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Doctor insights on: My Liver Enzymes Are Elevated My Dr Says I Need An Ultrasound What Else Should I Be Doing

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My liver enzymes are elevated. My dr says I need an ultrasound. What else should I be doing?

My liver enzymes are elevated. My dr says I need an ultrasound. What else should I be doing?

First, repeat labs: It is very common for liver enzymes to go up and down slightly, even in healthy people, so always good to repeat the test and see if normalized. Must review meds list carefully, as this is common effect of drugs (e.g. Statins). Alcohol, esp. Binges but even moderate intake, can cause transient spikes in values as well. If stays high, need thorough evaluation for causes of hepatitis. ...Read more

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Dr. Michael Gabor
2,270 doctors shared insights

Sonogram (Definition)

An ultraound, also known as a sonogram, is a painless and relatively inexpensive imaging test that utilizes sound waves instead of ionizing radiation. There are no side effects. Ultrasound can give us two-dimensional, and in some applications three-dimensional, images of structures and organs in virtually any part of the body. In addition to diagnostic uses, such as evaluating abnormalities in the abdomen, pelvis, and breast, ultrasounds are commonly used to guide needle and catheter placement in a variety of surgical ...Read more


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My liver enzyme level is elevated and I am scheduled for an ultrasound. Should I be concerned?

My liver enzyme level is elevated and I am scheduled for an ultrasound. Should I be concerned?

Not specifically: It is very good that you ate following up on your blood tests. I do not know which blood tests are elevated. An ultrasound can look at both your liver and gallbladder. Sometimes blood tests to check for hepatitis exposure is indicated. Some medications can also affect the liver & your doctor may change them if indicated. Not to worry about, but good to have checked. ...Read more

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I had mildly elevated liver enzymes on two blood tests but ultrasound was normal. What could be causing this?

I had mildly elevated liver enzymes on two blood tests but ultrasound was normal. What could be causing this?

Many possibilities.: There are entire text books written on the causes of abnormal liver tests. It would be impossible to list all of them here. It is important if you have persistently abnormal liver tests to have an evaluation performed to determine the cause. Initially, your primary care doctor can start the process, but if no obvious answer is present, you should see a gastroenterologist. Good luck. ...Read more

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Ex-heavy drinker teens/20s. Quit 4 years ago. Liver enzymes continue to be mildly elevated. Ultrasound normal/hep neg. Should I have further testing?

Ex-heavy drinker teens/20s. Quit 4 years ago. Liver enzymes continue to be mildly elevated. Ultrasound normal/hep neg.  Should I have further testing?

Yes!: You need to talk with your doctor so that they can see if you are taking any prescriptions, drugs or supplements that can be harmful to your liver. You need test for Hep A/B/C/D/E/etc based on risk factors. You can be tested for other forms of liver disease such as autoimmune hepatitis. Since ultrasound was normal, you can have FibroSure blood test to detect any liver inflammation and/or fibrosis. ...Read more

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I am 24 years old with unknown cause of elevated liver enzymes for more than 6 months with negative ultrasound can I use milk thistle as a liver tonic?

I am 24 years old with unknown cause of elevated liver enzymes for more than 6 months with negative ultrasound can I use milk thistle as a liver tonic?

Yes: However, it is unlikely to benefit you; most studies show no value. Health doesn't come from taking pills. You need to discover the cause. I trust you've been tested for hepatitis b and c, hemochromatosis, wilson's, autoimmune hepatitis, and antitrypsin deficiency. Elite athletes tend to run high transaminases & that's healthy. If you're sedentary, think about a new focus on fitness instead. ...Read more

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Elevated liver enzyme with normal other liver function and normal ultrasound and negative hepatitis b and c virus??

Elevated liver enzyme with normal other liver function and normal ultrasound and negative hepatitis b and c virus??

2 thoughts:: A common cause of asymptomatic elevations in liver enzymes is fatty liver(Non alcoholic fatty liver disease: NAFLD). This is very common in obesity and is considered
to be part of the metabolic syndrome. Ultrasound will be "normal" (i.e. falsely negative) in 17% of patients with NAFLD.

A less common cause=choledocholithiasis(stones in common bile duct). Often missed on ultrasound. Can be
asymptom ...Read more

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Mildly elevated liver enzymes 2 – 4 x upper limit 60% of tests for 3 years. Now liver enlarged on ultrasound. Episodes of edema and fevers. What now?

Mildly elevated liver enzymes 2 – 4 x upper limit 60% of tests for 3 years. Now liver enlarged on ultrasound. Episodes of edema and fevers. What now?

Consult hepatologist: Hi, the tests and the clinical symptoms that you describe warrant further work up by an experienced hepatologist. The possibilities are too numerous to discuss in the current setting. The main crux of the w/u would be to assess if the damage to the liver is not irreversible(cirrhosis); find the underlying cause to treat it. A liver biopsy may be indicated if all tests are neg. Hope this helps. ...Read more

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Healthy 60 year old female have had elevated liver enzymes for 20+ years, no health issues. Have had ultrasounds, mri, all that showed where liver cyst?

Healthy 60 year old female have had elevated liver enzymes for 20+ years, no health issues. Have had ultrasounds, mri, all that showed where liver cyst?

Many potential cause: Liver enzymes can go up due to hepatitis caused from one of many causes like excess of alcohol use, viral hepatitis, fatty liver in an overweight person and then some rare conditions which are familial/hereditary. Your primary care doctor can sort it all out for you. A hepatologist is a specialist in case you wanted further advice. ...Read more

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Is it possible to have mildly elevated liver enzymes and some small spots on your liver during an ultrasound and have the two findings be totally unrelated? Could you have non-alcoholic fatty liver disease and cysts or something similar?

Is it possible to have mildly elevated liver enzymes and some small spots on your liver during an ultrasound and have the two findings be totally unrelated? Could you have non-alcoholic fatty liver disease and cysts or something similar?

Yes.: This is in fact common. Both liver cysts and liver enzyme abnormalities are very common. Therefore, the overlap of those two is also common. It would be unlikely that a cyst alone would be responsible for liver enzyme elevations. ...Read more

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Why would liver enzymes fluctuate in and out of range in 3 months? Ultrasound clear but immunoglobulin m was slightly elevated with ast 60 and alt 100

Why would liver enzymes fluctuate in and out of range in 3 months? Ultrasound clear but immunoglobulin m was slightly elevated with ast 60 and alt 100

See below: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, it could be due to alcohol use, some medication you are taking or being overweight. Or you may have chronic liver inflammation. You should talk to the doctor who ordered the tests. ...Read more

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Liver enzymes high normal ultrasound doctor wants me to go see stomach doctor but didn't say why?

Liver enzymes high normal ultrasound doctor wants me to go see stomach doctor but didn't say why?

Possibly Hepatitis: High liver enzymes suggest irritation to the liver. A normal ultrasound suggests it is not due to gallstones (that is why he did not send you to a surgeon). There are many things that can cause this. Vitamins, medications, alcohol, poisons or various infections are all possibilities. A "stomach doctor" or Gastroenterologist specializes in disorders of the liver. They can sort it out for you. ...Read more

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What do elevated liver enzymes and low sodium levels indicate? I have had scan, ultrasound of liver, and hepatitis panel. All of these were negative.

Not easy to answer: Elevated liver numbers can result from many things. Infection, obstruction, medications, drug use, fatty liver, carcinoma, alcohol consumption, gallbladder and pancreas problems. Its great that the us was negative. But I'd suggest a ct for further clarification. Low sodium can be from a number of reasons from drinking way too much water to losing sodium inappropriately from the kidney. ...Read more

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For 2 negative ultrasound in chronic elevated liver enzymes, and running away from biopsy, can an MRI help and does it need contrast? R/o NASH nafld?

For 2 negative ultrasound in chronic elevated liver enzymes, and running away from biopsy, can an MRI help and does it need contrast? R/o NASH nafld?

Need biopsy: If your enzymes have been elevated for a long period, the only definitive test is a liver biopsy, performed either under ultrasound or ct. It is a relatively painless procedure, done as an outpatient, usually with local anesthetic. You should be able to go home within 2 hours. Bleeding is a potential complication, but usually self-limited if you have normal clotting. Treatment follows dx. ...Read more

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Been constipated for 2 weeks, used enema Sat. Had very small bm, have elevated liver enzymes and bilirubin in urine, ultrasound was normal. Now what?

Been constipated for 2 weeks, used enema Sat. Had very small bm, have elevated liver enzymes and bilirubin in urine, ultrasound was normal. Now what?

Do this next: Are you on any meds? Get a thyroid check and porphyria screen. Drink plenty of water and read about fiber, consider a stool softener. Trust you have no toxic exposures (lead) or risk for Chagas. Colonoscopy may be in the future. How much bilirubin in the urine? How high were the liver enzymes? Has the liver workup proceeded (hep B/ c / iron overload, Wilson's, antinuclear antibodies)? ...Read more

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Elevated liver enzymes. ALT- 72 AST- 59. ALL other labs are normal. Liver/gallbladder ultrasound is normal. Negative for hepatitis. What can cause it?

Elevated liver enzymes. ALT- 72 AST- 59. ALL other labs are normal. Liver/gallbladder ultrasound is normal. Negative for hepatitis. What can cause it?

Need more info: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, it may be due to alcohol intake, medications you may be taking and/or from being overweight. If you drink, stop entirely and discuss any medications you take with your doctor. ...Read more

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Routine physical found elevated liver enzymes. Follow-up blood work showed lingering hepa antibodies. Ultrasound today, and I saw black spots on my liver — waiting for radiology report. Thoughts?

Routine physical found elevated liver enzymes. Follow-up blood work showed lingering hepa antibodies. Ultrasound today, and I saw black spots on my liver — waiting for radiology report. Thoughts?

Family practice : I doubt hepatitis a caused a persistent elevation of your liver enzymes. The u/s is to look for gallbladder thickening and stones. Avoid alcohol if you drink. Tylenol (acetaminophen) is metabolized in the liver so avoid that. Wait for the u/s report. ...Read more

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Elevated amylase (250) and liver enzymes (ALT, AST). Normal abdominal ultrasound & CBC. WHat could cause this if ultrasound is normal?

Elevated amylase (250) and liver enzymes (ALT, AST). Normal abdominal ultrasound & CBC. WHat could cause this if ultrasound is normal?

See below: Why were these tests ordered? There are many causes of elevated amylase and it would require in person evaluation to ascertain the cause. You may consult this site for information on this topic: https://medlineplus.gov/ency/article/003464.htm ...Read more

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After my 2nd blood test came back that my liver enzymes came back elevated now my doctor wants an ultra sound done do I have to be worried?

After my 2nd blood test came back that my liver enzymes came back elevated now my doctor wants an ultra sound done do I have to be worried?

Not enough info: You give no specifics as to why the tests were ordered, your medical conditions or your meds. You should direct your question to the doctor who ordered the tests. ...Read more

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Elevated Liver Enzymes & White Blood Cell. Sonogram showed lesion and fatty. I don't drink alcohol. Hep. Was neg.

Elevated Liver Enzymes & White Blood Cell.  Sonogram showed lesion and fatty.  I don't drink alcohol. Hep. Was neg.

Need more info: What is your BMI? Are you diabetic? Are you on any medications? If you are overweight, even if you are on the high side of normal, losing weight will help.
For good health — Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form.
Practice safe sex. ...Read more

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I am working in cambodia. I have elevated liver enzymes (alt 149) & GGT is 280. Is it safe to get hep a & b vaccines? Liver sonogram normal -

I am working in cambodia.  I have elevated liver enzymes (alt 149) & GGT is 280.  Is it safe to get hep a & b vaccines?  Liver sonogram normal -

Get serology first,,: Before you even think of getting vaccinated it'd be good to get a serologic result to see if you've already been exposed and made antibodies to hep a, b or the other hepatitis viruses. You might have contracted one of them without knowing it. Next, liver tests/other tests would be needed to find out why your enzymes are elevated. You might have gone to an area endemic for malaria, etc. ...Read more

Dr. Andrew Seibert
2 doctors shared insights

Liver (Definition)

This organ plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. It lies below the diaphragm in the abdominal-pelvic region of the abdomen. It produces bile, an alkaline compound which aids in digestion via the emulsification of ...Read more


Enzyme (Definition)

An enzyme causes the transformation of a compoond to another compound. In living structures, it is the transformation of a protein to another form. An example is from an inactive state ...Read more