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The liver is the chemical factory of the body: it stores and releases energy and minerals, makes bile and controls fat absorption. It also makes proteins, vitamins and hormones, regulates blood clotting, filters blood and breaks down waste products. A blood test can show problems with various of these processes, indicating what illness is causing the problems.
Diagnosis & Tests
Reasons for testing liver function include:- The liver is vital for existence and its failure is fatal.
- There are many processes that affect and are affected by the liver - we need to know which are working correctly.
- Many drugs affect the liver. It may be important to check the effect they are having on liver function.
- It can confirm or rule out conditions such as suspected liver disease, terminal liver failure, kidney disease, pancreatitis, damage due to alcohol (ab)use, glandular fever, vitamin B6 deficiency, heart disease, heart failure, myocardial infarction, liver trauma, muscle damage, metastases (certain cancers), healing fractures, Paget's liver disease, hyperpaprathyroidism, hepatic damage (e.g.hepatitis, toxins, cirrhosis), biliary obstruction, cholestasis, dehydration, diabetes insipidus, cystic fibrosis, leukemia, alcoholic cirrhosis, Hodgkin's disease, malnutrition, nephrotic syndrome, multiple myeloma, inflammatory bowel disease, collagen-vascular diseases.
A series of special blood tests can often determine whether or not the liver is functioning properly. These tests can also distinguish between acute and chronic liver disorders and between hepatitis and cholestasis. The most commonly performed blood tests include:- Serum Bilirubin Test. Elevated levels of bilirubin often indicate an obstruction of bile flow or a defect in the processing of bile by the liver. Bilirubin is produced by the liver and is excreted in the bile.
- Serum Albumin Test. Below-normal levels of albumin, a protein made by the liver, are associated with many chronic liver disorders.
- Serum Alkaline Phosphatase Test. Elevated levels of alkaline phosphatase, an enzyme found in the bile, usually indicate an obstruction of bile flow, liver injury, or certain cancers.
- Serum Aminotransferases (transaminases). This enzyme is released from damaged liver cells.
- Prothrombin Time (PTT) Test. This test measures the time it takes for blood to clot. Blood clotting requires vitamin K and a protein made by the liver. Liver cell damage and bile flow obstruction can both interfere with proper blood clotting.
- Alanine Transaminase (ALT) Test. This enzyme is released from damaged liver cells.
- Aspartate Transaminase (AST) Test. This enzyme is released from damaged liver, heart, muscle, or brain cells.
- Gamma-glutamyl Transpeptidase Test. This enzyme is produced by the liver, pancreas, and kidneys and released into the blood when these organs are injured.
- Lactic Dehydrogenase Test. This enzyme is released when organs such as the liver, heart, lung, or brain are injured.
- 5-Nucleotidase Test. This enzyme is released by the liver when the liver is injured due to bile duct obstruction or impaired bile flow.
- Alpha-fetoprotein Test. This protein is produced by the fetal liver and testes, indicating hepatitis or cancer.
- Mitochondrial Antibodies Test. The presence of these antibodies can indicate primary biliary cirrhosis, chronic active hepatitis, and certain other autoimmune disorders.
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Signs, symptoms & indicators of Liver Function That Should Be Checked: | | | | | Lab Values - Chemistries | Counter-indicators:
 Elevated liver enzymes |
Symptoms - General |
 Constant fatigue |
Symptoms - Skin - General |
 Itchy skin | The reason why patients with liver disease itch is not known, although it is commonly believed that some substances accumulate in the blood as a result of a poorly functioning liver and thus cause itching. A simple blood test can exclude liver disease as a cause for the itching, as liver enzymes are often elevated with liver involvement. |
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Conditions that suggest Liver Function That Should Be Checked:
Risk factors for Liver Function That Should Be Checked:
Recommendations and treatments for Liver Function That Should Be Checked:
KEY | | Strong or generally accepted link | | | Proven definite or direct link | | | Very strongly or absolutely counter-indicative |  | | Highly recommended |
GLOSSARY
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Alkaline
A substance having a pH above that of neutral water (7.0) when in solution. Signified as pH (potential of Hydrogen), alkaline fluids, such as the blood (pH about 7.4), have the ability to neutralize acids (solutions below pH 7.0). Metabolic wastes are acids, and the alkaline reserve of the blood neutralizes them until they are excreted.
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Bile
A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.
Bilirubin
A waste product of hemoglobin recycling, it is primarily excreted in feces, oxidizing into that familiar brown color (except for beets).
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Cholestasis
Cessation or suppression of bile flow.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Cystic Fibrosis
(CF) An incurable genetic disease involving a sticky buildup of mucus in the lungs (which makes breathing difficult and leads to infections), as well as pancreatic insufficiency (which leads to digestive problems). Symptoms include chronic cough producing thick mucus, excessive appetite combined with weight loss, intestinal disorders, salty sweat/skin and pneumonia. Lung-related problems are the most frequent cause of death. CF is a recessive disease, occurring only when a person inherits two mutated copies of the CF gene - one from each parent. Individuals with CF generally have a life expectancy of about 30 years.
Diabetes Insipidus
Excessive production of urine, usually due to insufficient production of antidiuretic hormone.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Glandular (Glandulars, Raw Glandulars)
Either referring to a gland, OR glands and organs from animals specially processed at temperatures not exceeding body heat and put into supplement form.
Hepatitis
Inflammation of the liver usually resulting in jaundice (yellowing of the skin), loss of appetite, stomach discomfort, abnormal liver function, clay-colored stools, and dark urine. May be caused by a bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins or transfusion of incompatible blood. Can be life-threatening. Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.
Hodgkin's Disease (Hodgkin's)
Cancer of the lymphatic system and lymph nodes.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Jaundice
Yellow discoloration of the skin, whites of the eyes and excreta as a result of an excess of the pigment bilirubin in the bloodstream.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Metastasize (Metastases, Metastasized, Metastasizes, Metastasizing, Metastatic)
Usually in reference to cancer: to spread, especially destructively.
Mineral (Minerals)
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Pancreatitis
Inflammation of the pancreas. Symptoms begin as those of acute pancreatitis: a gradual or sudden severe pain in the center part of the upper abdomen goes through to the back, perhaps becoming worse when eating and building to a persistent pain; nausea and vomiting; fever; jaundice (yellowing of the skin); shock; weight loss; symptoms of diabetes mellitus. Chronic pancreatitis occurs when the symptoms of acute pancreatitis continue to recur.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Prothrombin
Protein needed for clotting of the blood.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Vitamin K
Helps the blood clot when the body is injured.
Last updated: Nov 08, 2009
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