How to Lower Liver Enzymes, and How Fast

The single most useful thing you can do is work with your healthcare provider to find the cause, because the right fix depends entirely on what's behind the number. Your provider may order more blood work or imaging, like an ultrasound, to figure out why your levels are up (1).

Some of the most common reasons enzymes run high include:

• Fatty liver disease linked to weight, blood sugar or metabolism
• Alcohol
• Certain medications, like statins or acetaminophen
• Some herbal and vitamin supplements
• Viral hepatitis and other infections

Not every elevation is serious, and some settle on their own. But you won't know which kind you have without that first conversation.

Make a full list of everything you take, including over-the-counter pain relievers, vitamins, herbs and powders, and share it with your provider. Plenty of everyday products are processed by the liver, and some can nudge enzymes up (1).

Acetaminophen is the big one to know. The FDA says adults should never take more than 4,000 mg in 24 hours, and that severe liver damage may occur if you have three or more alcoholic drinks a day while using it (2). It's in a lot of cold and flu combos, so check labels.

Yes, that list includes ours! If you take The Plug Pills, which contain milk thistle, add them to the list too. Milk thistle has a long traditional history, but NCCIH notes there isn't enough high-quality evidence to draw firm conclusions about its effects on health conditions (3), so your provider should know about it.

If you drink, cutting back is one of the most direct ways to take pressure off your liver. Your liver processes almost all of the alcohol you drink, and while your provider figures out the cause, many will suggest pausing it altogether. If you do drink, the CDC's guidance is 2 drinks or less in a day for men and 1 or less for women (4).

Curious what actually happens after that second glass? We broke it down in The Effects of Alcohol Explained. Swapping in sparkling water with lime on weeknights is an easy place to start. And if you smoke, add quitting to the list. Your whole body, liver included, will be better for it.

When excess weight and fatty liver are part of the picture, gradual weight loss is one of the best-supported changes there is. According to the NIDDK, losing at least 3% to 5% of your body weight can reduce fat in the liver, and you may need to lose up to 7% to 10% to reduce inflammation (5).

To put that in real numbers, 5% of 200 pounds is 10 pounds. That's a goal you can work toward over months, not days.

Slow and steady really does win here! Doctors recommend losing weight gradually, since rapid weight loss and malnutrition can make liver problems worse (5). Crash diets and extreme cleanses are the wrong tools for this job. If you have diabetes, keeping your blood sugar in your target range is part of this step too (1).

A liver-friendly plate looks a lot like the Mediterranean way of eating: plenty of plants, whole grains and healthy fats, with fewer processed foods. The NIDDK recommends a healthy eating plan for fatty liver and specifically calls out limiting foods and drinks with lots of simple sugars, especially fructose (6).

• Vegetables and fruit at most meals
• Whole grains like oats, brown rice and quinoa
• Beans, lentils, fish and poultry for protein
• Olive oil, nuts and avocado instead of butter and fried foods
• Fewer pastries, white bread and packaged snacks

You don't need a special detox or juice cleanse. Your liver already does that work for you, and whole foods help it along. Cooking a few more meals at home makes all of this so much easier, since you control what goes in the pan.

What you drink matters as much as what you eat. Sweetened sodas, sports drinks, sweet tea and juice are some of the biggest sources of added fructose in most diets (6), so trading them for water is a meaningful change.

Coffee lovers, we have good news. Research on coffee and liver health has been encouraging, and Cleveland Clinic's liver specialists say black coffee is best, since sugar and cream work against you (7). The science is still being worked out, so think of coffee as a nice bonus, not a treatment.

If you want something besides water in the evening, The Plug Drink is a small bottle of 13 Korean botanicals with electrolytes, 15 calories, no added sugar and no caffeine. Enjoy it alongside your water, not instead of it.

Regular activity supports a healthy weight and metabolism, both of which your liver depends on. The CDC recommends at least 150 minutes of moderate activity a week, like 30 minutes a day, 5 days a week, plus 2 days of muscle strengthening (8).

Brisk walks count, and so do bike rides, swims and dance classes. If you're not sure where to begin, our 7 easy exercises to support your liver and gut are a friendly starting point.

The honest answer to "how fast?" is: it depends on the cause. Your provider may repeat your blood tests after a few weeks to see whether your levels are improving (1), and some changes, like stopping a medication, can show up quickly while others, like weight loss, take months.

Before your next test, a little prep goes a long way:

1. Ask whether you need to fast. Many liver panels call for 10 to 12 hours without food or drink (9).
2. Tell the lab about every medication and supplement you take.
3. Keep your routine steady for a few days: no big nights out and no brand-new hardcore workouts.

Then compare the new numbers with your provider, not with a stranger's results online. The trend over time tells a much clearer story than any single test.