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About the test
What is this test done for?
Liver function tests are performed to assess the functioning of the liver by measuring the various substances and enzymes produced in it.
Why is it Done?
It is done to screen liver infections and to monitor the functioning of the liver when a person is on medications which can affect the liver.
When should it be performed?

The test is performed when one has to be screened for liver infections like hepatitis A, B, C, E.

- The test should be done if the person is a chronic alcohol drinker

- is overweight

- is on medications which affect liver e.g. anti-epilepsy medicines

- there is a strong family history of liver disease

-The test is ordered if one shows the following symptoms:

  • Dark colored urine
  • Light colored stools
  • Appetite reduced.
  • Nausea or vomiting
  • Swelling in abdomen
  • Fatigue
  • Yellowish eyes or skin (jaundice)
How is it done
You need to fast for 12 hours overnight before giving a blood sample from your arm the next morning.

Liver function tests involve: ALT, AST, Alkaline phosphatase, Albumin and Bilirubin.

  • ALT and AST: Normal levels are 10 to 40 units/liter. These are the enzymes that help break down proteins. If the levels are high, they indicate liver damage. They levels may also rise in muscular problems. If the levels are within range, it is a good sign as it indicates that liver is functioning well.
  • Alkaline Phosphatase: It is an enzyme found in bones, bile duct and liver. If the levels are high it indicates liver damage or bone diseases like Paget’s disease or bone cancer. In growing children and pregnancy the levels tend to be on the higher side usually.
  • Albumin- normal range is 3.5 to 5.5g/dL: It is one of the main proteins formed by liver. The levels go high in albuminemia, in acute pancreatitis or in dehydration. The levels fall below the normal range in liver diseases, like cirrhosis, but should be confirmed along with other parameters. Albumin levels can drop in inflammation or shock too.
  • Bilirubin: Normal levels of total bilirubin is 0.0 to 1.4 mg/dL, of direct bilirubin 0.0 to 0.3mg/dL, indirect bilirubin is 0.2 to 1.2 mg/dL. There are 2 kinds of bilirubin tested in a liver function test- unconjugated and conjugated. The levels of unconjugated bilirubin are high mostly in hemolytic or perinicious anemia, cirrhosis or Gilbert syndrome. Levels of conjugated bilirubin increase in conditions like viral hepatitis or alcohol liver disease or when bile duct is obstructed due to gall stones.
Other Tests
Specific viral tests to confirm hepatitis like HCV, an ultrasound to assess changes in liver structure can be ordered.
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