Liver Function Tests - Understanding LFTs

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Diseases of the liver may not come with symptoms and so it is often after one may have undertaken a blood test that some abnormalities are found. Before I go into explaining the meaning of each of the components of the liver function test (LFT), I shall run through a few preambles.

Symptoms - what one may feel:

  • Nothing
  • loss of appetite
  • Yellowish discoloration of the eyes
  • Nausea and vomiting
  • chronic tiredness
  • dark urine 
  • generalised skin itch
  • light coloured stools
  • swelling of the abdomen
Apart from those that will be found to have an abnormal result sporadically, you can ask for a liver function test if you belong in any of the following:
  1. Family history of liver diseases, such as haemochromatosis
  2. you have a history referral to the intestinal system
  3. you have gall stone disease or a family history of same
  4. You drink alcohol over the limits
  5. you take performance enhancing drugs
  6. you suffer from eating disorder
  7. You take medications that may harm your liver - if in doubt, just ask for a test
When the results - which is a blood test returns, it would contain information on the following:
  • Total protein
  • Serum albumin
  • Globulin
  • Bilirubin
  • alkaline phosphatase
  • gamma GT
  • Alanine transferase
  • Prothrombin time
I will provide a snap-shot explanation of the implication of each, in relation to the function of the liver.

Alanine transferase
ALT is an enzyme that is also produced in the heart as well as the liver. It indicates liver cell damage. It is located within the liver cell and thus a potent biomarker of liver damage - as its release into the blood stream follows death of the liver or heart tissues.

Alkaline Phosphatase
ALP is an enzyme, located within the bile ductal system of the liver. It is also released by other organs, such as bones, intestines, kidneys and placenta in women. It is thus not very specific to the liver; but interpreted alongside gamma GT.

Gamma glutamyltransferase
Gamma GT, as it is popularly called is found in the liver cells as well as the bile ductal system. It is elevated in the setting of diseases of the liver, bile duct and to monitor alcohol abuse. It is used to rule in the source of ALP elevation.

Bilirubin
This is a pigment that is produced as part of the normal process of breakdown of the red blood cells. It is elevated in the blood in response of diseases of the liver and the gall bladder.

Albumin
This is a protein produced in the liver. It performs several functions, among which are transport of hormones, vitamins and drugs in the body. It helps in equitable balanced distribution of water in different body compartments. It is low in diseases of the liver and is an ideal indicator of liver function.

Prothrombin time
These proteins are useful in the clotting mechanism and if they are diminished in the body (in a diseased liver), then abnormal clotting results, leading to uncontrolled bleeding. It is a more reliable indicator of acute liver damage than most of the other LFTs. Its measure yields a prolonged time in the setting of liver disease.

- Kindly write me if you have any comments - 

Nimzing




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