Minimal elevations of liver enzymes may not be serious. However, extremely high enzyme levels, especially when accompanied by high bilirubin levels, are regarded as an alarm bell. Catching a potential problem early can prevent the development of permanent liver damage. Generally, abnormal test measures return to normal when the offending agent is stopped or the dosage reduced. It may be possible to restart a stopped medication at a later time.
Herbs associated with liver toxicity include chaparral, comfrey and coltsfoot.
Combining these agents with one another or with alcohol amplifies the risk. They should be reported immediately.