Liver Blood Tests

ByYedidya Saiman, MD, PhD, Lewis Katz School of Medicine, Temple University
Reviewed/Revised Aug 2023

    Liver tests are blood tests that represent a noninvasive way to screen for the presence of liver disease (for example, viral hepatitis in donated blood) and to measure the severity and progress of liver disease as well as the response to treatment.

    Laboratory tests are generally effective for the following:

    • Detecting liver inflammation, damage, or dysfunction

    • Assessing the severity of liver injury

    • Monitoring the course of liver diseases and a person's response to treatment

    • Refining the diagnosis

    Liver tests are done on blood samples and measure the levels of enzymes and other substances produced by the liver. These substances include

    • Alanine aminotransferase (ALT)

    • Albumin

    • Alkaline phosphatase (ALP)

    • Alpha-fetoprotein (AFP)

    • Aspartate aminotransferase (AST)

    • Bilirubin

    • Gamma-glutamyl transpeptidase (GGT)

    • Lactate dehydrogenase (LDH)

    • 5’-Nucleotidase

    Levels of some of these substances measure the presence and degree of liver inflammation (for example, ALT, AST). Levels of other substances measure how well the liver performs its normal functions of making proteins and secreting bile (for example, albumin, bilirubin). What constitutes a normal value for many of these tests can be found in the table Blood Tests. However, some of these values can be higher than normal in people with disorders not related to the liver.

    One test of liver function is the prothrombin time (PT), which is used to calculate the international normalized ratio (INR). Both the PT and the INR are measures of the time needed for blood to clot (the liver synthesizes some proteins necessary for blood clotting, called blood clotting factors). An abnormal PT or INR result can indicate an acute or chronic liver disorder. In both acute and chronic liver disorders, an increasing PT or INR typically indicates progression to liver failure.

    To determine the possible cause of any liver test abnormalities, the doctor will also take a history and may conduct imaging studies and/or do a liver biopsy.

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