Abnormal Liver Function Tests

The liver is an amazing organ!  It gets rid of waste products the body doesn’t need;  it manufactures things the body needs and then transports them around the body, as well as storing  other vitamins and elements that preserve good health.  Liver function tests are routine blood tests that your doctor may order to assess the health of your liver.  The tests can give information to your doctor about possible liver problems and how to best investigate and treatment it.  The tests can show if there is jaundice and what the causes for that might be i.e. related to a blood problem, and problem with the liver itself or a blockage to the flow of bile.  The basic blood tests are:

Bilirubin – this goes up with jaundice and is a marker of the livers ability to remove waste products

Albumin – this represents the manufacturing component of the liver, if the levels are low this suggests the “factory” isn’t happy

Alkaline phosphatase – the liver makes bile to help digest fats and absorb vitamins if the bile is taking a long time to get through the liver this test will go up

Alanine and aspartate transaminase (ALT and AST) – this tests mark liver cell (hepatocyte) damage and crudely are a measure of ongoing inflammation or insult to the liver

Gamma-Glutamyl transferase – Gamma GT – this test can be a marker of alcohol consumption but can also go up with blockage to bile flow or as a response to medication or fatty infiltration.

Other tests your Doctor may look at will be the ability of the blood to clot (prothrombin time (PT) or international normalized ratio (INR) – this goes up if the liver is damaged and the liver is less able to make substances that help the blood clot.  Your doctor may also look at your platelet count as this can drop in the context of more advanced liver disease.

The blood tests provide useful information but may not tell you about the extent of liver scarring (fibrosis).  Very Advanced scarring of the liver when the normal structure and architecture is lost is called cirrhosis.  Alcohol is only one cause of cirrhosis.  It can be caused by many things including chronic viral infections, autoimmune disease, metabolic diseases and rare diseases.  To assess for liver damage your doctor may recommend a fibroscan or more rarely a liver biopsy.


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