Liver Function Tests (LFT)

£46.00+ visit fee (from £24.00)

LFT

9 tests included

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The hepatic function panel may be used to help diagnose the liver disease if a person has signs and symptoms that indicate possible liver dysfunction. If a person has a known condition or liver disease, testing may be performed at intervals to monitor the health of the liver and to evaluate the effectiveness of any treatments. Abnormal tests on a liver panel may prompt a repeat analysis of one or more tests, or of the whole panel, to see if the elevations or decreases persist and may indicate the need for additional testing to determine the cause of the liver dysfunction.

About

A liver panel is a group of tests that are performed together to detect, evaluate, and monitor liver disease or damage. The liver is one of the largest organs in the body and is located in the upper right-hand part of the abdomen and behind the lower ribs. The liver metabolizes and detoxifies drugs and substances that are harmful to the body. It produces blood clotting factors, proteins, and enzymes, helps maintain hormone balances, and stores vitamins and minerals. Bile, a fluid produced by the liver, is transported through ducts directly to the small intestine to help digest fats or to the gallbladder to be stored and concentrated for later use.


A variety of diseases and infections can cause acute or chronic damage to the liver, causing inflammation (hepatitis), scarring (cirrhosis), bile duct obstructions, liver tumours, and liver dysfunction. Alcohol, drugs, some herbal supplements, and toxins can also pose a threat. A significant amount of liver damage may be present before symptoms such as jaundice, dark urine, light-coloured stools, itching (pruritus), nausea, fatigue, diarrhoea, and unexplained weight loss or gain emerge. Early detection is essential in order to minimize damage and preserve liver function.


The liver panel measures enzymes, proteins, and substances that are produced, processed or eliminated by the liver and are affected by a liver injury. Some are released by damaged liver cells and some reflect a decrease in the liver's ability to perform one or more of its functions. When performed together, these tests give a healthcare practitioner a snapshot of the health of a person's liver, an indication of the potential severity of any liver injury, change in liver status over time, and a starting place for further diagnostic testing.

Preparation

You may be instructed to fast overnight with only water permitted. Follow any instructions you are given. Inform the healthcare practitioner about all prescription and over-the-counter medications, herbal medications, vitamins and supplements you are taking.

Indications

A liver panel, or one or more of its components, may be ordered when someone is at risk for liver dysfunction. Some examples include:
  • People who take medications that may potentially damage the liver
  • Those who are alcoholics or heavy drinkers
  • Those who have a history of known or possible exposure to hepatitis viruses
  • Individuals whose families have a history of liver disease
  • People who are overweight, especially if they have diabetes and/or high blood pressure
A liver panel may be ordered when a person has signs and symptoms of liver disease; however, most people who have the liver disease do not have any of these symptoms until the disease has been present for many years or is very severe. Some of these include:
  • Weakness, fatigue
  • Loss of appetite
  • Nausea, vomiting
  • Abdominal swelling and/or pain
  • Jaundice (yellowing of eyes or skin)
  • Dark urine, light-coloured stool
  • Itching (pruritus)
  • Diarrhoea
Usually, no single set of liver tests is used to make a diagnosis. Often, several liver panels will be ordered over a few days or weeks to help determine the cause of the liver disorder and evaluate its severity.


When liver disease is detected, it may be monitored on a regular basis over time with the liver panel or with one or more of its components. A liver panel may also be ordered regularly to monitor the effectiveness of treatment for a liver disorder.

Interpretation

Liver panel test results are not diagnostic of a specific condition; they indicate that there may be a problem with the liver. In a person who does not have symptoms or identifiable risk factors, abnormal liver test results may indicate a temporary liver injury or reflect something that is happening elsewhere in the body – such as in the skeletal muscles, pancreas, or heart. It may also indicate early liver disease and the need for further testing and/or periodic monitoring.


Results of liver panels are usually evaluated together. Several sets of results from tests performed over a few days or weeks are often assessed together to determine if a pattern is present. Each person will have a unique set of test results that will typically change over time. A healthcare practitioner evaluates the combination of liver test results to gain clues about the underlying condition. Often, further testing is necessary to determine what is causing the liver damage and/or disease.


This table shows examples of some combinations of results that may be seen in certain types of liver conditions or diseases.

Type of liver condition or disease Bilirubin ALT and AST ALP Albumin PT
Acute liver damage (due, for example, to infection, toxins or drugs, etc.) Normal or increased usually after ALT and AST are already increased Usually greatly increased (> 10 times); ALT is usually higher than AST Normal or only moderately increased Normal Usually normal
Chronic forms of various liver disorders Normal or increased Mildly or moderately increased; ALT is persistently increased Normal to slightly increased Normal Normal
Alcoholic Hepatitis Normal or increased AST is moderately increased, usually at least twice the level of ALT Normal or moderately increased Normal Normal
Cirrhosis May be increased but this usually occurs later in the disease AST is usually higher than ALT but levels are usually lower than in alcoholic disease Normal or increased Normal or decreased Usually prolonged
Bile duct obstruction, cholestasis Normal or increased; increased incomplete obstruction Normal to moderately increased Increased; often greater than 4 times what is normal Usually normal but if the disease is chronic, levels may decrease Usually normal
Cancer that has spread to the liver (metastasized) Usually normal Normal or slightly increased Usually greatly increased Normal Normal
Cancer originating in the liver (hepatocellular carcinoma, HCC) May be increased, especially if the disease has progressed AST higher than ALT but levels lower than that seen in alcoholic disease Normal or increased Normal or decreased Usually prolonged
Autoimmune Normal or increased Moderately increased; ALT usually higher than AST Normal or slightly increased Usually decreased Normal
If a person is taking drugs that may affect their liver, then abnormal test results may indicate a need to reevaluate the dosage or choice of medication. When a person with liver disease is being monitored, then the healthcare practitioner will evaluate the results of the liver panel together to determine if a liver function or damage is worsening or improving. For example, increasingly abnormal bilirubin, albumin, and/or PT may indicate a deterioration in liver function, while stable or improving results of these tests may indicate liver function preservation or improvement.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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