enzymes?

The liver is the body’s primary metabolic organ responsible for processing a wide range of compounds, including nutrients, hormones, toxins, medications, and waste products. 

“This leaves the liver at increased risk of injury and inflammation, which can lead to cirrhosis, characterized by progressive scarring of liver tissue and loss of liver cell functionality,” explains Dr Berg.  

To compensate for the loss of liver function, liver cells start producing more enzymes to maintain metabolic processes.   

Healthy liver cells have structural integrity and release minimal amounts of enzymes into the bloodstream. However, damaged or injured liver cells can leak, resulting in abnormal blood liver enzyme concentrations. 

Man with jaundice

Symptoms of elevated liver enzymes 

Many liver diseases progress silently during their initial stages, making it challenging to diagnose potential health issues early. 

In addition, elevated liver enzymes themselves don’t cause physiological symptoms but are a general marker of liver health that can be assessed with a simple blood test. 

Prolonged elevated liver enzymes typically indicate a persistent and potentially serious underlying liver problem, which can cause a wide range of health issues.

Here are common signs and symptoms of poor liver function:

  • Jaundice

  • Poor exercise tolerance 

  • Ascites

  • Fatigue 

  • Itchy feet 

  • Swollen feet and legs

  • Digestive issues

  • Dark urine

  • Pale stools 

  • Spider veins 

Liver infection, typically linked to the hepatitis virus, can trigger severe liver inflammation associated with symptoms including fever, abdominal pain, nausea, and vomiting. 

Acute hepatitis can cause liver failure, and it’s crucial to seek immediate medical attention if you experience symptoms of liver infection. 

Obese woman

Risk factors for elevated liver enzymes 

According to a study published in the Journal of Hepatology, the leading causes of cirrhosis are alcoholic liver disease, obesity, and viral hepatitis.   

While it’s widely known that alcohol is toxic to the liver, the impact of excess body weight on liver function is often overlooked. 

Obesity can cause non-alcoholic fatty liver disease (NAFLD), characterized by excessive liver fat accumulation. This leaves obese individuals and those with metabolic syndrome at increased risk of elevated liver enzymes.

Research published in The American Journal of Clinical Nutrition suggests that regular consumption of processed foods, typically high in sugars, refined grains, and unhealthy fats, is associated with liver disease.  

Processed foods can lead to obesity, insulin resistance, and inflammation, which impair liver function and potentially contribute to NAFLD.

In addition, long-term exposure to toxins such as black mold, environmental pollutants, chemical solvents, and certain medications can damage liver tissue and subsequently lead to liver abnormalities. 

Elevated liver enzymes can also be linked to thyroid disorders, bacterial infection, Celiac disease, or primary sclerosing cholangitis, an autoimmune disorder that can cause liver damage and an increased risk of liver cancer.

Clock in front of a salad

Ways to lower your liver enzyme levels 

Elevated liver enzyme levels are a marker of poor liver function, and taking steps to support a healthy liver is the best way to lower elevated liver enzymes. 

Here are four ways to naturally normalize liver enzyme levels.

1. Avoid alcohol

Alcohol is a known hepatotoxin, causing liver inflammation and fatty liver disease, which leads to liver damage and elevated liver enzymes.

Detoxing your liver from alcohol allows liver cells to regenerate and helps normalize liver enzyme levels, promoting overall liver health and function.

2. Combine Healthy Keto® and intermittent fasting   

Healthy Keto is a low-carb, high-fat diet focusing on nutrient-rich whole foods. Following a nutritious low-carb diet promotes a healthy body weight and has been found to enhance liver health. 

A study published in the Proceedings of the National Academy of Sciences investigated the effects of a ketogenic diet for treating fatty liver disease. 

The authors reported that participants following a ketogenic diet for only six days showed markedly reduced liver fat and concluded, “The ketogenic diet is an effective treatment for nonalcoholic fatty liver disease.

Combining Healthy Keto with intermittent fasting can augment the benefits of a low-carb diet for liver health. 

During fasting periods, the liver’s need to process and metabolize nutrients is significantly reduced. This allows liver cells to regenerate and repair more efficiently, supporting overall liver health.

Herbal remedies

3. Take liver cleansing herbs 

The liver is the body’s main detoxification organ, which exposes liver cells to toxic compounds, making liver tissue especially susceptible to inflammation and scarring.

Various herbs have been found to cleanse the liver and protect liver cells from inflammation and harmful by-products of detoxification processes.  

Here are some of the best liver-cleansing natural remedies:

  • Milk thistle 

  • Spirulina

  • Turmeric root

  • Dandelion root

  • Liquorice root

Evidence published in the Annals of Medicine supports the use of liver-cleansing herbs and highlights that milk thistle has been shown to protect liver cells from the harmful effects of detox reactions. 

While liver-cleansing herbs can benefit liver function and may help lower liver enzymes, they can interact with certain drugs. It’s crucial to discuss the use of herbal remedies with a healthcare provider if you are taking prescription medication to minimize the risk of side effects.  

4. Address underlying health issues

Commonly used medications, including statins, antibiotics, antidepressants, and acetaminophen, can lead to liver damage if taken for prolonged periods or in excessive dosages.

Many of these drugs are taken to manage health issues that may respond to beneficial dietary and lifestyle changes, reducing the need for medication.

Following a nutritious diet, promoting optimal nutrient stores, regularly engaging in exercises, getting enough sleep, and practicing stress-reduction techniques can be an effective strategy to address various underlying health issues. 

It's crucial not to stop taking prescribed medication without consulting your healthcare provider about potential non-pharmacological approaches to managing health issues.

Human liver illustration

Key takeaways

What causes elevated liver enzymes? Abnormal liver markers are indicative of liver damage, often linked to excessive alcohol intake, poor dietary habits, and obesity.  

Avoiding alcohol, processed food, and sugar while focusing on a nutrient-dense, low-carb diet such as Healthy Keto in combination with intermittent fasting can promote liver cell regeneration and help improve elevated liver enzyme levels. 


1. What causes high liver enzymes?

Elevated liver enzymes are primarily caused by liver injury, damage, or inflammation. 

Healthy liver cells release only small concentrations of liver enzymes. In contrast, damaged and impaired liver cells can leak enzymes into the bloodstream, which explains why liver damage causes elevated liver enzymes. 

2. How do you fix elevated liver enzymes?

Because a damaged liver causes elevated liver enzymes, it’s crucial to promote liver health to normalize enzyme levels. 

Consuming a nutritious low-carb diet rich in whole foods, practicing intermittent fasting, and supporting liver function with natural remedies such as milk thistle can stimulate liver cell regeneration. 

3. What foods can cause your liver enzymes to be high?

Processed foods, especially those high in sugar, refined carbs, and trans fats, can cause liver inflammation and elevated liver enzymes. 

Packaged and junk foods often contain additives, preservatives, and artificial ingredients that can burden the liver and contribute to elevated enzyme levels over time.

4. How are elevated liver enzymes treated? 

Elevated liver enzymes are generally treated by addressing the underlying cause, which may involve dietary and lifestyle changes or medication adjustments, depending on the specific condition.

5. Can dehydration cause elevated liver enzymes?

Yes, dehydration can potentially cause elevated liver enzymes. Dehydration can decrease blood volume, leading to reduced blood flow to the liver and affecting its ability to function optimally.


  1. https://pubmed.ncbi.nlm.nih.gov/30266282/ 

  2. https://www.sciencedirect.com/science/article/pii/S000291652366188

  3. https://www.pnas.org/doi/epdf/10.1073/pnas.1922344117 

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9186366/


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