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British Liver Trust
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Very High Liver Enzymes

Hi I am 41 yo female. I have been moderately drinking for 4 years and also taking panadol for headaches (had a newborn and I got crippling headaches at night when abruptly waking up). Or other nights, lots of nights, I did not sleep at all when he was sick. In the morning I would get 4 panadols for headache without thinking, and so on for a year as I also worked full time and could not afford to be sleepy or achey at work. After my child grew I had less panadol but still took it for headaches. I also drank half wine bottle and a beer most evenings😯when cooking with my partner after work and to unwind after a long day.

The other day I got horrible palpitations (which I have had since 25yo but not to yhis extent) and high bp so I went to ER. My liver enzymes, all four, came back very high (in the hundreds). I am now dead scared of liver chirrosis or cancer or some other bad disease. My platelets, hemoglobin, bilirubin and albumin, t protein, crp were all okay. I am so scared, how much damage could I have done to my liver in four years?

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Stop drinking alcohol & taking painkillers immediately! What you've done is foolish but it doesn't mean that you have cirrhosis. Your high liver enzymes mean that your liver is inflamed but the liver is very resilient and will recover if you give it a chance.

The following quote by hepatologist Melissa Palmer in her book 'Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease' covers your behaviour:

Taking two hepatotoxic drugs in combination can greatly increase the likelihood of liver damage compared with taking one hepatotoxic drug alone.

You haven't indicated that you have any symptoms of acute inflammation let alone cirrhosis so in all likelihood your liver is moderately inflamed and if you stop drinking alcohol & taking Panadol it will recover. Your doctor should retest you after you've lived clean of alcohol & Panadol for several months and your enzymes will probably have come down to normal or be heading that way.


Thanks Edward.. you are totally right. I stopped, and I realize that my behaviour was immature. My doc will test me again very soon, and then periodically until they come completely down. If they do, that is..

I will have an US as well to look at the liver, and maybe a CT scan.

What other signs are there that would indicate chirrosis?

Thanks for taking time to answer.

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When my liver became acutely inflamed around 8 months ago I suffered the following symptoms:

Encephalopathy-I felt ‘foggy headed’ and like I had a hangover on a daily basis for several months. I experienced numerous instances of losing orientation at shopping centres and while driving and not knowing where I was until I got my bearings. I also misplaced items putting them in places I'd never normally put them. I also found it hard to post coherently on a forum such as this because I couldn't think straight. This was because my liver couldn't remove toxins which were poisoning my brain.

Unpleasant flushes rising from the stomach to the top of my head-when I checked online I found that these unpleasant flushes are a known early symptom of liver damage.

Excessive frequent yawning-for the first 4 to 6 weeks I found myself yawning frequently through the day despite not feeling tired. When I looked it up online I found it was a symptom of end stage liver disease!

Daily bouts of extreme fatigue-I often felt extremely tired typically in the late morning and late afternoon. On occasions I had to nap after only being up for a few hours.

Disturbed sleep pattern-I started going to bed much earlier than normal around 7:00 p.m. instead of my usual 10 or 11 p.m. My sleep was fitful and I typically woke multiple times through the night sometimes sweating abnormally.

Itchy skin (Pruritus)

A general feeling of malaise that was constant.

Almost all of my symptoms have cleared up now (I still have some pruritus) after living clean of painkillers for 8 months. If I hadn't stopped the painkillers when I did I suspect that my liver might have failed completely given how severe my symptoms were.

You haven't mentioned any of the above symptoms which suggests that you have moderate inflammation of your liver which will resolve itself if you do the right thing from now on.

Note that even with all of my symptoms it turned out that I didn't have fibrosis or cirrhosis so given your absence of symptoms like I experienced it's unlikely that you have serious liver damage.


Oh thank you so much for sharing Edward. I feel less depressed now, seeing that there is hope. I am glad that you are well. I hope that you stay well and healthy!

Indeed I have no symptoms other than headaches that I have been blessed with since childhood, and heart palpitations which I attributed to a minor heart deffect that I have, but lately I began to consider the liver as a possible source too.

May I ask if you took painkillers as well and if yes for how long and if your enzymes were also high?

Thanks again!

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I did have an abnormal blood test result before my symptoms started in earnest but my enzymes were not sky high and my doctor downplayed the abnormal result. Everyone is different. In all the years I took painkillers my ALT & AST were normal while occasionally some of the other values were slightly outside the normal range. Just before my symptoms became really bad my ALT rose above the normal range for the first time ever & so far it hasn't come back down to normal but I expect it will when I have my next blood test. My enzymes never sky rocketed because I never abused painkillers. I wore my liver down through consistent long term use of painkillers until it complained big time!

Given how bad my symptoms I thought I had end stage liver disease plus my mother died of liver failure from long term use of medication. I was lucky it was just severe inflammation. An ultrasound showed my liver to be normal sized and smooth in outline. A FibroScan result (4.3) confirmed no fibrosis or cirrhosis.

I took painkillers pretty much daily for around 35 years and I drank alcohol moderately until I gave up drinking 2 ½ years ago. I took painkillers similar to your Panadol except mine also contained codeine. I also took tramadol intermittently. I took a lot more painkillers than you however I rarely mixed alcohol and painkillers. What you did was very foolish but given your absence of serious symptoms your liver should make a full recovery.


Thank you. Yes I fully understand the magnitude of my foolishness.

Today I discovered that a heat pack takes away like 30% of my headaches, and that is good, as I can live with 70% of them.

As for the wine, I quit and I will not go back. My son will grow with a mum. We now drink spicy tea instead, and it is okay, even nice.

I guess wine offered me instant gratification after a day at work. That was the wrong mindset.

Anyway thank you for sharing your experience with me.



I agree with Edward- cut down on alcohol or stop and cease routinely taking pain killers and things should improve. I had something similar in jan after root canal treatment

A toxic mix of antibiotics . Stopped drinking for 2 months and ggt and alt levels more or less back to normal. You’re just 41 so relatively young. Good luck

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Thanks Briccolone 👍. This website is a great place to get help in need!


Indeed it is-it’s certainly helped me- all the best

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That’s a very useful post edward

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Hi folks

Just a follow up on my latests medical visits. Have been in for a new blood test, which showed good reduction in AST and ALT, but small increase in ALP (by 6 units). Also small decrease in GGT (445 from 497). Ultrasound showed mildly fatty liver and small kidney cyst. The lady there said ‘no bumps and lumps seen’, so that was cool to hear. The ER doc then came over and reffered me to a liver specialist based on the fact that two of my enzymes did not come down as expected. The GGT and ALP. He mentioned possible billiary obstruction, even if no indication of this was seen on the US. He added that he sends me as a precaution because he sees my anxiety and this is no way to live. I appreciate that he is doing his job in a remarkable way. But needless to say, I am worried sick. What is it with the billiary obstruction now. At times, my throat is closing off, at night I wake up chocking, and indeed this is no way to live. Apart from my anxiety, I feel physically good, alert and awake. No pains, no headaches. At the times of the blood test I had ceased alcohol and paracetamol for three days. It is now seven days since I stopped, and heck pls excuse my French if I will ever go back!

Also I need to say I had a moderate cold at the time of my blood test, could this influence GGT and ALP..?

After the ER doc gave me the referral, I booked a CT scan and the specialist for next week. Then I came home and saw my new GP, who said GGT is the last of the enzymes to fall and do not worry about ALP. He was quite happy with the bloods, as opposed to the ER doctor. I mentioned to him that I had nausea and small pains in my right side. He gave me Maxalon; the pains disappeared straight away.

So why am I here again.. I guess I am looking for reassurance, fully realizing how foolish this is, but who knows maybe someone else out there had a similar experience...

So yeah does a virus influence GGT and ALP, and is it true they are the last to fall? Also is US a useless test, someone can have an obstruction but not be seen on the films? And what even is an obstruction, can be a tumor, right...? Or a gallstone I guess, - but shouldn’t US show that..? At least something? And can pain and nausea from tumors or chirrosis go away from Maxalon (basically it looked like trapped gas pain to me.. that is how the Maxalon helped). Oh the GP said intestines can hurt from overeating and recommended to go down to 54kg. I am now 59 kgs.

My anxiety is beyond limits. How do you guys deal with it? Sorry for the lenghty post. I am so scared.




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