Liver Function Test (LFT)

The liver performs more than 500 crucial functions in the body like metabolization of fats, proteins, and carbohydrates, storage of vitamins and minerals, blood filtration, and building the body’s immunity against diseases of the gut. The liver also helps in digestive processes through bile production, regeneration of blood cells, and supporting the clotting of blood. This complex organ can be afflicted with a range of problems that may be genetic or acquired. While genetic defects are mostly due to defects in the enzymes, transport proteins that alter a metabolic pathway, acquired diseases are caused due to several external reasons. These include viral and bacterial infections, drinking too much alcohol, consuming too many fats, etc. This is where the importance of a liver function test comes in. Also known as LFT, is a group of tests that are designed to screen, diagnose, evaluate, and monitor the existence and level of infection, disease, and damage that has occurred in the liver. The LFT measures different proteins, enzymes, and other substances produced by the liver to check the overall health of the organ. A liver function test is a simple blood test that involves extracting blood from a vein in your arm or through a finger prick. Advanced technologies and the advent of unique telemedicine platforms have now made in-home diagnostic tests a possibility. Not only is the liver function test at home convenient, but it is also affordable. The in-home liver function test cost is lower as compared to getting the test done at a lab, clinic, or hospital.

The liver function test includes the following tests: Alanine Aminotransferase (SGPT): The levels of the ALT enzyme indicate liver damages and are an important liver function test for early detection of liver problems. Albumin: This test assesses the levels of this protein that is produced in the liver. Albumin/Globulin Ratio: The A/G ratio is calculated by measuring the total protein, albumin, and the calculated globulin. This ratio indicates the reasons behind the changes in the protein levels in the blood. Alkaline Phosphatase (ALP): This enzyme is found in the bones and the liver and its elevated levels provide a clue about damages in the liver, blockages in the bile ducts, and diseases of the bones. Aspartate Aminotransferase (SGOT): The AST enzyme is found mostly in the heart and the liver and healthy individuals have low levels of this. High levels of AST indicate liver damage. Bilirubin Total: This LFT measures the levels of bilirubin that is produced when our body breaks down red blood cells and is discarded through the stool and urine. High levels of bilirubin indicate that the liver is not functioning properly. Bilirubin Direct: This liver function test measures the direct or conjugated bilirubin attached by the liver to the glucose-derived acid. Bilirubin Indirect: This test measures the bilirubin not attached to glucuronic acid. Gamma Glutamyl Transferase (GGT): The GGT enzyme helps in transporting molecules and the metabolic processes of the liver in the release of toxins. Elevated levels of GGT indicate damages to the bile ducts or the liver. Globulin: This LFT measures the levels of the globulin protein that plays an important part in the functioning of the immune system. Protein Total: This test measures the levels of proteins in the body, mainly albumin and globulin that are produced by the liver. Deficiencies in these proteins indicate improper functioning of the liver. Besides these normal liver function tests, there are several other add-on tests available like: Kidney Function Test (KFT): This add-on liver function test checks for the health and functioning of your kidneys. Lipid profile: This add-on LFT test checks your cholesterol and triglyceride levels. Diabetes screening (FBS, HBA1C): This test helps in assessing and monitoring blood glucose levels. Complete haemogram (CBC+ESR): This test measures the levels of your RBC, WBC, and platelets and includes a peripheral smear examination to rule out chronic diseases, anaemia, cancers, etc. Urine routine examination: This measures the presence of substances in the urine that may be a result of bacterial infections, abnormal cell metabolism, etc.

There are several good reasons to get a liver function test annually like: The liver function tests are used to screen and diagnose diseases or damages in the liver. An annual normal liver function test helps in the early detection of liver diseases. This helps in seeking early treatment and management plans. With the healthcare costs spiralling upwards, early treatment helps in avoiding letting the problems become unmanageable and expensive medical procedures later on. This is possible by proactively getting a liver function test annually. If you are already undergoing treatment for liver disease, a liver function test (LFT) helps in monitoring the effectiveness of the treatment. It also helps in suggesting if any corrective action is required in case the disease is progressing. The LFT test helps in monitoring if certain medications are causing side effects and causing the symptoms of liver disorders. Getting an annual LFT test helps you in living stress-free since you can manage your symptoms effectively and live healthily. Getting the add-on tests in addition to the LFT test helps in screening and diagnosing other problems like kidney diseases, diabetes, heart diseases, etc.

While it is strongly recommended to get a preventive liver function test done annually, it may be advised by your doctor if she/he suspects liver disease through these symptoms: Constant fatigue and loss of energy Unexplained weight loss Decreased appetite Weakness Jaundice i.e. yellow eyes and skin Ascites i.e. fluid collection in the abdomen Dark coloured urine Excessive itching without a rash Unexplained bruising Frequent diarrhea, nausea, abdominal pain, and vomiting Bruising or bleeding in the abdomen Swelling of the legs A liver function test may also be advised when: When you are on medications that may lead to liver problems. These include some herbal supplements, over the counter medicines, anti-depressants, cholesterol-lowering medicines, etc. When you suffer from gastrointestinal diseases like colon polyps, haemorrhoids, etc. When your liver imaging test was abnormal or inconclusive. This requires a follow up with a liver function test LFT. Your lifestyle choices include dependence on alcohol, IV drug usage, etc. You have or are suffering from liver diseases like cancer, cirrhosis, infectious hepatitis, etc. In this case, you will need a periodic follow-up to ascertain changes in your LFT test. You have other chronic medical conditions like lupus, diabetes, colon cancer, hypertension, etc. You have a family history of liver disorders and diseases.

Your doctor will give you instructions on how to prepare for your liver function test. Normally, these are the guidelines to be followed: You may need to fast i.e. not eat or drink anything 10-12 hours before the test. Since some medications may interfere with the results of the liver function test, you must inform your doctor about these in advance. Since you will have blood drawn from your hand or arm, make sure to wear a short-sleeved shirt. If you are consulting a gastroenterologist online, make sure to send your medical reports, history, and prescriptions to her/him before the test. If you are getting a liver function test at home, prepare a comfortable corner beforehand for the phlebotomist to place the equipment and take your sample. Make sure to check if the liver function test cost is being covered in your insurance plan to make adequate financial arrangements in advance.

With the advancements in technology, it is now possible to get an LFT test done at home. This is how it works: Buy the relevant test pack after checking the liver function test cost. Schedule the LFT test at a time convenient to you. A WHO and DMLT trained phlebotomist will collect your samples from home. These samples will be processed by credible labs under the supervision of experienced doctors. You will receive the result of your liver function test within 24 hours on your email.

Since a liver function test is a simple blood test, there are not many side effects. However, some people may experience: Light-headedness or dizziness, however, this is rare. In this case, you will need to sit for a while and eat or drink something before leaving the lab. If you are suffering from liver disease, there are chances that your bleeding doesn’t stop immediately. Or the puncture site becomes blue, warm, or swells, you must inform the doctor. Travelling to a clinic or lab for a liver function test may increase the chances of infections, especially in children, the elderly, or those who suffer from autoimmune diseases.

Generally, this is how LFT tests are interpreted, though certain conditions and diseases like pregnancy, rheumatoid arthritis, obstructive jaundice, etc. may affect your liver function test results: S.no Enzyme/Protein Normal/ healthy range 1. Alanine Aminotransferase (ALT) 5-40 units/litre 2. Aspartate Phosphatase (AST) Males: 8-46 units/lire Females: 7-34 units/litre 3. Albumin 3.5-5 grams/100 ml 4. Alkaline Phosphates 13-39 units/litre 5. Bilirubin Total: 0.3-1.9 mg/100 ml Direct: less than 0.4 mg/100 ml 6. Gamma-Glutamyl Transferase 9-48 units/litre

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