How to read an analysis
Standards vary by laboratory and gender. The doctor evaluates how many times enzymes exceed the upper limit of normal, the ratio of AST to ALT, and changes in other indicators. A one-time small increase often normalizes when the test is repeated, so the test is often repeated after a few weeks.
- A slight increase (up to 5 norms) - fatty liver disease, chronic hepatitis, alcohol, medications
- Moderate (5–15 norms) - active hepatitis, drug damage
- Severe (more than 15 norms) - acute viral or toxic hepatitis, liver ischemia
- AST is noticeably higher than ALT - possible alcoholic origin or muscle cause
- At the same time, GGT and alkaline phosphatase are increased - a violation of the outflow of bile
Main reasons
The most common cause in the world and in Uzbekistan is metabolically associated fatty liver disease, which develops with excess weight, diabetes and high cholesterol. It is equally important to exclude viral hepatitis B and C: they often occur without symptoms, but are well treated.
- Fatty liver disease
- Viral hepatitis B, C, less often D and E
- Alcohol
- Medicines: paracetamol, some antibiotics, statins, anti-tuberculosis drugs
- Herbal preparations and dietary supplements
- Autoimmune hepatitis, hemochromatosis, Wilson's disease
- Celiac disease, thyroid disease
- Intense physical activity and muscle injuries
Symptoms
As a rule, with moderately elevated enzymes, a person does not feel anything - the deviation is detected during a preventive examination. Symptoms appear with severe or prolonged liver damage.
- Fatigue, weakness
- Heaviness in the right hypochondrium
- Decreased appetite, nausea
- Jaundice and dark urine in acute hepatitis
- Itchy skin
Further examination
The examination usually begins with a repeat analysis and advanced biochemistry, markers of hepatitis B and C and ultrasound of the liver. In case of fatty liver disease, it is important to assess the degree of fibrosis: for this, elastography (fibroscan) and calculated indices from blood tests are used. If the cause is unclear, autoimmune markers, iron and copper metabolism, thyroid function, and antibodies to tissue transglutaminase are checked.
- ALT, AST, GGT, alkaline phosphatase, bilirubin, albumin
- Complete blood count, glucose, lipid profile
- HBsAg, anti-HCV
- Ultrasound of the liver and gallbladder
- Liver elastography
- According to indications: ferritin, ceruloplasmin, autoantibodies, TSH, CPK
What to do
Treatment depends on the cause found. For fatty liver disease, gradual weight loss of 7–10% and increased physical activity are most effective. For viral hepatitis, antiviral drugs are prescribed: modern therapy for hepatitis C cures most patients. If enzymes have increased due to a medication or dietary supplement, the doctor will decide whether it needs to be discontinued. Hepatoprotectors do not replace eliminating the cause.
- Stop drinking alcohol until the cause is determined
- Do not take herbs and dietary supplements without consulting a doctor
- Lose weight gradually and increase physical activity
- Get vaccinated against hepatitis B if you don't have one
- Do not do intense training for 2-3 days before the analysis.
