Hi, I was diagnosed with elevated liver enzymes in October 2020. Since then I’m on diet, eg. no alcohol, no drugs, no sugar, no fried food, mostly no fat... but the enzymes are still elevated. AST and ALT altering around 0,6-0,7 (limit for both is 0,52). When I had the bloodwork done this week they were even higher 0,8. I ate bread with cream cheese two days before the tests. Is it possible that this is the reason for the increase? I had a fibroscan and ultrasound done last month, but both doctors confirmed that my liver is healthy and ok, no NAFDL or NASH. I’m 52 years and slim. I was never fat or obese, I exercised all my life, but my diet was sometimes poor with a lot of sugar and fat in it. I’ve never drank much, just ocassionaly. I keep wondering why are the enzymes elevated and what more I can do to improve it?
Can cream cheese increase your liver ... - Living with Fatty...
Can cream cheese increase your liver enzymes?
Hello Monicka ,I have no medical training but I would say it's doubtful whether eating a reasonable amount of cream cheese would have affected your liver enzymes levels? Some cheese is higher in fat than others. But moderation in all things is a good yardstick.
I wondered if you are a coffee drinker? I remember seeing a news report showing a liver consultant advising his patients to drink coffee due to its protective affect on the liver. I was interested because my son has been diagnosed with fatty liver disease recently.
His doctor advised healthy eating and plenty of exercise as being extremely important. Alongside weighltoss and limiting alcohol. You are doing all the right things.
Medication can be harmful to the liver as can metabolic health. How your body copes with insulin for example. ? Many people can be diabetic and not know it ?
I have my liver function tested regularly because of the medication I take for rheumatoid arthritis.
I repeat I have no medical training but I take a keen interest in trying to optimise my own health by my own actions. I wanted to praise you for doing the same.
Best wishes
A lot of people will say no fat but the correct advice is no saturated fat. Unsaturated fat is a much better source of energy than lots of carbs. Here is a link to our view of the most liver friendly diet, and a bit of cream cheese isn't likely to be the issue.
fattyliverfoundation.org/li...
Wayne
Hi Monicka
Abnormal liver function test results do not always indicate liver disease. Your doctor should be able to explain to you about your results.
Liver function tests check the levels of certain enzymes and proteins in your blood. Levels that are higher or lower than normal can indicate liver problems. Some common liver function tests include:
Alanine transaminase (ALT). ALT is an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, ALT is released into the bloodstream and levels increase.
Aspartate transaminase (AST). AST is an enzyme that helps metabolize amino acids. Like ALT, AST is normally present in blood at low levels. An increase in AST levels may indicate liver damage, disease or muscle damage.
Alkaline phosphatase (ALP). ALP is an enzyme found in the liver and bone and is important for breaking down proteins. Higher-than-normal levels of ALP may indicate liver damage or disease, such as a blocked bile duct, or certain bone diseases.
Albumin and total protein. Albumin is one of several proteins made in the liver. Your body needs these proteins to fight infections and to perform other functions. Lower-than-normal levels of albumin and total protein may indicate liver damage or disease.
Bilirubin. Bilirubin is a substance produced during the normal breakdown of red blood cells. Bilirubin passes through the liver and is excreted in stool. Elevated levels of bilirubin (jaundice) might indicate liver damage or disease or certain types of anemia.
Gamma-glutamyltransferase (GGT). GGT is an enzyme in the blood. Higher-than-normal levels may indicate liver or bile duct damage.
L-lactate dehydrogenase (LD). LD is an enzyme found in the liver. Elevated levels may indicate liver damage but can be elevated in many other disorders.
Prothrombin time (PT). PT is the time it takes your blood to clot. Increased PT may indicate liver damage but can also be elevated if you're taking certain blood-thinning drugs, such as warfarin.
There are other reasons AST can be increased and not related to the liver. If you have suffered a recent heart attack, suffer from celiac disease, had an injection in your muscle, have an auto immune condition, I am sure there are many more reasons.
Exposure to drugs or other substances that are toxic to your liver may also be elevate you AST
Have you looked at any medication you take or have taken. Have you checked to see whether previous historical blood tests have been carried out are within normal range. Did they check you for folate and B vitamins? What other health conditions do you have, why did the liver function test get carried out in the first place.
As already mentioned coffee is supposed to help in lowering ALT. Increasing folate is also supposed to lower ALT, as is exercise, losing weight, avoid eating processed foods, in particular fried foods and foods high in sugar and salt. Reduce saturated fat, avoid trans fats, increase fibre.
Excess iron and vitamin A can be harmful to the liver, also some herbal teas, really worth looking at everything you eat, drink and take.
Discuss with your doctor any possible reasons.
Hello, thanks for your comprehensive answer. It’s a bit mystery wifh my liver. I take NO DRUGS at all. I haven’t drunk alcohol for 4 months at all. I don’t eat any sugar and very little fat. I had a fibroscan and ultrasound last month and they rendered nothing. All my other blood tests are ok. Only the enzymes AST and ALT are elevated 0,75 (limit 0,52). I feel good, just a bit itchy on my back ocassionally. The doctor said I need a re-check in 2 months. The elevation started in October after I was ill with covid for 2 weeks. Before my results were ok.
Hi Monicka
I had not known you had covid previously, hopefully some of the following will help you understand how the liver enzyme levels have been noted during the covid pandemic. It is great you have had your scans and continue to be monitored. You are certainly doing all the right things and the liver is a remarkable organ. I suspect but obviously not sure if your doctor will be aware of covid and differing results with blood enzyme and hope the following will help:
Hi Monicka, what is your red meat intake like? Reason I ask, I had a similar situation where I went in for some blood work. My liver enzymes had been on a steady decline for multiple months in a row and then out of the blue, they had gone back up. I asked my doctor at the time about it over email, but never got an answer. As I went through my food log, I had smoked a brisket that week and had eaten higher quantities of red meat. Not sure if it is right or not, but I chalked it up to that. I believe lower quantities of red meat was also mentioned in the NAFLD diet recommendations on this site.
2nd question, you mentioned eating cream cheese and bread. Are you still eating bread routinely? Based on my own diet/experience with NAFLD (take that for what's worth), I have been eating more cheese (including cream cheese), but I have cut bread out completely and really tried to stick to a moderately low carb diet.
David
Hello David, has your blood been checked again after the unsual increase? And was it ok then? My understanding is that your enzymes were high so you adopted a healthy diet and consequently they were steadily decreasing until the last check when they were higher again. Is that correct? And you think it’s because what you have eaten week before? Actually I wonder about the same, eg. how much you can affect them by what you eat or do in the week before the blood is drawn.
In december 2020 I tried to eat very very healthy for 10 days and my enzymes decreased a lot, almost to normal levels. Unfortunatelly I’m unable to be so strict for longer time.
But I almost eat no red meat, just pork and fish ocassionally. My diet for past 4 months included a lot of vegetables, legume, grains (quinoa, buckwheat, rice, oatmeal,...and others don’t know the English names of them 
and fruit. But with this diet I started loosing weight which I definitelly can’t afford so I had to incorporate bread to get enough calories. I thought that cheese, milk and meat is not good for liver.
I went in for annual physical in oct 2020, and my blood work showed slightly elevated enzymes. My Dr told me no Tylenol or alcohol and to retest in a month. In Nov 2020, they went from 60/40 alt/ast to 180/130.
Got the ultra sound which confirmed fatty liver. I had to wait 2 months to see a hepatoligist. So during that time, I did all the research everyone else probably did (finding my way here). The week before my hepatoligist appt (jan 2021), I retested and showed back into 50/30 range. Next week, liver doc re-ordered a bunch of tests and my alt/ast went back up to 65/48. I dont know for sure if the diet in that one week was the cause, but it was my best guess.
Since Nov 2020, Ive lost 27lbs (dont know the stone conversion yet). I got retested in feb 2021 and my alt/ast were back to sub 40s and my new hepatoligist said I didnt need to see him again. Just monitor with routine blood work.
Carbs and sugar were my weak spots so i had to cut bread, rice, pasta, sodas, cookies...etc out almost completely. I try to stay under 100 total carbs a day, so there is some wiggle room but not a ton. I am in the same boat of some days finding it hard to eat enough calories, but doing it with healthy options. There is only so much broccoli, cauliflower, zuchinni..etc i can eat in a day. So for me, cheese and some meat is a must. I did cut out milk though because of the high sugar in low fat stuff I was drinking.
One thing that was shocking to me was how much sugar and salt is in condiments, sauces, marinades and soups. Cutting those out and either doing my own or finding replacemrnts probably dropped my daily sugar load by 25%.
Now the maintenance battle begins.
Hopefully this helps a bit and wasnt to lengthy. If you're not doing it already, i recommend getting a food tracking app like my fitness pal. I used to track calories with it, but not the nutrients in th3 food. It was very eye opening just how unhealthy some things were that I thought were good options
NASH
No fibrosis 
To Keto or not to Keto?
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Waiting on Second yearly blood test 
