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Can Exercise Affect Liver Enzymes?

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Southwest Integrative Medicine

Have you recently discovered you have elevated liver enzymes maybe you've been exercising more and you want to know can exercise affect elevated liver enzymes.  in this video we're going to look at that specific question we're going to look at how much exercise would potentially cause this, the difference between being trained and untrained in causing elevated liver enzymes, how long the liver enzymes might be elevated if you are exercising and potentially causing your body to have higher liver enzymes and what is actually meant by liver enzymes are these enzymes really just in your liver or are they found in other places?Can Exercise Affect Liver Enzymes?

Several people have asked this question about the effect of exercise on elevated liver enzymes.  This article will specifically address this topic in detail.  Fist we will  look at a case example of someone that had elevated liver enzymes specifically from exercise.  Then we will look at a research study that looks at the effect of exercise on elevated liver enzymes. 

The case example documents a female graduate student that presented to determine whether or not she was eligible for a pharmacological study involving a new psychiatric medication.  She did not consume much alcohol but did drink one to two times a week.  We would typically expect higher consumption is needed to cause elevated liver enzymes.  They also did a physical exam on her which was all normal.  The laboratory assessment was not however.  In this they found elevated alanine amino transferase which is ALT at a level of 87 so moderately high.  They also found AST was also high at 120.  She also had elevated lactate dehydrogenase and creatinine kinase.  Other than these findings she was otherwise very healthy young female, as far as she knew.  With now real symptoms these findings were a surprise for her too. While reviewing the results with her she did report that she had been training a lot more for a "ToughMudder."  Once she stopped the exercise altogether, three weeks later her repeated results were in the normal range.  This just illustrates the fact that these liver enzymes are also highly concentrated and muscle.  Yes they are more concentrated in the liver but they are also very abundant in other tissues too, specifically the muscles.  AST is in cells of muscle, heart, kidneys, red blood cells, the brain, and the small bowel.  ALT is present in the cells of liver, muscle, and kidneys.

If you look at it on the larger scale, since our muscles have a larger mass than your liver does they contain more AST and ALT enzymes overall.  They are just more concentrated in liver cells.  So if you are doing a full body workout, it's possible to get elevated liver enzymes from this, depending on your training level.   You can get elevated liver enzymes from simply exercising.  Tissue damage in muscle occurs with exercise in a dose dependent manor.  As you ramp up the intensity of exercise you're going to get more muscle damage especially if you're not trained. 

This also brings in a larger point that elevated liver enzymes can be signs of other tissue damage too, not just muscle but heart kidney etc.  You can also have an elevation in these enzymes from hemolysis which is just breaking open of red blood cells.  Heart attack and small bowel damage from ischemia or lack of blood flow also can raise these enzyme levels. 

This study does go into more detail on some of these things. It specifically looks to answer the question of the effect of exercise on liver enzymes.  The study enrolled healthy male subjects to perform weight lifting exercises.  They choose people that were not trained at all or exercises that the people were not used to doing.  The exercise was done for about one hour.  The results showed significant increases in AST, ALT, lactate dehydrogenase, creatinine kinase and myoglobulin (a muscle protein) levels.  What was kind of interesting to me when reading this study is that the effects of this were prolonged.  Most subjects still had increased enzyme concentrations one week after performing the weightlifting program.  This was in line with other studies looking to answer this question too.  They found using strenuous onearm exercises resulted in significant muscle damage and increases in liver enzymes which are also muscle enzymes or up to ten days after the exercise. 

By the way AST and ALT are typically referred to as liver enzymes and generally we call them liver function tests and liver enzymes.  As noted above, they are in other tissues.  Just because we call them liver enzymes doesn't mean they can't be in other tissues.  It is the enzymes within the cells themselves that are spilling out into the blood.   When those tissues and cells are damaged, the contents of the cells go into the blood.  So whether there's damage to the liver, the kidneys, the muscles you can see elevations in these enzymes.  The liver is just the more common culprit.

posted by aber92