Liver Function Test (LFT)

This test will help in the early detection of any abnormal function of liver cells like infection or inflammation. It will detect toxin induced damage to the liver cells or any blockage in the drainage of bile from the liver cells to the small intestines.

What does the liver do?

Liver performs about 500 vital functions in your body. Of these a few are mentioned below: 

• Liver converts substances into energy. It breaks glucose, proteins and fats into energy.
• It breaks down medicines and toxins into inactive metabolites.
• It is the largest storage organ. It stores glycogen, fats and vitamins.
• It produces proteins like albumin and clotting factors like prothrombin.
• Regulates blood clotting
• Builds up immunity by synthesizing immune factors and fights against infections.

What are the proteins and hormones measured by LFT?

1. Proteins synthesized in the liver – for example, Albumin.
2. Chemical processed or excreted in the liver – for example, Bilirubin.
3. Hormones made in the liver – for example, SGOT.

When will your doctor advise you to do LFT?

1. If you develop fever, vomiting, stomach pain, especially right-sided upper abdominal pain, yellow discolouration of eyes or skin, yellowish urine and tiredness.
2. If you are on any medicines which can affect the liver, like statins.
3. If you take alcohol regularly.
4. If you already have liver disease, LFT is done regularly to monitor the course of the disease.

When will the tests be abnormal?

The tests will be abnormal in the following cases,

1. Most commonly in metabolic syndrome– Fatty liver
2. NASH – Non-Alcoholic SteatoHepatitis
3. Liver infection – Hepatitis virus
4. Inflammation of the liver – alcohol, drugs, immune diseases
5. Liver toxins – alcohol, poisons
6. Blockage to biliary drainage by gallstones
7. Liver tumour or abscess

Normal range of LFT

1. Bilirubin – 0.1 to 1 mg/dL
2. SGOT(ALT) – 5 to 40 units per L
3. SGPT ( ALP) – 7 to 56 units per L
4. GGT- 9 to 50 units per L
5. ALP – 45 to 115 units per L
6. Albumin – 3.5 to 5 gm/ dL
7. A/G ratio = 1.5 to 2.5

Different Liver Function Tests

1. Bilirubin – From the breakdown of red blood cells and is excreted after being processed in the liver to conjugated Bilirubin via kidneys and stools. It increases in Jaundice.
2. SGPT (ALT) and SGOT(AST) are hormones present inside liver cells.
3. Mild increase occurs commonly in NAFLD – Non Alcoholic Fatty Liver Disease.
4. It increases in Hepatitis, Cirrhosis.
5. GGT increases in liver cells and bile duct damage. It increases in alcoholism and drug induced liver damage.
6. ALP – Alkaline phosphatase is present in the lining cells of bile duct and is released following obstruction of bile ducts. It increases in gallstones, Hepatitis, Cirrhosis and biliary duct blockage of any cause.
7. Albumin, Globulin, A/G ratio
8. Albumin is made in the liver and forms 60% of total proteins.  
9. Globulin is formed by liver and immune system and constitutes 40% of the proteins.
10. Normally, there is a little more albumin than globulins, giving a normal A/G ratio – 1.5- 2.5
11. The A/G ratio can be high or low because of any increase or decrease in these 2 proteins.
12. Low A/G ratio is seen in malnutrition, chronic kidney disease, certain cancers and autoimmune diseases.
13. High AG ratio is seen in low thyroid activity and leukemia.

How to interpret your abnormal Liver Tests?

Interpretation of liver tests should be made only by doctors. Not all results are abnormal.

• Mildly abnormal refers to test results which are less than twice the upper limit of the ‘normal’ value.
• Very abnormal liver function tests refer to test results more than two or three the upper limit of the ‘normal’ value.
• Abnormal liver function tests in a SICK person is more worrying than in a normal person. 

How to boost liver Health and safeguard your liver?

• A balanced diet with good fibre content.
• Regular physical activity and exercise.
• Maintain weight within healthy limits.
• Avoid ‘fad’ diets (which can challenge the kidneys and liver hard), for example, Keto and Paleo diets.
• Avoid unnecessary medicines, supplements and traditional medicines. 
• Stop smoking.
• Alcohol in moderation.
• Regular health checkups.
• Breathing exercises.

CONCLUSION

Liver is a vital organ. Watch out for any liver symptoms and immediately do a liver function test. If a liver problem is detected early, we can prevent the progression of liver disease. Preserve and safeguard your liver.