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Elevated Liver Enzyme
August 2000

Q. I am a rigorously athletic 59-year-old male in excellent shape. My recent physical revealed a mildly elevated liver enzyme (the test was RLB AT, GOT, and the number was 60; the normal range indicated on the print out was 5-43). I eat well, take no drugs or supplements (other than protein powder once a day) and have 1 or 2 beers a week; that's it. Any idea of what may have caused this elevation and is the number high enough for concern?

A. Indeed your lifestyle sounds quite healthy! Let's review some information on liver function and then get to the specific test in question.

The liver and kidneys are the two main "filters" for human metabolism. They filter out the by-products of basic cell activity as occurs in energy production, to keep all systems running well. They also process any drugs or chemicals that the body might be exposed to via ingestion, respiration, etc. The GOT enzyme is in high concentration is the liver cells and low concentration in the bloodstream, so if the liver cells are inflamed or injured, the enzyme will "leak" out of the liver cells into the blood causing elevated levels.

The GOT enzyme is also present in muscle and bone tissue, so in your case it could even be a bit high (your level would be considered a mild elevation) from muscle breakdown due to exercise! The enzyme itself is not harmful but it is a signal that something needs to be investigated further. The test could be repeated after a few days of no exercise to clarify this, plus additional markers of liver activity can be measured. The SGPT enzyme is liver-specific.

If the two enzymes remain elevated, your doctor will determine the next step, which may include a referral to a gastroenterologist. Mild elevations may not turn out to be of importance, but they definitely need evaluation. Some common conditions that can cause the elevation include viral hepatitis, toxic reaction to a drug or medication, fatty liver (usually associated with obesity), and excess alcohol intake.

HELPFUL WEBSITES:

  • http://gi.ucsf.edu/alf/info.html
  • http://cpmcnet.columbia.edu/dept/gi/disliv.html
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