- Common Symptoms
- Associated Conditions
- Treatment Options
Transaminitis refers to elevated levels of specific liver enzymes called transaminases.
The normal range of values for aspartate transaminase (AST) is about 5 to 40 units and for alanine transaminase (ALT) is about 7 to 56 units.
- When the liver is damaged, cells release more of the two major enzymes, ALT and AST, into the bloodstream.
- Several blood tests will be performed to determine the type and amount of liver enzymes in the blood to determine if the liver is damaged.
- Because these enzymes are normally only found in the liver, the presence of elevated abnormal liver enzymes may indicate liver damage.
- In most cases, liver enzyme levels are only mildly or temporarily elevated and do not indicate a serious liver problem.
However, abnormal liver enzymes can be a sign of:
- Chronic and acute alcohol use
- Chronic hepatitis B and C
- Drug overdose
- Possibly liver cancer
- Transaminitis can be caused by high cholesterol, certain medications, and herbal supplements (as a common side effect, the statin family of cholesterol-lowering drugs causes elevated transaminases)
Even if the tests do not reveal liver disease, elevated transaminases are always a cause for concern because they either indicate liver damage or other condition that may be of great concern (e.g., elevated AST is a sign of heart disease).
Even if the cause is a medication side effect, the effect may indicate that the medication or dosage should be changed.
What are the common symptoms of transaminitis?
Liver disease is always a cause for concern even if there are no obvious symptoms in some cases and the early stages of progressive diseases.
Mild to moderate elevations in liver enzymes may cause the following symptoms:
Which conditions commonly elevate liver enzymes levels?
Higher levels of alanine transaminase (ALT) than aspartate transaminase (AST) are found in most types of liver diseases.
Extremely high levels of AST (more than 10 times the normal level) are usually caused by:
- Acute hepatitis or, sometimes, a viral infection: In acute hepatitis, AST levels typically remain elevated for one to two months but can take up to three to six months to return to normal.
- AST levels can be significantly elevated (often more than 100 times the normal) as a result of exposure to toxic drugs or other substances, as well as conditions that cause decreased blood flow (ischemia) to the liver.
- AST levels are typically lower in chronic hepatitis, often less than four times the normal, and are more likely to be normal than ALT levels. With chronic hepatitis, AST frequently varies between normal and slightly elevated, so the test may be ordered regularly to determine the pattern.
- Moderate increases could be seen in other liver diseases, particularly when the bile ducts are blocked, such as cirrhosis or certain liver cancers.
- AST can rise after a heart attack or a muscle injury, and it is usually higher than ALT.
AST and ALT ratio
- In most liver diseases, it is usually low (less than one).
- In alcoholic hepatitis, cirrhosis, or injury from bile duct obstruction, the AST and ALT ratio is usually elevated.
- When there is a heart or muscle injury, AST levels are often much higher than ALT (often three to five times higher) and levels tend to stay higher than ALT for a longer period than when there is a liver injury.
What are the treatment options for transaminitis?
Because transaminitis is not a disease, there is no treatment pattern for it. It is a good diagnostic for the success of treatments aimed at reversing the underlying diseases.
Transaminitis treatment will vary depending on the cause but may include:
- Abstaining from alcohol
- Losing weight if needed
- Eliminating red meat, trans fats, high fructose corn syrup, and processed carbohydrates from the diet
- Monitoring liver functions
- Liver transplant
Additional testing is sometimes required. These tests may include ultrasound imaging or a check for blood antibody levels. If transaminase levels remain elevated for six months, the doctor may recommend a biopsy.
What is the significance of transaminitis in COVID-19 patients?
Transaminitis has been linked to mortality in COVID-19 patients according to research. Coronavirus disease has been well described in terms of gastrointestinal symptoms. Transaminitis has been observed in COVID-19 patients in recent studies.
Several studies have been conducted to compare the characteristics of patients with transaminitis and those who do not have transaminitis.
- Transaminitis at presentation is associated with a higher mortality rate in COVID-19 patients.
- Identifying transaminitis in COVID-19 patients is important. It will aid clinicians in prognosis based on the presence or absence of transaminitis at the time of initial presentation.
- Transaminases may act as a surrogate marker for disease severity and a predictor of mortality.
- This could be due to the virus' ability to bind to the angiotensin-converting enzyme 2 receptor. During the early stages, this binding would allow for viral entry and replication within the hepatocytes.
The clinical significance of COVID-19 infection's hepatic manifestations has prompted an attempt to describe the relationship of transaminitis with patient morbidity and mortality.
Latest Digestion News
Daily Health News
Health Solutions From Our Sponsors
WebMD. What Is Transaminitis? https://www.webmd.com/a-to-z-guides/what-is-transaminitis
Oh RC, Hustead TR. Causes and Evaluation of Mildly Elevated Liver Transaminase Levels. Am Fam Physician. 2011 Nov 1;84(9):1003-1008. https://www.aafp.org/afp/2011/1101/p1003.html
Stellpflug SJ. Transaminitis: the lab test that has inflammation…. J Med Toxicol. 2011;7(3):252-253. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550201/
Top Is Transaminitis Life-Threatening Related Articles
Digestive Disorders: Symptoms of Liver ProblemsBy the time a liver disease shows symptoms, it could already be advanced. Here are the signs to look for so you can stop the condition before it leads to liver failure.
Does Liver Cancer Spread Quickly?Liver cancer can spread quickly depending on the type of cancer. Hemangiosarcoma and angiosarcoma types of liver cancer are fast spreading, whereas hepatocellular carcinoma spreads late in the disease.
Liver QuizDo you know the symptoms of liver disease? What is hepatitis? Take this quiz to learn about your liver and how to keep it healthy.
14 Best and Worst Foods for Your LiverGet some simple diet tips to keep your liver healthy, including the best veggies to keep disease away and some snacks you'll want to avoid.
Liver Damage CausesAlcohol and acetaminophen are well-known liver dangers, but what else can be harmful? WebMD says some of them may surprise you.
How Do You Flush Out Your Liver?Detox or flush is a fancy term that implies making dietary changes that help the liver function better. Many claims are made, wherein certain powders, pills, and enemas can be taken by individuals to clean their system; however, your liver can cleanse itself. It does not require any extra aid; in fact, many times, such detox can cause more harm than any good.
How Long Can You Live With Liver Cancer?The overall survival rate of liver cancer patients is low, due to other underlying medical conditions, such as cirrhosis. Generally, a five-year survival rate for all stages of liver cancer is only 15%, but it can vary depending on the extent of cancer spread.
Liver (Anatomy and Function)The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
Liver BiopsyLiver biopsy is a procedure used to remove a small piece of liver tissue for examination for signs of disease or damage to the liver. Preparation for liver biopsy includes discontinuing certain medications. The techniques used to perform liver biopsy include percutaneous liver biopsy, transvenous liver biopsy, and laparoscopic liver biopsy. Recovery from liver biopsy are generally one to two days. Certain risks are associated with liver biopsy.
Liver Blood TestsAn 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, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Liver DiseaseLiver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Liver Disease QuizWhat is liver disease? Take the Liver Disease Quiz and test your knowledge about this organ and its function.
Liver PictureFront View of the Liver. The liver is a large, meaty organ that sits on the right side of the belly. See a picture of the Liver and learn more about the health topic.
What Is Liver Resection?Liver resection is a surgical procedure in which a portion of the liver is removed. The operation is generally performed to remove various types of tumors that are located in the liver. The goal of liver resection is to remove the tumor(s) and the surrounding liver tissue without leaving any tumor tissue behind.
What Does It Mean When You Have Liver Pain After Drinking Alcohol?What is liver pain after drinking alcohol? Learn the signs of liver disease and what to do if you have a painful liver after drinking alcohol.
What Are Signs That Your Liver Is Not Functioning Properly?Liver pain can be a sign that you have a serious health problem like cirrhosis or liver cancer. Find out more about what could be causing your liver pain and how to treat it.