Abnormal Liver function tests



Liver function tests (LFTs) comprise of a number of blood markers:

Bilirubin: which is made up from the breakdown of red blood cells, it is processed in the liver.

Transferases (comprised of Alanine Aminotransferase –ALT and Aspartate aminotransferase - AST). These are enzymes that are located within the liver cells.

Alkaline phosphatise (ALP) – comes mainly from the cells lining the bile ducts in the liver.

Gamma-glutamyltransferase (GGT) – is an enzyme present within the liver and can be raised in a number of conditions.

Albumin and total protein: these are proteins manufactured in the liver; monitoring these levels in patients with established liver disease is often helpful.

There are hundreds of causes of abnormal liver function tests and investigation of the underlying cause can be a complex process.


What will happen if I am referred to a doctor?


If you are referred to a doctor for investigation of these abnormal LFTs the following tests and investigations may be done:

A full clinical history and examination – identifying possible causes of abnormal LFTs.

Further blood tests to find out the underlying cause, these blood tests may include tests for viruses, autoimmune diseases, iron levels and other specialised blood tests.

You may be referred for an ultrasound scan of your abdomen, to look at the liver.

Other tests that may be performed will be dependent on the cause and also prior to consideration of treatment.

  • Fibroscan: is a test to assess the level of fibrosis (scarring) in the liver. It is non-invasive and painless.

  • CT scan: may be used to further determine the liver and evaluate any abnormality which may have been present on ultrasound.

  • Liver biopsy: is a test that involves taking a small sample of tissue from the liver. Liver cells can then be looked at in detail. It is used to diagnose and monitor certain conditions.


  • Treatment of the abnormal LFTs will be dependent on the underlying cause.

  • If no cause is found, sometimes the doctor may recommend regular monitoring the LFTs at regular intervals.