What are normal bilirubin levels in adults and children. How does a bilirubin test help diagnose liver conditions. What causes high alkaline phosphatase levels. When should you get an ALP test.

Bilirubin Blood Test: Purpose and Procedure

A bilirubin test is a crucial diagnostic tool used to measure the amount of bilirubin in your blood. This test plays a vital role in identifying various health conditions, including jaundice, anemia, and liver disease. Bilirubin, an orange-yellow pigment, is produced when red blood cells break down naturally. The liver processes this bilirubin, altering its chemical structure so that most of it can be excreted through feces as bile.

The test procedure is straightforward:

• A small blood sample is drawn from a vein in your arm using a needle.
• For newborns, blood is typically collected by pricking the heel.
• The blood sample is sent to a laboratory for analysis.

Before undergoing the test, it’s essential to inform your doctor about your recent activities, diet, and any medications you’re taking, as certain drugs may affect the results.

Types of Bilirubin and Normal Levels

A bilirubin test measures the total bilirubin in your blood and can also provide levels of two distinct types:

1. Unconjugated (indirect) bilirubin: This is the form created from red blood cell breakdown and transported in the blood to the liver.
2. Conjugated (direct) bilirubin: This is the form after the liver processes it, which then moves to the intestines for excretion.

What are the normal bilirubin levels? For adults over 18, normal total bilirubin can be up to 1.2 milligrams per deciliter (mg/dl) of blood. For those under 18, the normal level is typically 1 mg/dl. Normal results for conjugated (direct) bilirubin should be less than 0.3 mg/dl. It’s worth noting that men tend to have slightly higher bilirubin levels than women, and African-Americans generally have lower levels compared to other races.

Interpreting High Bilirubin Levels

Elevated bilirubin levels can be indicative of various health issues. What conditions might cause high bilirubin? Some potential causes include:

• Anemia
• Cirrhosis
• Reactions to blood transfusions
• Gilbert syndrome (an inherited condition affecting bilirubin breakdown)
• Viral hepatitis
• Drug reactions
• Alcoholic liver disease
• Gallstones

Interestingly, very strenuous exercise, such as marathon running, can also temporarily increase bilirubin levels. In newborns, persistently high bilirubin levels may signal blood type incompatibility between mother and child, lack of oxygen, inherited infections, or liver diseases.

Alkaline Phosphatase (ALP) Test: Overview and Significance

Alkaline phosphatase (ALP) is another important enzyme found throughout the body, particularly in the liver, digestive system, kidneys, and bones. An ALP test measures the amount of this enzyme in your blood, helping diagnose liver diseases or bone disorders.

When might a doctor order an ALP test? This test is typically recommended if you show signs of liver disease or a bone disorder. It’s often included as part of a comprehensive metabolic panel, which assesses overall health and screens for various conditions.

ALP Test Procedure

The ALP test procedure is similar to the bilirubin test:

• A blood sample is drawn from a vein in your arm.
• The sample is sent to a laboratory for analysis.
• Results are usually available within a few days.

Understanding ALP Test Results

Interpreting ALP test results requires considering various factors, including age, gender, and overall health. How do you interpret ALP levels? Generally, normal ALP levels for adults range from 20 to 140 international units per liter (IU/L). However, these ranges can vary depending on the laboratory and the specific testing method used.

High ALP levels may indicate:

• Liver diseases (such as hepatitis or cirrhosis)
• Bone disorders (like Paget’s disease or osteomalacia)
• Certain cancers (particularly those affecting the liver or bones)
• Gallbladder issues
• Pregnancy (ALP levels naturally increase during pregnancy)

It’s important to note that slightly elevated ALP levels don’t always indicate a serious condition. Factors such as healing fractures, certain medications, or even recent food consumption can temporarily increase ALP levels.

Bilirubin and ALP Tests: Clinical Applications

Both bilirubin and ALP tests play crucial roles in diagnosing and monitoring various health conditions. How do these tests complement each other in clinical practice?

Bilirubin tests are particularly useful for:

• Diagnosing and monitoring liver and bile duct diseases
• Assessing conditions like cirrhosis, hepatitis, and gallstones
• Evaluating hemolytic anemia and sickle cell disease
• Monitoring newborn jaundice

ALP tests, on the other hand, are valuable for:

• Detecting liver dysfunction
• Identifying bone disorders
• Monitoring treatment effectiveness for liver and bone conditions
• Screening for certain types of cancer

When used together, these tests provide a more comprehensive picture of liver and bone health, allowing for more accurate diagnoses and treatment plans.

Factors Affecting Bilirubin and ALP Levels

Several factors can influence bilirubin and ALP levels, potentially leading to misleading test results. What should you be aware of before taking these tests?

Factors Affecting Bilirubin Levels:

• Certain medications (e.g., caffeine, penicillin, barbiturates, NSAIDs)
• Strenuous exercise
• Fasting
• Stress
• Pregnancy

Factors Affecting ALP Levels:

• Age (ALP levels are naturally higher in children and older adults)
• Pregnancy
• Certain medications
• Recent food consumption
• Smoking

It’s crucial to inform your healthcare provider about any medications, lifestyle factors, or recent activities that might affect your test results. This information helps ensure accurate interpretation of the results and appropriate medical decisions.

Preparing for Bilirubin and ALP Tests

Proper preparation can help ensure accurate test results. How should you prepare for these blood tests?

For both bilirubin and ALP tests:

• Inform your doctor about all medications, supplements, and herbal remedies you’re taking
• Discuss any recent illnesses or medical procedures
• Follow any fasting instructions provided by your healthcare provider
• Avoid strenuous exercise for 24 hours before the test
• If you smoke, try to avoid smoking for at least one hour before the test

Remember, these tests are typically quick and minimally invasive. You should be able to resume normal activities immediately after the blood draw.

Beyond Bilirubin and ALP: Other Liver Function Tests

While bilirubin and ALP tests provide valuable information about liver health, they are often part of a broader panel of liver function tests. What other tests might your doctor order to assess liver function?

• Alanine transaminase (ALT) test
• Aspartate transaminase (AST) test
• Gamma-glutamyl transferase (GGT) test
• Albumin test
• Prothrombin time (PT) test

These tests, when used in combination, provide a comprehensive overview of liver function and can help diagnose a wide range of liver conditions, from hepatitis to cirrhosis.

Interpreting Comprehensive Liver Function Tests

Interpreting liver function tests requires considering the results collectively rather than in isolation. For instance, elevated ALT and AST levels alongside high bilirubin might suggest liver cell damage, while high ALP and GGT could indicate bile duct obstruction.

It’s important to remember that liver function tests are just one tool in diagnosing liver conditions. Your healthcare provider will consider these results alongside your medical history, physical examination, and potentially other diagnostic tests to make an accurate diagnosis.

When to Seek Medical Attention

Understanding when to seek medical attention based on symptoms related to liver function is crucial. What signs should prompt you to consult a healthcare provider?

• Yellowing of the skin or eyes (jaundice)
• Dark urine
• Pale or clay-colored stools
• Persistent fatigue or weakness
• Abdominal pain or swelling
• Nausea or loss of appetite
• Easy bruising or bleeding

If you experience any of these symptoms, especially in combination, it’s important to seek medical attention promptly. Early detection and treatment of liver conditions can significantly improve outcomes and prevent complications.

Regular Health Check-ups

Even in the absence of symptoms, regular health check-ups that include liver function tests can be beneficial, especially for individuals with risk factors for liver disease. These risk factors include:

• Heavy alcohol consumption
• Obesity
• Diabetes
• Family history of liver disease
• Exposure to certain chemicals or toxins
• History of blood transfusions

Discussing your individual risk factors with your healthcare provider can help determine the appropriate frequency of liver function testing for you.

Lifestyle Factors Influencing Liver Health

Maintaining good liver health goes beyond regular testing. What lifestyle factors can influence your liver function and overall health?

• Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports liver health.
• Exercise: Regular physical activity helps maintain a healthy weight and reduces the risk of fatty liver disease.
• Alcohol consumption: Limiting alcohol intake can prevent alcohol-related liver damage.
• Hydration: Drinking adequate water helps the liver flush out toxins.
• Sleep: Getting enough quality sleep allows the liver to perform its regenerative functions.
• Stress management: Chronic stress can negatively impact liver function, so stress-reduction techniques are beneficial.

By adopting these healthy lifestyle habits, you can support your liver function and potentially improve your bilirubin and ALP test results over time.

Supplements and Liver Health

While a balanced diet is the best way to support liver health, some supplements have been studied for their potential liver-protective properties. These include:

• Milk thistle
• N-acetyl cysteine (NAC)
• Turmeric
• Alpha-lipoic acid

However, it’s crucial to consult with a healthcare provider before starting any supplement regimen, as some supplements can interact with medications or have adverse effects on liver function in certain individuals.

Future Developments in Liver Function Testing

As medical science advances, new methods for assessing liver function are being developed. What future developments might we see in liver function testing?

• Non-invasive imaging techniques: Advanced imaging methods like elastography are becoming more widely used to assess liver fibrosis and cirrhosis without the need for invasive biopsies.
• Genetic testing: Identifying genetic markers for liver diseases could allow for earlier intervention and personalized treatment plans.
• Biomarker discovery: Researchers are continually identifying new biomarkers that could provide more specific information about liver health and disease progression.
• Point-of-care testing: Rapid, portable tests for liver function could make monitoring more accessible, especially in resource-limited settings.

These advancements hold the promise of more accurate, less invasive, and more accessible liver function testing in the future, potentially leading to improved outcomes for patients with liver conditions.

The Role of Artificial Intelligence in Liver Function Analysis

Artificial intelligence (AI) is increasingly being applied to medical diagnostics, including liver function analysis. AI algorithms can analyze complex patterns in liver function test results, imaging studies, and patient data to assist in diagnosis and treatment planning. This technology has the potential to:

• Improve the accuracy of liver disease diagnosis
• Predict disease progression more reliably
• Personalize treatment plans based on individual patient characteristics
• Identify subtle changes in liver function that might be missed by human observers

While AI is not intended to replace healthcare providers, it can serve as a powerful tool to augment clinical decision-making and improve patient care.

Global Perspectives on Liver Health

Liver health is a global concern, with different regions facing unique challenges. How do liver health issues vary around the world?

• In many developing countries, infectious causes of liver disease, such as hepatitis B and C, remain significant public health issues.
• In developed nations, non-alcoholic fatty liver disease (NAFLD) is becoming increasingly prevalent, largely due to rising obesity rates.
• Alcohol-related liver disease is a major concern in regions with high alcohol consumption.
• Environmental factors, such as exposure to aflatoxins in certain parts of Africa and Asia, contribute to liver cancer risk.

These global variations highlight the need for tailored approaches to liver health promotion and disease prevention in different parts of the world.

Global Initiatives for Liver Health

Several global initiatives are working to address liver health issues worldwide:

• The World Health Organization’s Global Health Sector Strategy on Viral Hepatitis aims to eliminate viral hepatitis as a public health threat by 2030.
• The Global Liver Institute advocates for liver health and provides education and support for patients worldwide.
• The European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD) lead research efforts and develop clinical guidelines for liver diseases.

These initiatives play crucial roles in advancing liver health research, improving access to treatment, and raising awareness about liver diseases globally.

High vs. Low Levels, Direct vs. Indirect

Written by WebMD Editorial Contributors

• Why Do You Get This Test?
• What Happens During the Test?
• Who Should Get It? Who Shouldn’t?
• What Do the Results Mean?

A bilirubin test measures the amount of bilirubin in your blood. It’s used to help find the cause of health conditions like jaundice, anemia, and liver disease.

Bilirubin is an orange-yellow pigment that occurs normally when part of your red blood cells break down. Your liver takes the bilirubin from your blood and changes its chemical make-up so that most of it is passed through your poop as bile.

If your bilirubin levels are higher than normal, it’s a sign that either your red blood cells are breaking down at an unusual rate or that your liver isn’t breaking down waste properly and clearing the bilirubin from your blood.

Another option is that there’s a problem somewhere along the pathway that gets the bilirubin out of your liver and into your stool.

In children and adults, doctors use it to diagnose and monitor liver and bile duct diseases. These include cirrhosis, hepatitis, and gallstones.

It’ll also help determine if you have sickle cell disease or other conditions that cause hemolytic anemia. That’s a disorder where red blood cells are destroyed faster than they’re made.

High levels of bilirubin can cause a yellowing of your skin and eyes, a condition doctors call jaundice.

High bilirubin levels are common in newborns. Doctors use the age of the newborn and the bilirubin type and levels to determine if treatment is necessary.

A nurse or lab technician will draw blood through a small needle inserted into a vein in your arm. The blood is collected in a tube.

With newborns, blood is usually drawn by using a needle to break the skin of the heel.

Your doctor will send the blood to a lab for analysis.

Before the test, tell your doctor about how active you’ve been and what food and medicines you’ve taken. Certain medications may alter your results.

After the test, you’ll be able to continue with your normal activities right away.

Your doctor may order a bilirubin test if you:

• Show signs of jaundice
• Have anemia, or low red blood cells
• Might be having a toxic reaction to drugs
• Have a history of heavy drinking
• Have been exposed to hepatitis viruses
• Have cirrhosis

You might also have your bilirubin tested if you have symptoms like:

• Dark urine
• Nausea and vomiting
• Abdominal pain or abdominal swelling
• Clay-colored stools
• Fatigue

A bilirubin test measures total bilirubin. It can also give levels of two different types of bilirubin: unconjugated and conjugated.

Unconjugated (“indirect”) bilirubin. This is the bilirubin created from red blood cell breakdown. It travels in the blood to the liver.

Conjugated (“direct”) bilirubin. This is the bilirubin once it reaches the liver and undergoes a chemical change. It moves to the intestines before being removed through your stool.

For adults over 18, normal total bilirubin can be up to 1.2 milligrams per deciliter (mg/dl) of blood. For those under 18, the normal level will be will be 1 mg/dl. Normal results for conjugated (direct) bilirubin should be less than 0.3 mg/dl.

Men tend to have slightly higher bilirubin levels than women. African-Americans tend to have lower bilirubin levels than people of other races.

High total bilirubin may be caused by:

• Anemia
• Cirrhosis
• A reaction to a blood transfusion
• Gilbert syndrome — a common, inherited condition in which there is a deficiency of an enzyme that helps to break down bilirubin.
• Viral hepatitis
• A reaction to drugs
• Alcoholic liver disease
• Gallstones

Very strenuous exercise, such as marathon running, can increase your bilirubin levels.

Caffeine, penicillin, barbiturates, and nonsteroidal anti-inflammatory drugs (NSAIDs) called salicylates all lower your bilirubin levels.

Lower-than-normal levels of bilirubin aren’t a problem.

In newborns, high bilirubin levels that don’t level out in a few days to 2 weeks may be a sign of:

• Blood type incompatibility between mother and child
• Lack of oxygen
• An inherited infection
• A disease affecting the liver

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Alkaline Phosphatase Test (ALP): High vs. Low Levels

Written by WebMD Editorial Contributors

• Why Would I Get This Test?
• How Is the Test Done?
• How Do I Prepare?
• What Do My Results Mean?

Alkaline phosphatase is one kind of enzyme found in your body. Enzymes are proteins that help chemical reactions happen. For instance, they can break big molecules down into smaller parts, or they can help smaller molecules join together to form bigger structures.

You have alkaline phosphatase throughout your body, including your liver, digestive system, kidneys, and bones.

If you show signs of liver disease or a bone disorder, your doctor may order an alkaline phosphatase (ALP) test to measure the amount of the enzyme in your blood and help in diagnosing the problem. Sometimes it’s part of a broader group of tests called a routine liver or hepatic panel, which checks how your liver is working.

If your liver isn’t working right, the amount of ALP in your blood may be high. Doctors often use the test to look for blocked bile ducts. Other conditions that can cause problems with your liver include:

• Liver cancer
• Cirrhosis
• Hepatitis
• Blockage in the bile ducts

The test can also spot problems with your bones, including:

• Cancers that have spread to your bones
• Paget’s disease, which affects how bones grow
• Issues caused by vitamin D deficiency

The lab will need a small amount of blood to perform the test.

The person in charge of taking your blood will start by placing a tight elastic band, called a tourniquet, around your upper arm. This makes your veins swell with blood.

The lab tech will clean an area of your skin with a germ-killing solution. (It might be a spot inside your elbow or the back of your hand). You’ll feel a small stick when the needle goes into your vein. The blood flows into a small vial attached to the needle.

When the test is done, the lab tech will take the tourniquet off, and you’ll get a bandage on the spot where the needle went in. It takes only a few minutes.

Taking blood samples is usually very safe. Some things that might happen after the test include a bruise at the spot where the needle went in, and a little dizziness. There’s also a slight chance of infection.

You may have to limit food and liquids for several hours before the test. Some medicines interfere with the results, so make sure your doctor knows about all drugs you take, including over-the-counter medicines, vitamins, and supplements.

Be sure to let your doctor know if you are pregnant, because that will increase the level of ALP in your blood.

It generally takes 1-2 days for results to come back from the lab.

Higher-than-normal ALP levels for your age and sex may not necessarily mean you have a problem. (Children and teens naturally have higher levels than adults because their bones are still developing).

If your ALP level is high, your doctor may have you take another test, called an ALP isoenzyme test, to determine whether the alkaline phosphatase in your blood is coming from your liver or your bones.

Low levels of ALP indicate a deficiency in zinc and magnesium but can also be an indicator of a rare genetic disease called hypophosphatasia (HPP), which affects bones and teeth.

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ALT (ALT, Alanine aminotransferase, alanine transaminase, SGPT, Alanine aminotransferase)

Alanine aminotransferase (AlAT, ALT) is an intracellular enzyme, the content of which in the blood of healthy people is low. It is mainly found in the cells of the liver, myocardium, skeletal muscles, pancreas. When cells containing ALT are damaged or destroyed, the enzyme is released into the bloodstream, and its concentration in the blood increases.

Determination of the level of alanine aminotransferase is carried out for the diagnosis of liver diseases and dynamic monitoring of their treatment. The analysis is performed for suspected acute or chronic hepatitis of viral or toxic etiology, cirrhosis of the liver, primary tumors, or metastatic liver disease.

The growth of alanine aminotransferase in the blood in hepatitis is noted much earlier than the onset of the icteric stage, which makes it possible to identify the pathology at the initial stage.

As part of a screening examination (preventive examination of persons who do not have complaints) to assess the state of the liver, before planned hospitalization and surgical treatment, an analysis for ALT is prescribed together with another enzyme – AsAT (aspartate aminotransferase).

The level of ALT together with other enzymes is evaluated in diseases of the pancreas and gallbladder – pancreatitis, cholecystitis, cholelithiasis; if there are complaints of unexplained general weakness, fatigue, yellowness of the skin and sclera, abdominal pain, including a feeling of heaviness in the right hypochondrium, nausea, vomiting.

In addition, the ALT level is taken into account in myocardial infarction and myocarditis, although in cases of heart damage it is only of secondary importance. The study is prescribed for suspected myositis, myodystrophy, when complaints of muscle pain cannot be explained by injuries or excessive physical activity.

Donation is a mandatory reason for testing for ALT.

ALT values ​​are assessed in any chronic disease, before prescribing drug therapy, for example, antitumor, anti-tuberculosis drugs, to assess the initial state of the liver and over time to assess drug tolerance.

Preparation for procedure

It is better to take the test in the morning on an empty stomach (after an 8-14 hour break after the last meal).

Drinking water is allowed.

If necessary, it is permissible to donate blood 4-6 hours after a light meal.

On the eve it is desirable to avoid physical and emotional overload, overeating.

Avoid drinking alcohol 5-6 days before the test.

Avoid smoking 30 minutes before blood sampling.

Deadline

The survey is completed within one business day.

What can affect the results

Intense physical activity the day before and even a few days before the test can lead to damage to muscle tissue (the so-called tear of muscle fibers) and, accordingly, an increase in the level of ALT. For the same reason, the analysis given after the injury is not informative.

Taking alcohol, certain drugs (antibiotics, non-steroidal anti-inflammatory drugs, anticancer drugs, oral contraceptives, etc.) often distort the result of the study. The list of medications taken should be discussed with the doctor who ordered the analysis, cancel those that are possible – without risk to health.

ALT (ALT, Alanine aminotransferase, alanine transaminase)

For research, blood is taken from a vein. Usually, ASAT (AST, Aspartate aminotransferase) is determined simultaneously and the ratio of ASAT / AlAT (de Ritis coefficient) is estimated.

You can take a blood test for ALT (ALT, Alanine aminotransferase, alanine transaminase) at the nearest INVITRO medical office. The list of offices where biomaterial is accepted for laboratory testing is presented in the “Addresses” section.

Interpretation of test results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. An accurate diagnosis is made by the doctor, using both the results of this examination and the necessary information from other sources: history, results of other examinations, etc.

Normal

Units of measure: U/l.

Reference values ​​

Explanation of indicators

The level of ALT depends on the age and sex of the patient. Minor deviations from the norm, as a rule, do not require drug therapy, and the recommendations associated with them, such as rational nutrition, avoidance of alcohol, etc. should be discussed with your doctor.

The AST/ALAT ratio (de Ritis ratio) is normally between 0.91 and 1.75.

What do low readings mean

A significant decrease in the level of ALT can be detected in severe liver damage, for example, in the terminal stage of liver cirrhosis, when the number of liver cells is significantly reduced.

What do increased indicators mean

First of all, with an increase in ALT, liver problems should be suspected: fatty hepatosis, hepatitis of viral or toxic etiology, cirrhosis of the liver, liver cancer – primary or metastatic.

The degree of increase in ALT is usually associated with the extent or severity of liver damage, but cannot be considered as a determining factor for the prognosis of the disease. The maximum levels of ALT (and AST) – more than a hundred times higher than the norm, are observed in patients with acute viral and drug-induced hepatitis.

A significant increase in alanine aminotransferase can be observed in acute cholecystitis, cholelithiasis, and acute destructive pancreatitis. Another reason may be the use of hepatotoxic drugs that damage liver cells.

An increase in the level of ALT is detected with extensive injuries of the skeletal muscles, severe myositis and myodystrophy, frequent intramuscular injections.

A less significant increase in ALT is recorded in acute myocardial infarction and myocarditis.

Additional examination in case of deviation of the indicator from the norm

If a change (often an increase) in the level of ALT is detected, patients are consulted

general practitioners

,

gastroenterologists

, hepatologists, infectious disease specialists.

To clarify the diagnosis, in addition to ALT, other liver enzymes (AST, gamma-HT, alkaline phosphatase, bilirubin), clinical blood counts, and markers of viral hepatitis, primarily hepatitis B and hepatitis C, are usually examined.

An ultrasound examination of the abdominal organs is performed, according to indications – computed tomography (CT) with contrast.

If damage to the skeletal muscles is suspected, the CPK enzyme is additionally examined and a rheumatologist is consulted.

If a heart muscle disorder is suspected, a cardiologist should be consulted. Usually the doctor prescribes additional electrocardiography (ECG), echocardiography, blood test for CF-CF, troponin I.

O.P. The role of new reference values ​​of alanine aminotransferase in the diagnosis of various forms of non-alcoholic fatty liver disease in patients with metabolic syndrome. Journal of Biomedical Technologies № 1. 2015. P. 9-15.

Clinical guidelines “Liver cancer (hepatocellular)”. Developed by: Association of Oncologists of Russia, Russian Society of Clinical Oncology, Russian Society of Radiologists and Radiologists. – 2020.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

Biochemical blood test

Biochemical blood test (BAC) is one of the most informative tests that gives an idea about the work of the kidneys, liver, gallbladder, pancreas, other organs, lipid, protein and carbohydrate metabolism, the balance of microelements.

Analyzes

Total bilirubin

1 day

from 125 ₽

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0003

from 125 ₽

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Alanine aminotransferase (ALT)

1 day

from 125 ₽

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LHC can be prescribed by any doctor, because with each disease it is important to see the big picture. For preventive purposes, blood biochemistry is done once a year, during pregnancy – in the 1st and 3rd trimesters with a normal course, and more often – with ailments and complaints of a woman about her well-being.

Test indications

• complaints of malaise;
• any disease;
• assessment of the state after therapy;
• preventive examination.

Blood chemistry tests

During a biochemical analysis, the blood sugar, urea, total lipids, low and high density cholesterol, triglycerides, total bilirubin, total protein, AsAt, AlAt enzymes, lipase, amylase, gamma-GTP and other indicators are determined. Each of the indicators may indicate the normal operation of an organ, system, or a deviation from the norm.

It should be remembered that blood biochemistry is a primary diagnosis, an assessment of a person’s overall health. Its results can only be interpreted by an experienced specialist. According to the indicators of the BAC, the doctor prescribes special tests if there are suspicions of a disease or pathology of organs.

Biochemical analysis of blood a large number of tested items. Next, we will talk about the main ones.

Further in the text are the norms of the research, WHICH ARE INFORMATIONAL CHARACTER. In all laboratories, the norms, units of measurement may differ, as well as THEY DEPEND on the sex and age of the patient. BE CAREFUL!

Specific proteins and inflammatory markers

More than 20 plasma proteins are called specific proteins and markers of inflammation, the concentration of which indicates the development of acute inflammation or tissue damage.

C-reactive protein

CRP is one of the most sensitive markers of acute inflammation and tissue damage. It appears in the blood serum and rapidly increases in volume when:

• various inflammations;
• diseases of the gastrointestinal tract;
• parasitic, viral, bacterial infections;
• systemic rheumatic diseases;
• metastases of cancerous tumors;
• tissue damage, including acute myocardial infarction;
• neonatal sepsis;
• meningitis;
• tuberculosis;
• burns;
• taking oral contraceptives, estrogens.

According to the above list, it is clear that the indicator has low specificity, therefore, with its high rates, narrower studies are immediately prescribed if the reason for the increase is unknown.

The CRP indicator is used to determine the success of therapy: if the treatment gives a result, the protein returns to normal after 6-10 days

Eosinophilic cationic protein (ECP)

ESR rises when:

• atopic bronchial asthma;
• allergic rhinitis;
• atopic dermatitis;
• food allergies;
• helminthiasis;
• acute respiratory infections;
• malignant diseases with activation of eosinophils;
• taking certain medications.

Rheumatoid factor

Rheumatoid factor is a protein produced by the human immune system. An increase in the rate of the RF may indicate rheumatoid arthritis, Sjögren’s syndrome, chronic infections of a bacterial, viral, parasitic nature, some types of oncology, diseases of the kidneys, liver, and lungs.

Myoglobin

The concentration of myoglobin increases if the myocardium or skeletal muscles are damaged. Normally, its concentration is not determined in the laboratory – so little myoglobin is contained in the blood of a healthy person, from 0 to 70 mcg / l.

Troponin I

Tn I is a heart muscle protein that enters the bloodstream during myocardial infarction. It is one of the most sensitive and specific indicators for damage to the heart muscle. After a heart attack, after about 3 hours, the level of Tn I in the blood rises significantly and remains so for up to 14 days.

Creatine kinase MB

KK-MB is a cell enzyme that is used as a specific and sensitive indicator of myocardial damage.

CK-MB is located almost in its entirety in the heart muscle, therefore its content in the bloodstream is negligibly small. If it increases, then the likelihood of acute heart attack, recurrent heart attack and other pathological processes associated with the heart is high.

NT-proBNP

NT-proBNP is a protein of the left ventricle of the heart. A change in its level may indicate heart failure, its severity. The level of this protein also evaluates the effectiveness of heart failure therapy.

The norm for people under 75 years old is 0-125 pg / ml, over 75 years old – up to 450 pg / ml.

Antistreptolysin-O (ASLO)

ASLO is a marker of streptococcal infection. Its increase is caused by angina, scarlet fever, chronic tonsillitis, acute glomerulonephritis, streptococcal pyoderma.

Procalcitonin

Procalcitonin rises in the blood during bacterial infections, sepsis, septic shock, multiple organ failure, and some other serious conditions.

Electrolytes

Electrolytes include chlorine, sodium, and potassium. They play an important role in metabolic processes, maintain the level of acidity, water balance. The level of electrolytes is the most important characteristic of human health, an indicator of the functionality of the heart and kidneys.

Abnormalities in kidney function, heart disease, diabetes mellitus, pathologies and disorders in the functioning of muscles and the nervous system lead to deviations from the norm. If the electrolyte imbalance is not stabilized by eliminating its causes, the person will experience dizziness, convulsions, and irregular heartbeats. In especially advanced cases, an electrolyte imbalance leads to death.

Lipid metabolism

The LHC shows the level of fats and allows you to assess the risk of occurrence, development of heart and vascular diseases. During testing, the level of triglycerides, cholesterol – total, LDL, HDL is checked.

Triglycerides

Triglycerides grow in diabetes, heart and vascular pathologies, pregnancy; decrease in case of disturbances in the functioning of the thyroid gland, at the terminal stage of liver damage, if a person eats poorly, monotonously.

Cholesterol

• HDL (“good cholesterol”). Participates in the processing and removal of fats from the body. If the values ​​are high, then the risk of formation of vascular plaques decreases. The norm is 1.03–1.55 mmol / l.
• LDL (“bad cholesterol”). Normally – 0-3.3 mmol / l – it is necessary for the body. Exceeding the norm threatens the development of atherosclerosis.
• Total (composed of HDL and LDL). The norm is 5.2 mmol/l. A decrease against the norm leads to psychophysiological disorders, reproductive dysfunction. Elevated levels can cause diabetes, atherosclerosis.

Carbohydrate metabolism

During the LHC, glucose and fructosamine levels are examined. An increase in their level can occur with diabetes mellitus, a decrease in pancreatic tumors, when taking insulin.

• the norm for glucose is 3.3-5.5 mmol / l;
• the norm for fructosamine is up to 285 µmol / l.

Pigments

During the LHC, the level of bilirubin is set – total (yellow), direct, indirect.

• General. Normally – 3.4-17.1 µmol / l, an increase occurs in pathologies, liver diseases, and disruption of its work.
• Straight. Normally – up to 7.9 µmol / l, an increase indicates pathologies of the liver, biliary tract.
• Indirect . Its indicators are calculated, depend on direct and total bilirubin. An increase in indirect bilirubin is often associated with anemia, malaria.

Iron

Serum iron is one of the most important indicators of health. It transports and deposits oxygen, participates in hematopoiesis, and is part of many proteins and enzymes. Especially carefully you need to monitor the level of iron in children, adolescents, pregnant and lactating women, the elderly, those who experience high physical exertion, suffer from chronic bleeding.
A decrease in the level of iron occurs with malnutrition, heavy blood loss, non-assimilation of iron, and an increased need for it.

Enzymes

1. Liver tests. The standard set of LHC indicators includes the so-called. “liver tests” – ASAT, ALT. Changes in the norm can signal diseases, pathologies of the liver, heart, inflammation and infections.

• The AST norm is up to 31 U/l in women, up to 37 U/l in men.
• The ALT norm is up to 34 U/l in women, up to 45 U/l in men.

2. Amylase – digestive juice enzyme. An increase in its level occurs in acute, chronic pancreatitis, other diseases (including tumors) affecting the pancreas.

• Amylase rate – 28-100 U / l.

3. Pancreatic amylase – P-type amylase. An increase in the level of P-type amylase occurs when the pancreatic duct is blocked by a tumor, stone, and in some other cases.

4. Creatine kinase (CK) is an enzyme that provides energy for muscle contraction. In the blood, it is present in different isomers. By increasing the concentration of individual isomers, an assumption is made about damage to muscles, myocardium, and oncological diseases.

5. L ipaza — digestive juice enzyme. A change in the norm indicates problems with the pancreas.

6. Vitamins . The standard BAC determines the concentration of vitamin B12. It is necessary, first of all, for hematopoiesis. An increase in the level of B12 occurs with diseases of the kidneys, liver, leukemia, a decrease in vegetarianism, inflammation of the gastrointestinal tract, and parasitic infections. The vitamin norm is from 208 to 963.5 pg / ml. The BAC may include a test for the content of vitamins of group D. Deficiency of this vitamin is experienced by up to 60% of people around the world. Vitamin deficiency is expressed in rickets (children), muscle weakness, pain in the pelvic bones, lower back, legs. With vitamin intoxication (uncontrolled intake of vitamin-containing complexes), headaches, nausea, vomiting, a metallic taste in the mouth, acute pancreatitis, nephro- and arteriolocalcinosis occur.

• The norm for vitamin D2 is 0. 8-7 ng / ml, for vitamin D3 – 2.2-42.6 ng / ml.

Rules for preparing for analysis and passing the LHC

Many factors affect blood counts: food (including drinking water), habits, physical and mental state, bathing, medications, alcohol, smoking, etc. Therefore, to obtain accurate data, several requirements must be met:

• donate blood on an empty stomach, from 8 to 11 am (all laboratory indicators are calculated for this time, they change over the course of the day). Even water is recommended not to drink whenever possible. At least 8 hours should have passed since the last meal, ideally 12 hours;
• the day before, and preferably a few days before, you should give up heavy, fatty, fried foods, strong tea, alcohol, carbonated drinks, and other foods that can change the functioning of the liver, kidneys, pancreas;
• a day before the analysis, avoid physical, psychological overload, do not visit the bathhouse, solarium, do not do x-rays, fluorography, physiotherapy, ultrasound;
• a day before the analysis, refrain from taking medications.