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High liver values ​​- causes and countermeasures

High liver values ​​- causes and countermeasures


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In medicine, poor liver values ​​are usually seen as a sign of an existing liver disease or at least a lifestyle that is harmful to the liver. With the latter, it is not uncommon for the poor values ​​to be due to poor nutrition or even a pronounced alcohol addiction. A fact that means a no less high risk of disease for the liver if the unhealthy lifestyle is not remedied promptly. We will inform you about the measures to be taken in the case of poor liver values ​​and how the increase in value can occur in individual cases.

Our liver

The liver (hepar) is essential for the body's own metabolic processes, which our organism has to deal with every day. As the largest glandular organ in our body, in addition to storing and transporting nutrients, it also plays an important role in digestion, since the liver plays a key role in fat digestion. For this purpose, it produces the biliary fluid (bilis), which is then transported via the gallbladder to the duodenum, where it is used to break down food fats. In addition to water (approx. 82%), the bile consists mainly of

  • Bile salts (12%),
  • Phospholipids (4%),
  • and cholesterol (0.7%).

It is similar in composition to blood plasma. The bile also contains breakdown products of the blood pigment hemoglobin, which are better known as the bile pigments bilirubin and biliverdin. They give the bile its typical yellow-green color and also show that the liver is involved in other metabolic processes in addition to fat digestion - in this case, blood purification. The organ is also crucial in the synthesis of

  • Blood cholesterol,
  • Blood protein,
  • Blood coagulants,
  • and blood sugar involved.

In unborn infants, the liver even takes over the blood formation up to the seventh month of pregnancy (so-called hepatolienal period). A healthy metabolic process is therefore not possible without the liver functioning properly.

All of these vital liver functions are also controlled by a series of liver enzymes, which are produced in the liver cells (hepatocytes). They serve to maintain the metabolic performance of the liver. If there are functional disorders of the liver, the liver enzyme values ​​in the blood are usually significantly increased. This is because the body causes increased production of liver enzymes in liver diseases to compensate for loss of function. In addition to liver enzymes, certain hormones play an important role in liver function. These include, in particular, the metabolic hormones insulin and glucagon, which are used to regulate blood sugar levels. The involvement of insulin in particular already gives an important indication that poor liver values ​​are often to be found, especially in metabolic diseases such as diabetes.

Causes of poor liver function tests

Our liver is fairly robust by nature and has an enormous ability to regenerate. According to the famous Greek Prometheus legend, this was already known to ancient people. The Titan Prometheus is chained to a rock by the gods as punishment for bringing the fire to man, where an eagle cuts out part of his liver every day, but grows back until the next day.

In reality, the liver tissue does not regenerate that quickly, but a large part of injuries and tissue damage can actually be repaired by the liver independently and replaced by renewable new tissue. Even if almost 50 percent of the liver is damaged, these impressive regeneration abilities still have an effect and can allow the liver to fully recover. The prerequisite for this is, of course, that the underlying cause of the disease or the cause of the liver damage has been eliminated beforehand.

It is not difficult to see that life-threatening diseases and damage to the liver are usually preceded by a considerable struggle for regeneration of the organ. Accordingly, health problems of the liver are often not noticed by patients over a long period of time. Only when the liver's ability to regenerate has been completely exhausted will the symptoms become noticeable through a significant loss of function. For this reason, people suffering from alcoholism frequently exacerbate their critical condition to the bitter end and play a real game of chance with the health of their liver. However, poor liver function tests also appear in numerous other health problems. Then a brief overview.

Improper diet and metabolic disorders

Eating too much fat is one of the most common reasons for poor liver function tests, since the liver has to produce more liver enzymes here, which increase the production of bile. Without this bile, the abundance of nutritional fats cannot be digested.

Now, greasy food is not a cause for concern with a time limit. It can happen again and again that individual dishes have an above-average amount of fat that the liver can handle, provided the consumption is limited. However, the situation is different with a constantly high-fat diet. In addition to chronically increased liver values, there is a risk of obesity and a so-called fatty liver, which leads to an increased storage of fat in the liver cells. The result is massive disturbances in the liver metabolism, which can result in liver failure (liver failure). In this context, a very high-sugar diet must also be mentioned as a particular risk to liver function. It can lead to the metabolic disease diabetes mellitus, which in itself provokes increased liver values ​​because it is based on deficient insulin production, which is essential for liver functionality. In the later course of the diabetes disease, secondary diseases such as fatty liver or inflammation of the liver are also conceivable.

Infections of the liver

In addition to alcohol addiction, diseases such as inflammation of the liver (hepatitis) can also lead to cirrhosis of the liver if they are not cured in time. However, the liver values ​​are already increased before the end stage. Hepatitis is often caused by a bacterial infection of the liver. However, other pathogens such as viruses, fungi or parasites can also cause liver inflammation. Often it is pathogens of specific pre-infections. Sooner or later, they also migrate into the liver via the blood if there is no timely treatment of the infection. Accordingly, hepatitis often occurs as a follow-up infection. The most important pathogens in this regard are:

  • Borrelia (causative agent of Lyme disease),
  • Candida mushrooms (causative agents of candidiasis),
  • Echinococci (causative agent of tapeworm infestation),
  • Epstein-Barr viruses (pathogens of Pfeiffer’s glandular fever),
  • Yellow fever viruses (causing yellow fever),
  • Herpes simplex virus (causative agent of herpes),
  • Mumps viruses (pathogens of mumps),
  • Plasmodia and cryptosporidia (pathogens of malaria),
  • Rubella viruses (pathogens of rubella),
  • Salmonella (causative agent of salmonellosis),
  • Treponema palladium (causative agent of syphilis),
  • Tubercle bacillus / Mycobacterium tuberculosis (causative agent of tuberculosis),
  • Varicella-zoster viruses (causative agents of chickenpox and shingles).

Influences of substances and poisoning

Now certain chemical substances can lead to liver inflammation, if not even liver poisoning. This applies in particular to pain medication and antibiotics such as diclofenac, isoniazid or paracetamol. Inflammation and symptoms of intoxication often occur with drug abuse. Painkillers in particular pose an increased risk of dependency. Anti-rheumatic, anti-epileptic and chemotherapeutic agents also have a severe impact on the liver due to ingredients that are difficult to break down. Likewise, food poisoning can sometimes cause liver poisoning. In addition, toxic liver inflammation comes through

  • toxic detergents,
  • Drug abuse,
  • Plant or mushroom poisons
  • and last but not least alcohol abuse.

Long-term and excessive alcohol consumption, like serious poisoning, can cause long-term serious damage to liver tissue, which can result in cirrhosis of the liver. This is irreversible liver damage, which usually occurs in the end stage of numerous liver diseases, such as fatty liver or hepatitis. However, unnatural irritation from chemical substances has a similarly harmful effect on the liver. The organ is in an absolutely exceptional state here and tries in vain to save what can still be saved by increasing the release of liver enzymes. As a result, cirrhosis of the liver usually causes the highest increase in liver function tests.

Abnormalities and injuries in the liver area

With regard to pathological changes in liver tissue, liver cancer and liver abscesses should not be overlooked as possible causes of increased liver values. Both diseases result in serious remodeling processes in the liver tissue, which logically also affect the enzyme production of the organ. Autoimmune diseases such as autoimmune hepatitis (AIH) should also be mentioned. Malfunctions of the immune system ensure that autoantibodies are formed, which incorrectly attack the liver tissue and lead to chronic inflammatory processes.

Another possible cause of poor liver function tests is liver injury. These not only cause an increase in liver enzymes, they can also be fatal. For example:

  • Bruises in the area of ​​the liver,
  • Stab wounds in the liver,
  • Liver tears,
  • Liver ruptures.

The injuries mostly occur in the context of an accident or an active confrontation with great violence on the liver. In addition, the liver tissue also tends to an increased risk of injury, even in the case of protracted disease courses, which usually results in liver rupture.

Bile diseases

Bile could also be considered as the immediate neighboring organ as a trigger for increased liver values. After all, liver and bile are in constant contact and secretion exchange with each other. If one of the two organs is malfunctioning due to illness, it logically has an impact on the initially healthy organ. Possible causes of the liver value increase include:

  • Inflammation of the gallbladder (cholecystitis),
  • Biliary stasis (cholestasis),
  • Gallstone disease (cholelithiasis,)
  • Gallbladder cancer (gallbladder cancer).

Inflammation of the gallbladder can also spread to the liver and cause hepatitis as a result of inflammation. In contrast, gallstone disease or gallbladder carcinoma often leads to a backflow of bile through blockages or narrowing of the bile duct, which also changes the liver values.

Concomitant symptoms

The accompanying symptoms that occur with increased liver values ​​often depend on the underlying health complaints. Patients with alcohol addiction often complain of simultaneous diarrhea, nosebleeds or yellow eyes, which are due to the so-called jaundice (jaundice). It stems from an increased concentration of the bilirubin in the blood and is an expression of a disturbed liver metabolism.

Jaundice can also occur with liver diseases such as hepatitis or biliary tract diseases. In addition to yellowing of the eyes, a yellowish discoloration of the skin and mucous membranes is also conceivable. If jaundice has progressed very far, dark urine or clay-colored stools are also conceivable. The causes of increased liver values ​​can also have an impact on digestion, since problems with fat, sugar and protein digestion often occur in the case of liver dysfunction. The nutrients make up a high proportion of the food components, which is why symptoms such as

  • Loss of appetite
  • stomach pain
  • Bloated belly
  • Nausea and vomiting are not uncommon.

Other possible complaints include:

  • Exhaustion,
  • Bruising,
  • Feeling of pressure in the right upper abdomen <, / li>
  • Weight changes,
  • Itching,
  • Difficulty concentrating,
  • Nosebleeds,
  • Fatigue,
  • Muscle and joint pain.

They show that liver problems can generally lead to body-wide problems, which can be attributed in particular to a disturbed metabolism.

Attention: If the detoxification function of the liver is severely impaired, a so-called liver-brain disorder (hepatic encephalopathy) can occur! The disorder causes an increasing deterioration in cognitive and motor skills through non-degradable metabolites. This can lead to problems with concentration, thinking and locomotion up to liver coma! Furthermore, hepatic encephalopathy is a sign of impending liver failure. Corresponding complaints of increased liver values ​​are to be taken very seriously.

Diagnosis

The liver values ​​are checked if there is a concrete suspicion during the medical history based on the patient's statements about existing symptoms and possible previous illnesses. During a physical exam, signs such as jaundice may suggest the measurement. Corresponding values ​​are taken as part of a blood analysis in the laboratory. The medical unit of measurement for liver values ​​is units per liter (U / l). Some liver values ​​are of particular importance, namely the liver enzyme values ​​AP, GGT, GOT and GPT. Although the enzymes are formed in the liver cells, they can also be detected in the blood, which makes it much easier for treating physicians to make a diagnosis, because this means that complex liver biopsies are rarely required. Depending on the liver enzyme in question, the values ​​provide important information on various health problems.

Alkaline phosphatases (AP)

This enzyme group of the liver is responsible for cleaving phosphoric acid monoesters. However, the functions of AP in the body have not yet been fully clarified, because they occur in the small intestine, kidneys and bones in addition to the liver. It is therefore reasonable to assume that they are also involved in certain metabolic processes outside the liver. In any case, however, increased AP values ​​either indicate inflammatory liver or biliary disease or are linked to cancer of the liver. Far from the liver, they can also indicate bone cancer or a profound bone remodeling, such as is characteristic of severe bone fractures or Paget's disease. The standard values ​​for AP in healthy people are as follows:

  • 35 to 105 U / l in women
  • 40 to 130 U / l in men
  • 40 to 390 U / l in children

Gamma Glutamyl Transferase (GGT)

This liver enzyme is responsible for the transfer of amino acids into the liver cells. The GGT values ​​are significantly increased for liver damage, liver diseases and certain health problems of the bile or pancreas. For example, diseases such as

  • Inflammation of the pancreas,
  • Gallbladder inflammation,
  • Biliary congestion,
  • Fatty liver,
  • Hepatitis,
  • Liver tumors,
  • Cirrhosis of the liver.

However, symptoms of intoxication of the liver by alcohol or medication can also increase the values. The following apply as standard values:

  • 38 to 40 U / l in women,
  • 55 to 60 U / l in men.

Glutamate oxaloacetate transaminase (GOT)

GOT occurs not only in the liver, but also in the skeletal muscles and in the heart muscle, which is why an increase in value in this case is not always easy to assess if there are no relevant symptoms. For example, increased physical exertion or muscular injuries lead to increased GOT values, which are much more harmless here than in the case of serious illnesses. Muscle loss, heart failure and an impending heart attack are also associated with an increase in the GOT value. Basically, increased GOT values ​​can indicate liver poisoning from alcohol, liver cirrhosis, liver cancer, liver poisoning or inflammation in the area of ​​the liver and bile ducts. The norm values ​​for GOT are:

  • 35 U / l in women,
  • 50 U / l in men and children.

Glutamate Pyruvate Transaminase (GPT)

This liver enzyme gives a fairly reliable indication of an unhealthy diet, as it is released especially when eating high-fat foods. In addition, GPT can also be an indicator of fatty liver, inflammation of the liver or venous occlusive disease within the bile. Furthermore, fungal infections and tumor diseases can be read from an increased GPT value. Standard values ​​for GPT are:

  • 35 U / l in women,
  • 50 U / l for men,
  • 44 U / l in children.

In addition to the measurement of liver values, specific examination measures are carried out, which depend on what causes the increased liver enzyme values ​​suggest. For example, a closer examination of the liver and bile by means of imaging methods such as ultrasound, MRI or CT is conceivable. Liver biopsies can also be performed for certain previous diseases.

Therapy

If increased liver values ​​can be determined from blood tests and the corresponding causes are found in further tests, therapy mostly includes the treatment of the underlying disease or injury to the liver. Anti-inflammatory drugs and antibiotics can be helpful in the case of liver inflammation, for example. For injuries, wound care surgery that requires surgery is as common as for gallstone and cancer. Alcohol abuse and other substances make intensive detoxification or weaning of the patient necessary. In addition, patients themselves can help lower elevated liver values. You will then find some recommendations.

Nutritional measures

Of course, alcohol should be avoided completely if the liver values ​​are elevated. In the case of causes that suggest a diet that is too high in fat (e.g. fatty liver), the intake of unhealthy food fats should be avoided. This primarily affects animal fats. Vegetable fats, on the other hand, mostly consist of healthy and unsaturated fatty acids, which can even support the metabolism, and thus the liver, in a well-dosed amount. As a substitute for butter or lard for searing, you should use vegetable oils such as

  • Safflower oil,
  • Pumpkin seed oil,
  • Linseed oil,
  • native olive oil,
  • Sunflower oil
  • or walnut oil

fall back and use this very sparingly. In the area of ​​animal food, lean meats and fish such as lean chicken, lean ham, redfish, plaice or haddock are to be selected. Fish also supplies important unsaturated fatty acids such as omega-6 fatty acids or omega-3 fatty acids. Easily digestible proteins are important for optimizing liver function tests because they improve the blood picture and strengthen damaged liver functions. Low-fat milk products such as yogurt or low-fat curd cheese are recommended for this. Overall, a fruit and vegetable-rich diet is recommended for a liver-friendly diet. Especially bitter vegetables such as

  • Artichokes,
  • Broccoli,
  • Chicory,
  • Endive salad,
  • Radicchio,
  • Brussels sprouts
  • or arugula

provide digestive and liver cleansing bitter substances that stimulate bile production and detoxify the liver. In addition, vegetables have a high proportion of fiber, which due to their digestive effect can compensate for any digestive deficits. In addition, fiber cannot be used by the body, which is why it is not a burden on the liver and is excreted undigested. Cucumbers and carrots are also liver-friendly vegetables. They are rich in vitamins and minerals such as vitamins A, B, C and E, potassium and phosphorus, which strengthen the liver in particular. In addition, there are antioxidants such as quercetin in both vegetable variants, which trap free radicals in the liver and thus help it with detoxification.

With regard to fruit, berries, tropical fruits and citrus fruits in particular are a great help for the liver. For example, citric acid neutralizes harmful liver acids, while pineapple and melons have a high water content. Grapes and berries are rich in antioxidants, which, as mentioned, have a cleansing effect on the liver.

Tip: A US study found that people who drink coffee regularly are significantly less likely to have elevated liver function tests. Thus, coffee consumption is also recommended when it comes to reducing liver values.

Herbalism

With regard to the daily drinking amount, it is important, especially with increased liver values, to implement the minimum daily amount of two liters and thus to help detoxify the liver. Herbal teas are recommended here, which can also be supplemented with medicinal plants that have an effect on the liver. Which includes:

  • Valerian,
  • Mugwort,
  • Gentian,
  • Hay flower,
  • Hop,
  • Dandelion,
  • Milk thistle,
  • Peppermint,
  • Sage,
  • Yarrow,
  • Way waiting,
  • Wormwood.

Similar to bitter vegetables, some of these herbs have a high proportion of bitter substances, which strengthens liver function and gently cleanses the organ. Medicinal herbs such as peppermint or sage also have an anti-inflammatory effect, which is helpful for hepatitis or inflammation of the gall bladder. Plants such as milk thistle even contain beneficial ingredients such as silymarin, which promotes the regeneration of liver cells and can thus counteract minor liver damage. (Ma)

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.

Swell:

  • Elke Roeb et al .: Non-alcoholic fatty liver diseases, German Society for Gastroenterology, Digestive and Metabolic Diseases e.V. (DGVS), (accessed July 8, 2019), AWMF
  • Christian P. Strassburg et al .: S2k Guideline Autoimmune Liver Diseases, German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), (accessed July 8, 2019), AWMF
  • Karl Mann et al .: S3 guideline "Screening, diagnosis and treatment of alcohol-related disorders", Working Group of the Scientific Medical Societies (AWMF), (accessed July 8, 2019), AWMF
  • Nicholas T. Orfanidis: Laboratory examinations of the liver and gallbladder, MSD Manual, (accessed July 8, 2019), MSD
  • Anna E. Rutherford: Hepatitis C, acute, MSD Manual, (accessed July 8, 2019), MSD


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