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  • Also Known As:
  • Liver Profile
  • Liver Function Tests
  • LFTs
  • Liver Enzyme Test
  • Liver Blood Test
  • Liver Test
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Test Quick Guide

The liver panel is a test with multiple measurements that help to assess the health and function of the liver. The test is conducted with a blood sample that is normally taken from a vein in your arm.

A liver panel can be used to help diagnose and monitor liver diseases. It can also provide information about other health conditions that affect the liver.

Test Quick Guide

The liver panel is a test with multiple measurements that help to assess the health and function of the liver. The test is conducted with a blood sample that is normally taken from a vein in your arm.

A liver panel can be used to help diagnose and monitor liver diseases. It can also provide information about other health conditions that affect the liver.

About the Test

 

Purpose of the test

The liver panel has many applications in medical care. While sometimes called a liver function test, it is better understood as a method of detecting liver disease and/or other health problems, including many that involve the liver.

Some of the specific ways that a liver panel can be used include:

  • Diagnosis: Although a liver panel alone is not able to diagnose liver diseases, its measurements can help identify the type of problem in people who have symptoms of liver conditions. The test can also help in the diagnostic process of other health concerns.
  • Evaluating disease severity: A liver panel can help determine the extent of illness in people who have known liver problems.
  • Monitoring: Follow-up testing can provide information about how well treatment for liver problems is working. A liver panel can also monitor for side effects when people take medications that can impact liver health.
  • Screening: Some people may have a liver panel as part of broader blood testing, known as the comprehensive metabolic panel, during routine medical checkups. If screening is abnormal, it may warrant more specific follow-up testing.

What does the test measure?

As a panel test, the liver panel involves multiple measurements. When the test is ordered, doctors can modify exactly which measurements to take.

For this reason, there is not a universal standard for what is measured on a liver panel. Nevertheless, some components of the test are more common. In most cases, a liver panel includes the following measurements:

  • Aspartate aminotransferase (AST): AST is a type of protein called an enzyme that is found in the liver as well as many muscles and organs.
  • Alanine aminotransferase (ALT): ALT is an enzyme found primarily in the liver.
  • Alkaline phosphatase (ALP): ALP is an enzyme found in the liver, bones, and other tissues in the body.
  • Bilirubin: Bilirubin is a yellow-colored waste product that is the result of normal breakdown of red blood cells. The liver works to remove bilirubin from the body.
  • Albumin: Albumin is a protein made by the liver that prevents fluids from leaking out of the bloodstream.

Additional measurements may be added to a liver panel if the doctor believes they can provide more information to evaluate your situation. These measures may be tested on an initial liver panel, or they may be included in repeat testing after an abnormal result on a previous test.

  • Gamma-glutamyl transferase (GGT): GGT is an enzyme found in the liver and other organs.
  • 5’ nucleotidase (5’-NT): 5’-NT is an enzyme that exists in the liver and other organs.
  • Total protein: This measures the sum of two kinds of protein in the blood known as albumin and globulin. The test may measure the relative levels of albumin and globulin, which is reported as the A/G ratio.
  • Globulins: Globulins are a class of proteins in the blood.
  • Prothrombin time: Prothrombin is a protein made by the liver that facilitates normal blood clotting. Prothrombin time measures how long it takes for the blood to clot.
  • Lactate dehydrogenase (LDH): LDH is an enzyme found in tissues throughout the body.

Finding a Liver Panel Test

 

How to get tested

A blood draw for a liver panel is generally conducted in a medical setting such as a doctor’s office or health clinic after the test has been ordered by a doctor. Analysis of the blood sample is performed in a medical laboratory.

A type of rapid, on-site test, known as a point-of-care test, has been developed that can measure multiple components of the liver panel. However, most liver panel testing still happens with a blood draw and standard laboratory analysis.

Can I take the test at home?

At-home liver panel tests are uncommon, but a basic version is available that involves taking a fingerstick blood sample at home and sending it by mail to a laboratory where it can be analyzed.

How much does the test cost?

The total cost of a liver panel can include fees for the office visit, blood draw, and laboratory analysis. The price can depend on where the testing takes place and the specific measurements that are ordered.

The cost also depends on whether you have health insurance, who your insurer is, and what your specific plan covers. If your doctor orders the test, most costs, minus copays or deductibles, are often covered by insurance. For specific details about total and out-of-pocket costs, contact your health insurance provider and your doctor’s office.

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Taking the Liver Panel Test

A liver panel requires a blood sample that is normally obtained by drawing a small amount of blood from a vein in your arm. This is a routine procedure that is done in a medical office, clinic, hospital, or lab.

Before the test

In many cases, you will be required to fast for up to 12 hours before the test. This means not eating any food or drinking any beverages besides water.

Some medications can affect the liver, so you will need to tell your doctor about any prescription drugs, over-the-counter medications, and/or dietary supplements that you take.

Ask your doctor’s office for details about pretest preparations, and make sure to follow any instructions closely.

If you are taking an at-home test, thoroughly read the instructions before getting started so that you know all the steps for properly collecting your test sample.

During the test

A blood draw is a routine procedure during which blood is removed from a vein in your arm and stored in a small vial. An elastic band may be tied around your upper arm to increase blood flow, and then an antiseptic will be used to clean the skin around where the blood will be drawn. A needle will be inserted and then removed after enough blood has been taken, which often takes less than a minute. There may be slight pain or a sting when the needle is inserted and removed.

For an at-home test, you will prick your fingertip with a small needle and then apply a drop of blood to an included test strip. The test strip is then prepared to be securely sent by mail to the testing lab.

After the test

A bandage is normally applied to the puncture site to stop any bleeding once the test is complete. Some tenderness or bruising is possible but usually heals quickly.

Once your blood has been drawn, you can typically return to standard activities, including driving, although you may be advised to avoid more intense or strenuous activities for a few hours. If you were told to fast before the test, you may want to bring something light to eat for right after the test.

At-home tests usually have no lasting side effects, although you may need to apply a bandage to stop bleeding from your fingertip.

Liver Panel Test Results

 

Receiving test results

Test results from a liver panel are generally available within a few business days after the lab receives your blood sample. Your results may be sent to you electronically or by mail. Your doctor’s office may also contact you to discuss your results or to arrange a follow-up appointment to review them.

Interpreting test results

The measurements in the liver panel can be interpreted both individually and collectively. While abnormal levels of one test component can provide useful information, doctors most often interpret these levels in relation to one another.

There are no universal reference ranges for each measurement of the liver panel. Individual laboratories establish a reference range and then compare individual patient results to that range. On your test report, you may see the reference ranges used by the laboratory that analyzed your blood sample.

When test results are abnormal, doctors often look for certain patterns of abnormalities in the specific levels that were detected.

  • Conditions involving acute or chronic liver damage often show disproportionate increases in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) compared to alkaline phosphatase (ALP).
  • Bile duct obstruction is more often associated with a disproportionate increase in ALP compared to ALT and AST.
  • Disorders affecting the normal processing of bilirubin may be demonstrated by elevated bilirubin with normal levels of ALT, AST, and ALP.
  • Health conditions originating outside the liver are more common when abnormal albumin or prothrombin time occurs with otherwise normal results.

The extent to which a measurement is elevated or abnormal can provide indications about the type of liver condition as well as its severity. Adding more components to the liver panel can provide more in-depth analysis that may help isolate the most likely cause of abnormal test results.

It is important to remember that these test results are not interpreted in isolation. Instead, the doctor will also take into account your present health and symptoms as well as your health history. Because some medications affect the liver, your doctor will also consider any drugs you are taking when they evaluate your test report.

The factors involved in understanding the significance of a liver panel test are complex, so it is important to always review your results with a doctor who is familiar with your case and can explain what the test results mean in your specific situation.

Do I need follow-up tests?

A liver panel provides details about the condition of the liver, but it alone does not definitively diagnose liver diseases. For this reason, follow-up tests are frequently necessary if abnormal results are found.

Follow-up testing could include additional blood tests as part of an expanded liver panel. Depending on the abnormal results, other specific tests can be used to detect a wide range of conditions. These could include blood tests, urine tests, imaging scans, and/or biopsies.

Because the initial test involves multiple measurements that are evaluated within the context of every individual patient, there is no uniform approach to subsequent testing. Instead, a plan for additional testing is tailored to your situation. Your doctor can best explain the benefits and downsides of different options for follow-up testing.

Questions for your doctor about test results

Your doctor can address detailed and specific questions about your test results. Some questions that you might review with your doctor include:

  • Was any part of my test result abnormal?
  • If there was an abnormal result, can you explain what was found and what it may mean?
  • If results were normal, will I need to have this testing again at any point in the future?
  • Are there any follow-up tests that may be beneficial given my test results?

Related Tests

 

How is a liver panel different from a comprehensive metabolic panel (CMP) test?

The comprehensive metabolic panel is a broader test than the liver panel. It includes the measurements found on most liver panels, such as AST, ALP, ALT, bilirubin, and albumin, but it also measures other indicators of the body’s metabolism and kidney function.

How is the liver panel different from individual measurements of liver health?

Any component of the liver panel can be tested individually, and in some circumstances, doctors may order a test for just one measurement. However, in most cases, different levels are best interpreted together. For that reason, a panel of measurements is frequently used to diagnose and monitor health conditions affecting the liver.

Other related tests

Sources and Resources

Resources that offer further information about liver health include:

Sources

A.D.A.M. Medical Encyclopedia. 5′-nucleotidase. Updated February 2, 2019. Accessed April 19, 2021. https://medlineplus.gov/ency/article/003575.htm

A.D.A.M. Medical Encyclopedia. Gamma-glutamyl transferase (GGT) blood test. Updated January 26, 2019. Accessed April 19, 2021. https://medlineplus.gov/ency/article/003458.htm

A.D.A.M. Medical Encyclopedia. Prothrombin time (PT). Updated January 29, 2019. Accessed April 19, 2021. https://medlineplus.gov/ency/article/003652.htm

A.D.A.M. Medical Encyclopedia. Total protein. Updated April 29, 2019. Accessed April 19, 2021. https://medlineplus.gov/ency/article/003483.htm

Akbas N, Gonzalez G, Edwards R, Devaraj S. Assessment of liver function tests on Piccolo Xpress point of care chemistry analyzer in a pediatric hospital. Pract Lab Med. 2015;3:1-7. Published 2015 Oct 3. doi:10.1016/j.plabm.2015.09.002

ARUP Consult. Liver disease evaluation. Updated February 2021. Accessed April 18, 2021. https://arupconsult.com/content/liver-disease-evaluation

Friedman LS. Approach to the patient with abnormal liver biochemical and function tests. In: Chopra S, ed. UpToDate. Updated June 10, 2020. Accessed April 17, 2021. https://www.uptodate.com/contents/approach-to-the-patient-with-abnormal-liver-biochemical-and-function-tests

Friedman LS. Enzymatic measures of cholestasis (eg, alkaline phosphatase, 5′-nucleotidase, gamma-glutamyl transpeptidase). In: Chopra S, ed. UpToDate. Updated September 11, 2020. Accessed April 19, 2021. https://www.uptodate.com/contents/enzymatic-measures-of-cholestasis-eg-alkaline-phosphatase-5-nucleotidase-gamma-glutamyl-transpeptidase

Friedman LS. Liver biochemical tests that detect injury to hepatocytes. In: Chopra S, ed. UpToDate. Updated March 4, 2021. Accessed April 17, 2021. https://www.uptodate.com/contents/liver-biochemical-tests-that-detect-injury-to-hepatocytes

Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol. 2017;112(1):18-35. doi:10.1038/ajg.2016.517

Lindenmeyer CC. Liver blood tests. Merck Manual Consumer Edition. Updated January 2020. Accessed April 17, 2021. https://www.merckmanuals.com/en-ca/home/liver-and-gallbladder-disorders/diagnosis-of-liver,-gallbladder,-and-biliary-disorders/liver-blood-tests

Lindenmeyer CC. Laboratory tests of the liver and gallbladder. Merck Manual Professional Edition. Updated December 2019. Accessed April 17, 2021. https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/testing-for-hepatic-and-biliary-disorders/laboratory-tests-of-the-liver-and-gallbladder

MedlinePlus: National Library of Medicine. Albumin blood test. Updated July 30, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/albumin-blood-test/

MedlinePlus: National Library of Medicine. Alkaline phosphatase. Updated July 30, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/alkaline-phosphatase/

MedlinePlus: National Library of Medicine. ALT blood test. Updated July 30, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/alt-blood-test/

MedlinePlus: National Library of Medicine. AST test. Updated July 30, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/ast-test/

MedlinePlus: National Library of Medicine. Bilirubin blood test. Updated July 30, 2020. Accessed April 17. 2021. https://medlineplus.gov/lab-tests/bilirubin-blood-test/

MedlinePlus: National Library of Medicine. Comprehensive metabolic panel (CMP). Updated March 2, 2021. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/comprehensive-metabolic-panel-cmp/

MedlinePlus: National Library of Medicine. Gamma-glutamyl transferase (GGT) test. Updated August 13, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/gamma-glutamyl-transferase-ggt-test/

MedlinePlus: National Library of Medicine. Globulin test. Updated July 31, 2020. Accessed April 18. 2021.https://medlineplus.gov/lab-tests/globulin-test/

MedlinePlus: National Library of Medicine. Lactate dehydrogenase (LDH) test. Updated December 17, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/lactate-dehydrogenase-ldh-test/

MedlinePlus: National Library of Medicine. Liver function tests. Updated March 4, 2021. Accessed April 17. 2021. https://medlineplus.gov/lab-tests/liver-function-tests/

MedlinePlus: National Library of Medicine. Prothrombin time test and INR (PT/INR). Updated July 31, 2020. Accessed April 18. 2021. https://medlineplus.gov/lab-tests/prothrombin-time-test-and-inr-ptinr/

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