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hello and welcome iamp;#39;m dr raj sharina budrypod iamp;#39;m board certified in internal medicine and todayamp;#39;s video is all about fatty liver disease one of the most common abnormalities i see on patients blood work is an elevation in their liver enzymes here we have my patient kevin and his alt and ast which are his liver enzymes are elevated on his blood work so his alt is 57 and his ast is 45 normal liver enzymes should be in the teens or 20s another term for the alt and asd is transaminases so if you have elevated transaminases your liver is saying help itamp;#39;s a sign of liver dysfunction and the number one cause is fatty liver disease itamp;#39;s a metabolic disease where fat gets stored and produced in liver cells the problem is this triggers a cascade of inflammation in the liver so letamp;#39;s take a look under the microscope so this is what a healthy liver looks like on a liver biopsy now letamp;#39;s compare it to a fatty liver see a diffe