What Is Transaminitis?

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Transaminitis is a term used to describe an elevated level of certain liver enzymes, called transaminases, in the blood. Transaminitis can be a sign that your liver is inflamed or has been damaged in some way.

There has been some debate over the usage of the word “transaminitis.” Many researchers use the word in their reports; some experts have written about how the word is not a true medical term. However, whether or not it gets the label transaminitis, elevated liver enzyme levels is certainly something that can and does happen. And if you do have higher-than-normal levels of transaminases in your blood, finding the cause is key.

What Are Transaminases?

The liver is a major organ in the body that has a variety of functions, including synthesizing different proteins, detoxifying different chemicals, and making digestive juices to help you break down food. Your liver has different enzymes, such as transaminases, to carry out all these functions.

Transaminases are mainly involved in the metabolism of amino acids, which are substances that help build proteins. Two of the main types of transaminases in the liver—and the levels of which are tested for transaminitis—are aspartate aminotransferase (AST) and alanine aminotransferase (ALT).

AST and ALT are both found in the blood in low concentrations among healthy people. When there is any sort of injury to the liver cells or liver disease is present, the enzymes escape from the cells and enter your blood. That means elevated transaminases—or transaminitis—can be a sign of some sort of liver inflammation or damage.

What Causes Transaminitis?

There are many potential causes of an increase in transaminase levels in your blood. Some common causes of transaminitis include:

Alcohol-related Liver Diseases

Alcohol-related liver disease can occur when you drink an excessive amount of alcohol. The liver helps break down alcohol, but excessive consumption can damage the liver over time. In alcohol-related liver diseases, AST will be elevated. This is one of the most common reasons for transaminitis.

Nonalcoholic Fatty Liver Diseases 

Nonalcoholic fatty liver disease (NAFLD) is liver damage not attributable to excessive alcohol consumption. With NAFLD, fat accumulates in your liver, resulting in damage to the liver cells. Over time, the fat accumulation can lead to an inflamed liver. Typically, both AST and ALT levels are elevated when you have NAFLD. NAFLD is one of the most common reasons for transaminitis.


Hepatitis is inflammation of the liver. The most common cause of hepatitis is a virus. There are several types of viruses that can cause hepatitis, including hepatitis B and C viruses. As the virus damages the liver cells, liver transaminases leak into the blood and cause transaminitis. Hepatitis is a less common cause of transaminitis.


Cirrhosis refers to scarring of the liver that is irreversible. High levels of ALT and AST may be a sign of damage from cirrhosis. Cirrhosis is most commonly caused by:

  • Alcohol-related liver disease 
  • Nonalcoholic fatty liver disease 
  • Chronic hepatitis C 
  • Chronic hepatitis B 

Certain Medications 

Your liver is responsible for metabolizing many medications, some of which can damage your liver and, in turn, raise the ALT in your blood. The medications can be prescribed or available over the counter. These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, statins, and drugs used to treat tuberculosis. Drug-induced liver injury is an uncommon cause of transaminitis.

Infectious Mononucleosis

Also known as mono, infectious mononucleosis can cause transaminitis. Mono is common among teenagers and young adults, causing symptoms like fever and fatigue. Less commonly, mono can cause a swollen liver. Research has shown that levels of AST and ALT are significantly higher among those with the infection.

Editor’s Note: Just because you have high levels of ALT or AST doesn’t automatically mean you have liver damage from a condition that needs to be treated. The following can affect your transaminase levels:

  • Age
  • Sex
  • Weight
  • Medications and supplements
  • Rigorous exercise
  • Menstruation

Transaminitis Symptoms

Transaminitis usually occurs when there is liver damage. That means rather than experiencing symptoms of transaminitis itself, you may experience symptoms of the underlying liver disease. Symptoms of liver disease include:

  • Jaundice, a yellowing of the skin and whites of the eye
  • Pain in the upper right part of your abdomen
  • Abdominal swelling
  • Nausea or vomiting
  • Loss of appetite
  • Dehydration
  • Fatigue or weakness
  • Weight loss
  • Dark urine or light stool
  • Frequent itching 

Impact of Transaminitis

The impact of the transaminitis will depend on what’s causing elevated transaminases in your blood. Your transaminases are often counted as part of a liver function test, a blood test that measures several aspects of your liver health. In about 8% of people who have a liver function test, liver enzymes, including transaminases, are elevated without any liver diseases. In some people, the elevated levels go back to normal levels on their own in three weeks.

In cases where the transaminases are much higher, treatment is necessary depending on the underlying cause. The higher the level of transaminases in your blood, the more likely your liver cells are damaged. Treatment is necessary in such cases.

How Is Transaminitis Diagnosed?

Tranaminitis can be diagnosed based on blood work results. Your healthcare provider may order the blood work to gauge your liver health as part of a routine preventive screening. They might also prescribe the blood work if you have any signs, symptoms, or family history of liver diseases.

Transaminase levels can be checked as part of a liver function test, which measures many liver enzymes and proteins using the same blood sample. Transaminase levels can also be checked in separate ALT and AST blood tests. You may have to fast before the tests.

If the blood tests reveal you have transaminitis, your healthcare provider will determine what is causing it. 

How Is Transaminitis Treated?

The treatment of transaminitis mainly involves diagnosing and treating the underlying cause that is causing elevated transaminases in the blood. 

For instance, if alcohol-related liver disease is causing transaminitis, the treatment mainly involves stopping alcohol consumption to minimize the liver damage. In cases of NAFLD, lifestyle modifications, such as maintaining a balanced diet and exercising, can improve your liver health.

If an infection is causing the transaminitis, treatment specific to the virus will be provided.

You may also need to undergo follow-up blood work to see how well treatment is working and to monitor liver health.


Transaminitis can occur for a variety of reasons. While some of the causes of transaminitis are not under your control, some causes that can be prevented. Things you can do to reduce the risk of transaminitis include:

  • Cutting down on alcohol consumption: Long-term excessive consumption of alcohol can lead to liver damage, so drinking less alcohol can reduce the risk of liver damage.
  • Making lifestyle modifications: You can try to prevent NAFLD by eating a balanced diet and getting regular exercise. You can try to prevent mono by not sharing drinks or utensils with other people.
  • Evaluating medications: While less common, certain medications can damage your liver to a degree that causes transaminitis. You can ask your healthcare provider about the risk or transaminitis and possible alternatives. You can also report any unusual side effects as soon as you notice them.
  • Getting vaccinated: Hepatitis B and C are the types of hepatitis more likely to cause transaminitis. While there is no vaccine against hepatitis C, there is a vaccine to protect yourself against hepatitis B. Getting the vaccine can help protect you against the infection and any liver damage it might cause.

A Quick Review

Transaminitis is the term used to describe an elevation in your blood of liver enzymes known as transaminases. The two main transaminases that are measured to determine transaminitis are aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes. These enzyme levels can become elevated due to damage or a disease process occurring in the liver cells. Alcohol-related liver disease and nonalcoholic fatty liver disease are the two most common reasons for transaminitis. Other potential causes are infections and medications. A blood test would confirm transaminitis and a healthcare provider can help determine what the underlying cause is to figure out if you need treatment. The aim of treatment would be getting the enzyme levels back to normal levels, and the pathway to that depends on the underlying cause of the elevation. 

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15 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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