The liver is one of the most important organs as it performs vital tasks in other body processes such as digestion, immunity, excretion and blood clotting. A liver function check therefore analyses quite a range of blood components.
Liver diseases can affect the liver's structure or function, with common types including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, viral hepatitis (types A-E), and cirrhosis (liver scarring). Other causes of liver disease can be genetic, such as haemochromatosis, autoimmune, or cancer. Symptoms of liver diseases can vary, but may include jaundice (yellow skin/eyes), abdominal swelling and fatigue, though sometimes can be asymptomatic.
Causes of liver disease include excessive alcohol consumption, obesity, diabetes, viral infections (Hepatitis A, B, and C), inherited disorders, autoimmune conditions, and some medications and toxins.
More information may be available from the NHS or British Liver Trust
Our panels include;
Albumin: Albumin is the most abundant circulating protein found in plasma. It represents half of the total protein content of plasma in healthy humans. Albumin is synthesized by the liver hepatocytes and is rapidly excreted into the bloodstream at the rate of about 10 gm to 15 gm per day.
Low serum albumin levels may indicate kidney or liver disease including hepatitis or cirrhosis of the liver.
Increased blood albumin levels may be a result of dehydration, a high protein diet, or even having a tourniquet on too long when having blood taken.
Alanine transaminase (ALT): ALT is an enzyme found within the liver. When the liver becomes damaged, ALT is released into the bloodstream.
Serum ALT levels may be elevated due to liver damage from alcohol consumption, fatty liver disease, high iron levels, hepatitis, liver cancer or cirrhosis of the liver, but could be elevated for many other reasons.
Low ALT levels are uncommon and generally little cause for concern but can be due to low levels of vitamin B6 or chronic kidney disease.
Alkaline Phosphatase (ALP): ALP is an enzyme found in the bloodstream. It helps break down proteins in the body and exists in different forms, depending on where it originates. The liver is one of the main sources of ALP, but some is also made in the bones, bile ducts, pancreas, and kidneys.
Elevated serum ALP levels could be due numerous ailments including biliary obstruction, bone disease, a healing fracture, hepatis, liver disease and sarcoidosis.
Lower serum ALP levels could be due to malnutrition, pernicious anaemia, zinc deficiency and hypothyroidism.
Aspartate transferase (AST): AST is an enzyme found within the liver. When the liver becomes damaged, AST is released into the bloodstream, similar to ALT.
When AST is elevated along with ALT, the problem can be isolated to the liver.
Elevated levels of AST are most commonly indication of a liver conditions such as hepatitis, alcohol-induced liver injury, cirrhosis and liver cancer but can also be caused by damage to other areas of the body such as the muscles and pancreas.
Direct/Total Bilirubin: Bilirubin is a pigment which occurs naturally when red cells break down. The liver is responsible for changing the chemical makeup of bilirubin, allowing it to pass through excrement as bile.
Total bilirubin is a measurement of the total volume of bilirubin in the blood. Direct (sometimes known as conjugated) bilirubin is a measure of the changed bilirubin product in the liver, which the body can get rid of. From this, indirect or unconjugated bilirubin levels can be calculated.
A high level of direct bilirubin indicates that red blood cells are breaking down at unusual rates or the liver is improperly breaking down waste and clearing bilirubin from the blood. High levels could be caused by jaundice, anaemia, cirrhosis, hepatitis, alcoholic liver disease and gallstones.
Low bilirubin levels typically are not cause for concern but can be the result of certain medications, caffeine intake or autoimmune diseases.
Gamma-glutamyl transferase (GGT): GGT is an enzyme found throughout the body but mainly found in the liver. GGT may leak into the bloodstream when damage occurs to the liver or bile ducts. GGT is typically the first liver enzyme to increase when the bile ducts become constricted or blocked, making it the most sensitive liver test for finding issues within the bile ducts.
Around ¾ people who have alcohol use disorder are found to have elevated levels of GGT in their blood. However, elevated levels of GGT can also be caused by non-alcohol related liver disease.
Total protein: The total protein test measures the body’s albumin and globulin levels combined. It is from the total protein and albumin measured levels that allows a globulin level to be determined.
An elevated total protein may be an indication of liver inflammation or infections, certain bone marrow disorders or a high protein diet.
Low total protein may be an indication of liver or kidney disorders, malnutrition, malabsorption or certain inflammatory conditions.
