The liver is the organ most responsible for clearing toxins out of the body. In the menopause years, eliminating excess estrogen and cell-damaging substances is especially important because of their impact on menopausal symptoms and hormone balance. One other effect of menopause on the liver is the risk of high liver enzymes. 

What are high liver enzymes?

Liver enzymes are proteins that accelerate chemical processes in the body, such as making bile, fighting infection, and metabolizing toxins and food. High or elevated liver enzymes may be a temporary condition or signal a medical issue, such as liver disease. 

Read about the importance of a healthy liver

The more common liver enzymes are:

• Alkaline phosphatase (ALP) is important for breaking down proteins.
• Alanine transaminase (ALT) is necessary for converting proteins into energy for liver cells, removing toxins from the blood, and making bile.
• Aspartate transaminase (AST) is an important enzyme for the metabolism of amino acids.
• Gamma-glutamyl transferase (GGT) helps metabolize drugs and other toxins.

High levels of any of these enzymes indicate damage or injury to the liver, so it’s important to have these levels checked routinely with a liver function test or liver panel. 

How high liver enzymes are associated with menopause

Declining estrogen, along with aging, can be a challenging situation. Estrogen may protect your cells’ powerhouses (mitochondria) in the liver. When this protection is compromised by fading estrogen, liver damage can occur.

As noted by the authors of an article appearing in the World Journal of Gastroenterology, “In menopause, the interplay of reductions in estrogen levels along with biochemical effects of the aging process fosters an environment that increases the propensity for damage within the liver.” 

In a study that looked at changing liver enzymes and triglycerides during the menopausal transition, researchers noted that levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) rose in early postmenopause and that AST stayed high in late postmenopause. The ratio of AST/ALT decreased in the late menopausal transition and very early postmenopause but then increased. Overall the authors reported, “Significant changes in ALT and AST/ALT ratio during the menopausal transition, which were associated with triglyceride, might be involved in the occurrence of metabolic syndrome and NAFLD [non-alcoholic fatty liver disease].” 

Read about fatty liver: what is it and how to get rid of it naturally

How to manage high liver enzymes naturally

Several lifestyle changes can help lower elevated liver enzyme levels and thus the risk of developing various liver problems, ranging from liver cancer to hepatitis, non-alcoholic fatty liver disease, and fibrosis.  

Drink coffee: Drinking coffee can reduce levels of liver enzymes. Research has shown that consuming coffee can reduce the risk of liver cancer, various liver diseases, and the ability of hepatitis C virus to replicate.  

Lose weight: If you are overweight, losing excess pounds can help prevent liver fibrosis, reduce inflammation, and fight fatty liver disease.

Boost folic acid intake: Take better care of your liver and reduce the risk of damage by increasing your intake of folic acid. The best foods to focus on are asparagus, avocado, Brussels sprouts, black-eyed peas, fortified breakfast cereals, lettuce, and spinach. The use of supplements is an option. Research shows that 0.8 milligrams of folic acid daily may help lower liver enzyme levels.

Change your diet: Eat more plant protein, vegetables, and fiber, and avoid processed foods, especially those high in sugar, salt, fat, and fried foods.

Avoid toxins: These come in various forms, including alcohol, food additives, nicotine, drugs, pesticides, chemicals in personal care products and household cleaners, and more. All of these substances can overburden the liver and elevate liver enzymes. 

Take herbs: Milk thistle, holy basil, and turmeric are reported to have the ability to help detox the liver. A study of milk thistle in people with non-alcohol fatty liver disease, for example, found that the herb improved liver enzymes. 

When to contact your doctor

If you have elevated levels of any of these enzymes, you may not know it because most people don’t have symptoms. However, you should consult with your healthcare provider if you experience symptoms associated with high enzyme levels, including abdominal pain, dark urine, itching, jaundice, loss of appetite, nausea and vomiting, and fatigue.

Bottom line

Elevated liver enzymes are not uncommon among women in their perimenopause and menopause years. To help maintain healthy liver enzyme levels and liver function, have your doctor order a liver enzyme test and report any symptoms of elevated liver enzymes.