Liver Function Test: Lab Tests That Detect Liver Issues
The best liver function test is actually a combination of lab tests that will show you the full scope of the state of your liver. A combination of a Comprehensive Wellness Panel, Anemia lab test, Inflammation lab test, and a Heavy Metals panel is the best way to make sure no liver issues go unnoticed.
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Lab tests help find liver problems early so they can be treated and managed better. Several diseases can hurt the liver, which gets rid of toxins, makes proteins, and makes biochemicals that help digestion. Symptoms may not show up until the late stages. Hepatitis, fatty liver disease, cirrhosis, and liver cancer can be found early in lab tests, which makes the treatment and outlook better. People can take charge of their liver health by learning which blood tests can find problems with the liver.
Comprehensive Wellness Panel
Comprehensive Metabolic Panel (CMP)
The Comprehensive Metabolic Panel (CMP) is a group of 14 blood tests that check the health of the liver, kidneys, electrolytes, acid/base, blood sugar, and proteins. The CMP has many parts that can help with liver problems:
Alanine Aminotransferase (ALT)
Function: The liver is the primary location for the enzyme ALT. It facilitates the liver cells’ conversion of proteins into energy.
Importance: Because the enzyme is released into the circulation when liver cells are damaged, elevated ALT levels may be a sign of liver disease.
Aspartate Aminotransferase (AST)
Function: The liver, heart, muscles, and other tissues all contain the enzyme AST. It is involved in the metabolism of amino acids.
Importance: Elevated AST levels may signal problems with the liver, but they can also be a sign of problems with the heart or muscles.
Alkaline Phosphatase (ALP)
Function: An enzyme called ALP is associated with the bile ducts and can also be found in the placenta, intestines, and bones.
Importance: Increased ALP levels may be a sign of liver illness, bone diseases, or bile duct obstruction.
Bilirubin
Function: A natural consequence of red blood cell disintegration is bilirubin. The liver breaks it down and excretes it as bile.
Importance: A natural consequence of red blood cell disintegration is bilirubin. The liver breaks it down and excretes it as bile.
Albumin and Total Protein
Function: Total protein measures the combined amount of globulins and albumin in the blood, which is the primary protein the liver produces.
Importance: Low albumin levels may be a sign of long-term liver disease or other illnesses that impact the synthesis or loss of proteins.1
Gamma-Glutamyl Transferase (GGT)
Function: An enzyme called GGT facilitates the passage of peptides and amino acids through cellular membranes.
Importance: Increased GGT levels are indicative of liver illness and bile duct issues, especially those associated with alcohol consumption.
Total and Direct (Conjugated) Bilirubin
Function: The liver breaks down bilirubin, making it more water soluble and conjugated.
Importance: Elevations in both total and direct bilirubin may suggest blockage of the bile duct or malfunction of the liver.
Interpreting CMP Results for Liver Health
Increased ALT and AST: Indicate inflammation or damage to the liver cells.
Elevated ALP: Could signify liver illness or occlusion of the bile duct.
Increased bilirubin: May indicate hepatic failure, obstruction of the bile duct, or an overabundance of erythrocyte lysis.
Low total protein and albumin levels may indicate chronic liver disease or compromised liver function.
Elevated GGT: Frequently associated with bile duct issues or alcohol-related liver disease.
Ferritin
Ferritin controls the flow of iron.2 Blood ferritin values show how much iron the body has stored. Ferritin is an important liver measure because it shows iron overload and liver disease.
Major Storage Site
Ferritin is mostly stored in the liver. Because the liver releases more ferritin into the circulation when it is injured or inflamed, elevated ferritin levels may be a sign of liver disease.
Iron Overload Disorders
Hemochromatosis: High ferritin levels are the result of excessive iron absorption and storage caused by this hereditary disease. Over time, the extra iron accumulates in the liver and other organs, causing harm.
Secondary Iron Overload: Increased ferritin levels indicate secondary iron overload, which can be brought on by illnesses such as chronic liver disease, repeated blood transfusions, or specific forms of anemia.
Inflammation and Damage
Hepatitis: Due to liver cell destruction and the consequent release of ferritin into the blood, both acute and chronic hepatitis can result in high ferritin levels.
Alcoholic Liver Disease: Long-term alcohol use can damage and inflame the liver, raising ferritin levels.3
Non-Alcoholic Fatty Liver Disease (NAFLD): This disorder, which is linked to obesity and metabolic syndrome, can lead to increased liver inflammation and fat storage, which raises ferritin levels.
Normal Range: Age, gender, and laboratory standards all affect the normal range for ferritin levels, which typically ranges from 30 to 400 nanograms per milliliter (ng/mL) for males and 13 to 150 ng/mL for women.
Elevated Ferritin: Elevated levels may signify disorders leading to excessive iron accumulation, such as hemochromatosis, liver illness, inflammation, or iron overload.
Low Ferritin: Low levels are usually indicative of an iron shortage, which is unrelated to liver function but can cause anemia.
Anemia Lab Test
Aside from the CMP and Ferritin tests that the anemia panel has as well, this panel also has a few more subtests that can detect liver issues.
Transferrin
By binding and transferring iron throughout the body, transferrin, a glycoprotein mostly made in the liver, is essential to iron metabolism. It is necessary for the transportation of iron into cells, where it is utilized for a number of biological functions, such as the synthesis of hemoglobin in red blood cells.
Liver Production
The liver produces transferrin, and liver function has a direct impact on transferrin levels. Decreased transferrin production may be a sign of a liver injury or malfunction.
Liver Diseases
Transferrin levels can be impacted by a number of liver conditions, including:
Chronic Liver Disease: Reduced amounts of transferrin can result from diseases including cirrhosis, hepatitis, and liver cancer that affect the liver’s capacity to generate the protein.4
Acute Liver Damage: Additionally, drugs, infections, or toxic liver damage can all cause sudden reductions in transferrin synthesis.
Malnutrition: Transferrin levels can be further lowered by poor nutritional conditions, which are frequently observed in chronic liver illnesses.
Normal Range: Although the normal range for transferrin levels varies from laboratory to laboratory, it typically ranges from 204 to 360 mg/dL.
High Transferrin Levels: Because the body produces more transferrin to enhance iron transport, elevated transferrin levels can develop in iron deficiency anemia.
Low Transferrin Levels may suggest: chronic liver disease, acute liver damage, malnutrition, or inflammatory conditions.
Iron
Iron is an essential component of hemoglobin in red blood cells, which transports oxygen from the lungs to tissues. Iron is required for cellular energy generation because it is a cofactor in numerous enzymes involved in metabolic activities. The immune system needs iron to operate properly.
Iron Storage
The liver is the primary storage location for iron in the body.5 It accumulates extra iron in the form of ferritin and hemosiderin, which it releases as needed.
Iron Metabolism Disorders
Hemochromatosis: This hereditary condition causes increased absorption of dietary iron, resulting in iron overload. Excess iron accumulates in different organs, most notably the liver, causing damage and potentially leading to illnesses such as cirrhosis, liver cancer, and liver failure.
Secondary Iron Overload: Chronic liver disease, numerous blood transfusions, and some kinds of anemia can all cause secondary iron overload, which can harm the liver.
Liver Damage: Liver disorders can compromise the liver’s capacity to retain and regulate iron, resulting in abnormal iron levels in the bloodstream.
Serum iron levels for people typically vary from 60 to 170 µg/dL; however, this varies by laboratory.
Inflammation Lab Test
The three most important subtests of the inflammation panel that can detect liver issues are the CRP, ESR, and LDH subtests.
C-Reactive Protein (CRP)
The liver produces C-reactive Protein (CRP) in reaction to inflammation. CRP levels in the blood rise in response to both acute and chronic inflammation, making it an effective marker for identifying inflammatory processes in the body.
The liver produces CRP in response to inflammatory signals. As a result, CRP levels can indicate liver activity associated with inflammation.
Liver Diseases and Inflammation
Hepatitis: Both acute and chronic hepatitis (viral, alcoholic, or autoimmune) can result in high CRP levels due to liver inflammation.
Cirrhosis: Chronic liver inflammation that progresses to fibrosis and cirrhosis can cause elevated CRP levels.
Liver Cancer: Inflammation caused by liver tumors or metastases might raise CRP levels.6
The normal range for CRP levels varies per laboratory; however, it is often 0.3 to 1.0 mg/dL. CRP readings between 10 and 40 mg/L might suggest moderate inflammation or infection. CRP values of 40–100 mg/L indicate more inflammation, which can be found in more severe infections or inflammatory diseases. CRP values greater than 100 mg/L usually indicate significant inflammation or infection, such as bacterial infections, serious trauma, or autoimmune disorders.
Erythrocyte Sedimentation Rate (ESR)
Erythrocyte Sedimentation Rate (ESR), also known as Sed Rate, is a blood test that determines how rapidly erythrocytes (red blood cells) settle to the bottom of a test tube over a specific time period, often one hour. The pace at which red blood cells fall is an indirect indicator of the body’s inflammatory status.
Chronic liver disease: ESR levels can be high in chronic liver illnesses such as hepatitis and cirrhosis, which are characterized by persistent inflammation.
Liver Inflammation: Both acute and chronic hepatitis can cause high ESR owing to liver inflammation. Chronic inflammation and fibrosis in cirrhosis can lead to elevated ESR levels.
Liver Cancer: ESR levels might rise due to inflammation caused by liver tumors or metastases.
The normal range for ESR varies by age and gender, although it typically falls between 0–22 millimeters per hour (mm/hr) for males and 0-27 mm/hr for females.7 ESR readings of 20–40 mm/hr might suggest moderate inflammation or infection. ESR values ranging from 40 to 70 mm/hr indicate mild inflammation, which can be found in persistent infections, autoimmune illnesses, and inflammatory disorders. ESR values greater than 70 mm/hr typically indicate significant inflammation, which may result from serious infections, autoimmune diseases, or cancer.
Lactate Dehydrogenase (LDH)
Lactate Dehydrogenase (LDH) is an enzyme present in nearly every bodily tissue, including the liver, heart, muscles, kidneys, lungs, and blood cells. It is essential for converting lactate to pyruvate, which is an important step in cellular energy generation. Because LDH is found throughout the body, its levels in the blood might rise as a result of injury or disease affecting a variety of organs.
Liver Cell Damage: LDH is found in liver cells (hepatocytes). When these cells are destroyed owing to liver illness or injury, LDH is released into the circulation, causing high levels.
Liver Diseases: Both acute and chronic hepatitis can generate high LDH levels as a result of liver cell inflammation and destruction. Chronic liver disease, which causes fibrosis and liver cell loss, can result in elevated LDH levels. Hepatocellular carcinoma and metastatic liver tumors can cause considerable liver cell destruction, resulting in elevated LDH levels.
The normal range for LDH levels varies per laboratory but is often between 140 and 280 units per liter (U/L).
Heavy Metals Panel
Because exposure to heavy metals can result in liver damage and malfunction, the following subtests in a heavy metals panel can aid in the detection of liver problems:
Arsenic
Toxic metalloid arsenic can cause serious harm to the liver, among other organs.8 Arsenic may be found in both organic and inorganic forms, with the latter being more hazardous. Arsenic exposure can happen in the workplace, in polluted food, water, or air. Prolonged exposure to arsenic can cause serious health problems, including liver damage.
Liver Damage
Many problems with the liver can result from long-term exposure to arsenic, including:
Hepatotoxicity: Direct liver cell toxicity, which results in cellular deterioration and death.
Fatty Liver Disease: Fat buildup in the liver cells might lead to more serious liver problems.
Liver Fibrosis: An overabundance of fibrous connective tissue in the liver can result in cirrhosis.9
Liver Cancer: Higher chance of getting the main liver cancer known as hepatocellular carcinoma.
A normal range for arsenic in the blood is often between 0.3-2 µg/L, and for creatinine in the urine, it is typically between 5-50 µg/L.
Cadmium
The liver is one of the many organs that can suffer damage from cadmium, an extremely poisonous metal.10 Cadmium exposure can happen as a result of tainted food, drink, air, or workplace settings. Cadmium exposure over an extended period of time can cause serious liver damage as well as other health issues.
Normal Cadmium Levels
A normal blood level of cadmium is typically around 0.4 micrograms per liter (µg/L) for non smokers, and a normal urine level is 0.08 µg/g creatinine.
Lead
Lead is a very harmful metal that may seriously harm the liver, among other organs.11 Lead exposure may happen in work environments as well as through polluted air, water, soil, food, and consumer goods. Prolonged exposure to lead can cause serious health issues, including liver damage.
Normal Lead Levels
It is considered normal to have blood that contains less than 1 µg/dL. The Centers for Disease Control and Prevention (CDC) consider blood lead levels over 3.5 µg/dL to be high, especially in children.
Mercury
The heavy metal mercury is extremely poisonous and can have a serious negative impact on the liver, among other organs.12 Mercury exposure can happen in the workplace, water, air, dental amalgams, contaminated food (particularly fish), and other environmental factors. Prolonged exposure to mercury can cause serious health issues, including damage to the liver.
Normal Mercury Levels
Generally, the amount of total mercury in the blood is less than 10 nanograms per milliliter (ng/mL), and the amount in the urine is less than 20 micrograms per liter (µg/L).13
Conclusion
Early detection of liver problems is critical for efficient management and therapy; many laboratory tests are vital in this regard. Tests that offer important information on liver health include the Comprehensive Metabolic Panel (CMP), iron, ferritin, transferrin, and some heavy metal panels. These tests can detect inflammation, malfunction, and liver damage, allowing for prompt treatment and improved health results. Knowing which blood tests can identify liver issues gives people the ability to take preventative measures to keep their livers healthy and, when necessary, seek the right medical attention.
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Book At Home Lab TestLab Testing - Frequently Asked Questions
Why is it important to do lab tests occasionally?
It is important to do lab tests occasionally because they can provide valuable information about an individual's health and help to identify potential health issues early on. Lab tests can measure a wide range of factors, including blood count, cholesterol levels, liver and kidney function, and hormone levels, and can provide insight into an individual's overall health and wellness. Additionally, lab tests can help to diagnose and monitor the progression of certain medical conditions, such as diabetes and heart disease, and can help to identify any potential health risks or concerns. By doing lab tests occasionally, individuals can take proactive steps to maintain their health and wellbeing and reduce the risk of potential health problems in the future.
What does a routine blood test cover?
A routine blood test is used to check for a range of things, including your blood count and the levels of certain chemicals and substances in your blood. Blood tests can also be used to check how well certain organs, such as your liver and kidneys, are functioning.
How is a blood sample collected for lab testing?
A blood sample for lab testing is typically collected through a process called venipuncture, which involves inserting a small needle into a vein to draw blood. This is usually done on the inside of the elbow or the back of the hand.
What is the cost of a lab test?
In general, the cost of a lab test can range from a few dollars to several hundred dollars. It is always best to consult with your doctor or healthcare provider to get an accurate estimate of the cost of a lab test.