Liver Function Blood Test Interpreter

Enter values to interpret

Enter values to interpret

Probability of Alcoholic Liver Disease:

000%

ANI is useful if patient's alcohol consumption history is unclear or deemed unreliable. Short-term abstinence (few months) does not significantly alter the ANI.

It is crucial to exclude other potential causes of liver disease before applying the ANI.

Cholestasis is seen in: Gallstones; Malignancy (pancreatic, cholangiocarcinoma); Primary Biliary Cholangitis (PBC); Primary Sclerosing Cholangitis (PSC), often associated with IBD;

Drugs associated with cholestasis: Amoxicillin-clavulanate; macrolides (erythromycin); trimethoprim-sulfamethoxazole; anabolic steroids; combined oral contraceptives; chlorpromazine.

Mixed pattern / inconclusive.

If the presentation is not acute, this pattern is most often seen with fatty liver (NAFLD or alcohol-related).

A hepatocellular pattern is seen in: Viral Hepatitis or other viral infections; Autoimmune hepatitis; ischemic “shock” liver; Wilson's disease, hemochromatosis, alpha-1 antitrypsin deficiency; Toxin exposure; Budd-Chiari syndrome

Drugs associated with hepatocellular pattern: Acetaminophen (paracetamol); statins; certain antibiotics (e.g., isoniazid, nitrofurantoin); antiepileptics (e.g., valproate, phenytoin); NSAIDs (e.g., diclofenac); methotrexate; amiodarone; herbal/dietary supplements.

Pre-hepatic pattern - mostly unconjugated bilirubin. The liver is conjugating normally; excess comes from over-production.

Pre-hepatic pattern is most commonly seen in hemolytic processes (e.g., autoimmune hemolytic anemia, transfusion reactions) and benign unconjugated syndromes (Gilbert's syndrome).

Hepatocellular injury pattern - both conjugation and canalicular export partly impaired.

Hepatocellular pattern is mostly seen in acute viral hepatitis or toxin/alcohol-related hepatocellular damage.

Cholestatic / obstructive pattern - predominantly conjugated bilirubin. Bilirubin is conjugated but can’t reach the gut.

Cholestatic pattern is most commonly seen in extra-hepatic biliary obstruction, like in choledocholithiasis; malignancy or less frequently intra-hepatic cholestasis.

Your

D/T Bilirubin Ratio

is optimal

Probabilities of having different fibrosis stages:

Elevated AST levels are seen in muscle injury (e.g., strenuous exercise, seizures, myopathies, myocardial infarction or heart failure), tissue damage (severe burns, surgery), liver injury (fatty liver, viral or other infections, malignancy), anorexia or rapid weight change (e.g., >5 kg/week), pancreatitis, gallbladder attack and hemolysis (e.g., hemolytic anemia, splenomegaly).

Several drugs can increase AST including: chronic alcohol, NSAIDs, acetaminophen, oral contraceptives, statins, certain antibiotics, corticosteroids, toxins like lead, mercury, and pesticides.

ALT is highly specific to liver injury (Fatty liver, Viral hepatitis, Autoimmune hepatitis, Liver cancer, Alcohol liver damage, Mononucleosis, Hemochromatosis).

Muscle damage – strenuous exercise, trauma, myocardial infarction, congestive heart failure.

Gallstones; Biliary disease; pancreatitis; both obesity and anorexia; rapid weight change; celiac disease; hemolysis.

Many toxins and drugs can increase ALT, but most notable are: Paracetamol, NSAIDs, statins, phenytoin, allopurinol, and antibiotics, especially amoxicillin.

ALP is seen decreased in Malnutrition (insufficient calories or very low protein diet), Magnesium or Zinc Deficiency, advanced liver disease, Hypothyroidism, severe anemia, excess cortisol levels and more.

Medication that can decrease ALP levels: mega-dosing vitamins D or B, Hormone replacement therapy, oxalates, nitrofurantoin, Cinacalcet and more.

Cholestatic liver injury – biliary obstruction, acute cholecystitis, cholangitis, cirrhosis, hepatic tumors.

Bone/osteoblastic activity – Paget’s disease, osteomalacia/rickets, fracture healing, growth spurts, hyperparathyroidism, bone metastases.

Gut/intestinal mucosa issues – IBS, celiac disease, intestinal ischemia; kidney disease; various malignancies; vitamin D deficiency; hyperthyroidism; rheumatoid arthritis; sickle cell crises.

Medications – birth control pills, allopurinol, colchicine, antibiotics, fluorides, verapamil, nicotinic acid, vigorous exercise.

Low GGT levels are usually not concerning. However, they may indicate Acute intrahepatic cholestasis, Hypothyroidism, magnesium deficiency or vitamin B6 deficiency, bone disease (low bone mass density).

Drugs that can cause low GGT: Fibrate Drugs (Clofibrate, Fenofibrate), Estrogen-Containing Medications,milk thistle, antioxidants.

Major serum GGT contributors: Liver (both hepatocytes and cholestasis), gallbladder, pancreas and kidneys. Also increased in insulin resistance, toxin exposure, oxidative stress and increased antioxidants (glutathione) need etc.

Drugs that can increase GGT: Alcohol, anti-seizure medications and more.

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Mixed pattern / inconclusive

High total bilirubin is associated with liver dysfunction, hepatitis, Gilbert’s Syndrome, Strenuous Exercise, Gallstones and Gallbladder Disease, Pancreatitis, Appendicitis, obstruction of extrahepatic ducts, RBC hemolysis.

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Your

Bilirubin (Total)

is optimal

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Mixed pattern / inconclusive

Elevated albumin levels occur with dehydration (commonly due to vomiting or diarrhea) and insulin resistance.

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