Liver test

The liver is a vital organ in the body that sits in the upper part of the stomach. It is the second largest organ in the body and plays over 500 functions in the body, including:

• Breaking down and storing nutrients
• Fighting infections
• Detoxifying blood
• Producing bile acids to aid food digestion
• Regulating blood sugar levels
• Maintaining hormone balances
• Helping blood to clot

What is a liver blood test?

A liver blood test, formerly called a liver function test (LFT), checks your liver health. The name change resulted from reports that only a liver blood test cannot diagnose or rule out liver disease. This means your liver blood test result can be normal even when you have liver disease. Some people with abnormal liver blood test results do not have liver disease.

What does a liver blood test check for?

A liver blood test can measure the levels of different blood components such as bilirubin, liver enzymes and proteins. The test can check your liver health and identify signs of damage or inflammation.

The following can affect your liver

• Liver infections such as hepatitis B and C
• Gallbladder disease
• Alcohol-related liver disease
• Non-alcoholic fatty liver disease
• Scarring of the liver – cirrhosis
• Haemochromatosis – excess iron storage in the body
• Side effects of herbal remedies and medications
• Autoimmune conditions – when the body attacks itself

Why get a liver blood test?

A liver blood test can help in the following cases

• You have a genetic disease like haemochromatosis
• You are concerned about fatty liver disease
• You have symptoms of nausea and fatigue
• You have elevated cholesterol
• You have type 2 diabetes
• You are overweight
• You drink more than 14 units of alcohol weekly
• You are taking medication that affects the liver

Before a liver blood test, we will review the following.

• Diet
• Health profile
• Alcohol consumption
• Previous liver blood test results
• Body mass index (BMI)

What does a liver blood test include?

Liver proteins

A liver blood test measures the following proteins

• Albumin – it helps to transport hormones and nutrients and aids in the growth and repair of tissues in the body
• Globulin – it helps in fighting infections and blood clotting
• Total protein – globulin and albumin levels combined

Liver enzymes

The liver blood test measures these enzymes

• Alkaline phosphatase (ALP) – this enzyme helps breakdown proteins for easy absorption in the body
• Alanine transferase (ALT) – it also helps in the breakdown of proteins
• Gamma-glutamyl transpeptidase (GGT) –detoxifies alcohol and drugs

Bilirubin

This is a yellow pigment produced when red blood cells in the body break down. This waste product has no known function in the body.

What symptoms occur from liver disease?

The symptoms and signs of liver disorders include:

• Loss of appetite
• Fatigue and tiredness
• Weight loss
• Diarrhoea
• Abdominal pain
• Vomiting and nausea
• Jaundice – when you have excess bilirubin resulting in itchy skin, yellow eyes and skin
• Low sex drive
• Abnormal bleeding and bruising
• Accumulation of fluid in the abdomen

Ensure you visit a doctor if you experience these symptoms.

How to check your liver health

You can assess your liver health with a liver blood test at our Clinic. Checking your liver health regularly is important if you:

• Are obese or have excess weight
• Drinks a lot of alcohol – more than 14 units a week
• Have diabetes
• Have haemochromatosis
• Have high triglyceride levels
• Have high blood pressure

You may need a liver biopsy or an ultrasound scan if your liver blood test result isn’t within the normal range.

What happens if the liver blood test result is abnormal?

Mild to moderate abnormalities in liver blood test results may indicate;

• Infections like hepatitis B and C
• Certain medications such as antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and anti-epileptic drugs
• Alcohol-related liver disease (increased GGT levels)
• Non-alcoholic fatty liver disease

We advise having a follow-up appointment with your healthcare provider if your liver blood test result is abnormal. Your doctor will conduct further investigations to diagnose or rule out liver disease.

Healthcare providers recommend a FibroScan if you drink over 50 units of alcohol weekly or 35 units for men and women, respectively. The FibroScan is a non-invasive medical device that checks for liver scarring (cirrhosis) and liver fibrosis by measuring stiffness in the liver.

Liver blood test results

A liver blood test measures several health markers to help diagnose different issues. Low or high levels of some enzymes and proteins can indicate a liver problem. Your test result will show the following.

• Albumin

  If your kidneys or liver are not working properly, your albumin levels can drop. Kidney inflammation or disease, infection and poor diet can reduce albumin levels.

  Normal albumin level is between 35 – 50 g/L.

• Globulin

  A wide range of conditions can result in an increase or decrease in globulin levels. Low protein, albumin and globulin can suggest kidney disease, liver disease, malabsorption or malnutrition.

  High albumin, protein and globulin levels may indicate an infection, inflammation and dehydration.

  In some cases of cirrhosis, albumin levels may become low, with an increase in globulin levels.

  The normal globulin level is between 19 – 35 g/L.

• Total protein (globulin and albumin)

  Low protein levels may indicate kidney or liver disorder. It can also indicate improper absorption of food, like in coeliac disease or inflammatory bowel disease (IBD). High protein levels indicate chronic inflammation, dehydration or infection such as viral hepatitis. It may also indicate HIV or a bone marrow disorder, but these instances are rare.

  If cirrhosis occurs, your total protein level may still be normal because as albumin levels fall, globulin rises.

  The normal protein levels fall between 63 – 87 g/L.

• Alkaline phosphatase (ALP)

  High ALP levels may indicate bone disease, damage to the gall bladder or liver inflammation. Increased levels may also occur during pregnancy and puberty.

  The normal ALP for men and women is below 130IU/L.

• Alanine transferase (ALT)

  ALT is mainly present in the liver, making it a good marker for liver health. Increased ALT levels may indicate liver damage.

  The normal range of ALP for men is 15 – 50 IU/L and 10 – 35 IU/L for women.

• Gamma-glutamyl transpeptidase (GGT)

  High levels of GGT can signify liver disease or damage. If you drink excess alcohol for an extended period, GGT levels will increase.

  The normal GGT level for men is below 71 IU/L, while below 42 IU/L is normal for women.

• Bilirubin

  High bilirubin levels can indicate liver damage. If you drink excess alcohol and take some medications or your body is destroying more red blood cells than usual (haemolysis), your bilirubin levels will be high.

  Sometimes, high bilirubin may result from Gilbert’s syndrome – a harmless inherited disorder. Normal bilirubin level for women is below 15 umol/L and below 24 umol/L for men.

What affects liver health?

• The effect of alcohol on the liver

Excess alcohol consumption can lead to alcohol-related fatty liver disease (ARLD) because alcohol increases fat levels in your liver. Research suggests that increased fat may be due to the waste products in alcohol that cause the liver to produce more fatty acids.

If you reduce your alcohol intake or stop drinking, your liver can repair itself. However, if you keep drinking excessively, your liver may become inflamed, and over the years, permanent liver scarring (cirrhosis) may occur, leading to liver failure.

• The effect of weight on the liver

Being obese or overweight can cause fatty liver disease (non-alcoholic fatty liver disease, NAFLD). Other risk factors for NAFLD include:

• Smoking
• High blood pressure
• Lack of exercise
• High triglycerides or cholesterol
• Type 2 diabetes

NAFLD can also cause permanent liver damage if left untreated for several years.

• The effect of drugs on the liver

Some common drugs, such as paracetamol (acetaminophen) and aspirin or ibuprofen (non-steroidal anti-inflammatories), can result in serious liver damage. This may occur from excess intake of these medications at once or high doses over a long period.

Avoid taking these drugs for hangover symptoms until the alcohol clears from your body. It takes your body system about one hour to clear a unit of alcohol. Alcohol interferes with your liver and can result in severe side effects, including death.

Other drugs that can affect the liver are:

• Steroids – a type of anti-inflammatory medicine for treating different conditions
• Antibiotics – for treating or preventing bacterial infections
• Statins – for reducing the level of low-density lipoprotein (LDL) cholesterol in the blood
• Antifungal drugs – used to treat fungal infections affecting the skin, nails and hair
• Antiviral drugs – to help the body fight off harmful viruses

Ensure you consult your doctor when taking any medication. If a possible side effect of a medication is liver damage, ensure you have regular liver blood tests.

• The effect of diet on the liver

Your diet significantly affects your liver health. Foods that negatively affect your liver health include:

• Trans and saturated fats, such as red meat, cream, pastries, cake, and fried foods
• Refined carbohydrates like white pasta and white bread
• Added sugars such as fizzy drinks, fruit juices and sweets
• Salt, such as frozen foods, cured or smoked meats, and salted nuts

How to improve your liver health

It takes several years for permanent liver damage to occur, so identifying signs of liver damage early can help you take steps to repair your liver.

You can improve your liver health with the following lifestyle changes:

• Reduce alcohol intake – you can drink up to 14 units of alcohol a week. This is the equivalent of six medium glasses of wine or six pints of beer. If possible, stop drinking
• Lose weight – if you are obese or overweight, try losing weight
• Eat a healthy, balanced diet like the Mediterranean diet
• Ensure you exercise often – aim for activities that improve your fitness level and aerobics
• Drink moderate amounts of coffee- some studies show that caffeine can improve your liver health
• Avoid excess sweet drinks and sugary food

If you need a liver blood test, visit Private Blood Tests London. You can also call us on 02071830244 to schedule your liver blood test appointment.