How to Lower Liver Enzymes

The liver is unique in many ways. It's the body's largest internal organ, and is one of the few organs with limited regenerative power.^{[1]XResearch source} The liver has many essential functions, from the removal of toxins to helping with digestion, but it can become strained with overuse. Elevated liver enzymes are a symptom of overuse, but simple diet changes can lower enzyme levels back to a healthy balance.

Method 1

Method 1 of 3:

Recognizing Liver Disease

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1
Learn what the liver does for your body.^{[2]XResearch source} The liver aids both in glandular function and with other organ systems. It protects the body by detoxifying hormones, drugs, and any biological molecules not produced in the human body. The liver also synthesizes cholesterol and proteins that might otherwise lead to clotting and inflammation. It stores vitamins, minerals, and sugar while removing bacteria.
- The liver is involved in several important body functions, so it can become taxed by overuse.
- It's very important to return an overburdened liver to healthy enzyme levels to ensure all of these processes continue to function normally.
2
Educate yourself on conditions that can tax the liver. Partly because the liver performs so many essential functions, it is prone to a number of different diseases. There are a wide variety of diseases that can cause your liver enzyme levels to shoot up:^{[3]XResearch source}
- Non-Alcoholic Steatohepatitis (NASH), also known as non-alcoholic fatty liver disease (NAFLD): fats such as triglycerides and cholesterol accumulate in the liver.
- Hepatitis viruses: Hepatitis A, B, C, D, and E all have different causes. However, each different type of hepatitis infection taxes the liver.
- Other infections that burden the liver include mononucleosis, adenoviruses, and cytomegalovirus. Tick bites and parasites can cause harmful diseases like Rocky Mountain Spotted Fever or toxoplasmosis.
- Cancer that is often related to previous viral infections and liver cirrhosis
- Alcoholic hepatitis
- Jaundice
- Cirrhosis or the late-stage scarring of the liver
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3
Recognize the symptoms of liver disease. Because the liver is involved in so many different processes, there is no single list of symptoms that point to liver disease. However, every liver disorder has both unique and shared symptoms. If you experience any of these symptoms, speak with your healthcare provider immediately:^{[4]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Yellowish skin and eyes that suggest jaundice
- Abdominal pain and swelling
- Swelling in the legs and ankles
- Itchy skin
- Dark yellow or reddish urine color
- Pale stools or bloody, tarry stools
- Chronic fatigue
- Nausea or vomiting
- Loss of appetite
- Weight loss
- Dry mouth, increased thirst
- A tendency to bruise easily
4
See your healthcare provider for a diagnosis. See your doctor for a physical exam, and provide him with a complete medical history and description of your symptoms. The doctor will also order a Liver Function Test (LFT) analysis of a blood sample. The LFT will test for the levels of various liver enzymes and proteins. Your doctor will use that information to aid in diagnosis. Some of these enzyme tests include:^{[5]XResearch source}
- AST (Aspartate aminotransferase): AST levels are analyzed to determine the likelihood of acute or chronic hepatitis.^{[6]XResearch source}
- ALT (Alanine aminotransferase): ALT is used to detect and follow the progress of hepatitis and liver injury.^{[7]XResearch source} High levels are found in those with alcoholism, viral hepatitis, and diabetes.
- The ratio between AST/ALT levels is often used to tell if liver disease is due to infection, inflammation, or alcohol use. ^{[8]XResearch source}
- ALP (Alkaline phosphatase): Can help diagnose bone disease, liver disease and gallbladder disorders.^{[9]XResearch source}
- GGT (Gamma-glutamyl transferase): With ALP, can be used to distinguish between liver and bone disease. GGT is also useful to help determine alcohol history; it is increased in about 75% of chronic alcoholics.^{[10]XResearch source}
- LD (Lactic dehydrogenase): LD (sometimes known as LDH) is used along with the other LFT values to monitor treatment of liver and other disorders. High levels are seen in various liver diseases, anemias, kidney disease, and infections.^{[11]XResearch source}
If you have a history of liver disease, you may need liver tests every month or every six to eight weeks. Keep track of the numbers carefully. A downward trend in lab values over six to twelve months will indicate success in supporting the liver. Always keep your physician informed regarding any supplements you are taking, and let her know if there is any change in your symptoms.

Method 2

Method 2 of 3:

Adjusting Your Diet

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Leafy green vegetables have high levels of vitamins, minerals and other nutrients. Importantly for liver function, they can lower the level of fat deposits in the liver.^{[12]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} Leafy greens include spinach, collard, beet, turnip and mustard greens, kale, the cruciferous vegetables (cauliflower, cabbage, broccoli, Brussels sprouts), Swiss chard, dandelion greens, and all lettuces.^{[13]XExpert SourceLyssandra Guerra
Certified Nutrition & Wellness ConsultantExpert Interview. 25 March 2020.}
2
Look for foods high in antioxidants. Beets alone won't lower your liver enzymes, but they're high in "flavonoids" that act as antioxidants that support liver function.^{[14]XResearch source}^{[15]XResearch sourceXiao J, Högger P., Metabolism of dietary flavonoids in liver microsomes. Curr Drug Metab. 2013 May;14(4):381-91.} Avocados can also be helpful, as they have a lot of vitamin E, which is an effective natural antioxidant. Avocados and walnuts have precursors for the body’s primary antioxidant — glutathione.^{[16]XResearch source}
- Walnuts are also a good source of omega-3 fatty acids, which can reduce liver inflammation.
- Other nuts, including walnuts, Brazil nuts, pecans, and almonds also contain B vitamins and minerals in significant amounts.
3
Get 35–50 grams of fiber a day. Foods that are high in fiber prevent your body from absorbing cholesterol. By reducing the amount of cholesterol your liver has to process, you increase liver health and lower enzyme levels.^{[17]XResearch source} Fiber also increases the liver's bile secretion, improving fat digestion and preventing liver disease down the line. Foods high in fiber include:^{[18]XResearch source}
- Oat, wheat, corn, rice bran
- Beans (lima, adzuki, black, red, kidney, white,navy and pinto beans), lentils (red, brown and yellow) and peas
- Berries (raspberry, blueberry, strawberry, blackberry, loganberry, gooseberry, boysenberry, salmonberry)
- Whole grains ( wheat, oats, corn, rye, teff, buckwheat, brown rice)
- Leafy green vegetables (Greens of turnips, mustard, collard, beets and Swiss chard, kale, and spinach)
- Nuts (almonds, pistachios, cashews, walnuts) and seeds (sesame, pumpkin, flax, sunflower)^{[19]XExpert SourceLyssandra Guerra
  Certified Nutrition & Wellness ConsultantExpert Interview. 25 March 2020.}
- Fruit (especially those with edible rinds such as pears, apples, prunes, plums, peaches, apricots)
Vitamin C helps in tissue repair and wound healing. Eating citrus fruits or drinking their juices will help the liver heal, bringing enzyme levels back to healthy levels. Citrus fruits are also known to reduce the risk of liver cancer.^{[20]XResearch source} Find ways to work oranges, grapefruits, lemons, and limes into your diet. When buying juices, look for products fortified with extra vitamin C.
5
Increase your consumption of cruciferous vegetables.^{[21]XExpert SourceLyssandra Guerra
Certified Nutrition & Wellness ConsultantExpert Interview. 25 March 2020.} The family of vegetables called "cruciferous vegetables" are known to balance the production of detoxifying liver enzymes. These "phase two detoxification enzymes" neutralize cancer-causing carcinogens in the body. These vegetables also have plenty of vitamins, minerals, antioxidants, and fiber:^{[22]XTrustworthy SourceNational Cancer InstituteAn agency in the National Institutes of Health focused on cancer research and patient supportGo to source}
- Broccoli
- Brussels sprouts
- Cauliflower
- Radishes
- Horseradish
- Rutabaga and turnips
- Wasabi
- Watercress
6
Ask your healthcare provider about your protein intake.^{[23]XResearch source} Protein is usually the key to repairing damage in the body, so you might think you should increase protein to treat a strained liver. But because the liver is the organ processing the protein, you may overwhelm it with too much protein. This causes even more strain, further elevating your enzyme levels.
- Speak to your doctor and/or nutritionist about how much protein you should be consuming. They will be able to provide you with a plan specific to your body's needs.
7
Hydrate your body well. Drinking enough water will help your liver flush out waste products, reducing its work burden.^{[24]XResearch source} Drink eight to ten 8 oz. glasses of water every day. Take special care to drink water at the following times:^{[25]XResearch source}
- When you first wake up.
- Before and during meals.
- Before and after physical activity.
- Right before you go to bed.
8
Avoid foods that harm liver health.

</ref> Healthy foods can support the liver, but unhealthy foods can damage the liver. Too much fat, salt, sugar, or oil can overburden the liver. If you already have high enzyme levels, you need to give your liver a break for a while. Avoid the following foods to balance your enzyme levels:^{[26]XExpert SourceLyssandra Guerra
Certified Nutrition & Wellness ConsultantExpert Interview. 25 March 2020.}

How.com.vn English: Lower Liver Enzymes Step 8

1
- Fatty foods like lamb, beef, chicken skin, foods made with shortening or lard, and vegetable oils.^{[27]XResearch source}
- Salty foods like most processed and prepared foods, snacks like pretzels and chips, and canned foods.
- Sugary foods like cakes, pies, or cookies.
- Fried foods.
- Raw or undercooked shellfish (these may contain liver-damaging toxins).
- Alcohol (though it’s not a food) should be avoided as much as possible, especially if you already have liver disease.

Method 3

Method 3 of 3:

Taking Herbs and Supplements

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1
Drink herbal teas that improve liver health. There are many herbs that have been traditionally used to support liver function. Little is known about how these herbs function, but there is a long history of safe use. In general, most of these herbs have been given as teas, so dosing is not often clear. Follow manufacturer’s instructions and consult your physician for dosing. The doses listed here should only be used as guidelines.
- Milk thistle: Research suggests it may be most useful for those with alcohol-related liver disease, cirrhosis, and hepatitis. Dosages range from 160-480 mg daily.
- Astragalus:^{[28]XResearch sourceZhang, B. Z., Ding, F., and Tan, L. W. [Clinical and experimental study on yi-gan-ning granule in treating chronic hepatitis B]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1993;13(10):597-9, 580.} The usual dose used is 20–500 mg of extract taken three to four times daily.
- Dandelion/Taraxacum root: Decreases cholesterol, reducing the burden on the liver. Drink two to four cups of dandelion root tea daily or two to four gm of root daily.^{[29]XResearch sourceSannia, A. [Phytotherapy with a mixture of dry extracts with hepato-protective effects containing artichoke leaves in the management of functional dyspepsia symptoms]. Minerva Gastroenterol Dietol. 2010;56(2):93-99.}
- Combination formulas: There are many of these on the market, though most have not been clinically tested. Examples include NOW’s Liver Detoxifier and Regenerator, Gaia Herbs Deep Liver Support, and Oregon’s Wild Harvest Milk Thistle Dandelion.
- Green tea: Reduces the risk of liver disease, but in some people, it can increase liver problems. The best course is to speak to your physician for advice regarding using green tea. In general, two to four cups of green tea has been shown to reduce the risk of liver disease.^{[30]XResearch source}
2
Cook with garlic and turmeric. These herbs not only taste delicious, but are also known to improve liver health. Add these herbs to taste, and use at least one of these daily.
- Garlic also prevents liver cancer and heart disease and boosts the immune system.
- Turmeric has anti-inflammatory properties that support the liver by decreasing the inflammation that leads to hepatitis, NASH, liver cancer, and cirrhosis.
3
Take antioxidant supplements. Though there are plenty of ways to get antioxidants through diet, supplements can help you get even more. Alpha-Lipoic acid (ALA) is an antioxidant that has been studied in diabetes, heart disease and liver disease. It supports sugar metabolism in the liver and prevents alcoholic liver disease. The most common dose is 100 mg three times a day.^{[31]XResearch sourcePodymova S. D., Davletshina I. V. [Efficacy of using alpha-lipoic acid (berlition) in patients with nonalcoholic steatohepatitis]. Eksp Klin Gastroenterol 2008;(5):77-84.}^{[32]XResearch sourceSchimmelpfennig W, Renger F, Wack R, and et al. [Results of a prospective double-blind study with alpha-lipoic acid against placebo in alcoholic liver damage] (Ergebnisse einer prospektiven Doppelblindstudie mit Alpha-Liponsäure gegen Plazebo bei alkoholischen Leberschäden). Dtsch Gesundheitswes 1983;38(18):690-693.} N-acetyl cysteine (NAC) serves as a precursor to glutathione, the body’s major antioxidant. The most common dose to support the liver is 200–250 mg twice daily.
- ALA may interact with diabetes medications, so consult your physician regarding the best dose.
- There have been rare cases where very high doses of NAC increased liver enzymes.^{[33]XResearch sourceBadawy, A. H., Abdel Aal, S. F., and Samour, S. A. Liver injury associated with N-acetylcysteine administration. J Egypt.Soc Parasitol. 1989;19(2):563-571.}

Expert Q&A

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Question
If I would like to cleanse my liver, what should I cut out of my diet?
Lyssandra Guerra
Certified Nutrition & Wellness Consultant
Lyssandra Guerra is a Certified Nutrition & Wellness Consultant and the Founder of Native Palms Nutrition based in Oakland, California. She has over five years of nutrition coaching experience and specializes in providing support to overcome digestive issues, food sensitivities, sugar cravings, and other related dilemmas. She received her holistic nutrition certification from the Bauman College: Holistic Nutrition and Culinary Arts in 2014.
Lyssandra Guerra
Certified Nutrition & Wellness Consultant
Expert Answer
To support a liver cleanse, eliminate refined carbohydrates, sugar, alcohol, fried food and processed oils.
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Is it dangerous to take antioxidant supplements, acid such as alpha-lipoic, and consume alcohol?
Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.
Chris M. Matsko, MD
Family Medicine Physician
Expert Answer
If you have liver disease you should not be consuming alcohol at all. This will further damage the liver and perhaps cause you to go into liver failure and hepatic encephalopathy, which is loss of brain function due to your liver being unable to remove toxins.
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What causes ALT levels to be low?
Chris M. Matsko, MD
Family Medicine Physician
Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.
Chris M. Matsko, MD
Family Medicine Physician
Expert Answer
Low ALT levels are considered normal in healthy people - they are a good thing.
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Tips

Liver function tests should be run every six months, or as directed by your physician, until your liver enzymes are at an acceptable level.
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Warnings

Those with high liver enzyme levels should not take statin drugs. Be sure to go over your medication list with your physician to make sure that there are no drugs in this class on your list.
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