From the Guidelines
Low liver enzymes are generally not a cause for concern and often represent normal variations in liver function, which can be influenced by various factors including genetic predisposition, nutritional deficiencies, and certain medications. When considering the potential causes of low liver enzymes, it's essential to evaluate the role of medications, as certain drugs can suppress liver enzyme production. According to a study published in Gut 1, medications such as statins, some antibiotics, and anti-inflammatory drugs can lower liver enzymes. Additionally, conditions like hypothyroidism can also contribute to low liver enzyme levels by slowing down metabolic processes. Some key points to consider when evaluating low liver enzymes include:
- Genetic factors, such as alpha-1 antitrypsin deficiency, can also play a role in low liver enzyme levels, as noted in a study published in the American Journal of Respiratory and Critical Care Medicine 1.
- Nutritional deficiencies, particularly vitamin B6 deficiency, can also contribute to low liver enzyme levels.
- Advanced liver damage, although uncommon, can also result in low liver enzyme levels, typically accompanied by other abnormal test results.
- Regular monitoring of liver function is often recommended for individuals with low liver enzyme levels but no symptoms, rather than immediate treatment. It's crucial to address any underlying conditions that may be contributing to low liver enzyme levels, such as hypothyroidism or nutritional deficiencies, to help normalize levels.
From the Research
Causes of Low Liver Enzymes
- Subnormal levels of liver enzymes can be caused by various factors, including vitamin B6 deficiency and chronic kidney disease, which can lead to low levels of aminotransferases 2
- Hypophosphatasia, Wilson's disease, deficiencies of divalent ions, and malnutrition can cause subnormal alkaline phosphatase levels 2
- Acute intrahepatic cholestasis, certain medications, and bone disease can result in subnormal levels of gamma glutamyl transferase 2
- Lead poisoning and nonspherocytic hemolytic anemia have been associated with subnormal levels of 5'-nucleotidase 2
Nutritional Deficiencies and Low Liver Enzymes
- A gluten-free diet, often necessary for individuals with celiac disease, can lead to nutrient deficiencies, including low levels of vitamin B6, vitamin D, and other essential micronutrients 3, 4
- These nutritional deficiencies can contribute to low liver enzyme levels, highlighting the importance of a balanced diet and proper nutrient intake 3, 4
Autoimmune Diseases and Low Liver Enzymes
- Autoimmune thyroid diseases, such as Hashimoto's thyroiditis, have been linked to celiac disease and may be associated with low liver enzyme levels 5, 6
- Vitamin D and iron deficiencies, common in individuals with celiac disease and autoimmune thyroid diseases, may also contribute to low liver enzyme levels 5, 6