Liver function tests , commonly known as LFT or liver panel, are essential blood tests used to evaluate liver health and functionality. Liver Function Test measures various substances produced by the liver, including enzymes, proteins, and bilirubin, providing valuable insights into the liver's condition.

The test measures the concentration of liver proteins and liver enzymes. LFTs are also used to diagnose and monitor liver injuries, monitor the progress of liver disease, as well as detect jaundice.

Assessment of these parameters collectively allows doctors to identify liver disease and monitor the individual’s response to treatment and the impact of any medications on liver health.

Liver Function Test starts from ₹950. We provide dependable and cost-effective testing services, ensuring samples are collected by trained eMedics from a location of your choice. Please note that the test prices may vary depending on your city and the selected laboratory. A breakdown of LFT costs across different cities is provided below:

No specific preparations or fasting are generally required for Liver Function Test. However, the following is essential:

Medication Disclosure: Inform your doctor about any medications, supplements, or herbal products you are taking, as these may affect liver enzyme levels.

A blood sample is required for the Liver Function Test . After booking the test with Orange Health Labs, a skilled eMedic will visit your location for sample collection. The LFT procedure is as follows:

• Preparation: The eMedic will explain the process to you and ensure you are seated comfortably.

• Site Selection: A suitable vein, usually in the inner elbow, will be chosen and cleaned with an antiseptic wipe to maintain hygiene.

• Needle Insertion: A sterile needle will be inserted into the vein to draw blood. You may feel a mild sting or pinch during this step.

• Blood Collection: The required amount of blood will be collected into a vial for testing.

• Needle Removal: The needle will be carefully removed, and pressure will be applied to the site using a gauze pad to prevent bleeding.

• Bandaging: A small bandage will be placed on the puncture site to protect it.

The sample collection can be completed in no time. The entire process typically takes 10–15 minutes. The results of LFTs are usually available within 3 hours after sample collection.

LFT plays a vital role in evaluating liver health and functionality. Liver Function Test are usually recommended by the doctor to:

• Detecting liver inflammation or disease : LFTs can help identify inflammation of the liver, such as hepatitis, which may be caused by infection, autoimmune conditions, or exposure to harmful substances.

• Evaluate liver function : These tests assess how well the liver is performing essential functions, such as processing nutrients, producing proteins, and detoxifying harmful substances. If liver function is impaired, LFTs help gauge the severity of the dysfunction.

• Identify bile flow issues : Abnormal results in certain liver enzymes can indicate problems in the bile ducts, such as blockages or cholestasis, which can affect bile flow and digestion.

• Monitor medication effects on the liver : Some medications, particularly long-term or high-dose drugs, can negatively affect liver health. Liver Function Tests are used to monitor how medications may be affecting liver function and detect early signs of damage.

• Assess alcohol-related liver damage : LFTs help distinguish between liver issues caused by alcohol use and other forms of liver disease, enabling better diagnosis and management of alcohol-related liver damage.

• Identify liver disease in individuals without symptoms : Even without clear symptoms, individuals at high risk for liver disease, such as those with a family history of liver disease or certain lifestyle factors, may benefit from regular LFTs to detect potential liver problems early.

• Track existing liver conditions and treatment effectiveness : For individuals with known liver disease, Liver Function Test are important for monitoring the progression of the condition and evaluating treatment efficacy to prevent further damage.

LFT are important for individuals at risk of liver disease or those showing signs of liver dysfunction. These tests help in the early detection and monitoring of liver health. LFTs may need to be checked in individuals:

• Experiencing symptoms like jaundice, abdominal pain, dark urine, and fatigue.

• With chronic liver conditions such as hepatitis, alcohol dependency, or metabolic disorders.

• On medications that may affect liver function.

• With a family history of liver disease, diabetes, and/or obesity.

• Who have been exposed to hepatitis.

Liver Function Test are recommended if you exhibit symptoms that may indicate liver disease or damage, such as:

• Persistent nausea and vomiting.

• Loss of appetite without an apparent cause.

• Constant fatigue or unexplained weakness.

• Yellowing of the skin and eyes (jaundice).

• Swelling or pain in the abdominal region.

• Fluid retention, causing swelling in the ankles and legs.

• Dark-coloured urine or pale-coloured stools.

• Frequent episodes of itching.

Interpreting LFT results involves assessing the levels of various parameters about their normal ranges. The normal results for Liver Function Test are as follows:

LFT results outside the normal range can indicate various liver-related conditions, such as liver injury or dysfunction, and the pattern of these elevations (hepatocellular, cholestatic, or mixed) can assist doctors in diagnosing the specific disease. The interpretation of abnormal levels of LFT parameters is as below.

There are several parameters checked in LFT such as enzymes, bilirubin, and proteins. The details of these parameters are provided below:

Enzymes

The following enzymes are checked in LFTs :

• Alanine Aminotransferase (ALT): ALT is a liver enzyme that is also present in the heart, kidneys, and muscles. High ALT levels are detected in liver disease involving injury or inflammation. Very low levels may be a sign of loss of liver cells or muscle mass.

• Aspartate Aminotransferase (AST): AST is another liver enzyme that, when elevated, suggests liver damage or conditions such as cirrhosis or advanced liver disease. Low levels of AST are usually not concerning.

• Alkaline Phosphatase (ALP): ALP is found in various organs, including the liver, bones, kidneys, and intestines. Elevated ALP levels may signal liver dysfunction or issues with bile flow. Low ALP levels may suggest malnutrition, bone disorder, or zinc deficiency.

• Gamma Glutamyl Transferase (GGT): GGT is a liver enzyme produced by bile ducts. Increased GGT levels can be indicative of conditions like liver or bile duct damage, alcohol use disorder, pancreatitis or heart failure.

Proteins

• Total Protein: This test measures the total amount of albumin and globulin in the blood. Both are synthesised by the liver and play an important role in maintaining fluid balance and immune function. Variations in total protein levels may reflect liver, kidney, or gastrointestinal problems. Low total protein levels can indicate liver disease, kidney disease, malnutrition, or gastrointestinal conditions affecting protein absorption like Crohn’s disease. High total protein levels may indicate conditions like viral hepatitis, HIV, or multiple myeloma.

• Albumin/Globulin (A/G) Ratio: Albumin is a key protein that helps transport various substances in the blood, while globulin plays a role in immunity and nutrient transport. The A/G ratio is useful in diagnosing liver and kidney diseases, nutritional deficiencies, and certain genetic or immune disorders. A low A/G ratio is often associated with liver disease, kidney disease, or chronic inflammation. It may also reflect autoimmune disease. A high A/G ratio may be caused by cancer of the blood cells (leukaemia) or some genetic disorders.

Bilirubin

• Total Bilirubin: Bilirubin is a yellow pigment produced from the breakdown of red blood cells. The liver processes it and eliminates it as bile. High bilirubin levels are a sign of liver dysfunction or bile duct obstruction. Low bilirubin levels can indicate reduced liver function in severe cases.

• Indirect Bilirubin: This form of bilirubin is water-insoluble and enters the liver, where it is converted into direct bilirubin. Increased levels may indicate liver problems. Low indirect bilirubin levels are rare and may suggest problems with red blood cell turnover.

• Direct Bilirubin: It is a water-soluble form of bilirubin. Elevated direct bilirubin levels often suggest liver impairment or obstruction in the bile ducts. Low direct bilirubin levels are uncommon and may indicate a decrease in liver function or excretion.

The normal range for parameters in the LFTs is given in the table above. Normal LFTs typically indicate that the liver is functioning well, with no significant damage or disease. For individuals receiving treatment for liver-related conditions, normal LFTs signify that the liver is responding well to treatment.

Staying within the normal range typically reflects a balanced lipid metabolism and a lower risk of heart disease and other cardiovascular complications. A deviation from the normal range requires further testing to address any underlying issues.

Medical Conditions That Can Impact LFT Results

Medical conditions, such as pre-existing liver diseases, including hepatitis, cirrhosis, and fatty liver, can significantly alter LFT outcomes. Infections, whether viral or bacterial, may cause elevated enzyme levels, while dehydration can impact protein levels in the blood, potentially affecting test accuracy.

Medications That Can Affect LFT Test Results

Certain medications are known to interfere with LFT results. Statins, commonly prescribed for lowering cholesterol, may increase liver enzyme levels. Antibiotics can temporarily affect enzyme readings, and anti-epileptic drugs used for seizure control may also influence LFT parameters.

Other Factors That Can Affect LFT Results

Lifestyle factors like alcohol consumption before the test can elevate liver enzyme levels and skew results. Similarly, eating a fatty or heavy meal before the test can temporarily affect specific liver markers.

Consulting a Doctor for High/Abnormal LFT Levels

Consulting a doctor is crucial if your LFT results show significantly elevated or abnormal levels of enzymes, bilirubin, or proteins. Persistently high values may indicate liver inflammation, damage, or diseases such as hepatitis, fatty liver disease, or bile duct obstruction. Prompt medical attention ensures timely diagnosis and treatment of underlying conditions.

Liver Function Test offer comprehensive insight into your liver health, providing essential information to detect and manage liver-related conditions, as follows:

• Early Detection of Liver Issues : LFTs help identify liver disease or damage in its initial stages, allowing for timely diagnosis and intervention before complications arise.

• Monitoring Liver Health Over Time : These tests are essential for tracking the progression or improvement of liver-related conditions, helping healthcare providers assess the effectiveness of treatments and lifestyle changes.

• Guidance for Medication Adjustments : LFT results provide the critical information needed to adjust medications that may impact liver function, ensuring safe and optimal therapeutic outcomes.

Liver Function Test can help identify a wide range of liver-related conditions, such as:

• Fatty liver disease

• Toxic hepatitis

• Autoimmune hepatitis

• Viral hepatitis (A, B, or C)

• Hemochromatosis (excessive iron buildup in the liver)

• Wilson’s disease (abnormal copper accumulation in the liver)

• Alpha-1 antitrypsin deficiency (a genetic condition affecting liver and lung health)

• Primary biliary cholangitis (damage to bile ducts leading to liver dysfunction)

• Cirrhosis (scarring of liver tissue)

• Liver cancer

Factors that increase the risk of liver dysfunction (leading to abnormal Liver Function Test) include:

• Excessive alcohol consumption

• Increased body weight and obesity

• Chronic hepatitis infections (B and C)

• Fatty liver

• Diabetes

• Long-term use of liver-toxic medications

Being aware of these risks helps in taking proactive measures to maintain liver health.

Untreated liver issues can cause progressive liver damage and, eventually, end-stage liver disease. Complications of end-stage renal disease include:

• Liver scarring

• Portal hypertension

• Liver cancer (hepatocellular carcinoma)

• Kidney failure (hepatorenal syndrome)

• Respiratory failure (hepatopulmonary syndrome)

• Enlarged spleen

A healthy liver helps maintain normal LFT parameters. To maintain a healthy liver, it's important to make a few lifestyle changes that protect and support its function. These include:

• Maintaining a Healthy Weight: Reduces the risk of fatty liver disease and improves liver health.

• Eating a Balanced Diet: Focus on fibre-rich foods, lean proteins, and healthy fats while avoiding excessive sugars and processed foods.

• Exercising Regularly: Helps burn fat and improve liver function.

• Avoiding Toxins: Minimise exposure to harmful chemicals and always use protective gear when necessary.

• Limiting Alcohol Intake: Excessive alcohol damages the liver. Consult your doctor for safe limits.

• Avoiding Illicit Drugs: They can cause significant liver damage.

• Following Medication Guidelines: Take medications as prescribed and inform your doctor about all drugs and supplements you use.

• Getting Vaccinated: Protect your liver health with hepatitis A and B vaccines.

• Scheduling Regular Checkups: Periodic liver health assessments allow for monitoring of liver health and also aid in the early detection and management of potential issues.

In addition to Liver Function Test, several other diagnostic tests can help evaluate liver health or identify liver-related conditions. These tests include:

• International Normalized Ratio (INR) : Measures blood clotting time, which can indicate liver dysfunction.

• 5'-Nucleotidase Test : Measures the enzyme elevated in conditions affecting bile flow, such as cholestasis.

• Viral Hepatitis Tests : Detects hepatitis A, B, C, D, and E infections, which can cause liver damage.

• Alpha-Fetoprotein (AFP) Test : Measures alpha-fetoprotein levels, which can be elevated in liver cancer (hepatocellular carcinoma) or other liver diseases, such as cirrhosis or hepatitis.

• Antimitochondrial Antibodies (AMAs) : Detects antibodies associated with autoimmune liver conditions like primary biliary cirrhosis, aiding in the diagnosis of autoimmune liver diseases.

• Serum Alpha-1 Antitrypsin Test (A1AT) : Detects low levels of alpha-1 antitrypsin, which can indicate a genetic disorder that leads to liver disease, particularly cirrhosis, in both children and adults.

While Liver Function Test can help identify liver damage, they do not pinpoint the exact cause or type of liver disorder. Other similar tests provide more specific information regarding the liver’s function or the presence of particular liver diseases:

• LFTs vs. INR : While LFTs give an overall view of liver function, INR specifically measures the liver's ability to produce clotting factors, providing more detailed insight into liver dysfunction that affects coagulation.

• LFTs vs. 5'-Nucleotidase : Liver Function Test may show general liver damage, but the 5'-nucleotidase test is more specific for identifying diseases that block bile flow, such as cholestasis, which is not always detected through routine LFTs.

• Liver Function Test vs. Viral Hepatitis Tests : Liver Function Test measure liver injury but do not indicate the underlying cause. Viral hepatitis tests, on the other hand, help identify whether a viral infection is contributing to liver damage, enabling targeted treatment.

Liver Function Test are essential in monitoring pregnant women, as abnormal results occur in 3–5% of pregnancies, indicating a range of conditions.

• Pregnancy-related liver diseases such as intrahepatic cholestasis of pregnancy, HELLP syndrome (haemolysis, elevated liver enzymes, low platelets), and acute fatty liver of pregnancy pose significant risks to both maternal and foetal health. These conditions can lead to severe liver damage, foetal distress, and sometimes liver failure, necessitating rapid diagnosis and intervention.

• In rare cases, pre-existing liver diseases, including chronic hepatitis, cirrhosis, and Budd Chiari syndrome, can complicate pregnancy. Early identification and appropriate management of these conditions are critical to minimise risks for both the mother and baby.

Early diagnosis and rapid management are essential to prevent severe complications, such as foetal distress during pregnancy or liver failure.