Elevated liver enzyme is one of the most common situations encountered by general practitioners in their clinics. Basically, elevated liver enzyme results indicate that liver cells are damaged. Liver enzymes are normally contained within the liver cells, and the enzymes leak out into the blood stream only when there is damage to the liver. A variety of liver conditions can cause this situation, for example, fatty liver, infections of hepatitis virus, alcohol excess and some medications. 

Fatty liver is the most common cause of elevated liver enzymes. In the U.S., one out of every four adults over the age of 18 has fatty liver. It can also occur in children. Fatty liver without alcohol abuse is also called Non-Alcoholic-Fatty-Liver-Disease (NAFLD) or Non-Alcoholic SteatoHepatosis (NASH). Whatever it is called, they all just mean that your liver is being invaded with fat.

When functioning correctly, the liver is involved in fat metabolism as the major fat-burning organ in the body. The healthy liver not only burns fat, but it pumps excessive fat out of your body through the bile and into the gut. In contrast, a fatty liver is storing fat when it should be burning and removing excess fat from your body. As a result, fatty liver becomes a warehouse for fat and if it is allowed to progress for many years, the liver may finally become a “sack of fat” with grave consequences for your health and longevity, such as liver cirrhosis and cancer.

How do you know if you have a fatty liver? Check the following list.

• Are you overweight, especially in the abdominal area?
• Do you have type 2 diabetes?
• Are you suffering from high blood pressure?
• Do you have elevated cholesterol and triglycerides in your blood?

If you answered yes to any of the above questions, there is a high chance you have a fatty liver.

Can fatty liver be reversed? Yes, of course. Luckily the liver cells are very resilient. However, there are no medications or surgeries that have proven effects. Only diet & exercise work.

Here’s a recommendation for your table to keep your liver happy.

• Reduce refined carbohydrates from bread, pastry, pasta, noodles, cakes, biscuits and desserts.
• Avoid deep-fried, fatty, and processed foods.
• Limit dairy foods including milk, processed cheese, cream and butter. Instead, try soy products. There are also rice milks and oat milks to try.
• Avoid margarines and similar type of spreads.
• Avoid sugary processed foods and drinks.
•Avoid artificial sweeteners.
• Increase the amount of raw fruits and vegetables. Also use raw vegetable juices.

With proper diet and lifestyle modification liver cells will repair and the enzyme levels will slowly go down over time. Medical specialists encourage a gradual weight reduction with as little as a 5 percent to 10 percent loss of initial body weight over 6 months, which has been shown to reverse liver damage. They warn that rapid weight loss from fad diets or radical surgery may have a negative impact on the progression of liver damage.

One thing you should keep in mind is that you will have a “plateau” period, when weight loss stops or slows down. This may continue for weeks or months. Don’t be frustrated at this time. Even though you may not see any visible fat loss from the body, the fat loss is actually occurring within your liver. So, stick with it! It is at this time that people give up, thinking that they won’t lose any more. That is not true!

A “fatty liver” is a common but often ignored problem. The fact is, poor eating habits and sedentary lifestyle created this new disease. Follow simple rules, be diligent and patient, and your liver can be fighting fit.

By Koh Kwang-cheol

The author is a professor in the Department of Gastroenterology at Sungkyunkwan University School of Medicine and medical doctor at Samsung Medical Center. ― Ed.