Liver blood tests monitor liver health, including enzyme and function tests, and tests for elevated levels of creatinine and alpha-fetoprotein. Elevated levels may indicate liver damage, but not always. Low levels of certain enzymes and proteins, such as albumin, can also signal liver disease. Bilirubin and creatinine levels can also indicate liver damage.
A doctor may order a number of different liver blood tests to monitor a patient’s health. Liver blood tests include liver enzyme tests and liver function tests, as well as tests for elevated levels of creatinine and alpha-fetoprotein (AFP). The tests are used to diagnose liver problems, including cirrhosis, cancer, and diseases such as hepatitis. However, elevated blood proteins and liver enzymes found during a liver blood test may not necessarily mean that the liver is damaged.
When a person’s liver is healthy, the enzymes remain within the liver cells. If the organ is damaged, the enzymes leak out of the cells and into a person’s bloodstream. There are usually low levels of certain enzymes, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST), in the blood, and liver damage causes levels to rise.
Common liver blood tests count the levels of ALT and AST in someone’s blood. Ideally, a person should have an ALT level between five and 40 units per liter of blood serum and an AST level between seven and 56 units per liter of blood serum. Higher levels may indicate liver damage or damage to another organ or muscle.
Other liver enzyme blood tests look for elevated levels of 5’nucleotidase (5’NT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP). Higher levels of these enzymes can indicate cirrhosis or hepatitis C. In some cases, pregnant women and children can have high ALP levels without experiencing liver damage, since the enzyme is also produced by the placenta and bones.
Liver blood tests that look at how well the organ is functioning look for low levels of certain blood proteins, such as albumin. The liver is responsible for producing albumin, a protein that prevents blood from flowing out of the vessels. Low albumin levels signal disease in the liver or kidneys. Someone who doesn’t eat enough protein or who is malnourished may also have low albumin levels.
Bilirubin is a waste product produced when red blood cells die. Usually, the liver helps the body excrete bilirubin by making bile. If a person has jaundice or yellowed skin, they most likely have excess bilirubin, which can be determined through a blood test.
An excessively damaged liver can affect how well the kidneys work. If a patient is on the waiting list for a transplant, she may have her creatinine levels tested to determine how damaged the organ is. The kidneys typically excrete creatinine, a waste product. Higher levels of creatinine suggest extensive kidney and liver damage.
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