Can a UTI Cause Elevated Liver Enzymes?

The Relationship Between UTIs and Liver Function

Urinary tract infections (UTIs) are common bacterial infections that affect the urethra and bladder. Symptoms include burning urination, pelvic pain, and frequent urination. While UTIs primarily impact the urinary system, some research suggests a link between UTIs and liver function based on certain shared mechanisms of inflammation.

How a UTI Could Potentially Affect Liver Enzymes

When bacteria invade the urinary tract, the immune system responds with an inflammatory reaction to fight off the infection. Inflammation is a key driver of symptoms during a UTI.

While intended to combat the infection, systemic inflammation can also have negative impacts on other areas of the body. Some theories propose that the widespread inflammation from a UTI could potentially affect liver function and cause transient elevation of certain liver enzymes.

Alanine Aminotransferase (ALT)

ALT is an enzyme found predominately in the liver that helps metabolize proteins. When liver cells are damaged, ALT is released into the bloodstream, increasing ALT blood levels.

Some studies have found connections between higher ALT levels and UTIs, hypothesizing that the immune response triggered by the infection may temporarily inflame or injure liver cells and cause more ALT to enter the blood.

Aspartate Aminotransferase (AST)

Like ALT, AST is involved in protein metabolism and liver cell function. AST is also present in other tissues like the heart, muscles, and kidneys. Elevated AST may signify liver or other tissue damage.

Increased AST has also been associated with UTIs in certain cases, potentially attributed to temporary inflammation-driven liver cell irritation during the acute infection phase.

Alkaline Phosphatase (ALP)

ALP helps metabolize proteins and supports liver and bone health. Higher ALP levels can signal liver disease or bone disorders. Some research indicates UTIs may be linked to mild ALP elevations as well.

However, elevated ALP is a less specific indicator of liver issues than ALT and AST since it can derive from both hepatic and non-hepatic sources like bone.

Key Studies on the Relationship Between UTIs and Liver Enzymes

While more research is still needed, a handful of studies have uncovered connections between UTIs and transient liver enzyme elevations:

UTI Association with Mild ALT Elevations

A 2016 study compared 50 patients hospitalized for UTIs against a control group. ALT levels were significantly higher in the UTI group, suggesting temporary liver impact from the systemic inflammation of the infection.

AST and ALT Levels Increased in UTI Patients

A small 2017 study of 36 UTI patients versus healthy controls found that those with UTIs had higher ALT and AST levels that normalized after antibiotic treatment, pointing to temporarily increased liver enzymes during the infection.

Correlations Between UTI Severity and Liver Enzymes

One study analyzed data from over 18,000 UTI cases, finding correlations between elevated ALT and AST levels and increased UTI severity based on the presence of certain bacteria strains and symptoms like fever and kidney infection.

Case Report of Marked Transient Liver Enzyme Elevations

A case report described an elderly man with a severe kidney and prostate UTI resulting in dramatically elevated ALT and AST levels over 7 times normal ranges that rapidly normalized with IV antibiotics, suggesting the UTI strongly impacted liver function.

Other Potential Causes of Elevated Liver Enzymes Besides a UTI

While UTIs may contribute to temporary liver enzyme elevations in some cases, many other conditions can cause increased ALT, AST, and ALP levels. It is important to investigate other potential reasons for liver test abnormalities too.

Medications

Many common medications like NSAIDs, certain antibiotics, cholesterol drugs, mood stabilizers, and others can impact liver tests. Recent new prescriptions should be considered as a cause of elevated enzymes.

Obesity

Being overweight stresses the liver and can result in mild enzyme elevations, especially of ALT. Gradual weight loss often improves liver tests.

Alcohol Use

Drinking heavily, even for short periods, can irritate the liver and raise ALT, AST, and sometimes ALP levels. Alcohol should be avoided when liver enzymes are elevated.

Hepatitis

Viral infections like hepatitis A, B, and C commonly increase liver enzymes. Specific hepatitis blood tests help identify if infection is the cause.

Fatty Liver Disease

Nonalcoholic fatty liver disease can mildly or significantly increase liver enzymes like ALT and AST as fat accumulates in liver cells.

Celiac Disease

Celiac disease and gluten sensitivity can raise levels of ALT, AST, and especially ALP due to liver injury and bone changes.

Congestive Heart Failure

When the heart fails to pump effectively, it can cause liver congestion and elevated enzymes like ALT, AST, and ALP.

Cancer

Cancers affecting the liver directly, like hepatocellular carcinoma, or spreading to the liver from other organs can increase liver enzymes.

Thyroid Disorders

Hypothyroidism and hyperthyroidism can both increase levels of liver enzymes due to reduced liver clearance and other metabolic effects.

When to Seek Emergency Care for Elevated Liver Enzymes

In most cases, mild to moderate elevations in liver enzymes like ALT, AST, and ALP do not constitute a medical emergency. However, seek immediate medical care if you experience:

• Jaundice (yellowing skin/eyes)
• Severe abdominal swelling or fluid retention
• Bleeding or black, tarry stools
• Severe nausea, vomiting, or diarrhea
• Confusion, slurred speech, or impaired cognition
• High fever and respiratory difficulty

These symptoms in combination with highly elevated liver enzymes may indicate acute liver failure or another serious condition requiring prompt treatment.

When to See a Doctor for Elevated Liver Enzymes

You should make an appointment with your healthcare provider if you have:

• Mild to moderate liver enzyme elevations
• Persistently elevated enzymes over several tests
• Enzyme elevations along with abnormal bilirubin
• Unexplained symptoms like fatigue, loss of appetite, nausea, abdominal pain

Your doctor will help determine if a UTI could be contributing to your enzyme elevations or if other causes need to be explored through additional testing and referrals to specialists like a gastroenterologist or hepatologist.

Treatment for Elevated Liver Enzymes from a UTI

If a UTI appears responsible for elevated liver tests, the most important treatment is tackling the underlying infection through appropriate antibiotic therapy.

Treating the UTI and resolving the inflammation causing symptoms should also correct any associated transient liver enzyme abnormalities. Repeat testing after finishing antibiotics can confirm if levels have normalized.

Managing any other medical conditions present and discontinuing any potentially hepatotoxic medications are also recommended. Your doctor may advise temporary dietary changes and over-the-counter supplements to help support your liver during recovery.

Preventing UTIs to Avoid Liver Enzyme Impacts

While not definitively proven, some UTIs may negatively affect liver function and enzyme levels. Strategies to prevent recurrent UTIs can also lower any associated risks of liver enzyme elevations.

• Urinate frequently and when feeling urge
• Wipe front to back after using bathroom
• Drink adequate fluids daily
• Avoid prolonged delay in urinating
• Prevent constipation and straining with bowel movements
• Don't use irritating feminine products
• Urinating after sex

Practicing good genital and toilet hygiene, hydrating well, urinating when needed, and not delaying urination can reduce UTI risk and any potential liver impacts.

The Bottom Line

While UTIs primarily affect the urinary system, some research indicates UTIs may rarely be associated with transient elevations in liver enzymes like ALT, AST, and ALP. This appears connected to systemic inflammation from the infection temporarily impacting liver cell function.

However, many other conditions can also lead to abnormal liver tests. A comprehensive medical workup is needed to determine the cause in any individual case. Treating the underlying UTI along with any other contributing factors is key to resolving abnormal liver enzyme levels.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.