What are liver function tests and why are they important. How does ALT testing help diagnose liver conditions. What is the normal range for ALT levels in adults. When should someone get their liver function tested. How are liver function tests performed and interpreted.

Understanding Liver Function Tests and ALT Levels

Liver function tests (LFTs) are a crucial set of blood tests used to assess the health and functionality of the liver. Among these tests, the measurement of alanine aminotransferase (ALT) levels plays a significant role in detecting potential liver damage or disease. ALT is an enzyme primarily found in liver cells that helps break down proteins for digestion and supports various liver functions.

When liver cells are damaged or inflamed, ALT is released into the bloodstream, causing elevated levels that can be detected through blood tests. This makes ALT testing an essential tool for healthcare professionals to screen for liver problems, monitor existing conditions, and evaluate the effectiveness of treatments.

Key Functions of ALT in the Liver

• Protein breakdown for digestion
• Assisting in basic liver functions
• Toxin filtration from the blood
• Nutrient and iron storage
• Bile production for digestion

Normal ALT Ranges and Their Significance

Understanding the normal range for ALT levels is crucial for interpreting liver function test results. However, it’s important to note that these ranges can vary slightly between laboratories and may be influenced by factors such as age and gender.

For adult males, the typical normal range for ALT is between 7 and 55 units per liter (U/L). Adult females often have a lower upper limit. It’s essential to consult with a healthcare provider to interpret individual results accurately, as they can explain any variations and their potential significance.

Factors Affecting ALT Levels

1. Age
2. Gender
3. Body mass index (BMI)
4. Alcohol consumption
5. Certain medications
6. Existing medical conditions

Causes of Elevated ALT Levels

Elevated ALT levels can indicate various liver issues or underlying health conditions. Some common causes include:

• Hepatitis (viral or alcoholic)
• Nonalcoholic fatty liver disease
• Cirrhosis
• Celiac disease
• Thyroid disorders
• Certain infections (e.g., mononucleosis, sepsis)
• Wilson’s disease
• Polymyositis
• Liver cancer
• Preeclampsia in pregnant or postpartum women

It’s important to note that elevated ALT levels don’t always indicate liver disease. Sometimes, temporary increases can occur due to intense physical activity or certain medications. This is why healthcare providers often consider ALT levels in conjunction with other liver function tests and clinical symptoms to make accurate diagnoses.

Symptoms of Liver Problems and When to Seek Testing

While liver function tests can detect issues before symptoms appear, it’s crucial to be aware of potential signs of liver problems. These symptoms may prompt healthcare providers to order liver function tests, including ALT measurements:

• Jaundice (yellowing of the eyes and skin)
• Pain in the upper right quadrant of the abdomen
• Referred pain in the right shoulder
• Easy bleeding or bruising
• Intense itching
• Pale stools
• Swelling in legs or abdomen

Are certain individuals more likely to need liver function tests? Yes, people with the following risk factors should consider regular liver function testing:

• Family history of liver disease
• Diabetes
• Overweight or obesity
• Heavy alcohol consumption
• Use of certain medications known to affect liver function

The Liver Function Test Process and Interpretation

How are liver function tests conducted? Liver function tests, including ALT measurements, are typically performed through a simple blood draw. The blood sample is then analyzed in a laboratory to determine the levels of various liver enzymes and proteins.

Interpreting liver function test results requires medical expertise. Healthcare providers consider multiple factors when evaluating these results:

1. Individual test results
2. Combination of different liver enzyme levels
3. Patient’s medical history
4. Presence of symptoms
5. Other relevant health factors

If ALT levels are found to be elevated, further testing may be necessary to determine the underlying cause. This could include additional blood tests, imaging studies, or in some cases, a liver biopsy.

Comprehensive Metabolic Panel and Liver Health

ALT testing is often part of a comprehensive metabolic panel, which provides a broader view of an individual’s overall health. This panel typically includes:

• Glucose level assessment
• Kidney function tests
• Liver function tests (including ALT)
• Electrolyte balance measurements

How often should one undergo a comprehensive metabolic panel? For healthy adults, it’s typically recommended as part of routine annual check-ups. However, individuals with known liver conditions or risk factors may require more frequent testing as determined by their healthcare provider.

Treatment Approaches for Abnormal Liver Function Tests

When liver function tests reveal abnormalities, the approach to treatment depends on the underlying cause. Some general strategies include:

1. Lifestyle modifications (e.g., reducing alcohol intake, losing weight)
2. Dietary changes
3. Medication adjustments
4. Treatment of underlying conditions (e.g., hepatitis, autoimmune disorders)
5. Regular monitoring and follow-up testing

In cases of severe liver damage or disease, more intensive treatments may be necessary, such as medications to manage complications, or in extreme cases, liver transplantation.

Preventive Measures for Maintaining Liver Health

While some liver conditions are genetic or caused by factors beyond an individual’s control, there are several steps one can take to promote liver health and potentially prevent liver damage:

• Maintain a healthy weight
• Limit alcohol consumption
• Exercise regularly
• Eat a balanced, nutritious diet
• Avoid unnecessary medications and follow prescribed dosages
• Get vaccinated against hepatitis A and B
• Practice safe sex and avoid sharing needles to prevent hepatitis C
• Manage chronic conditions like diabetes and high cholesterol

By adopting these healthy habits, individuals can support their liver function and potentially reduce the risk of liver-related health issues.

Advancements in Liver Function Testing and Future Directions

As medical technology advances, new methods for assessing liver health are being developed. Some emerging areas of research and development include:

• Non-invasive imaging techniques for liver assessment
• Biomarker discovery for early detection of liver diseases
• Genetic testing to identify inherited liver conditions
• Artificial intelligence applications in interpreting liver function test results

These advancements may lead to more accurate and earlier diagnoses of liver conditions, potentially improving treatment outcomes and patient quality of life.

How might these developments impact future liver health management? As new technologies become available, they could allow for more personalized approaches to liver health monitoring and treatment. This could include tailored screening protocols based on individual risk factors and genetic predispositions.

The Role of Liver Function Tests in Personalized Medicine

As the field of personalized medicine grows, liver function tests, including ALT measurements, are likely to play an increasingly important role in tailoring healthcare approaches to individual patients. This may involve:

• Customized testing frequencies based on personal risk factors
• Integration of genetic information with liver function test results
• Development of personalized treatment plans based on comprehensive health data
• Use of wearable technology for continuous liver health monitoring

These advancements could potentially lead to earlier interventions and more effective management of liver conditions, ultimately improving patient outcomes and quality of life.

Understanding liver function tests, particularly ALT levels, is crucial for maintaining overall health and detecting potential liver issues early. By staying informed about these tests, their significance, and the factors that can affect liver health, individuals can take proactive steps to protect this vital organ. Regular check-ups, healthy lifestyle choices, and open communication with healthcare providers are key components of maintaining optimal liver function and overall well-being.

Alanine aminotransferase (ALT) test: Uses and results

The liver makes several enzymes, including alanine aminotransferase, or ALT. These enzymes help break down proteins so that the body can digest them.

Besides helping the liver break down proteins, ALT helps the liver perform its basic functions. Some of these include:

• filtering toxins from the blood
• storing nutrients and iron
• producing bile, which aids digestion

Most ALT that the liver produces stays within the organ. However, when the liver is damaged or inflamed, it may release ALT into the bloodstream.

When this happens, the level of ALT in the blood rises. Therefore, doctors use an ALT blood test to screen for liver disease or damage. Learn more about the test in this article.

Share on PinterestAn ALT test can help a doctor diagnose various liver conditions.

A doctor orders an ALT test to look for problems with liver function. Many people have this test as part of a comprehensive metabolic panel.

The comprehensive metabolic panel is a routine blood test that checks a person’s glucose level, kidney function, and liver function. It is often part of a routine checkup that gives a doctor insight into an individual’s overall health.

Other times, a doctor orders the ALT blood test as part of a series of blood tests called liver panels if they suspect that a person’s liver is damaged or diseased.

Doctors may order liver panels if a person has symptoms of liver disease or damage. Symptoms of liver problems include:

• yellowing of the eyes and skin (jaundice)
• pain in the upper right quadrant of the abdomen
• referred pain in the right shoulder
• easy bleeding or bruising
• intense itching
• pale stools
• swelling in legs or abdomen

These symptoms can indicate liver disease, injury, or another problem that may be affecting the liver.

Medical problems that can cause elevated ALT levels include:

• hepatitis
• nonalcoholic fatty liver disease
• cirrhosis
• celiac disease
• thyroid disorders
• preeclampsia in pregnant or immediately postpartum women
• certain infections, including mononucleosis and sepsis
• Wilson’s disease
• polymyositis
• liver cancer

Certain medications can also cause ALT levels in the blood to be high.

Often, these levels are elevated before symptoms of liver damage occur, making the test useful for people at risk of liver damage.

When a doctor can detect liver damage early, they may be better able to treat it and prevent further injury.

People at risk of liver damage or disease include:

• people with a family history of liver disease
• people who have diabetes
• people who are overweight
• people who consume a lot of alcoholic beverages
• people taking certain medications

Doctors routinely order liver panels to monitor diagnosed liver disease or injury. The results of these tests can show how well the treatment plan is working.

Share on PinterestA doctor can explain the results of an ALT test in detail.

A person with a healthy liver will have an ALT level in the normal range. The normal range can vary from laboratory to laboratory.

According to the Mayo Clinic, the normal range for adult males is 7–55 units per liter. Females may have a lower upper limit normal than males.

Age can also affect results. A person should speak with their doctor about what their results mean.

If a person has results above the normal range, this may indicate liver damage.

Causes of elevated ALT levels include:

• the destruction of liver cells
• a lack of blood flow to the liver
• hepatitis
• cirrhosis, or severe scarring of the liver
• diabetes
• hemochromatosis, or iron buildup
• mononucleosis, an infection usually caused by the Epstein-Barr virus
• a tumor in the liver
• pancreatitis

A person should discuss their results with their doctor, who can say if the numbers returned are within a normal range.

If a person’s results are too low or high, a doctor can help determine the appropriate course of treatment.

People with higher ALT levels often need additional tests to discover the underlying cause of the liver damage and treat it.

An ALT blood test helps determine if a person has liver damage. Uncovering the cause of the problem often requires further testing.

The normal range for results tends to vary among facilities, and a doctor can discuss what the results mean on an individual basis.

Once they know the underlying cause of the liver damage, based on symptoms and test results, the doctor will discuss appropriate treatment options.

Liver Function Test (LFT): Normal Range, Purpose, Types

• What is Liver Function Test (LFT) 
• What is Included in Liver Function Test
• What is the Purpose of Liver Tests
• Liver Function Test Normal Range
• Who Should Get a Liver Test?
• How it Works?
• Is a Liver Test Risky?
• Certain Dos & Don’ts  

Synopsis

A Liver Function Test (LFT) is a set of blood tests conducted to help diagnose and monitor liver disease and damage. These tests analyses the levels of specific proteins and enzymes in the patient’s blood. Read on to learn more interesting facts about Liver Function Test and its importance.

Key Takeaways

• Liver function tests are used to diagnose liver problems, check the severity of illnesses, etc.
• The main tests included in the LFTs are APTT, prothrombin time, bilirubin, and albumin
• A few of these tests also evaluate the level of performance of the liver

LFT test normal range differs for the different LFT tests like ALT, ALP, AST, etc. A Liver Function Test can help evaluate the health of your liver by measuring the level of liver enzymes, proteins, and bilirubin in your blood. LFT can also help identify the progression and treatment of certain diseases. 

What is Liver Function Test (LFT) 

Liver tests are used by doctors to understand the health of an individual’s liver. If a physician suspects that a person has liver disease or liver damage, he may ask the person for one or more tests to examine and determine the underlying cause.

Depending upon the nature of LFT, higher or lower values than the LFT test normal range can indicate a liver problem. An LFT test is typically performed to screen for diseases such as hepatitis, monitor the side effects of medicines, and understand the severity of the liver disease. LFT test normal range’s important to:

• Decide if you need a diagnosis for liver diseases such as hepatitis [1]
• Monitor treatment of liver disease as the tests can show how the treatment is working
• Check how badly the liver is affected by diseases such as cirrhosis
• Monitor the side effects of certain medications

Additional Read: Troponin Test

What is Included in Liver Function Test

The tests included in the Liver function test panel showing an LFT normal range if your liver is alright are:

1. Alanine transaminase (ALT) 
2. Aspartate aminotransferase (AST)
3. Alkaline phosphatase (ALP)
4. Albumin (ALB)
5. Total Protein (TP)
6. Total Bilirubin (TB)
7. Direct Bilirubin (DB)
8. Indirect Bilirubin (IDB)
9. Gamma-glutamyl transferase (GGT)
10. Prothrombin Time (PT)

Additional Read: D-Dimer Test

What is the Purpose of Liver Tests

The liver function test involves many measurements, and when the test is actually done, physicians can modify what measurements need to be done. No universal standard is there for what is measured on an LFT but given below are the most common components that are measured:

Alanine Transaminase (ALT)

ALT is an enzyme in the liver that helps convert proteins into energy needed for the liver cells. When the liver does not function properly, ALT enzyme levels increase as they are released into the bloodstream.

Aspartate Transaminase (AST)

The AST enzyme helps to metabolize amino acids. Usually, AST is present in the blood at normal levels, but an increased amount of AST could be a sign of liver disease, damage or muscle damage. You won’t achieve the LFT test report normal result if you have more AST in your blood than required.

Alkaline Phosphatase (ALP)

The ALP enzyme too occurs in the liver and bone and is vital for breaking down proteins. [2] Greater than regular levels of ALP can signal liver disease, damage, bone disease or blocked bile duct.

Albumin and total protein 

Our liver makes several proteins, one of which is albumin, and our body needs these proteins to perform various functions and fight infections. Albumin and protein levels lower than normal may indicate liver disease or damage.

Bilirubin

Bilirubin is produced when the red blood cells break down. It passes through the liver and is excreted via stools. Higher than normal bilirubin levels may signal liver disease, damage, or certain types of anemia.

Gamma-Glutamyl Transferase (GGT)

GGT is another enzyme in the blood, and greater than normal levels can be a sign of bile duct or liver damage. You won’t be able to have an LFT test normal range if you have an increased amount of this enzyme in your blood.

L-Lactate Dehydrogenase (LD)

LD is another type of liver enzyme, and elevated levels of this enzyme can signal liver damage. This enzyme also increases due to certain other disorders as well.

Prothrombin time (PT)

Prothrombin Time is the time taken for your blood to clot. Increased PT can signal liver damage, but PT can also be elevated if you are consuming certain blood-thinning medications like warfarin.

 Additional Read: Types of Blood Test

Liver Function Test Normal Range

Given below are the LFT test normal range and indications of the liver function test:

Liver Function Test	Indication	LFT Normal Values
ALT Test	A higher number on this test can indicate liver damage. Very high levels of over 1000 U/L are usually due to hepatitis or injury from drugs.	A number above 25 U/L in women and 33 U/L in men requires further evaluation.
AST Test	A high number on the AST test may signal a problem with your muscles or liver. High AST with low ALT can indicate muscle or heart disease. Elevated ALT, ALP and bilirubin signal liver damage.	The typical AST range is up to 36U/L in adults and higher in children and infants.
ALP Test	High ALP may be a sign of bone disease, bile duct blockage, or liver inflammation.	The typical ALP range in adults is between 20-140 U/L. Children, teenagers and pregnant women may have elevated levels of ALP.
Albumin Test	A low albumin test result can indicate liver malfunction. This may be due to diseases such as malnutrition, cancer or cirrhosis.	The acceptable albumin range in adults is between 30-50 g/L. But kidney disease, poor nutrition, and inflammation can also lower the levels.
Bilirubin Test	A high level of bilirubin may indicate improper liver functioning and, combined with ALT or AST, may indicate hepatitis or cirrhosis.	The range for total bilirubin is typically between 0.1-1.2 mg/DL.

Who Should Get a Liver Test?

Physicians do liver function tests to diagnose the liver health of a person. If he suspects that someone has a liver disease or damaged liver, he may conduct one or more LFTs to identify the primary cause. You may need to take up liver function tests if you are experiencing any of the following liver disease symptoms:

• Fatigue
• Nausea or vomiting
• Jaundice
• Darker color urine or lighter color stool
• Abdominal swelling or pain
• Itching
• Diarrhoea
• Loss of appetite

You may need to take LFT tests if you have certain risk factors or are at an increased risk of liver disease in the case you:

• Think that you are exposed to the hepatitis virus
• Have a chronic condition such as alcohol use disorder or alcohol addiction
• Take certain medications that may impact the liver and cause liver damage
• Have a family medical history of any liver condition
• Show symptoms of liver damage
• Have used intravenous drugs
• Have been obese or overweight

If you have any medical conditions affecting the liver, show unusual symptoms, consume alcohol regularly, or are undergoing treatment for liver disease, you are at an increased risk of liver disease and must undergo liver function tests to properly monitor and diagnose the condition. If you are in a dilemma if you need to take the LFT for an LFT test normal range, book an online doctor consultation.

How it Works?

The blood sample is needed for the LFT test procedure. Blood is usually drawn from the patient via a small needle inserted into a vein at the bend of his arm. During the blood draw, the staff will disinfect the area over a big vein in the arm. They may sometimes tie an elastic band a little above the draw site to increase the vein pressure. Once the healthcare staff can spot the vein under the skin, they will insert a needle at a 30-degree angle.

A small tube is connected to the needle, where the blood is collected. The patient may feel mild pain and small discomfort when the needle is inserted or removed from the arm.

After the blood sample is drawn, it is sent to the lab for analysis. You can get the test results within a few hours if the lab analysis is done on-site. If your physician sends your blood sample off-site, you will receive the results only after a few days.

Additional Read: Complete Blood Count (CBC) Test

Is a Liver Test Risky?

There is little or no risk in taking a liver function test. The blood sample is taken from one of your arm veins. The only risk with these blood tests is mild bruising, soreness or pain at the spot the needle was inserted, but these symptoms will go away quickly. The majority of people do not have any serious reactions to liver function tests.

Certain Dos & Don’ts  

Since certain medications and food may affect the results of your liver function tests, and you may not achieve an LFT test normal range, your physician may ask you not to eat or take medicines before the blood sample is drawn. Typically, you may be required not to eat or drink anything for 10-12 hours before the LFT is done.

The LFT test’s purpose is to check the overall health of your liver. Once you get your LFT done, your physician can interpret the results and advise what the results mean. If he suspects a liver disease, he may suggest future courses of action such as detailed imaging, biopsy and so on. Log on to Bajaj Finserv Health to connect with the best doctors near you and book online lab tests.

Published on 7 Mar 2023Last Updated on 3 May 2023

1. https://stanfordhealthcare.org/medical-conditions/liver-kidneys-and-urinary-system/chronic-liver-disease/diagnosis/liver-function-tests.html
2. https://cura4u.com/blog/what-does-high-alkaline-phosphatase-indicate

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

Altered liver function tests in patients with COVID-19 | Abdulganieva

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Gilbert’s syndrome / Diseases / Clinic EXPERT

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Gilbert’s syndrome, or benign functional hyperbilirubinemia , in which predominantly indirect bilirubin rises in the blood.

This condition is caused by a mutation in the gene that codes for an enzyme involved in bilirubin metabolism.

Gilbert’s syndrome is characterized by :

• moderate increase in the content of indirect (unbound) bilirubin in the blood
• partial deficiency of glucuronyl transferase, the activity of which is approximately 30% of the norm
• decrease in elevated bilirubin under the influence of phenobarbital
• or morphological changes in the liver.

Gilbert’s syndrome is more common in men aged 20-30 years.

Symptoms of Gilbert’s syndrome

Symptoms of Gilbert’s syndrome include:

• fatigue
• weakness, dizziness
• insomnia, sleep disturbances
• right hypochondrium discomfort degree of intensity (icteric coloration of the skin is noted only in some patients), not accompanied by skin itching, appearing or aggravated by physical exertion, drinking alcohol, starvation, during infectious diseases
• formation of bilirubin stones in the gallbladder or ducts.

More rare symptoms include symptoms of dyspepsia (digestion disorders) :

• decreased or no appetite
• bitter taste in the mouth
• bitter belching after eating 9007 5
• heartburn
• nausea, rarely vomiting
• stool disorders – constipation (no stool for days or weeks) or diarrhea (frequent loose stools)
• bloating
• feeling of stomach fullness
• discomfort and pain in the right hypochondrium. As a rule, they are dull, pulling in nature. More often they occur after errors in the diet, for example, after eating fatty or spicy foods
• sometimes there is an increase in the size of the liver.

Gilbert’s syndrome worsens under the following conditions:0075

drinking alcohol

taking certain drugs (anabolic steroids – analogues of sex hormones used to treat hormonal diseases, and also used by athletes to achieve the highest sports performance; glucocorticoids, antibacterial drugs, non-stroid anti-inflammatory drugs)

excessive exercise

stress

various surgeries, injuries

colds and viral diseases (influenza, SARS, viral hepatitis (inflammation of the liver caused by hepatitis viruses A,B,C,D,E)).

Diagnosis

The start of diagnosis is a blood test for total bilirubin. Total bilirubin in Gilbert’s syndrome ranges from 21 to 51 µmol/l and periodically, under the influence of physical stress or diseases, rises to 85-140 µmol/ l.

Whereas normal bilirubin values ​​ for adult men and women are:

• total bilirubin: 5.1 – 17.1 mmol/l
• direct bilirubin: 1.7 – 5.1 mmol/l
• indirect bilirubin: 3.4 – 12 mmol/l.

If Gilbert’s syndrome is suspected, special diagnostic tests are performed:

1. Fasting test . Against the background of starvation or adherence to a low-calorie diet (400 kcal per day) for 48 hours, the concentration of bilirubin in the blood serum increases by 50-100%. Bilirubin is determined on the day of the start of the test in the morning on an empty stomach and two days later. At the same time, the exact cause of the increase in bilirubin during fasting is unknown.
2. Phenobarbital test . Taking phenobarbital stimulates the activity of the enzyme glucuronyl transferase and leads to a decrease in the level of bilirubin.
3. The most accurate diagnostic method is a genetic study that reveals a typical mutation.

Treatment of Gilbert’s syndrome

As a rule, patients with Gilbert’s syndrome do not need special treatment, since Gilbert’s syndrome is not a true disease, but an individual feature of the body.

Of primary importance is compliance with the regime of work, nutrition, rest . Excessive physical overload (professional sports), direct sunlight, long breaks in food, fluid restriction are not recommended.

If bilirubin reaches 50 µmol/l and is accompanied by poor health, it is possible to conduct a course of treatment with intravenous drip infusion of crystalloid solutions, hepatoprotectors, against which the bilirubin content decreases to normal and the patient’s condition improves during the procedure itself.

For a rapid decrease in bilirubin, a course of treatment with phenobarbital and sorbents is carried out.

Gilbert’s syndrome is not a reason to refuse vaccinations.

In the future, preventive ultrasound of the abdominal organs is recommended once every 6 months.

Prognosis

Gilbert’s syndrome can be considered a variant of the norm , so the prognosis for these patients is favorable. People with Gilbert’s syndrome are generally healthy and do not need treatment. Although hyperbilirubinemia persists for life, Gilbert’s syndrome is not accompanied by an increase in mortality. However, the development of cholelithiasis, psychosomatic disorders is possible.

Doctors treating the disease

Pakhomova Inna Grigorievna

Doctor – gastroenterologist, hepatologist of the highest category, internist, candidate of medical sciences, associate professor

About the doctor

Prashnova Maria Konstantinovna

90 002 Chief physician, gastroenterologist, hepatologist, .