What blood tests are used to assess liver function. How do liver function tests work. What do elevated liver enzymes indicate. When should you get a liver function test. How to interpret liver function test results. What are the common causes of abnormal liver function tests. Can liver function tests detect early stages of liver disease.

The Importance of Liver Function Tests in Diagnosing Liver Disorders

Liver function tests are a crucial set of blood tests that provide valuable insights into the health and functionality of the liver. These tests are essential for diagnosing liver disorders, monitoring liver health, and assessing the effectiveness of treatments. By measuring various enzymes, proteins, and substances in the blood, healthcare providers can gain a comprehensive understanding of liver function and detect potential issues early on.

Liver function tests are particularly useful in distinguishing between acute and chronic liver disorders, as well as differentiating between hepatitis (inflammation or infection of the liver) and cholestasis (disruption in bile formation or flow). These tests play a vital role in the early detection and management of liver diseases, allowing for timely interventions and improved patient outcomes.

Common Liver Function Tests: A Comprehensive Overview

Several blood tests are commonly performed to evaluate liver function. Each test provides specific information about different aspects of liver health and functionality. Here’s an overview of the most frequently conducted liver function tests:

Serum Bilirubin Test

The serum bilirubin test measures the levels of bilirubin in the blood. Bilirubin is a yellowish pigment produced during the breakdown of red blood cells and is processed by the liver. Elevated bilirubin levels may indicate an obstruction in bile flow or problems with the liver’s ability to process bile.

Serum Albumin Test

This test measures the level of albumin, a protein produced by the liver, in the blood. Low albumin levels can be indicative of impaired liver function, as the liver may not be producing enough of this essential protein.

International Normalized Ratio (INR) Test

Formerly known as the prothrombin time (PT) test, the INR test measures blood clotting time. The liver produces clotting factors necessary for blood coagulation, so prolonged clotting times may suggest liver disease or deficiencies in specific clotting factors.

Liver Enzyme Tests: Key Indicators of Liver Health

Liver enzyme tests are crucial components of liver function assessment. These tests measure the levels of specific enzymes in the blood that are typically found in liver cells. When liver cells are damaged or inflamed, these enzymes are released into the bloodstream, leading to elevated levels that can be detected through blood tests.

Alkaline Phosphatase (ALP) Test

The serum alkaline phosphatase test measures the level of ALP, an enzyme found in various tissues, with the highest concentrations in the liver, biliary tract, and bone. Elevated ALP levels may indicate liver dysfunction or biliary obstruction caused by tumors or abscesses.

Alanine Transaminase (ALT) Test

The ALT test measures the level of alanine aminotransferase, an enzyme primarily found in the liver. Elevated ALT levels often indicate acute liver cell damage and are useful in assessing liver function and evaluating treatment efficacy for acute liver diseases like hepatitis.

Aspartate Transaminase (AST) Test

This test measures the level of aspartate transaminase, an enzyme found in various organs, including the liver, kidneys, pancreas, heart, and skeletal muscles. Elevated AST levels can indicate liver or heart problems and are released into the bloodstream after acute liver cell damage.

Gamma-Glutamyl Transpeptidase (GGT) Test

The GGT test measures the level of gamma-glutamyl transpeptidase, an enzyme produced in the liver, pancreas, and biliary tract. This test is valuable for assessing liver function, providing information about liver diseases, and detecting alcohol consumption.

Additional Diagnostic Tests for Comprehensive Liver Assessment

While the aforementioned tests form the core of liver function assessment, additional diagnostic tests can provide further insights into specific liver conditions and autoimmune disorders. These tests include:

• Lactic Dehydrogenase (LDH) Test: Helps detect tissue damage and may assist in diagnosing liver disease, although it is less specific for liver assessment.
• 5′-Nucleotidase Test: Measures levels of an enzyme specific to the liver, which can be elevated in liver diseases, particularly those associated with cholestasis.
• Alpha-Fetoprotein (AFP) Test: Used to predict the risk of primary liver cancer and monitor treatment effectiveness in certain liver cancers.
• Mitochondrial Antibodies Test: Detects antibodies that can indicate primary biliary cirrhosis, chronic active hepatitis, and other autoimmune disorders.
• Serum Alpha-1 Antitrypsin (A1AT) Test: Measures levels of A1AT to help identify rare forms of emphysema in adults and cirrhosis in children and adults.

Interpreting Liver Function Test Results: What Do They Mean?

Interpreting liver function test results requires careful consideration of various factors, including the specific tests performed, the patient’s medical history, and any underlying conditions. While abnormal results may indicate liver problems, it’s essential to understand that other factors can influence test outcomes.

Are elevated liver enzymes always a cause for concern? Not necessarily. Mild elevations in liver enzymes can occur due to temporary factors such as medications, alcohol consumption, or recent physical exertion. However, persistently elevated levels or significant increases may warrant further investigation.

How do healthcare providers interpret liver function test results? They typically consider the following aspects:

1. The specific enzymes or substances that are elevated or decreased
2. The magnitude of the abnormality
3. The pattern of abnormalities across different tests
4. The patient’s symptoms and medical history
5. Other relevant test results and imaging studies

By analyzing these factors, healthcare providers can develop a comprehensive understanding of the patient’s liver health and determine the appropriate next steps, which may include additional testing, lifestyle modifications, or treatment interventions.

Common Causes of Abnormal Liver Function Tests

Abnormal liver function test results can stem from various causes, ranging from benign conditions to serious liver diseases. Understanding these potential causes is crucial for accurate diagnosis and appropriate treatment. Some common reasons for abnormal liver function tests include:

• Viral hepatitis (e.g., hepatitis A, B, C)
• Alcoholic liver disease
• Nonalcoholic fatty liver disease (NAFLD)
• Autoimmune liver diseases
• Medication-induced liver injury
• Cirrhosis
• Liver cancer
• Genetic liver disorders
• Biliary obstruction
• Metabolic disorders affecting the liver

Can liver function tests detect early stages of liver disease? Yes, in many cases, liver function tests can detect liver problems before symptoms become apparent. This early detection capability makes these tests invaluable for preventive healthcare and timely intervention.

When Should You Get a Liver Function Test?

Liver function tests are recommended in various scenarios to assess liver health and detect potential issues. Healthcare providers may order these tests under the following circumstances:

• As part of routine health check-ups
• When evaluating unexplained symptoms that may be related to liver problems
• To monitor known liver conditions or the effectiveness of treatments
• Before starting certain medications that may affect liver function
• To assess liver health in individuals with risk factors for liver disease
• As a follow-up to abnormal results from other tests or imaging studies

How often should liver function tests be performed? The frequency of testing depends on individual circumstances, including age, risk factors, and existing health conditions. Your healthcare provider can recommend an appropriate testing schedule based on your specific needs.

Preparing for Liver Function Tests: What You Need to Know

Proper preparation is essential to ensure accurate liver function test results. Here are some important considerations when preparing for these tests:

• Fasting: Some liver function tests may require fasting for a specified period before the blood draw. Your healthcare provider will provide specific instructions if fasting is necessary.
• Medications: Inform your healthcare provider about all medications, supplements, and herbal products you’re taking, as some may affect test results.
• Alcohol consumption: Avoid alcohol for at least 24 hours before the test, as it can temporarily elevate liver enzyme levels.
• Exercise: Strenuous physical activity can affect some liver enzyme levels, so avoid intense exercise in the 24 hours leading up to the test.
• Hydration: Stay well-hydrated before the test, unless instructed otherwise by your healthcare provider.

What should you do if you’re anxious about the blood draw? If you experience anxiety related to blood tests, inform the healthcare staff. They can provide reassurance and may use techniques to make the process more comfortable for you.

The Future of Liver Function Testing: Emerging Technologies and Approaches

As medical science advances, new technologies and approaches are being developed to enhance liver function testing and improve diagnostic accuracy. Some promising developments in this field include:

• Non-invasive imaging techniques: Advanced imaging methods, such as elastography, are being used to assess liver fibrosis and cirrhosis without the need for invasive biopsies.
• Biomarker panels: Researchers are identifying new biomarkers and developing comprehensive panels that can provide more detailed information about liver health and specific liver diseases.
• Genetic testing: Advances in genetic testing are allowing for the identification of genetic factors that may contribute to liver diseases or influence treatment responses.
• Artificial intelligence: Machine learning algorithms are being developed to analyze liver function test results and other clinical data to improve diagnostic accuracy and predict disease progression.
• Point-of-care testing: Portable devices for rapid liver function testing are being developed, allowing for more accessible and timely assessments in various healthcare settings.

How will these advancements impact liver disease diagnosis and management? These emerging technologies have the potential to revolutionize liver function testing by providing more accurate, comprehensive, and personalized assessments of liver health. This, in turn, may lead to earlier detection of liver diseases, more tailored treatment approaches, and improved patient outcomes.

As research in this field continues to progress, it’s likely that liver function testing will become increasingly sophisticated and integrated with other diagnostic modalities, offering a more holistic approach to liver health assessment and management.

Common Liver Tests | Johns Hopkins Medicine

Common Liver Tests | Johns Hopkins Medicine

What are some of the most common liver tests?

A series of special blood tests can often determine whether or not the liver is inflamed, injured, or functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis (infection or inflammation of the liver) and cholestasis (disruption in the formation of or obstruction in the flow of bile). 

The most commonly performed blood tests include the following:

Function tests

• Serum bilirubin test. This test measures the levels of bilirubin in the blood. Bilirubin is made by the liver and is excreted in the bile. Elevated levels of bilirubin may indicate an obstruction of bile flow or a problem in the processing of bile by the liver.

• Serum albumin test. This test is used to measure the level of albumin (a protein in the blood) and may be useful in the diagnosis of liver disease. Low levels of albumin may indicate the liver is not functioning properly. 

• International normalized ratio (INR), formally called prothrombin time (PT) test. This test measures how long it takes for blood to clot. Blood clotting needs vitamin K and a protein that is made by the liver. Prolonged clotting may indicate liver disease or other deficiencies in specific clotting factors.

Liver enzymes

• Serum alkaline phosphatase test. This test is used to measure the level of alkaline phosphatase (an enzyme) in the blood. Alkaline phosphatase is found in many tissues, with the highest concentrations in the liver, biliary tract, and bone. This test may be performed to assess liver functioning and to find liver lesions that may cause biliary obstruction, such as tumors or abscesses.

• Alanine transaminase (ALT) test. This test measures the level of alanine aminotransferase. This is an enzyme found mostly in the liver that is released into the bloodstream after acute liver cell damage. This test may be performed to assess liver function, and/or to evaluate treatment of acute liver disease, such as hepatitis.

• Aspartate transaminase (AST) test. This test measures the level of aspartate transaminase. This is an enzyme that is found in the liver, kidneys, pancreas, heart, skeletal muscle, and red blood cells that is released into the bloodstream after liver or heart problems. This enzyme is released into the bloodstream after acute liver cell damage.

• Gamma-glutamyl transpeptidase test. This test measures the level of gamma-glutamyl transpeptidase. This is an enzyme that is made in the liver, pancreas, and biliary tract. This test is often performed to assess liver function, to provide information about liver diseases, and to detect alcohol ingestion.

• Lactic dehydrogenase test. This test can find tissue damage and may assist in the diagnosis of liver disease. Lactic dehydrogenase is a type of protein (also called an isoenzyme). It is involved in the body’s metabolic process. However, this is a very nonspecific liver test. It is rarely used for liver disease assessment.

• 5′-nucleotidase test. This test measures the levels of 5′- nucleotidase (an enzyme specific to the liver). The 5′- nucleotidase level is elevated in persons with liver diseases, especially those diseases associated with cholestasis. This is disruption in the formation of, or obstruction in the flow of bile.

Additional diagnostic tests

• Alpha-fetoprotein test. Alpha-fetoprotein (a specific blood protein) is made by fetal tissue and by tumors. This test may be done to predict the risk for primary liver cancer (hepatocellular carcinoma). It is also done to monitor the effectiveness of therapy in certain cancers, such as hepatomas (a type of liver cancer).

• Mitochondrial antibodies test. The presence of these antibodies can indicate primary biliary cirrhosis, chronic active hepatitis, and certain other autoimmune disorders.

• Serum alpha-1 antitrypsin test (A1AT). This test measures the levels of alpha-1 antitrypsin in the blood. This test is performed to help identify a rare form of emphysema in adults and a rare form of liver disease (cirrhosis) in children and adults.

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Liver Function Tests: Purpose, Procedure, and Results

Liver function tests are blood tests that can be used to monitor the health of your liver. Ask the doctor what you need to do to prepare. In some cases you may need to avoid food or certain medications before the test.

Liver function tests, also known as liver chemistries, help determine the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood. They can also monitor the progression or treatment of an existing disease.

Depending on the test, either higher- or lower-than-typical levels of these enzymes or proteins can indicate a problem with your liver.

Some of the reasons liver function tests may be performed include screening for diseases such as hepatitis, monitoring the side effects of your medications, and examining the severity of liver disease.

In this article, we take a look at when you might need a liver function test, the different types of tests used, and how to interpret results.

A liver function test is often recommended in the following situations:

• to check for damage from liver infections, such as hepatitis B and hepatitis C, especially if it’s suspected you were exposed to a virus that causes hepatitis
• to monitor the side effects of certain medications because some medications are known to affect the liver, including:
  • NSAIDs
  • statins
  • antibiotics
  • antiseizure medications
  • tuberculosis drugs
• if you already have liver disease, to monitor the disease and how well a particular treatment is working
• if you’re experiencing the symptoms of a liver disorder or have a family history of a liver disease, such as fatty liver disease
• if you have certain medical conditions, such as:
  • high triglycerides
  • diabetes
  • high blood pressure
  • anemia
• if you drink alcohol frequently
• if you have gallbladder disease

Certain tests can reflect different aspects of liver function. For example, elevated alanine transaminase and aspartate transaminase disproportional to bilirubin and alkaline phosphatase levels often indicates liver disease.

Liver function tests are used to measure specific enzymes and proteins in your blood.

Having atypical results on any of these liver tests usually requires a follow-up to determine the cause of the atypical characteristics. Even mildly elevated results can be associated with liver disease.

Common liver function tests include:

Alanine transaminase (ALT) test

Alanine transaminase (ALT) is used by your body to metabolize protein. If the liver is damaged or not functioning properly, ALT can be released into the blood. This causes ALT levels to increase. A higher result than what’s typical on this test can be a sign of liver damage.

It’s estimated that about 10 percent of people in the United States have elevated ALT levels.

Aspartate aminotransferase (AST) test

Aspartate aminotransferase (AST) is an enzyme found in several parts of your body, including your:

• heart
• brain
• pancreas
• liver
• muscles

When the liver is damaged, AST can be released into the bloodstream. A high result on an AST test might indicate a problem with the liver or muscles.

Since AST levels aren’t as specific of a marker for liver damage as ALT, it’s usually measured together with ALT to check for liver problems. For example, a high AST:ALT ratio may indicate alcoholic liver disease.

Alkaline phosphatase (ALP) test

Alkaline phosphatase (ALP) is an enzyme found in your bones, bile ducts, and liver. An ALP test is typically ordered in combination with several other tests. An ALP test can be used to evaluate the bile duct system of the liver.

Albumin test

Albumin is the main protein made by your liver. It performs many important bodily functions.

For example, albumin nourishes your tissues and transports hormones, vitamins, and other substances throughout your body. An albumin test measures how well your liver is making this particular protein.

Bilirubin test

Bilirubin is a waste product from the breakdown of red blood cells. It’s ordinarily processed by the liver. It passes through the liver before being excreted through your stool.

A damaged liver can’t properly process bilirubin. This leads to an atypically high level of bilirubin in the blood. Certain inherited diseases can raise bilirubin levels, even when liver function works as expected.

The following table shows what liver function tests may indicate in terms of higher or lower results than typical. Following any liver function test, you should have a discussion with your doctor about your test results and what they mean for you.

Problems with the liver can make a person very sick and can even be life threatening. Approximately 4.5 million adults in the United States have chronic liver disease.

Symptoms of a liver disorder include:

• weakness
• fatigue or loss of energy
• weight loss
• jaundice (yellow skin and eyes)
• fluid collection in the abdomen, known as ascites
• discolored bodily discharge (dark urine or light stools)
• nausea
• vomiting
• diarrhea
• abdominal pain
• atypical bruising or bleeding

Your doctor may order a liver function test if you’re experiencing symptoms of a liver disorder.

Liver function tests can also monitor the progression or treatment of a disease and test for the side effects of certain medications.

Your doctor will give you complete instructions on how to prepare for the blood sample portion of the test.

Certain medications and foods may affect levels of these enzymes and proteins in your blood. Your doctor may ask you to avoid some types of medications, or they may ask you to avoid eating anything for a period of time before the test. Be sure to continue drinking water prior to the test.

You may want to wear a shirt with sleeves that can easily be rolled up to make it easier for the medical expert to collect the blood sample.

You may have your blood drawn in a hospital or at a specialized testing facility. To administer the test:

1. The healthcare technician will clean your skin before the test to decrease the likelihood that any microorganisms on your skin will cause an infection.
2. They’ll likely wrap an elastic strap on your arm. This will help your veins become more visible. They’ll then use a needle to draw samples of blood from your arm.
3. After the draw, the technician will place some gauze and a bandage over the puncture site. Your blood sample will be sent to a laboratory for testing.

Potential risks of a liver function test

Blood draws are routine procedures and rarely cause any serious side effects. However, the risks of giving a blood sample can include:

• bleeding under the skin, or hematoma
• excessive bleeding
• fainting
• infection

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After the test, you can usually resume everyday activities. However, if you feel faint or lightheaded during the blood draw, you should rest before you leave the testing facility.

The results of these tests may not tell your doctor exactly which condition you have or the degree of liver damage, but they might help your doctor determine the next steps. Your doctor will call you with the results or discuss them with you at a follow-up appointment.

In general, if your results indicate a problem with your liver function, your doctor will review your medications and your past medical history to help determine the cause.

If you drink alcohol frequently, then you’ll need to stop drinking it. If your doctor identifies that a medication is causing the elevated liver enzymes, they’ll advise you to stop the medication.

Other diagnostic tests

Your doctor may decide to test you for hepatitis, other infections, or other diseases that can affect the liver. They may also choose to do imaging tests, like an ultrasound or CT scan.

In addition, they may recommend a liver biopsy to evaluate the liver for fibrosis, fatty liver disease, or other liver conditions.

Liver function tests are blood tests used to help determine the health of your liver. Changes in certain levels of proteins or enzymes can alert doctors of potential problems such as liver cancer, fatty liver disease, or hepatitis.

Liver function tests can also help determine if certain medications are damaging your liver or help you monitor the progression of liver disease.

After you get a liver function test, your doctor can help you interpret the results and discuss what the results mean for you. If they suspect you have liver disease, you may need to undergo other tests such as imaging or a liver biopsy.

Blood tests to check the liver / Gastrohepatocenter EXPERT

Many patients are interested in: how to check the liver and what tests to take before consulting a hepatologist?

If you do not know where to start the examination, then the doctors of the GastroHepatoCenter EXPERT recommend that you contact a hepatologist for a free conversation, who will prescribe a list of indicators that is suitable for your case. This will help you save your resources:

• time – you pass all the necessary indicators in 1 visit to the clinic
• money – you will not hand over what is not needed at the moment.

However, for those who are being screened for prevention or suspected of having liver disease, we have prepared a list of essential blood tests that may be helpful for your doctor to see.

Indications

Comprehensive laboratory analysis of the liver condition is required:

• for symptoms : yellowness of the skin and sclera of the eyes, bitterness in the mouth, nausea, heaviness in the right hypochondrium, chronic fatigue
• with risk factors : overweight or sudden weight loss, sedentary lifestyle, regular consumption of alcohol and heavy meals (suspicion of fatty liver disease)
• if possible infection with viral hepatitis B, C, D is suspected 0013 with heredity factor and suspected genetic disorder of iron and copper metabolism
• with suspected autoimmune diseases – this also applies to other organs (thyroid gland, hematopoietic system, etc.)
• for preventive examination .

Prevention of liver diseases is of particular importance, because it has no nerve endings and does not hurt. Therefore, diseases of this organ occur without obvious symptoms.

Basic blood tests for the liver

Among the tests to check liver function, biochemical and virological indicators are key:

1. Liver enzymes – AST, ALT analysis . These enzymes are released from liver cells (hepatocytes) when they are damaged. Depending on the activity of the course of the disease, they can even exceed the norm by 50 times.
2. GGTP enzymes, alkaline phosphatase . The activity of these enzymes increases in violation of the outflow of bile and congestion (cholestasis). GGTP is also sensitive to alcohol consumption.
3. Bilirubin total, direct, indirect . Bilirubin is an intermediate product of hemoglobin processing. One of the stages of hemoglobin metabolism occurs in the liver. If the metabolic process is disturbed due to damage to hepatocytes, excess bilirubin is released into the blood. It is he who gives the icteric color to the skin, mucous membranes and sclera of the eyes.
4. Screening for viral hepatitis . Unfortunately, many people do not know that they are infected with viral hepatitis or know, but cannot even guess how the infection occurred. Therefore, an analysis for antibodies to hepatitis C and B is carried out for all patients who seek help from a hepatologist. With a positive analysis, further virological examination is carried out.
5. CBC . This is a mandatory analysis for all diseases, showing the state of the body as a whole and the presence of an inflammatory or other pathological process.

In addition, the doctor may prescribe an assessment of the level of copper and iron in the blood with genetic studies (if Wilson-Konovalov’s disease and hemochromatosis are suspected), pancreatic amylase and glucose to assess pancreatic function, screening for autoimmune disorders and others.

The cost of tests for liver diseases

Biochemistry of the liver and blood for hepatitis, the prices for which are listed below, are given strictly on an empty stomach 10-12 hours after the last meal.

In case of any liver disease, the examination should be supplemented by liver ultrasound with elastography. This will give the doctor information about the anatomical features of the organ, its size, location, stage of fibrosis / cirrhosis, and the state of the biliary tract.

To clarify the activity of the course of the disease, the doctor may prescribe fibrotest / fibromax. This is one of the most informative tests for the liver, giving additional information about the stage of fibrosis and steatosis.

Consult a hepatologist with the results of the examination.

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When choosing where to take a profile of tests “Assessment of liver function” at an affordable price in Moscow and other cities of Russia, do not forget that the cost, methods and terms of performing studies in regional medical offices may differ.

If a liver disease is suspected, for the initial laboratory assessment of its condition, biochemical blood tests for bilirubin are used (it is removed from the bloodstream by the liver, the concentration increases with its pathology or difficulty in the outflow of bile) and enzymes that are rich in hepatocytes and bile duct epithelium (their content increases when these tissues are damaged).