The liver is the largest organ in the body. It performs a wide range of biochemical, secretory and excretory functions such as
- Metabolism of fats, carbohydrates, and proteins.
- Storage of nutrients like vitamins A, B12 and D, amino acids, glycogen, iron, and folic acid.
- Synthesis of immunoglobulins, clotting factors, hormone binding proteins, and steroids.
- Secretion of bile
- Excretion of cholesterol, bile pigments, toxins, bacteria and heavy metals (lead, bismuth, arsenic) through bile.
- Heat production due to metabolic activities
The Table Below Mentions Two Major Liver Enzymes Along with their Normal Reference Ranges
|Sr. No.||Liver Enzyme||Normal Reference Range|
|1.||SGOT (Serum Glutamate Oxaloacetic Transaminase)
It is also known as AST (Aspartate Aminotransferase)
|17 – 59 units per liter|
|2.||SGPT (Serum Glutamic Pyruvate Transaminase)
It is also known as ALT (Alanine Aminotransferase)
|0 – 35 units per liter|
High SGOT And SGPT Levels
- SGOT is found in red blood cells and also in organs such as liver, heart, pancreas, and kidneys. Damage to these results in the release of SGOT into blood circulation.
- SGPT is found exclusively in the liver. Therefore any conditions of the liver will show high SGPT levels in the blood.
- Both SGPT and SGOT are frequently found elevated in conditions which cause extensive hepatocellular necrosis (destruction or death of cells or tissues of the liver).
High SGOT Level Symptoms
High SGOT levels can be asymptomatic. Since a high SGOT level is not a separate clinical entity, the presenting signs and symptoms will correspond to the underlying medical condition. Signs and symptoms related to high
SGOT levels are
- Fever with chills, loss of appetite, weakness, and diarrhea
- Nausea and vomiting is a constant feature.
- Abdominal fullness, bloating or even ascites (accumulation of fluid within the abdominal cavity)
- Yellowish discoloration of skin and eyes (icterus) along with itching of the skin
Drug Induced Hepatitis
- A history of taking medicines before the onset of signs and symptoms is elicited by patients.
- Signs and symptoms are similar to that of hepatitis such as abdominal fullness, nausea, vomiting, loss of appetite and fever occasionally.
Congestive Cardiac Failure
- Chest pain may be present along with difficulty in breathing, wheezing and swelling over feet and ankles.
- Irregular heartbeat and rapid breathing.
- Bluish discoloration of skin over extremities (Cyanosis).
Causes For High SGOT Levels
- Moderately elevated SGOT levels can suggest damage to the liver or other tissues as in alcoholics.
- Very high levels of SGOT can be found in recent liver injury or infection involving the liver.
- SGOT levels tend to be higher than SGPT in non-hepatic conditions such as shock and congestive heart failure.
- SGOT levels higher than 1000 units/L are usually due to viral or drug-induced hepatitis.
Diagnosis Of SGOT
- To diagnose high SGOT levels, your doctor by simply advising you to undergo a liver function test or a specific “SGOT” test to determine the exact count.
- Liver function tests are performed as a routine test when a patient is admitted to the hospital with shock, congestive heart failure or hepatitis.
- Suitable laboratory tests and radiological investigations may have to be done to arrive at a confirmatory diagnosis of the underlying condition.
How To Lower High SGOT Levels?
Treatment for lowering SGOT levels depends entirely upon the underlying clinical condition. There are no medications which work directly towards lowering SGOT levels. If you have been admitted to the hospital for any of the above-mentioned conditions, the treatment approach is likely to be a comprehensive one which includes the following
- Antibiotics or antiviral medicines to manage infection
- Intensive care unit management is required to treat congestive cardiac failure
- Medications to improve the functioning of the liver
- Supportive medications for symptoms like fever, abdominal pain, nausea, and vomiting.
- Alcoholic hepatitis may require counseling following treatment
High SGPT Levels Symptoms
SGPT levels are found raised (>50 U/L) in conditions where the liver cells and tissues are damaged. Therefore signs and symptoms for high SGPT levels will correspond with the underlying cause
- Hepatitis can be due to viruses A, B, C, D or E.
- Fever with chills may be present.
- Nausea, vomiting, and diarrhea are seen
- Abdominal fullness due to enlargement of the liver may be present
- Yellowish discoloration of the skin (icterus) with itching is seen due to high bilirubin levels. This condition is often called jaundice.
- This is a contagious illness caused by Epstein Barr Virus (EBV).
- Fever and sore throat along with enlarged lymph nodes of the neck are common symptoms.
- Liver and spleen are found enlarged in several cases with EBV infection.
Alcoholic Liver Disease
Patients with a history consuming alcohol in large quantities over a long period of time tend to show deranged liver function test results. Such patients are known to have “Alcoholic Liver Disease”. This term encompasses both entities “Alcoholic Hepatitis” and “Liver Cirrhosis”.
- In alcoholic liver disease, there is oxidative damage to liver cells. This causes inflammation to occur. The inflamed and damaged liver cells are replaced by scar tissue. Features of hepatitis are seen even in alcoholic hepatitis. As and when scar tissue starts to replace normal, healthy liver cells, the liver size and shape alters along with a decline in its ability to carry out normal functions.
- Shrinkage of the liver due to fibrosis is called liver cirrhosis.
- The enlarged abdomen is seen due to the accumulation of fluid.
- Yellowish discoloration of the skin (Icterus)
- A patient with liver cirrhosis shows a gradual decline in function of other organs as well especially the kidneys and hence the prognosis is poor in liver cirrhosis.
High SGPT Levels Causes
Since SGPT is found mostly in the liver, its presence in blood is associated with conditions of the liver such as
- Infectious mononucleosis
- Excess alcohol consumption
- Heavy use of acetaminophen
- Excess exposure to chemicals such as chloroform
- Tumors of liver
- Liver cirrhosis
Diagnosis Of High SGPT
Similar to SGOT, the presence of high levels of SGPT in blood is not a separate clinical condition, but a result of some serious underlying pathology.
High SGPT levels can be suspected if one of the above causative conditions is in the picture. Your doctor will then advise you liver function test or a simple test for SGPT count.
How To Lower High SGPT Levels?
Lowering SGPT levels requires treatment of the underlying cause
- Patients with alcoholic liver disease need appropriate counseling and detoxification unless changes of liver cirrhosis have set in.
- Antibiotics or antiviral medications may have to be given to control damage to liver cells due to infection.
- Antidote treatment is administered in cases of liver disease arising out of the abuse of acetaminophen and exposure to heavy chemicals.
- Tumors of liver need to be diagnosed and treated according to their type.
- Supportive therapy is given to managing signs and symptoms like fever, abdominal pain, nausea, vomiting, diarrhea, and itching.
SGPT and SGOT are generally raised in all clinical conditions which involve the liver. Rarely are these two enzymes tested singly. Doctors dig into the history of sign and symptoms and perform an entire liver function test profile in order to correctly diagnose the cause behind raised SGOT and SGPT levels.