Can Fatty Liver Cause Elevated ALT Levels?

Fatty liver, also known as hepatic steatosis, typically does not cause abnormal liver function tests in its early stages. However, when it progresses to non-alcoholic steatohepatitis (NASH), it can lead to elevated liver enzymes, including alanine aminotransferase (ALT). This occurs due to the accumulation of fat in liver cells, which leads to cellular stress and inflammation. As a result, the permeability of the cell membrane increases, allowing ALT and aspartate aminotransferase (AST) to leak into the bloodstream.

In the simple form of fatty liver disease, also called non-alcoholic fatty liver (NAFL), liver enzyme levels are usually within the normal range. In such cases, diagnosis often relies on imaging techniques such as ultrasound or CT scans, which can detect fat accumulation in the liver even when blood tests appear normal.

If left untreated, fatty liver can progress to more severe conditions such as fatty liver fibrosis or cirrhosis. In these advanced stages, liver function is significantly impaired, and elevated ALT levels become more common due to ongoing liver cell damage and inflammation. Therefore, it is crucial for individuals diagnosed with fatty liver to take preventive measures early on.

Waiting until liver enzymes become abnormal may mean the disease has already progressed to a more serious stage. Early intervention through lifestyle changes, such as weight loss, a balanced diet, and regular physical activity, can help reverse or halt the progression of fatty liver disease. Timely management is key to preventing complications like NASH, fibrosis, and ultimately, cirrhosis.