Liver Function Test Gold (LFT Gold)

Key Aspects of the Test

• What it Measures:
  • Albumin: Produced by the liver, it prevents fluid leakage from blood vessels and transports substances.
  • Globulins: Produced by the immune system and liver, they fight infections.
  • A/G Ratio: The ratio of albumin to globulins is often included.
• When it is Used: To investigate unexplained weight loss, fatigue, or symptoms of kidney/liver disease (e.g., swelling, jaundice).
• Procedure: A blood sample is drawn from a vein. Generally, no fasting is required, but it can depend on whether other tests are ordered simultaneously.

Interpreting Results

• Low Protein Levels: Can indicate liver disease (e.g., cirrhosis), kidney disease (kidney damage allows protein to leak into urine), or malnutrition/malabsorption.
• High Protein Levels: Can be caused by chronic infections (e.g., HIV, Hepatitis C), inflammatory conditions, or bone marrow disorders like multiple myeloma.
• A/G Ratio: Low ratios suggest autoimmune diseases or chronic inflammation, while high ratios may indicate leukemia or genetic deficiencies.

Albumin, Serum - Lab test

Albumin : Globulin Ratio (A:G Ratio) - Lab test

Combined bilirubin measurement

Aspartate Aminotransferase (AST) SGOT - Lab test

Key Details About ALT/SGPT

• Purpose: The test measures the level of ALT in the blood to diagnose liver disease, monitor treatments, and evaluate liver damage.
• Normal Range: While laboratory standards vary, normal ALT levels are generally between 7 to 56 U/L for men and 7 to 45 U/L for women.
• Causes of High Levels: Elevated ALT can be caused by hepatitis, fatty liver disease, cirrhosis, liver infection, or excessive alcohol intake.
• Symptoms of High ALT: High levels may be suggested by fatigue, nausea, jaundice (yellowing skin/eyes), dark urine, or abdominal swelling.

When is the Test Ordered?

Physicians order this test when a patient exhibits symptoms of liver disease or as part of a routine comprehensive metabolic panel (CMP). It is highly specific to the liver, although smaller amounts are found in kidneys, heart, and muscles.

Preparation and Results

• Preparation: No special fasting or preparation is usually required.
• Results: Results are typically available within a few days.
• Interpretation: High levels indicate the liver needs to be investigated, but they do not specifically diagnose the exact cause without further testing.

Key Aspects of ALP:

• High ALP Levels: Commonly indicate liver damage (hepatitis, cirrhosis), bile duct blockage, or bone diseases such as Paget's disease, bone cancer, or rickets.
• Low ALP Levels: Less common, but may indicate malnutrition, magnesium deficiency, protein deficiency, or hypophosphatasia.
• Physiological Factors: ALP levels can be higher in children (due to bone growth), during pregnancy (placental ALP), and slightly higher with age.
• Symptoms of Abnormal Levels: Fatigue, nausea, jaundice (yellow skin/eyes), dark urine, abdominal pain (liver issues), or bone pain and frequent fractures (bone issues).

Commonly Associated Conditions:

• Liver Disease: Hepatitis, bile duct obstruction.
• Bone Diseases: Paget's disease, bone tumors, osteomalacia, rickets.
• Other: Hyperparathyroidism, hyperthyroidism, kidney tumors.

The ALP test is typically part of a comprehensive metabolic panel (CMP) or liver function test. If ALP is high, doctors often order additional tests (like an ALP isoenzyme test or liver ultrasound) to determine if the cause is liver or bone-related.

Key Aspects of GGT:

• Purpose: GGT helps transport amino acids and metabolizes glutathione, acting as a key marker for liver injury, particularly cholestasis (bile flow stoppage).
• What High Levels Mean: While commonly associated with alcohol abuse, elevated GGT can indicate fatty liver, hepatitis, cirrhosis, bile duct tumours, pancreatitis, or drug toxicity.
• When It’s Tested: Often ordered alongside other tests (like ALT, ALP, AST) to investigate liver issues, especially if the patient has jaundice, dark urine, or abdominal pain.
• Normal Range: Typical levels range from 5 to 40 units per liter (U/L), though this can vary by lab and is often higher in newborns or with age in females.
• Sensitivity: GGT is highly sensitive to liver injury, but not very specific—meaning it can show as high for many different causes, including diabetes or heart failure.

Causes of Elevated GGT Levels:

• Alcohol Use: Regular, heavy alcohol consumption often significantly raises GGT.
• Liver Disease: Fatty liver, hepatitis, or cirrhosis.
• Bile Duct Blockage: Conditions that block bile flow from the liver.
• Medications: Certain over-the-counter and prescription drugs, including phenytoin and phenobarbital.
• Other Factors: Smoking, heart failure, diabetes, and certain infections.

What to Expect (Test Procedure):

• Preparation: Usually requires fasting, as food can cause a temporary decrease in GGT levels.
• Procedure: A standard blood draw (venipuncture).
• Risks: Generally, there are very few risks, such as minor bruising or pain at the site.