LFT's - what do the results mean?

[nomorepanic]

I wasn't sure where to post this but I think this will do for now.

In chat last night we were talking about LFT's (Liver function tests) and what do all the different readings mean and what are normal results etc.

Some people were worried about their liver because of alcohol use whereas others were worried because they had high readings and yet didn't drink.

I think what people want to know is what are the names of the different tests, what does it measure, what are the "normal" levels for that test and what are the symptoms of liver problems.

Meg kindly offered to give us some advice if I posted this here so thanks in advance Meg.:)


Nicola

[Meg]

Liver function.

The liver is a vital organ situated in the upper right part of the abdomen and one we can not do without .

Its main functions are:
To store and filter blood, removing the toxic components from drugs, food or body waste
It makes bile, a liquid which is stored in the gall bladder and released into the gut to help digest fat and protein ;
It metabolizes nutrients from food,
It stores glycogen (fuel for the body) which is made from sugars
It is vital in the mechanism in releasing energy (glucose) into the bloodstream and storing vitamins and minerals.
It makes proteins that are essential for blood to clot

The good news is that it is the only organ in the body that can regenerate itself so even if it is damaged, given the right circumstances, it can bring itself back from a severely damaged state and become as good as new. As a last resort the liver is an organ that can be transplanted extremely successfully.

There are many, many different diseases that can affect the liver including illnesses that you may have heard of such as Alcoholic Liver Disease, the whole gamut of Hepatitis A, B and C, as well as liver cancer, Primary Biliary Cirrhosis, paracetamol overdose and many that I hope you have never had cause to know about.

Liver Function Tests (LFT’s) are a series of blood tests that together can give an overview of how well your liver is functioning. On single test alone is not a good indicator initially.

Different cells have different enzymes inside them, depending on the function of the cell. Liver cells happen to have lots of AST, ALT, and GGTP inside them. When cells die or are damaged, the enzymes leak out causing the blood level of these enzymes to rise; that is why the levels of these enzymes in the blood are considered good indicators of liver cell damage.
Other cells throughout the body also contain some of these enzymes so a high ALT could be indicative of disease elsewhere, which is why we do a liver profile rather than a one off test, as it is the series seen as a whole that indicates the degree of liver function.

I am specifically not going to mention any of the other possible permutations as this is a health anxiety site and I don't want to be responsible for starting anyone off on a mission.

I have used the International Units of measurements throughout, but many places still measure in different units so these are for the UK.

The numbers are not linear. An AST that is 300 is not twice as bad as 150 and an AST of 94 and 80 is essentially showing the same amount of liver damage


ALT (SGPT) ALANINE AMINOTRANSFERASE (3-40 iu/L) provides an indication of the degree of inflammation

AST (SGOT) ASPARTATE TRANSAMINASE (3- 48 iu/L( provides an indication of the degree of inflammation

ALKALINE PHOSPHATASE (30-300 iu/L) This enzyme level is elevated in a large number of disorders that affects the drainage of bile, such as a gallstone blocking the common bile duct, or alcoholic liver disease, or drug-induced hepatitis, blocking the flow of bile in smaller bile channels within the liver.

GGT GAMMA-GLUTAMYL TRANSPEPTIDASE (11- 70 iu/L) increases can be suggestive of obstructive liver disease, and is commonly used as the indicator of alcohol usage

Bilirubin (3-17 UMOL/L) increases are suggestive of liver disease, especially in disease of the bile ducts. Bilirubin is the main bile pigment in humans which, when elevated, causes the yellow discoloration of the skin and eyes called jaundice. Bilirubin is formed primarily from the breakdown of a substance in red blood cells called "heme." It is taken up from blood processed through the liver, and then secreted into the bile by the liver. Conditions which cause increased formation of bilirubin, such as destruction of red blood cells, or decrease its removal from the blood stream, such as liver disease may result in an increase in the level of serum bilirubin

Albumin is a major protein which is produced by th

[vernon]

Hi nic this might answer your questions.

Component of LFTs Approx Normal range (will vary with each laboratory) What it all means:


Alanine aminotransferase (ALT) <35 IU/L This enzyme, normally part of the chemical production process is raised in inflammation from various causes
High: Liver disease, kidney disease, pancreatitis, alcohol use, glandular fever
Low: Pyridoxine (vit B6) deficiency


Aspartate aminotransferase((AST) <35 IU/L (20-48) This enzyme is raised in inflammation from various causes
High: Heart disease, myocardial infarction, pancreatitis, liver disease, trauma, muscle damage, alcohol
Low: Pyridoxine (vit B6) deficiency, terminal liver failure


Alkaline Phosphatase (ALP) 33 - 131 IU/L (over 60's: 51 - 153 IU/L) A liver enzyme raised when there is obstruction in the liver tubing and in high alcohol intake
High: Bone growth, metastases, healing fractures Pagets, liver disease, heart failure, pregnancy, hyperpaprathyroidism


Gamma-Glutamyl transferase ‘Gamma GT' 8 - 78 IU/L This enzyme normally works in the liver but will be raised in obstruction and by alcohol use.
Bilirubin Total:0.2 -1.2mg/dl; Direct: <0.3 mg/dl Bilirubin is part of the metabolism of digestion and is raised by blockage of the gall duct such as by gall stones or cancer
High total: hepatic damage (e.g.hepatitis, toxins, cirrhosis), biliary obstruction, haemolysis, fasting.
High direct (conjugated): biliary obstruction, cholestasis,


Albumin 3.5 - 5.0 mg/dl Albumin is the basic protein in the body
High: Dehydration, diabetes insipidus
Low: cystic fibrosis, leukaemia, alcoholic cirrhosis, Hodgkin's disease, malnutrition, nephrotic syndrome, multiple myeloma, inflammatory bowel disease, collagen-vascular diseases



Clotting Studies:
APTT
APTT Ratio
Prothrombin
Time (PT)
Thrombin
Time(TT)
26 - 39 secs
1.5 - 2.5
11.0 - 16.0 Secs

11 - 16 secs

There are several elements in the clotting ‘cascade' which makes blood clot and stops us continuously bleeding. These tests tell us which part of the cascade is faulty. Prothrombin time (PT) is particularly affected by chronic liver disease


Questions to ask your doctor/Nnurse
To gain a better understanding of this test you may like to ask your doctor or nurse some of the following suggested questions.

- What are you looking for in my LFTs?
- Which part of my LFTss is abnormal and why?
- What is the cause of this abnormal result and how can it be treated?
- Why does my liver function matter?
- Is it caused by medication I am taking?
- What about my alcohol intake - is it affecting my liver function?

This is the website

http://www.bbc.co.uk/health/talking/tests/function_liver_tests.shtml


Take care Vernon

[vernon]

Sorry Meg, we must have posted same time. Thanks for that I like to look at both as yours do show the upper and lower limits tc. vernon

[nomorepanic]

Thanks for that Meg - much appreciated.

Nicola

[vernon]

Looks like none was interested anyway

[nomorepanic]

Yeah Vern after they were all interested in chat lol!

Always the way!

Nicola