How to Test Your Liver Function & What the Results Mean

10 min readDec 10, 2020

Written by David Kahana, MD for 1MD

Dr. David Kahana is board certified in Pediatrics and Gastroenterology through the American Board of Pediatrics (ABP), as well as Medical Nutrition through the National Board of Physician Nutrition Specialists. He also sits on the 1MD Scientific Advisory Board and LiverMD physician-formulator.

The liver is the largest solid organ in the body and is responsible for many essential functions. Although classified as part of the digestive system, the liver performs tasks that benefit your entire body.

Decontamination: The liver is responsible for removing contaminants from your blood and processing any substances that could harm your body. This can include compounds from the body, such as hormones, as well as compounds from outside the body, like alcohol and drugs.
Nutrient assimilation: The liver converts nutrients from the food you eat into substances your body can use, and stores vitamins and minerals until they are required.
Protein production: The liver is a protein factory that makes essential proteins such as albumin, the main transport-carrier protein in the body. It also makes proteins for blood clotting and antimicrobial proteins that act on behalf of the immune system.
Digestive support: Through the production of bile and enzymes, the liver supports the breakdown of food and proper digestion.

The many roles of the liver make it an important organ that requires daily maintenance. Problems with the liver can be life-threatening, so getting liver function tests should be done regularly to ensure optimal health.

Why Do I Need to Test Liver Function?

Liver function tests check the overall health of your liver and can detect problems and damage. Testing involves blood tests or panels that measure proteins, enzymes, and other substances that are produced by the liver. If levels for any of these substances are outside of normal ranges, it may be a sign of liver disease.

Liver function tests are most often used to:

Detect liver disease, such as hepatitis
Monitor treatment of liver disease, to confirm how well the treatment is working.
Check for liver damage or scarring from other diseases, such as diabetes and high cholesterol.
Monitor side effects of certain medications, like antibiotics and pain relievers.

More frequent testing is recommended if you have certain medical conditions such as:

High triglyceride levels: These contribute to increased fat storage in the body and can be associated with fatty liver disease.
Diabetes: The liver plays an important role in glucose storage and release, so patients with diabetes are at risk for liver dysfunction.
Heart disease: Congestive heart failure can cause blood to backup in the liver, which can cause damage called congestive hepatopathy
Cancer: Therapy for cancer can hurt the liver and anyone undergoing chemotherapy should have frequent liver testing.

It is also advised that you get liver function testing:

If you drink alcohol regularly. The liver is in charge of breaking down alcohol, but in the process creates substances called metabolites that can cause damage, especially if the amount of alcohol is excessive.
To check for damage from liver infections, such as hepatitis B and C, but common viruses like Epstein-Barr or CMV can also cause liver damage
If you take any medications or strong supplements on a regular basis, even ones that are available over-the-counter

Symptoms of Liver Problems

Liver function tests are important if you have any symptoms of liver disease. Symptoms vary by condition, but there are also general symptoms that may indicate early issues with liver function. The most common symptoms associated with liver inflammation or damage include:

abdominal pain, especially in the right upper part of the abdomen
abdominal distention or bloating
fatigue or loss of energy
nausea or vomiting
indigestion
weakness
weight loss or excessive weight gain from water retention
fluid collection in the abdomen, known as ascites
discolored bodily discharge (dark urine, pale stool) or yellowing of the whites of the eyes (called icterus)
abnormal bruising or bleeding

These symptoms can also indicate other health conditions, which is why it is important to get tested to discover if the liver is affected. Early identification of a liver problem may be essential for effective treatment.

Your doctor may also recommend that you get regular liver testing if you have certain risk factors. You may be at higher risk for liver disease if you:

Have a family history of liver disease
Have alcohol use disorder
Think you have been exposed to a hepatitis virus
Take medicines that may cause liver damage

Liver Testing

Liver function tests are blood tests. The lab will collect a small sample of blood from you and typically you will need to fast for 10 to 12 hours before the test. Measuring the levels of proteins and enzymes in the blood helps determine the health and function of your liver.

Commonly used tests to check liver abnormalities will look at:

Alanine aminotransaminase (ALT): ALT is an important enzyme for amino acid metabolism. A damaged liver will release more ALT into the blood, so higher blood levels can indicate liver damage and disease.
Aspartate aminotransferase (AST): AST is also an important enzyme for amino acid metabolism; it can be found throughout the body, but is mostly in the liver and muscle . A healthy individual will have low levels of ALT and AST in the blood. A damaged liver will release more of the enzymes into the blood causing elevated levels to appear in testing.
Alkaline phosphatase (ALP): ALP has several isotypes and is important in multiple enzymatic reactions. The liver is one of the main sources of ALP and, again, high levels of this enzyme in the blood may indicate liver damage.
Albumin: Albumin is the main transport-carrier protein in the body; it chaperones most drugs and binds many nutrients as it delivers them to cells throughout the body. It also creates an oncotic pressure within your blood vessels, keeping fluid in your bloodstream and preventing water retention. Low albumin levels can indicate a problem with the liver and should be examined further. A normal albumin range is 3.4 to 5.4 g/dL, with lower levels possibly indicating liver damage or inflammation.
Bilirubin: Bilirubin is a component of bile, which the liver makes to help emulsify fat for proper digestion and absorption. Levels of bilirubin in the blood remain low with a healthy liver, but a damaged liver will cause levels of bilirubin to rise in the blood, causing scleral icterus (yellowing of the eyes) and jaundice (yellowing of the skin), as well as itching. Having a little bit of bilirubin the blood is normal, but normal results are very low (under 1 mg/dL).

What Do My Results Mean?

If one or more of your liver function tests produce abnormal results, it may mean your liver is damaged or not working properly. Liver damage can be caused by a number of different conditions, including:

Fatty liver disease: Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease and is characterized by too much fat stored in liver cells. Certain health problems such as obesity, insulin resistance, high blood sugar levels, and high triglyceride levels promote the deposit of fat in the liver. Excess fat in the liver cells may trigger inflammation that can lead to scarring. Elevated ALT and AST levels in testing may indicate fatty liver disease.
Hepatitis: This is an inflammatory condition of the liver most commonly caused by a viral infection. Hepatitis B and C are common chronic conditions that can slowly lead to cirrhosis and liver failure. Hepatitis can also be caused by autoimmunity, as a result of medications, exposure to toxins, and excessive alcohol intake (e.g. binge drinking). Autoimmune hepatitis occurs when your body makes antibodies against liver cells and may be associated with other autoimmune conditions, such as lupus, rheumatoid arthritis, scleroderma, and multiple sclerosis. Chronic hepatitis can lead to serious problems beyond liver impairment, including liver cancer.
Alcohol-induced damage: Excessive alcohol consumption can lead to serious damage that leads to alcohol-induced liver disease. This is common and may be acute or chronic. Your liver breaks down alcohol, and if you consume more than it can process, it becomes damaged. Elevated AST, ALT, and bilirubin levels in the blood can be indicators of alcohol-induced liver damage.

Can Liver Damage Be Treated?

Treatment for liver damage is more effective when identified early. The liver is remarkable in that it has the ability to regenerate, but this will depend on the severity of damage done. Regular testing of liver function is important for early detection and to reduce the risk of irreversible damage.

Some liver issues can be treated with lifestyle modifications, such as weight loss, dietary changes or abstaining from alcohol consumption. Adding a clinically studied liver support supplement, like 1MD’s LiverMD®️, may result in improved repair and better liver function. Other problems may require medications, surgery, or even organ transplant. The treatment prescribed will depend on the cause and extent of the liver damage.

Hepatitis infections are treated based on the virus you have. Hepatitis A usually clears up on its own and rarely results in long-term health effects. Hepatitis B and C are chronic, but there is therapy now in the form of antiviral medications.
Alcohol use disorder requires lifestyle changes beginning with the immediate cessation of alcohol use. Sometimes, steroid drugs are prescribed to help reduce inflammation in the liver and prevent or slow down scarring.
Liver cancer is treated with chemotherapy, surgery, and sometimes organ transplant. Cancer that spreads to the liver (e.g. colon cancer) is more common than cancer that begins in the liver. Symptoms do not typically appear in the early stages of liver cancer, so aggressive therapy is required by the time symptoms do appear.
Cirrhosis treatment will depend on the cause and the extent of the damage. Cirrhosis cannot be reversed, so the goal is to slow progression of the scarring and prevent complications associated with the condition. Typically, medications such as beta-blockers and diuretics are prescribed, but nutritional support is usually required (e.g. fat-soluble vitamins, trace minerals) as well as dietary changes (increase in plant-based proteins). Endoscopy and certain procedures, such as paracentesis, may be necessary for maintenance and to prevent complications.

Natural Treatment for Your Liver

While the liver has the ability to regenerate cells under the right conditions, not all damage to the liver can be reversed. Testing liver function is recommended to keep track of liver health and to identify potential problems or damage early. In addition to this, supporting liver health with natural supplements may improve liver function and help reduce the symptoms of liver damage, lowering the risk of liver disease.

Certain natural supplements can boost liver health by optimizing liver function and supporting the production of new liver cells. In cases where liver damage has already occurred, these supplements may help maintain residual liver function and slow the further progression of liver disease.

As a gastroenterologist, my mission with LiverMD® was to create the single most effective liver health supplement on the market today. LiverMD is designed to address the growing epidemic of liver disease, estimated to affect over 100 million Americans and many more around the globe. Each LiverMD® ingredient was hand-picked for its proven scientific significance in a data-driven analysis for optimal liver health.

Backed by clinical studies, the benefits of LiverMD® include significant improvements in liver function, detoxification, and an overall statistically significant positive effect on liver health. I recommend LiverMD® in my clinic and my patients really feel the difference.

The combination of patented, potent ingredients, such as those found in LiverMD®️, is an effective way to provide natural and safe everyday care for your liver.

EVNolMax®️ is a supercharged vitamin E that has been clinically proven to prevent abnormal cell division in the liver. As a full spectrum complex of tocotrienols and tocopherols, EVNolMax®️ gives you the best in anti-inflammatory and antioxidant protection to help fatty liver disease and promote optimal liver function.
Siliphos® Bioavailable silybin comes from the main component of milk thistle, an herb that has been used for centuries to treat liver disease. Siliphos® is ten times more bioavailable than generic milk thistle extract, which allows it to be more effective for boosting liver health. Siliphos® strengthens liver cells, promotes the breakdown of toxins, and provides antioxidant protection to reduce the risk of liver damage.
Alpha-lipoic acid (ALA) has the ability to bind with free radicals in fatty liver cells and protect them from oxidative damage. Protecting damaged liver cells from inflammation and free radical damage can slow down the progression of liver disease and allow time for liver cells to heal and regenerate.
Zinc is an essential micronutrient that is involved in thousands of enzymatic reactions. As a supplement, it can inhibit oxidative damage and inflammation associated with liver disease, slowing the progression of cirrhosis. Zinc deficiency, which is commonly seen in liver disease, has been shown to impair the ability of the liver to regenerate, so daily supplementation is essential.
Selenium, a trace mineral, is a powerful antioxidant that can promote a healthy environment for your liver, helping prevent free radical damage and inflammation. Selenium also promotes the healing of cells and, especially when combined with other compounds such as ALA, helps heal the liver.
N-Acetylcysteine (NAC) is an amino acid that replenishes glutathione, the main antioxidant in the body. This helps with liver detoxification and reduction of inflammation. Glutathione fights free radicals that damage liver cells.

Final Thoughts

The liver is an essential organ for digestive and metabolic health. It is responsible for processing nutrients, detoxifying the body, and producing important proteins. The liver endures damage through inflammation and oxidative stress all the time and needs to regenerate and repair itself on a regular basis.

Along with healthy lifestyle choices, including a diet rich in healthy fat (e.g. avocado, salmon) and low in sugar and high-fructose corn syrup, as well as regular exercise, LiverMD®️ provides excellent enhanced protection for liver cells, as well as support for liver regeneration.

Severe liver damage, such as cirrhosis, cannot be reversed, but disease progression may be slowed down. Regular liver function testing is essential for optimal liver care, and the clinically proven ingredients of LiverMD®️ will help take care of your liver, boosting function, so you can maintain better overall health.