Friday, 8 January 2016

How to read Liver Function Tests Report?

How to read Liver Function Tests Report?

Liver function tests are a group of blood tests that detect inflammation and damage to the liver. They can also check how well the liver is working. Liver enzyme testing includes ALT, AST, GGT, Alkaline Phosphatase; True liver function tests include albumin, and bilirubin.

Why Check Liver Function?
Your doctor may conduct liver enzyme and liver function tests if:
·                You are taking a medication that can harm the liver
·                You have liver disease
·                You have symptoms of liver or bile system disease (abdominal pain, nausea and vomiting, or yellow    skin)
·                You drink alcohol excessively
·                You always sleep late

Liver Function Tests: Total Protein
Albumin and globulin are two types of protein in your body. The total protein test measures the total amount albumin and globulin in your body. It is part of the routine health checkup. It may also be used if you have unexpected weight loss, fatigue, or symptoms of a kidney or liver disease.

Total protein measurements can reflect nutritional status and may be used to screen for and help diagnose kidney disease or liver disease, for example. If total protein is abnormal, further testing must be performed to identify which specific protein is abnormally low or high so that a specific diagnosis can be made.

Liver Function Tests: Albumin
The liver also makes albumin, an essential protein that circulates in blood. Albumin levels are low in people with severe chronic liver disease, because the liver does not make normal amounts of albumin. However, albumin levels also may drop in a variety of medical conditions. A low albumin level is often temporary; hence, it is not a reliable way to diagnose liver disease.

Liver Function Tests: Bilirubin       
Bilirubin is a waste product from the breakdown of red blood cells. The liver digests bilirubin so it can be excreted in stool. Bilirubin flows through the liver's bile ducts, dissolved in bile.
Bilirubin blood levels may be elevated in people with impaired bile flow. This may occur in severe liver disease, gallbladder disease, or other bile system conditions. Very high bilirubin levels cause jaundice, where the skin and whites of the eyes turn yellow. Bilirubin can be a useful liver function test in people with a known bile flow problem. An elevated bilirubin may also be present in people with a type of anemia, called hemolytic anemia.

Liver Function Tests: A/G Ratio (Albumin to Globulin Ratio)
The A/G ratio may provide a clue as to the cause of the change in protein levels.

A low A/G ratio may reflect overproduction of globulins, such as seen in multiple myeloma or autoimmune diseases, or underproduction of albumin, such as may occur with cirrhosis, or selective loss of albumin from the circulation, as may occur with kidney disease (nephrotic syndrome).

A high A/G ratio suggests underproduction of immunoglobulins as may be seen in some genetic deficiencies and in some leukemias. More specific tests, such as liver enzyme tests and serum protein electrophoresis, must be performed to make an accurate diagnosis.

With a low total protein that is due to plasma expansion (dilution of the blood), the A/G ratio will typically be normal because both albumin and globulin will be diluted to the same extent.

Liver Enzyme Tests: ALT and AST
The liver filters and processes blood as it circulates through the body. It metabolizes nutrients, detoxifies, makes blood clotting proteins, and performs many other vital functions. The cells in the liver contain proteins called enzymes that drive these chemical reactions.

When liver cells are damaged, the enzymes in the cells leak out into the blood, where they can be measured by blood tests. Liver tests check the blood for two main liver enzymes:
1. Aspartate aminotransferase (AST), formerly called SGOT; the AST enzyme is also found in muscles and many other tissues besides the liver.
2. Alanine aminotransferase (ALT), formerly called SGPT; ALT is almost exclusively found in the liver.

If ALT and AST are found together in elevated amounts in the blood, liver damage is most likely present.

Liver Enzyme Tests: Alkaline Phosphatase and GGT
Another key function of liver is the production of bile, which helps digest fat. Bile flows through the liver in a system of small ducts, and then stored in the gallbladder in the liver.

When bile flow is blocked or damaged, blood levels of certain liver enzymes rise:
1. Alkaline phosphatase
2. Gamma-glutamyl transpeptidase (GGT)

If alkaline phosphatase and GGT are elevated, a problem with bile flow is most likely present. Bile flow problems can be due to a problem in the liver, the gallbladder, or the tubes connecting them. Since alkaline phosphatase is also found in bone, it can be elevated in certain bone medical conditions.

Liver Function Tests: Alpha Foetoprotein (AFP)
AFP test can help diagnose certain liver conditions, such as liver cancer, cirrhosis, and hepatitis. It can also help detect several other cancers like:
  • testes
  • ovaries
  • biliary tract
  • stomach
  • pancreas

Liver Supplements:
There are 3 main liver supplements that can be found in the community pharmacies in Malaysia which are quite useful and effective as liver tonic.

1. Essential phospholipids (EPLs) - Repair

EPLs help to repair liver cells, restore liver function and regenerate the phospholipids in our liver cell membranes which are damaged by unhealthy lifestyle of eating fatty foods and drinking too much alcohol or by intake of too much medication or by infection from certain viruses.

EPLs fight oxidation, contain powerful antioxidants and help cellular damage reparation.

2 caps 3 times daily (max 6 caps / day)
1 cap 3 times daily (maintenance)
Swallow without chewing after meals.

2. Phyllanthus Extract - antimicrobial
Phyllanthus niruri standardized extract EPN 797 250mg
(Standardized to contain 4% Corilagin and 18% Total Flavonoids)

Phyllanthus is antimicrobial, antiviral and super anti-oxidant. It showed significant effects against hepatitis C and HIV-1 virus.

2 (250mg) capsules 2-3 times daily.
1 (500mg) caplets 2-3 times daily.

Milk Thistle (silybum marianum) extracts 100mg
Equiv. to dry fruit 7000mg (standardized contain flavanolignans 84mg)

Milk thistle is commonly used as a natural treatment for liver problems. These liver problems include cirrhosis, jaundice, hepatitis, and gallbladder disorders.
Silymarin is the main active ingredient in milk thistle. Silymarin is both an anti-inflammatory and antioxidant. At this point, there is not enough scientific data to say whether or not milk thistle can help liver problems. However, some early research suggests milk thistle may aid people with alcohol-related liver disease.

Adult ( above 18years old): 1 tab 3 times daily

Drink 6-8 glasses of water daily. 

Lifestyle counseling:
Daily lifestyle tips to keep our liver healthy. 

1. Eat Right
A balanced diet rich in different vegetables, fruits and proteins is important to maintain healthy liver function. Excess fats and carbohydrates can cause fat deposits in the liver. Eat small meals as they can easily be digested and create less load to the liver.

2. Minimize or avoid alcohol
Minimizing or avoiding beer, wine, cocktails, champagne, and liquor in any other form.

3. Take medicines as prescribed and do not OVERDOSE
If you have diabetes and high blood cholesterol and triglycerides, strictly follow your doctor's prescribed treatment and follow the exact dosage prescribed.

4. Avoid environmental pollutants
Fumes of chemicals like insect sprays, paints, car fumes and other aerosol sprays may be absorbed in the liver and damage the liver when inhaled.

5. Beware of herbal supplements
Not all "natural" are safe. Some herbal remedies are reported to cause liver toxicity.

6. Practice proper hygienic habits
Wash your hands properly after using the toilet and before eating, practice safe sex and consider vaccination for viral hepatitis. 

7. Exercise
Research showed that gradual weight loss coupled with increased exercise will reduce the fat deposits in the liver.

8. Sleep
Get at least 8 hours of sleep daily. Sleep before 11pm, as 11pm-1am is the liver detox time.


  1. Hi Angela, those liver function tests above are similar to mine so does that mean i have liver disease? Or by taking these supplements it will slowly heal and the high numbers will reduce?

    1. Hi Hypr,

      Yes, if you have higher than normal range LFT reading, you may need to have some healthy lifestyle changes as mentioned above. On top of that, supplements as stated above can help enhance the effects of liver detoxifying and regeneration.

      Hope i had answered your question.
      Take care and thanks for reading my post.


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