Would alcohol consumption on Saturday cause significant elevation of liver enzymes, such as Alanine Transaminase (ALT) and Aspartate Transaminase (AST), on blood work the following week?

From the Guidelines

Drinking alcohol on Saturday is unlikely to cause significant liver enzyme elevation on blood work the following week if the consumption is moderate (1-2 drinks) and the individual has no pre-existing liver disease. However, heavy drinking (more than 4-5 drinks in one sitting) can cause temporary elevations in liver enzymes like ALT, AST, and GGT that might still be detectable several days later, as indicated by the EASL clinical practice guidelines for the management of alcohol-related liver disease 1. For someone with existing liver disease or who drinks regularly, even moderate alcohol consumption could lead to more pronounced and longer-lasting elevations. Some key factors to consider include:

• The amount of alcohol consumed: above a daily consumption of 30 g/day, or a weekly consumption above seven units in women and 14 units in men, the risk of developing ALD is increased 1
• The pattern of drinking: drinking alcohol outside meals, and consuming more than one type of alcoholic beverage increased the risk of cirrhosis 1
• The presence of other risk factors: such as cigarette smoking, which tripled the risk of ALD compared to non-smokers, irrespective of alcohol consumption 1
• The timing of the blood test: enzyme levels typically peak 12-48 hours after drinking and then gradually return to normal over several days. If you're scheduled for liver function tests, it's best to avoid alcohol completely for at least 3-5 days beforehand to ensure accurate results, considering the liver's metabolism of alcohol and the temporary stress this places on liver cells 1.

From the Research

Liver Enzyme Elevation After Drinking on Saturday

• The elevation of liver enzymes after drinking on Saturday can be significant, depending on the amount and pattern of alcohol consumption 2, 3, 4, 5.
• Studies have shown that heavy drinking (≥24 g/day) can lead to a significant increase in liver enzymes, such as gamma-glutamyl transferase (GGT) and aspartate aminotransferase (AST) 2, 4.
• The pattern of drinking also plays a role, with weekend drinking being associated with higher levels of GGT in women 3.
• Binge drinking, even in those with low-risk overall consumption, can lead to higher GGT and ALT activities 5.
• The frequency and amount of alcohol consumption can have a cumulative effect on liver enzyme elevation, with higher consumption leading to greater elevation 4, 5.

Factors Influencing Liver Enzyme Elevation

• Metabolic syndrome, cigarette smoking, and excess body weight can modulate the thresholds for significant liver enzyme elevation towards smaller quantities of alcohol 2, 4.
• Physical inactivity and smoking can also increase the risk of abnormal liver enzyme activities 4.
• Age over 40 years can also influence the risk of liver enzyme elevation, with older individuals being more susceptible to the effects of alcohol consumption 4.

Clinical Interpretation of Liver Enzyme Elevation

• Abnormal liver biochemical tests can be categorized based on the pattern and magnitude of aminotransferase elevation 6.
• Hepatocellular pattern causes, including alcohol use, can lead to mild, moderate, or severe elevation of aminotransferases 6.
• Accurate interpretation of liver enzyme elevation is crucial for appropriate further workup, treatment, and referral 6.