Liver enzymes can fluctuate due to factors like hormonal changes or reactions to medications. Fluctuations are often temporary, but long-term changes may indicate a condition that requires medical attention.

Liver enzymes are proteins that your liver produces to help your body perform necessary functions, such as fighting infections, producing blood coagulation factors, and metabolizing toxins, foods, and other substances.

The amount of these proteins in your blood is a good indication of your liver’s overall health.

Elevated liver enzyme levels don’t always mean serious liver damage or disease. Sometimes, elevated liver enzymes will return to normal after 3 weeks without treatment.

However, liver enzyme fluctuations may indicate an underlying health condition that requires medical attention.

Keep reading to learn more about normal and elevated liver enzyme levels, the causes of fluctuations, and how to manage them.

There are many reasons liver enzyme levels can change. Some causes are temporary and will resolve on their own, while others are more serious and will require medical treatment.

Temporary causes

Temporary causes of liver enzyme level changes may include:

Chronic causes

Several chronic medical conditions may cause elevated liver enzyme levels, including:

The exact threshold for what is considered an elevated level or a typical level depends on several factors, such as your age, sex assigned at birth, health goals, and the values used by the specific lab.

Liver enzyme levels are measured in units per liter (U/L). The standard ranges are:

  • AST: 5 to 30 U/L
  • ALP: 30 to 120 U/L
  • ALT: 4 to 36 U/L
  • GGT: 6 to 50 U/L

A healthcare professional will often test for other markers of liver function, including albumin and bilirubin. Albumin is a protein produced by your liver, and bilirubin is a liver waste product.

The standard ranges for these tests are:

  • Albumin: 35 to 50 U/L
  • Bilirubin: between 0.1 and 1.2 milligrams per deciliter (mg/dL)

These values are not enzymes, but they’re also important chemicals made by your liver.

Liver function is often measured through blood tests. A standard blood draw involves a nurse or another healthcare professional inserting a needle into a vein, usually in the arm, and drawing blood.

Liver blood tests can be done during a regular office visit. You don’t generally need any special preparation before a liver function test, but a doctor might ask you to fast for 10 to 12 hours before the blood draw.

They might order this test as part of routine blood work to assess your risk for liver disease, or as a diagnostic test if you have symptoms of liver disease or liver damage.

Treatment for elevated liver enzymes depends on the cause.

In some cases, liver enzyme levels will return to normal within 1 month. You may need to switch medications, stop taking a supplement, or limit alcohol consumption if you drink, but you will not need a treatment plan.

In most cases, however, a doctor might need to develop a treatment plan to help manage the underlying cause.

To do this, they’ll usually order more tests to help determine the underlying cause of your elevated enzyme levels. These may include blood tests, imaging tests to better examine your liver, and a liver biopsy.

Depending on the results, you might be referred to a liver specialist, known as a hepatologist. Treatment will depend on your final diagnosis.

Some life changes and natural remedies can also help lower your liver enzyme levels, including:

  • limiting or eliminating alcohol from your diet
  • quitting smoking, if you smoke
  • being cautious about the medications and supplements you take
  • staying active, including exercising regularly
  • adding liver-friendly foods to your diet
  • maintaining a moderate weight

The duration it takes to lower liver enzymes will depend on the underlying cause and the severity.

Some research suggests that in around 3 in 10 people, elevated liver enzyme levels will return to normal in 3 weeks. However, if a chronic condition is causing liver enzyme fluctuations, then this will likely take a few months.

A healthcare professional can help you better understand how long it will take for your liver enzyme levels to return to normal ranges.

Limited research has examined the effects of drinking water on liver enzymes. A 2021 study found that a higher water intake was associated with a lower risk for nonalcoholic fatty liver disease in men, but not in women.

Overall, more research is needed, but staying well hydrated is important for optimal health.

It depends on several factors, such as the type of medication and whether you experienced liver injury.

For some medications, your liver may start to heal, and enzymes go down, within a few days of stopping the medication. In general, however, it can take up to 3 months for the liver to heal and your liver enzymes to return to normal ranges.

It depends on how long before your blood test you drink alcohol. Generally, you’ll be asked to fast for at least 10 hours before a blood test. This involves not consuming any fluids or foods, including alcohol.

Alcohol is metabolized by the liver, so drinking alcohol within this timeframe could affect your enzyme levels and, therefore, your test results.

Liver enzyme levels are an important indication of liver health. When they are too high, it can be a symptom of liver damage or disease.

Some causes of elevated liver levels, such as hormonal changes or certain medications, are temporary and might resolve without treatment. Other causes are more serious and can include conditions such as cirrhosis, hepatitis, and liver cancer.

Treatment for high liver enzyme levels depends on the cause.