Liver helps remove toxins from the body. It synthesizes proteins which are essential for timely clotting of blood. It promotes the metabolism of medications and nutrients and helps store fat, vitamins, bile, and cholesterol. Liver helps control glucose levels and process (recycle) the waste products of hemoglobin (bilirubin) in blood.
The enzymes that are present in the liver help accelerate the chemical reactions within the liver. These enzymes are nothing but proteins. Because of their presence, the liver is able to perform a variety of functions. It is a vital organ which helps in blood purification, detoxification, digestion, excretion, and metabolism. Insufficient amount of liver enzymes may be a sign of liver impairment or damaged liver cells which can affect liver function and the overall health of the person seriously.
The following list contains the different liver enzymes and the explanation of their normal values, along with the causes of what might be the reason behind low levels of each of these enzymes.
Albumin: An important protein that is present in the blood is albumin, and this is produced by the liver. Badly damaged liver cannot produce albumin. A blood test helps detect albumin levels in blood. Its normal range is 3.4 to 5.4 grams/deciliter.
Causes: Liver dysfunction due to liver cirrhosis or hepatitis, or even kidney diseases can cause low albumin levels. Also, a low-protein diet, Crohn's disease, and after weight-loss surgery may lead to low levels of this enzyme.
Globulin: The protein globulin is produced in the liver and the immune system. Albumin and globulin are the main proteins present in the bloodstream. The normal total protein levels, which are determined by calculating the albumin and globulin levels, ranges between 6.0 to 8.3 gm/dL (grams per deciliter).
Causes: Damaged liver cells, kidney diseases, inflammatory bowel disease (IBD), celiac disease, various neoplasms, acute hemolytic anemia, hypogammaglobulinemia/agammaglobulinemia, etc., can be the cause.
Prothrombin: Liver produces prothrombin, a kind of protein which promotes timely clotting of blood. A prothrombin time test helps measure the time required for a person's blood to clot. The normal range for this test, if you are not taking any blood thinning medications, is between INR of 0.8 to 1.1, where INR stands for International Normalized Ratio. Low levels of this enzyme will give you a result above INR 1.1, which means that your blood is taking longer than usual to clot.
Causes: Serious liver diseases can lead to low prothrombin levels, resulting in longer time for clotting. Vitamin K deficiency, blood-thinning medicines, certain other medications, and certain bleeding disorders can affect prothrombin function, as well.
ALT or Alanine Aminotransferase or SGPT: ALT is primarily present in the liver only and helps in metabolizing the protein present in the body. The normal ALT levels range is 10 to 40 international units per liter (IU/L).
Causes: The ALT levels usually stay low, and are mostly not a cause of concern. It is the elevated level of this enzyme that is considered to be dangerous.
AST or Aspartate Aminotransferase or SGOT: AST is present in the liver, heart, and in other tissues of the body. The normal blood AST range is 10 to 34 IU/L. ALT and AST are used to metabolize amino acids and make proteins. Liver dysfunction can alter the production of AST.
Causes: Like ALT levels, low levels of AST are not considered to be problematic. High levels are a cause of concern.
ALP or Alkaline Phosphatase: ALP is present in all the tissues of the body. However, its large quantities are found in the bones, liver, and bile ducts. The normal range of ALP is 44 to 147 IU/L.
Causes: Conditions such as hypophosphatasia, Wilson's disease, protein deficiency, and malnutrition may lower the production of ALP.
Bilirubin: Bilirubin is a waste product of the red blood cells and is produced during their breakdown. Normal total bilirubin level ranges between 0.3 to 1.9 mg/dL. Low bilirubin levels are usually not of any major concern.
Causes: Decreased levels may be a result of using medications that may alter the levels of this enzyme. Some of them include, vitamin C, phenobarbital, and theophylline.
Gamma-glutamyl Transpeptidase (GGT): This enzyme is found in the blood. The normal values range from 0 to 51 international units per liter (IU/L).
Causes: Usually, the amount of GGT is decreased in the body due to the usage of birth control pills and clofibrate.
Lactate Dehydrogenase (LDH): The LDH or LD enzyme is found in the liver, and its normal range is between 105 to 333 IU/L. Usually, elevated levels of this enzyme are a cause of concern.
Causes: Low levels are rarely seen, and that too in case the person has consumed a high amount of vitamin C or ascorbic acid. A genetic mutation may also cause abnormally low levels.
Symptoms that indicate liver disorders may vary from person to person. Mostly, there are no symptoms observed, or perhaps they are so mild in nature, that most people do not even find out that they have low liver enzymes. Some of the symptoms that may or may not be seen in this condition are listed as under.
- Abdominal swelling
- Tenderness in abdomen in the region of the liver
- Loss of appetite
- Enlarged spleen
- Weight loss
A series of liver function tests (LFTs: blood tests) and other tests including the ultrasound, CT scan, MRI, biopsy, etc., help find out the enzyme(s) that are deficient in the body. The test results help the doctors diagnose and chalk out the possible causes behind the same. Doctors may prescribe medicines to treat the specific underlying cause. But patients need to make some lifestyle changes, as well.
A high-fiber diet that is low in 'calories and saturated fats' can prove to be beneficial for the people diagnosed with liver problems. Avoiding alcohol is a must. Avoiding high-glycemic foods, controlling diseases such as diabetes with prompt medication, cholesterol, and triglyceride levels through diet, regular exercise, and use of 'necessary and sufficient' medication is equally important. Liver diseases are called 'silent killers' as they don't exhibit any symptoms in the early stages, so make sure you get yourself checked at regular intervals, especially if you have a family history of the same.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice. Note that the normal ranges mentioned in this article may vary from laboratory to laboratory. Kindly consult a trusted doctor to interpret the results and follow an appropriate treatment plan.