BillinSD

Liver enzymes are a very good indicator of how inflamed the liver currently is due to recent injury or disease processes going on, but high enzymes do not indicate how much damage has been done in the past.

If a young man with a healthy pristine liver goes out on his 21st birthday and gets extremely drunk, he will have very high enzymes for a week or so after this with little or no permanent damage done to his liver. If an older man with a long drinking history and substantial fibrosis/damage stops drinking, he may have fairly normal enzymes following a period of sobriety, even though his liver is substantially and permanently damaged.

I know fatty liver is different from alcoholic liver disease, but this is an easy to understand way to view the differences between enzymes and liver damage.

If you've got a fatty liver and normal enzymes, this typically would indicate you're not having a lot of inflammation or damage going on at the moment, but you may be pre-disposed to inflammation and damage in the future.

The fat in fatty livers may not cause problems unless it begins to oxidize through exposure to alcohol, chemicals or drugs (including prescription drugs). Many people have fatty livers for many years without problems, but then run into trouble from medications or toxic exposures that rapidly oxidize the fat in the liver producing inflammation.

I'm not a doctor, but this is simply my understanding of the situation. Hope it helps.