Liver Function Test

A hepatic panel measures liver enzymes, bilirubin and the proteins the liver makes, from one blood sample. It is less a test of how well the liver works than a way of telling whether liver cells are being injured, whether bile is flowing, and whether the liver is still manufacturing what it should.

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What it is

The panel groups measurements that answer three different questions about the same organ. The transaminases, ALT and AST, leak out of liver cells when those cells are damaged, so they report injury. Alkaline phosphatase and bilirubin rise when bile is not draining properly, so they report obstruction. Albumin and total protein are made by the liver itself, so they report manufacturing capacity, which is a slower-moving signal. Reading the panel is largely a matter of seeing which of those three patterns dominates, which is why the tests are ordered together rather than one at a time.

Why it is done

  • To investigate symptoms that point at the liver, such as yellowing of the skin or eyes, dark urine, abdominal pain or persistent fatigue
  • To check whether a medication is affecting the liver, which is the reason many people have this panel repeated on a schedule
  • To assess and follow known liver disease, including hepatitis and disease related to alcohol or fatty liver
  • To sort out an unexpected abnormality found on a broader chemistry panel

What to expect

A blood draw from a vein in the arm. Fasting is sometimes requested; otherwise there is nothing to do beforehand. Results usually return within a day. Mildly elevated enzymes are common and frequently transient, so a repeat after several weeks is a normal next step rather than a sign of alarm. Where the panel is genuinely abnormal, imaging of the liver and bile ducts, or hepatitis testing, tends to follow.

Questions worth asking

  • Was a comprehensive metabolic panel also drawn? It already contains most of these measurements, and both appearing on the same day's bill is worth questioning.
  • If individual enzymes were ordered separately rather than as the panel, does that price out higher than the bundled code?
  • For monitoring on a medication, how often is the recheck required, and is that frequency covered?
  • If imaging is the likely next step, is the ultrasound or scan it points to done at this facility, and at what price?

What Liver Function Test costs by state

Liver Function Test prices at hospitals

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Sources

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