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Transaminitis is a medical term used to describe elevated levels of liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in the bloodstream. It is not a disease itself but rather a sign of an underlying issue affecting the liver. Transaminitis can be a concerning finding, as it may indicate liver damage or disease. In this article, we will delve into the causes, symptoms, diagnosis, and management of transaminitis.

Causes of Transaminitis

  1. Hepatitis: One of the most common causes of transaminitis is viral hepatitis, which includes hepatitis A, B, C, and E. These viruses can cause inflammation and damage to the liver, leading to increased ALT and AST levels.

  2. Non-Alcoholic Fatty Liver Disease (NAFLD): NAFLD is a condition characterized by the accumulation of fat in the liver. It can lead to inflammation and elevated liver enzymes. In more severe cases, it can progress to non-alcoholic steatohepatitis (NASH), which can cause liver fibrosis and cirrhosis.

  3. Alcohol Consumption: Excessive alcohol consumption can damage the liver and elevate liver enzyme levels. Alcoholic liver disease ranges from fatty liver to alcoholic hepatitis and cirrhosis.

  4. Medications: Certain medications, such as statins (used to lower cholesterol), acetaminophen (Tylenol), and some antibiotics, can cause transaminitis as a side effect.

  5. Autoimmune Diseases: Conditions like autoimmune hepatitis and primary biliary cirrhosis can trigger the immune system to attack the liver, leading to elevated liver enzymes.

  6. Hemochromatosis: This hereditary disorder causes the body to absorb and store too much iron, leading to iron buildup in the liver, which can cause liver damage and transaminitis.

  7. Wilson’s Disease: Wilson’s disease is a rare genetic disorder that causes copper to accumulate in the liver and other organs. This can result in liver damage and elevated liver enzymes.

Symptoms of Transaminitis

Transaminitis itself does not typically cause symptoms. Instead, symptoms are usually related to the underlying condition causing the elevated liver enzymes. Common symptoms of liver disease or damage may include:

  1. Fatigue
  2. Jaundice (yellowing of the skin and eyes)
  3. Abdominal pain or discomfort
  4. Dark urine
  5. Pale-colored stools
  6. Nausea and vomiting
  7. Loss of appetite
  8. Unexplained weight loss


Diagnosing transaminitis involves a combination of medical history, physical examination, and laboratory tests. A healthcare provider will typically start with blood tests to measure ALT and AST levels. If these enzymes are elevated, further tests may be necessary to identify the underlying cause. These tests may include:

  1. Hepatitis panel to check for viral infections
  2. Imaging studies like ultrasound, CT scans, or MRI to assess the liver’s condition and detect any abnormalities
  3. Liver biopsy to evaluate liver tissue for signs of inflammation, fibrosis, or cirrhosis
  4. Blood tests for autoimmune markers or markers of other liver diseases

Management and Treatment

The treatment of transaminitis depends on its underlying cause. Here are some common approaches to managing transaminitis:

  1. Lifestyle Changes: For conditions like NAFLD, weight loss, a healthy diet, and regular exercise can help reduce liver fat and lower enzyme levels.

  2. Medication Adjustments: If transaminitis is a side effect of medications, your healthcare provider may adjust your medication or prescribe an alternative.

  3. Antiviral Therapy: In the case of viral hepatitis, antiviral medications may be prescribed to manage the infection and reduce liver enzyme levels.

  4. Alcohol Cessation: For individuals with alcoholic liver disease, quitting alcohol is essential to prevent further liver damage.

  5. Management of Underlying Diseases: Autoimmune diseases and genetic disorders causing transaminitis may require specific medications or treatments to manage the underlying condition.

  6. Regular Monitoring: People with transaminitis should undergo regular follow-up appointments and monitoring to track liver enzyme levels and assess the effectiveness of treatment.


Transaminitis is not a disease but rather a sign of underlying liver damage or disease. Timely diagnosis and appropriate management are crucial to address the root cause and prevent further liver damage. If you have elevated liver enzymes, it’s essential to consult with a healthcare professional for a thorough evaluation and personalized treatment plan. Lifestyle changes, medication adjustments, and treatments tailored to the underlying condition can help manage transaminitis and promote liver health.



Written by Jack Smith

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