Exercise can significantly affect your blood test results, especially when it comes to liver enzymes. Understanding the function of the liver, its role in recovering and responding to exercise, and how this affects critical biomarkers in a blood test will help you better interpret your results and draw an accurate conclusion.
Liver Function: Do you have elevated liver enzymes?
The liver is a large organ located on the right side of the stomach. Its primary job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. Because it acts primarily as a filter, it is heavily involved in detoxification, especially in the elimination of heavy metals, drugs and other toxicities. The liver also dramatically affects metabolism, helping to regulate glycogen storage, decomposition of red blood cells, plasma synthesis and hormone production.
Due to its substantial involvement in many functions within the body, liver health is vital for optimal athletic performance, recovery from strenuous exercise and hormonal health. Some key aspects in which the liver affects these areas are (Source):
- Flushing and clearing excess quantities of hormones like estrogen and cortisol (this is especially beneficial for anti-aromatase efforts)
- Converting Vitamin D into a usable form
- Converting carbohydrates into glycogen (stored kind of energy)
- Converting glycogen into glucose (a usable form of energy)
- Breaking down fats for energy
If your goals involve increasing testosterone, building muscle, improving endurance, recovering faster from exercise and having more energy during the day, it is vital that your liver is functioning optimally. Monitoring key biomarkers can help assess the level in which the liver is working, and in what aspects you might want to support the organ.
Primary Liver Enzymes Measured in Blood Tests:
Many people make the mistake of not preparing for their blood test properly. Take the necessary precautions leading into your blood draw so you will have accurate results. Prior to your blood draw with your doctor or lab, make sure not to take supplements unless you have to, don’t drink alcohol or exercise heavily. Check out our blood test instructions.
AST and ALT (Alanine transaminase & aspartate aminotransferase)
These enzymes are indications of liver and muscle inflammation. Strenuous exercise such as weightlifting or distance running can abnormally elevate levels 1-2 times above the standard limit for as long as one week after exercise is completed. Those working out strenuously multiple times in a row many find that these levels are even more elevated the more intense their workouts are. Strength training also has a more drastic effect on ALT and AST levels than aerobic exercise. (Source)
GGT is less likely to be elevated by strenuous exercise than other markers like ALT, AST or Creatinine. In many research studies, it has been found that weightlifting exercises have led to elevated levels of ALT, AST and creatinine, but have caused no elevation in GGT levels 5. This indicates that muscle breakdown is occurring (likely due to exercise), rather than liver damage. GGT is often the only liver enzyme elevated (as in ALT and AST are in normal range) in the presence of alcohol or aromatic medications, but usually with no liver disease (source). However, cases where all three primary liver enzymes are elevated (ALT, AST and GGT), the possibility of liver damage should be considered and a physician should be consulted. (Source)
Ferritin is a protein that helps store and release iron when the body needs it. While this is a common biomarker checked when anemia or iron deficiency is suspected, Ferritin can also be increased in response to inflammation, infection or trauma. Ferritin is stored in many types of cells, including liver cells. Thus, elevated levels can be indicative of muscle cell damage due to strenuous exercise. High Ferritin that is coupled with normal serum Iron levels is considered to be the result of inflammation, not Iron deficiency. (Source: “Management of Elevated Serum Ferritin Levels.” Gastroenterology & Hepatology 4.5 (2008): 333–334. Print.)
Creatinine and BUN
Blood urea nitrogen (BUN) is the ratio between the production of urea and the clearance of urea in the body. It is formed almost entirely by the liver and is usually presented as a ratio with creatinine. While significantly low BUN and Creatinine levels are usually present with liver disease or damage, it is often caused by dehydration, which causes BUN levels to rise more than creatinine levels and creates a high BUN-to-creatinine ratio. This also highlights the usefulness of Creatinine and BUN levels in determining kidney function along with liver function. A high Creatinine level may indicate that your kidneys are under stress. In this case, kidney disease or blockage will cause both BUN and creatinine levels to go up. (Source)
Bilirubin and Albumin
Elevated levels of bilirubin are considered to be a marker for lowered risk of cardiovascular disease. Healthy elevations in bilirubin have also been known to be caused by increased exercise 10. However, higher levels of physical exercise are actually associated with lower albumin excretion. Liver dysfunction can also create a decrease in albumin levels, so it is essential to convey activity levels to your doctor when discussing blood test results. (Source, Source)
ALP (Alkaline Phosphatase)
In healthy athletes, ALP elevations up to 2 fold are common. In fact, a healthy person who trains hard or participates in strenuous exercise is likely to have the same elevation that is seen in patients with liver disease. It is crucial to consider this when looking at your liver test results. Need some proof? A recent study has found that exercising on an ergometer cycle until exhaustion causes a significant elevation in serum bone ALP isoforms. ALP is also a biomarker of the growth or healing of bones, so if you are recovering from a recent fracture don’t be too concerned about the elevated ALP levels you may see in your test results while healing as well. (Source)
Low levels of ALP have been associated with zinc deficiency (source). So if you’re looking to boost testosterone and improve your bone density, zinc supplementation is a must. Keep in mind, things in the body need to work in balance and zinc supplementation can deplete copper and vice vera. So we like Jarrow’s Zinc Balance. (affiliate link). You can also go dropper style from professional formula’s. (affiliate link)
When looking at liver enzyme levels, it is important to consider the multiple causes and how they might fit into your lifestyle. If you are ever concerned about elevated liver enzymes, talk to your physician to figure out what treatment plan is best for you.
Some actions steps and things to be aware of
- Sleep more
- Drink less alcohol
- Keep tabs on your prescription medications
- Ibuprofen and NSAIDs can negatively impact the liver
- Eat more healthy fat
- Eat nutrient and mineral dense foods. ie. veggies and fruit
- A great all around supplement for liver inflammation. DFH Hepatone (affiliate link)