Liver Blood Test
Medical Author: Siamak Nabili, MD, MPH
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
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Dietary Supplements Can Cause Liver Damage
Medical Author: Tse-Ling Fong, MD
Medical Editor: Dennis Lee, MD
 Dietary supplements, which are also referred to as health supplements,
include herbal products, vitamins,
minerals, and any product that is not being
marketed as a food or drug (medication). People take dietary supplements with
the idea of maintaining or improving their health. However, my
colleagues and I reported in a medical journal a series of seven patients who
were referred to us with severe liver injury. They developed the liver damage
after taking a health supplement called Lipokinetix® to lose weight. This
supplement is a mixture of chemicals that includes an extract from a particular
tea. It is said to reduce weight by working to mimic exercise and increase
metabolism.
How and why can dietary supplements damage the liver? Within three months of
starting Lipokinetix®, these seven patients developed symptoms of acute
hepatitis, including tiredness, loss of appetite, and
abdominal pain. They
sought medical attention and their blood tests revealed severe liver damage. One
of the patients actually developed acute (rapid) liver failure and almost
required a liver transplant to save her life. After being in a coma for three
days, she miraculously recovered and was able to leave the hospital. Indeed, in
all seven patients, the symptoms disappeared and the liver tests returned to
normal within several months after discontinuing Lipokinetix®. That said, I have
since been informed of another individual who took this same supplement,
developed acute liver failure, and did require a liver transplant. She is doing
well now. However, so that her body can continue to accept the new (foreign)
liver, she will be taking powerful anti-rejection medications for the rest of
her life.
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Introduction to liver blood test
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured for any reason, these enzymes are spilled into the blood stream. Enzymes are proteins that are present throughout the body, each with a unique function. Enzymes help to speed up (catalyze) routine and necessary chemical reactions in the body.
Among the most sensitive and widely used of these liver enzymes are the aminotransferases. They include aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These enzymes are normally contained within liver cells. If the liver is injured, the liver cells spill the enzymes into blood, raising the enzyme levels in the blood and signaling the liver damage.
What are the aminotransferases?The aminotransferases catalyze chemical reactions in the cells in which an amino group (amino acids are building blocks of proteins) is transferred from a donor molecule to a recipient molecule. Hence, the names "aminotransferases."
Medical terms can sometimes be confusing, as is the case
with these enzymes.
- Another name for aminotransferase is
transaminase.
- The enzyme aspartate aminotransferase (AST) is also known as serum
glutamic oxaloacetic transaminase (SGOT); and
- alanine aminotransferase (ALT) is also known as
serum glutamic pyruvic transaminase (SGPT).
To put matters
briefly, AST = SGOT and ALT = SGPT.
Normally, where are the aminotransferases?AST (SGOT) is normally found in a diversity of tissues
including liver, heart, muscle, kidney, and brain. It is
released into serum when any one of these tissues is
damaged. For example, its level in serum rises with
heart
attacks and with muscle disorders. It is therefore, not a
highly specific indicator of liver injury.
ALT (SGPT) is, by contrast, normally found largely in
the liver. This is not to say that it is exclusively
located in liver, but that is where it is most concentrated.
It is released into the bloodstream as the result of liver
injury. It therefore serves as a fairly specific indicator
of liver status.
Next: What are normal levels of AST and ALT? »
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