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Bad liver function tests
Based on the so-called liver values, possible overloads, diseases or damage to the liver can be read. Increased liver values are usually found in routine blood tests. In the studies, the concentration of the metabolite bilirubin and the liver enzymes glutamate pyruvate transaminase (GPT or ALT), glutamate oxalate transaminase (GOT or AST) and gamma glutamyl transferase (GammaGT or GGT) and the alkaline phosphatase (AP) determined in the laboratory. Other serum enzymes that are associated with the liver include billirubin, albumin, cholinesterase and ammonia.
Are the liver values too high?
Experts speak of increased liver values if the serum concentration of the most important enzymes mentioned exceeds the following limit values (expressed in units per liter; U / l):
- GOT: over 50 U / l men; 35 U / l women
- GPT: over 50 U / l men; 35 U / l women
- GGT: over 66 U / l men; 39 U / l women
- AP: over 129 U / l men; 105 U / L women
However, exceeding the limit values is only of limited significance and in many cases the pathological significance can only be recognized through their relationship to one another or to other blood values. In addition, the specialist literature refers to the fact that there may be significant fluctuations in the recording of liver values, which is why further examinations may be useful for a clear determination.
Dead liver cells
Increased concentrations of the liver enzymes mentioned in the blood indicate that liver cells have recently died. Standard values that stand for a balanced metabolic state are used for comparison. Excesses are called increased liver values. In many forms of liver damage, for example due to liver inflammation, liver cancer, alcohol abuse or poisoning, the blood values of the liver enzymes are increased in a characteristic manner.
Causes of increased liver function tests
The most common cause of elevated liver function tests is excessive alcohol consumption. However, there are actually a number of factors that can trigger the normal value to be exceeded. In addition to alcohol, drugs and medication, infections with parasites, bacteria or viruses should also be mentioned here, as well as a particularly fatty diet or narrowing of the bile ducts. If increased liver values are found during the blood test, further medical clarification is urgently required, as in the worst case, liver cirrhosis or liver cancer can also cause the normal value to be exceeded.
Infections as the cause of inflammation of the liver
Different infections with viruses, bacteria, fungi or parasites can cause damage to the liver and associated increased liver values, which primarily include an increase in transaminases.
Viral infectionsExamples that can lead to inflammation of the liver include:
- Rubella (rubella virus),
- Yellow fever,
- Infections with herpes viruses (e.g. varicella zoster virus),
- Infections with hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E).
While inflammation of the liver occurs as an acute side effect in most viral infectious diseases, infections with hepatitis viruses often go into a chronic stage.
Bacterial liver infectionsSome of the things that can cause increased liver function tests are:
- Tuberculosis (Mycobacterium tuberculosis),
- Syphilis (Treponema pallidum),
- certain enterobacteria (salmonella, shigella)
- and borrelia (triggers of borreliosis).
As a rule, typical signs of bacterial diseases can be detected long before the increased liver values occur. For example, a Salmonella infection is often accompanied by abdominal pain, diarrhea, nausea and vomiting.
A tuberculosis disease is usually accompanied by non-specific symptoms such as fatigue, loss of appetite, fever and cough.
Syphilis is mainly characterized by the formation of ulcers in the area of the genitals and flu-like symptoms such as fever, headache and body aches. In addition, a moderately itchy rash can often be observed in the later course of the disease. If increased liver values are found, an exact description of the accompanying symptoms helps the therapist to determine the causative disease.
Fungal infections also occasionally result in inflammation of the liver, which are subsequently expressed in increased liver values. Above all, pathological multiplication of yeast mushrooms (Candida) are to be mentioned. Parasites that can cause inflammation of the liver include so-called liver fluke and other types of suction worms, plasmodia (single-cell parasites, pathogens of malaria), amoebas, roundworms, tapeworms and leishmanias (intracellular parasites). The parasitic infestation of the liver can have life-threatening consequences, which is why the suspicion should be checked or ruled out urgently by a doctor.
Increased liver values through unhealthy nutrition
Greasy food strains the liver and can lead to what is known as fatty liver in the long term. This is also often reflected in increased liver values, especially in the area of transaminases (GPT, GOT) and gamma glutamyl transferase. However, fatty liver is difficult to diagnose based on the increased liver values. This usually requires an ultrasound examination (sonography) or magnetic resonance imaging.
Normally, a liver change caused by a fatty diet is reversible or can be remedied by changing the diet. An early stage fatty liver is therefore not classified as a serious disease, but it can go into an inflammatory stage, a so-called steatohepatitis (also fatty liver hepatitis), which is manifested, for example, in increased sensitivity to pressure in the organ, loss of appetite, nausea, a significant Weight loss (underweight) and fever can manifest. At worst, steatohepatitis develops into cirrhosis of the liver, which threatens the end stage of most chronic liver diseases. Cirrhosis of the liver can have life-threatening consequences for those affected.
Toxic damage to the liver
The liver is significantly involved in the glucose, fat and protein metabolism and also makes a significant contribution to the breakdown of toxins. In the latter, a distinction must be made between the ingested toxins and those produced by the organism itself (waste products of the metabolism). The best-known external toxin that can cause damage to the liver and correspondingly increased liver values is alcohol. With long-term high alcohol consumption, the organ is overwhelmed in its degradation function and so-called alcoholic fatty liver hepatitis develops.
As with normal fatty liver hepatitis, this can lead to liver cirrhosis and, under certain circumstances, liver cancer. A comparable development threatens through the long-term use of certain medications and drugs. Poisoning from eating poisonous mushrooms can also lead to increased liver values. The fungal poisoning is usually over after ten days at the latest, but in the worst case can lead to the death of those affected. Liver overloads and correspondingly increased liver values are also to be expected in other acute poisonings. These can be caused by toxins such as phosphorus, chloroform, carbon tetrachloride, arsenic and numerous other environmental toxins.
Bile duct disorders as a trigger
If the drainage of the bile is impaired by narrowing of the bile ducts or other diseases of the gall bladder, this can also lead to inflammation of the liver and increased liver values. Possible causes are, for example, gallstones or biliary tract infections. The accompanying symptoms in diseases of the bile ducts are usually pain in the area of the right upper abdomen, fever, chills and jaundice. The increased liver values mainly affect the bilirubin concentration.
Severe inflammation of the bile duct can cause disorders of the central nervous system and kidney function as well as, in the worst case, shock conditions. Therefore, a medical examination of the complaints should be carried out urgently.
Lower elevated liver values
The possible therapeutic approaches for increased liver values are extremely different according to the numerous different causal diseases. If the cause lies in the diet, a change in diet and gentle weight loss are recommended first. Viral hepatitis infections may, however, be treated with antiviral drugs. In the case of bacterial liver inflammation, antibiotics are usually promising.
In general, it is important to avoid further stress on the organ if possible. That means: No alcohol, no drugs and, if possible, no toxic substances or medicines. With drugs, however, this can be problematic if they need to be taken due to other serious illnesses. A simple weaning is often not possible. Here, the treating doctor should look for alternatives in the interests of those affected. If necessary, hepatologists or gastroenterologists can be consulted as specialists.
If the increased liver values are due to diseases of the bile ducts, it is not seldom necessary to have an operation. For example, this applies more frequently to inflammation of the bile ducts, which cause a backflow of the bile. Gallstones, which are the cause of increased liver values, can also be removed as part of a surgical procedure. With gallstones from cholesterol, however, drug lysis (dissolution) is usually possible.
If the inflammation of the liver is caused by suction worms or other types of worms, different medications are available, which may, however, cause further strain on the liver. This should urgently be taken into account when choosing the medication. Other parasites that can cause inflammation of the liver and the associated increased liver values can also be treated with medication in most cases. This also applies to Leishmania, in which complete healing of the disease is relatively often not successful.
The therapy aims - like most other parasitic infections - primarily to eliminate the parasites. In addition, measures that generally strengthen the immune system are often part of the treatment. However, there is usually no way around drug therapy. Mostly active ingredients are used that interfere with the metabolism of the parasites and cause their death. Medicinal strengthening of the cellular immune system with recombinant interferon may also be considered.
Naturopathy and holistic medicine
Accompanying the treatment approaches mentioned, naturopathic procedures can be used to support the respective underlying diseases in order to rid the body of toxins and relieve the organ. Herbal medicine offers options for detoxifying the liver. The positive effects of dandelions, artichokes and milk thistle are particularly worth mentioning here. However, the use of artichokes for liver detoxification is contraindicated if the bile ducts are narrowed because the activity of the bile is stimulated and the increased backflow of bile can lead to painful colic or, in the worst case, a breakthrough of the gallbladder.
Other options for detoxifying the liver include special fasting, detoxifying and therapeutic fasting. Glaucoma juice is also sometimes used for liver detoxification, but can cause violent vomiting and massive diarrhea. More gentle options for liver detoxification are available based on homeopathy and the use of Schüßler salts. Since some of these treatment methods may be contraindicated in the case of liver damage, the selection of urgently experienced therapists should be left to the choice, especially in the case of already increased liver values. (fp)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters
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