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.
Exciting Announcement! We’re launching the Progress Your Hormones Community today—a space designed to empower women with expert guidance and support for navigating perimenopause and menopause. Get access to live office hours, hormone hot seats, lab interpretation, and more! 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.
Launching August 11: Join our new Progress Your Hormones Community! Get expert guidance, real support, and answers to your HRT questions—together, not alone. Get expert guidance, real support, and answers to your HRT questions—together, not alone. 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.
Welcome to Episode 2 with our upgraded video setup! Dr. Valorie Davidson and Dr. Robert Maki from Progress Your Health answer a thoughtful listener’s question: Why are my progesterone labs always low even on 200mg oral HRT? If you’re taking progesterone and worried about low numbers or uterine protection, this episode is for you. 💡 We cover: ‘ ● ⏱️ Why timing your blood draw makes or breaks your lab results ● 💊 The difference between sustained-release vs. instant-release progesterone ● 🧬 How genetic variants (like CYP enzymes) impact progesterone metabolism ● 🩺 When to get a transvaginal ultrasound to assess uterine lining health ● ✅ What blood level to aim for—and when to test it ● 💡 Bonus: How your detox pathways (and even caffeine tolerance!) can affect hormones 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.
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In this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki dive into a question from Sabrina about the accuracy and usefulness of saliva versus blood testing for hormone replacement therapy (HRT). 👉 Is saliva testing more accurate for transdermal Bi-Est creams? 👉 Why does your estradiol look low in bloodwork but high in saliva? 👉 Does skipping your hormones before testing give a better result—or just confuse the picture? 👉 What’s a true 80/20 Bi-Est ratio, and how can you read your prescription dose properly? 👉 Why might oral progesterone make you anxious instead of sleepy? You’ll learn: ● How to interpret blood and saliva test results when you’re on HRT ● The pros and cons of different testing methods (serum vs. saliva vs. urine) ● The real reason your progesterone might backfire and worsen sleep ● Why your estrogen dose may be too low—even if your labs say you’re “in range” ● How to work with your practitioner to adjust your HRT plan safely This episode is perfect for anyone on HRT who’s feeling confused about their labs, frustrated by persistent symptoms, or stuck between conflicting advice. 🧠 Bonus: Dr. Davidson breaks down estrogen ratios and cream dosing using real-world examples. 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 this episode of the Progress Your Health Podcast, Dr. Valorie Davidson and Dr. Robert Maki dive deep into a question from “Amber,” a 49-year-old woman struggling with extreme perimenopausal symptoms — despite being on progesterone, an estradiol patch, and thyroid medication. 🔍 Topics Covered: ● Why HRT (Hormone Replacement Therapy) might not be working ● Common perimenopause symptoms: sleep issues, fatigue, brain fog, weight gain ● The pitfalls of cookie-cutter hormone prescriptions ● How cortisol, stress, and over-exercising sabotage your hormones ● When estrogen dominance, low progesterone, and thyroid dysfunction overlap ● Could progesterone be making things worse? ● Why rhythmic hormone dosing may offer a better solution 💡 Learn why so many women feel dismissed or misdiagnosed during this transition—and how to find a treatment that actually works for your body. 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.
