What Are Liver Enzymes?
Liver Enzymes are made by cells throughout the body but are found in highest concentrations in liver cells. These enzymes are found inside liver cells, so when the concentration is elevated in the blood, usually indicates liver cells (hepatocytes) are inflamed, damaged for dying. Below is a list of the four common liver enzymes that are routinely tested on an annual basis or monitored due to certain medications, such as Statin drugs and acetaminophen.
Liver Enzymes:
Liver Enzyme Reference Range: (Quest Diagnostics)
|
Liver Enzyme Test |
Male | Female |
|
AST |
10 – 40 U/L | 10 – 35 U/L |
|
ALT |
9 – 46 U/L |
6 – 29 U/L |
| ALP | 40 – 115 U/L |
33 – 130 U/L |
|
GGT |
3 – 95 U/L |
3 – 70 U/L |
Something we have consistently observed with our patients over the past ten years is slightly elevated liver enzymes. Specifically, a slight elevation to AST and ALT.
For example, on a routine Comprehensive Metabolic Panel (CMP), a woman will have an AST level of 54 U/L and an ALT level of 47 U/L. Both enzymes are slightly outside the normal range, but this often gets blown off by the primary care physician because the liver enzyme levels are not high enough to indicate major a concern. However, if the enzymes levels were in the hundreds, then the doctor would do some follow-up testing for some liver disease like Hepatitis.
Slightly elevated liver enzymes is an indication of having a fatty liver. Most people do not even know they have a fatty liver. And it is found incidentally on an ultrasound. A typical scenario is having a gallbladder attack. You wake up in the middle of the night with terrible stomach pain, radiating to the right side or even the right scapula. Many people have ended up in the emergency room in the middle of the night for a gallbladder attack. In the emergency room, an ultrasound of the abdomen is done. The doctor will tell you that you have gallstones and schedule you for surgery. Then in passing they will remark that you have a fatty liver and that is the last you will hear of that.
Conventional Approach:
If your liver enzymes are slightly elevated, your doctor will most likely not even address it. Below is a list of the conventional approaches that are taken when the liver enzymes are just outside the normal ranges.
If your liver enzymes are elevated, then you have, or you are on the way to having a fatty liver. When the liver enzymes are found elevated on blood work, most doctors will ask how much are you drinking and tell you to cut down. People with NAFLD have a fatty liver, but it is not due to alcohol intake. I have had many patients say their doctor will not believe they don’t drink. This is called Non-Alcoholic Fatty Liver Disease, abbreviated as NAFLD (pronounced Na-Fold’).
One of the most significant contributors to fatty liver is high levels of insulin. Having a diet high in sugar will raise insulin. Insulin is supposed to tell the body to store fat in adipocytes (fat cells). When there is a lot of insulin, the liver will start storing the fat into the hepatocytes (liver cell). Over time the liver becomes fatty, and the liver enzymes will begin to rise.
The liver metabolizes fructose. Having a lot of high fructose corn syrup is especially hard on the liver. Because high fructose corn syrup will skyrocket insulin and the liver has to work extra hard at metabolizing it. NAFLD usually gets dismissed by doctors. I think that is because there is no medication for fatty liver. If there is not a medication for it, then most docs do not know how to treat it.
People often ask me:
One of the major consequences of fatty liver disease is liver cancer. That is a clear indication that fatty liver and slightly elevated liver enzymes should be addressed.
Other issues that occur with a fatty liver:
The liver is an extremely powerful organ. It has over 600 different functions such as detoxifying metabolites and making proteins important for our blood, role in hormone production, the list goes on. If the liver is burdened and not able to function efficiently, this can impact our quality of life and our health.
As mentioned above, there is no medication to take for a fatty liver disease. Because of this many conventional doctors do not treat fatty liver. And most people are dismissed to watch and wait. Fatty liver is very treatable. But it is a multifactorial process.
Treatment Approach for Fatty Liver Disease (NAFLD):
The process takes time and effort. But the effort is worth it. By healing fatty liver, people reduce the risk of liver cancer and live healthier and more energetic lives. If you have any questions, feel free to leave a comment below or send an email to [email protected].
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Discover the common and unfamiliar symptoms that you might be experiencing. Get access to cases of real women with hormonal conditions.
Protecting your `heart health` is crucial, especially during `menopause`, when risks can increase. In this `women’s health` episode, Dr. Valorie Davidson and Dr. Robert Maki share essential `health tips` and insights into how `hormones` impact cardiovascular well-being. Learn about important lab tests and supplements to safeguard your heart. You’ll learn: ● Why heart disease in women is often a “silent” problem until it’s serious ● The difference between general “heart disease” and atherosclerosis ● Coronary calcium scores: what they are, what the numbers mean, and when to consider one ● Why total cholesterol alone is useless (and often scary for no reason) ● The key markers that matter more: ○ Triglycerides ○ HDL ○ Triglyceride HDL ratio (and why 1.5 is a powerful insulin-resistance clue) ○ ApoB ○ Lp(a) ○ hs-CRP (cardio CRP) ○ Blood pressure & insulin resistance ● How estrogen decline in perimenopause & menopause affects cholesterol, visceral fat, inflammation, and heart risk ● How rhythmic dosing and thoughtfully prescribed HRT can support metabolic and cardiovascular health ● Visceral fat vs “roly poly” fat: why where you store fat matters more than the scale ● Foundational supplements for heart protection (education only, not personal medical advice): ○ Omega3s (EPA/DHA) ○ Vitamin D 2 ○ CoQ10 ○ Curcumin/turmeric ○ Magnesium Red yeast rice, bergamot, berberine & more metabolic support ○ Nitric oxide support (beet root, citrulline, etc.) If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Can You Do Rhythmic Dosing After a Hysterectomy? Short answer: Yes, but there are some other factors to take into consideration to make sure someone is a good candidate. In this episode, Dr. Valorie and Dr. Maki explain how rhythmic dosing works without a uterus, why it can be an excellent option after total hysterectomy (with oophorectomy) or surgical menopause, and when a simpler static approach might be better. We cover candidates, myths (like “no uterus = no progesterone”), brain and bone benefits, and how to personalize dosing for real-life outcomes—sleep, mood, cognition, libido, and long-term bone strength. What you’ll learn ● Rhythmic dosing 101 (mimicking a 26–28-day cycle) ● Hysterectomy types: uterus-only vs. total (with ovary removal) ● Why rhythmic dosing can still help—even without a period ● Customizing estrogen + progesterone to symptoms and goals ● Brain fog & sleep: why declining estradiol hits cognition ● Bone density protection in the first 5–7 years post-menopause ● Endometriosis & fibroids: nuance, not one-size-fits-all ● When rhythmic dosing may not be ideal (e.g., 60 and off HRT for many years) If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Confused by your DEXA scan results? Not sure if your T-score is “normal,” “osteopenia,” or “osteoporosis”or what to actually do about it? In this episode, Dr. Valorie Davidson and Dr. Robert Maki walk through three real viewer examples to show You exactly how to interpret bone density scores in your 50s and beyond. You’ll learn: ● How to read your DEXA scan: T-score vs Z-score in plain English ● The cutoffs: ○ 0 to -0.9 → normal bone density ○ -1.0 to -2.4 → osteopenia ○ ≤ -2.5 → osteoporosis ● Why two women in their early 50s can have completely different bone density ● What a T-score of -3.7 or -3.8 really means—and whether it’s reversible ● How surgical menopause, long-term steroids, vitamin D deficiency, RA, and genetics impact bone health ● Why your 50s are really about protecting your 70s (fracture risk, independence, and longevity) ● How weight loss, GLP-1 meds, and low muscle mass affect bones ● Practical foundations to protect and improve bone density: ○ Smart movement: walking, weighted vests, strength & resistance training ○ Protein targets & why bone = “calcified protein” ○ Stress, cortisol & steroid impact on bone loss ○ Vitamin D + K2, food-based calcium & targeted bone support formulas ○ Where HRT—and rhythmic dosing—fit into a long-term bone strategy If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Many women confuse cycling static HRT with rhythmic dosing, but they’re not the same thing. In this episode, Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health break down the difference between the two, why it matters for your safety, and how to do hormone therapy the right way. In this video, you’ll learn: ● What “rhythmic dosing” actually means ● Why cycling your static HRT is not rhythmic dosing ● How improper dosing can impact mood, energy, and breast tenderness ● The risks of trying to adjust hormones on your own ● Why rhythmic dosing must follow the body’s natural ovarian rhythm ● How men and women can use synchronized rhythmic dosing safely If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
In Part 2, we go symptom-by-symptom so you can sleep through the night again. Dr. Valorie and Dr. Maki cover night sweats, frequent urination, heart palpitations, muscle cramps, headaches, itchy skin, vivid dreams, and when to suspect sleep apnea (under-recognized in women). You’ll hear practical tactics—electrolytes, targeted magnesium types, phosphatidylserine timing, glycine, L-theanine, and smart melatonin use—plus when HRT helps and how to pair data (CGM, wearables) with your sleep plan. You’ll also discover practical, science-backed fixes like: 💧 Smart electrolyte balance & targeted magnesium types 🧠 Phosphatidylserine timing for cortisol control 😴 Glycine, L-theanine, and optimal melatonin use 💊 When HRT makes sense—and how to pair it with CGM or wearable sleep data What you’ll learn ● What nighttime urination signals (estrogen & ADH, electrolytes, cortisol) ● Palpitations in midlife: estrogen link, when to see cardiology, calming strategies ● Cramps/headaches/itchy skin—common causes & quick fixes ● How/when to test for sleep apnea at home (and why it’s missed in women) ● Fine-tuning supplements & dosing; when HRT is the lever Still not sure what’s really causing your sleepless nights? Find out if you’re in the In-Between stage of perimenopause and menopause. If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
Why midlife wrecks your sleep—and how to fix it naturally. In Part 1, Dr. Valorie and Dr. Maki unpack the hormone triad behind women’s insomnia: shifting estrogen/progesterone, cortisol dysregulation, and blood sugar/insulin resistance. You’ll learn the difference between trouble falling vs. staying asleep, how low progesterone affects GABA (hello 2–3 a.m. wake-ups), and the daily habits that reset your circadian rhythm. What you’ll learn ● The hormone triad driving midlife sleep loss ● “Vampire / Zombie / Ghoul” sleep patterns—what they mean ● Why blood sugar swings trigger nighttime cortisol spikes ● Morning fixes that help nights: protein breakfast, light exposure, movement, temperature ● Starter supplements & how to think about them: magnesium (glycinate, L-threonate), L-theanine, glycine, phosphatidylserine, melatonin If you have a question, please visit our website and click Ask the Doctor a question. Join the Progress Your Hormones Community Stay Connected Instagram: @drvalorie TikTok: @drvaloried Disclaimer: All content in this blog, including text, images, audio, video, or other formats, was created for informational purposes only. This video, website, and blog aim to promote consumer/public understanding and general knowledge of various health topics. This content is not a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concerns regarding this topic, then it is time to find a new doctor.
