Learning About Transaminitis

Transaminitis means you have high levels of two liver enzymes in your blood. These enzymes are ALT and AST. ALT stands for alanine aminotransferase. AST stands for aspartate aminotransferase.

When the liver is inflamed or damaged, it may release extra ALT and AST into the bloodstream.

Doctors often group liver enzyme levels by how high they are. For example, levels may be mildly high, moderately high, or severely high. But even if they are mildly high, it can be a sign of a liver problem.

If you have a health condition or other problem that is harming your liver, it can cause high levels of liver enzymes in your blood.

Things that can harm the liver include:

• A buildup of fat in the liver (metabolic dysfunction-associated steatotic liver disease, or MASLD).
• Long-term alcohol use.
• Drug use.
• Infections, like viral hepatitis.
• Some prescription and over-the-counter medicines.
• Some herbs and supplements.
• Some diseases that run in the family. These include Wilson’s disease and hemochromatosis (too much iron in the body).
• Some autoimmune diseases, such as autoimmune hepatitis.

All of these things can lead to serious liver problems (liver disease).

But high levels of liver enzymes do not always mean there is something wrong with your liver. High levels can also be caused by other things, like strenuous exercise or a severe injury to a muscle.

Your doctor will try to find out why your levels are high and then treat the cause.

High levels of liver enzymes alone do not cause any symptoms. Symptoms you feel may come from a medical problem that is causing the high levels.

For example, some symptoms of liver disease include:

• Pain or swelling in the upper belly.
• Nausea.
• Vomiting.
• Fever.
• Weight loss.
• Feeling very tired.
• Yellowing of your eyes or skin (jaundice).

These are symptoms of problems with your liver, not of high levels of liver enzymes.

Your doctor will try to find out what is causing the high levels of liver enzymes in your blood. Your doctor will ask questions about your symptoms. The doctor will also ask about your health history. This includes your family history of liver disease.

You will be asked about any medicines and supplements you take. The doctor will also ask questions about your alcohol use and drug use. You may have a physical exam.

Your doctor may do more lab tests to find the problem that is making the liver enzyme levels high. If your doctor still can't find the problem, they may order an ultrasound of the liver. In some cases, doctors will do a liver biopsy.

Once your doctor figures out what is causing the high levels of liver enzymes, they will treat that problem.

Treatment for liver problems often includes making healthy lifestyle changes. This can mean eating healthy foods, being more active, drinking less alcohol, and losing weight, if needed. You may also need to take medicines.