What Is Transaminitis?

Written by Nichole Owens
Medically Reviewed by Shruthi N, MD on May 01, 2025
6 min read

The largest solid internal organ in your body is the liver. It performs over 500 functions, including cleaning toxins from your blood and breaking down nutrients from food to produce energy. It does a lot of this with enzymes, which are proteins that help speed up the chemical reactions in your body.

Transaminitis is when you have high levels of an enzyme known as transaminase in your blood. Two of the most common enzymes are alanine transaminase (ALT) and aspartate transaminase (AST). Transaminitis means your liver is stressed. It can happen because of certain diseases, medicines, or substance abuse.

Juan Pablo Arab, MD, associate professor of medicine in the Gastroenterology, Hepatology, and Nutrition division at Virginia Commonwealth University School of Medicine, says making certain lifestyle changes may help lower your liver enzymes.

“Avoiding alcohol, managing body weight, exercising, and controlling diabetes can significantly improve liver health,” he says. “And avoid unnecessary supplements or medications, too. Many herbal supplements marketed for ‘liver health’ can paradoxically harm the liver.”

When your liver cells are injured or inflamed, they leak more enzymes into your bloodstream than normal. There are a lot of different diseases and conditions that can damage your liver cells.

Some of these include:‌‌

Nonalcoholic fatty liver disease (NAFLD) 

Nonalcoholic fatty liver disease happens when too much fat builds up in the liver of people who don’t drink too much alcohol. It’s the most common cause of transaminitis in the world.

Some cases of NAFLD can progress into more serious forms of liver disease that can cause liver failure. Scientists don’t know exactly why some people develop NAFLD, but it has been linked to:

  • Being overweight or obese
  • Having high levels of fat, especially triglycerides, in your blood
  • Being resistant to insulin, which happens when your cells don’t take up sugar when your body releases insulin
  • Having high blood sugar, such as with prediabetes or type 2 diabetes

Alcoholic liver disease (ALD) 

Alcoholic liver disease includes a range of diseases that are caused by drinking alcohol. Alcohol is broken down by your liver. Drinking too much alcohol can damage your liver and cause alcoholic liver disease.

Alcoholic liver disease can progress to steatohepatitis, which is an inflammation of the liver along with fatty liver or cirrhosis. There is no direct link between how much you drink and ALD. Some heavy drinkers never develop liver problems, while some moderate drinkers develop ALD. ‌

Some liver injuries can result from binge drinking over several days. Anyone with any form of ALD needs to quit drinking completely to prevent further liver damage or death.

Viral hepatitis 

Hepatitis means inflammation of the liver. When this inflammation is caused by a virus, it’s called viral hepatitis. There are five types of viral hepatitis, but the three most common are:

Hepatitis A. It is highly contagious and can make you sick for a few weeks to a few months. You usually get it from contaminated food or water, or by being in close contact with someone who has it. Mild cases usually don’t need treatment, and most people recover without liver damage. There’s a vaccine for hepatitis A that’s routinely given to children between 12 and 23 months of age. If you didn’t get the vaccination as a child, it’s available and effective for adults, too. ‌

Hepatitis B. It’s primarily spread through bodily fluids, including blood and semen. It can lead to chronic liver infection and liver cancer. About half of the people with hepatitis B don’t realize they have it. Like hepatitis A, there’s a safe and effective vaccine against hepatitis B that’s routinely given to infants and children. It’s also available to anyone who wants it.

Hepatitis C. It is spread through contact with the blood of someone who’s infected. Hepatitis C can be a mild infection that lasts a few weeks, but most people who get it will develop a chronic infection that can be lifelong. Unfortunately, there’s currently no vaccine for hepatitis C. But there is an 8- to 12-week course of medicine that can cure up to 90% of people with chronic hepatitis.

Rare causes also include conditions such as alpha1-antitrypsin deficiency, autoimmune hepatitis, and Wilson’s disease. 

Transaminitis itself doesn’t cause symptoms, but underlying liver disorders can. These symptoms include:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Weakness
  • Tiredness
  • Stomach pain or fullness
  • Yellow color of the skin or whites of the eyes (jaundice)
  • Urine that is dark or looks like tea
  • Stool that is light in color
  • Itching

To diagnose transaminitis, your doctor will probably do a physical exam and take your full medical history. They’ll also order blood tests to check your liver function and look for increased levels of the enzymes AST and ALT, as well as certain proteins. 

Liver function blood tests are usually ordered: 

  • As part of routine blood tests during a yearly physical
  • If you have symptoms of liver disease
  • If you are at risk for liver disease
  • To monitor the treatment of liver disease

If your blood tests show you have higher-than-normal levels of the AST and ALT enzymes, your doctor will need to check why. If you’re having any other symptoms, they’ll treat those first, especially if you need critical care for something like liver failure. Other symptoms might be treatable with medications. Your doctor may run more tests and screenings before they come up with a treatment plan.

Treating transaminitis depends on the cause, but it may include:

  • Abstaining from alcohol
  • Losing weight if needed
  • Exercising
  • Changing your diet to avoid red meat, trans fats, high fructose corn syrup, and processed carbohydrates
  • Medicines
  • Tracking your liver function
  • Liver transplant

Arab says if your liver enzymes remain high after repeat tests and your doctor isn’t sure why, it’s important to see a hepatologist or gastroenterologist.

Transaminitis is a condition where your liver enzyme levels are higher than normal. It can happen because of disease, medication, or alcohol use. In many cases, you have no symptoms, and your doctor learns that your liver enzymes are higher than normal during routine blood tests.

In many cases, your liver enzymes go back to normal levels once you treat the cause.

Can transaminitis be cured?

Transaminitis refers to higher levels of liver enzymes, indicating liver inflammation or injury. Once your doctor treats the cause of this inflammation, your enzyme levels will typically go back to normal.

What cancers cause elevated liver enzymes?

Several cancers can cause increased liver enzymes. These include:

  • Liver cancers
  • Cancer that has spread from the breast, pancreas, lung, or digestive tract
  • Leukemia
  • Lymphoma

If you have increased liver enzymes, that doesn’t mean you have cancer. Talk to your doctor about your concerns.

What else causes liver enzymes to be elevated?

Several things can cause your liver enzymes to be higher than normal, such as:

  • Alcohol-associated liver disease
  • Viral hepatitis (Hepatitis A, B, C, D, E)
  • Liver injury caused by medication (acetaminophen, antibiotics, herbal supplements)
  • Genetic liver diseases

Talk to your doctor if you have questions.

Is transaminitis life-threatening?

On its own, no. But if your blood test shows higher-than-normal liver enzymes, you may have an underlying liver problem that needs attention. Your doctor will find the source of the problem and work with you on the right treatment.