Physician ready to check liver health

How to Check Liver Health: Key Points to Know

Medically reviewed on June 27, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Your liver is roughly the size of a football and weighs just over three pounds, making it one of the largest organs in the human body. It is located below the diaphragm, under the ribs in the upper right abdomen. It stores about 13 percent of the body’s total blood supply [1].

Healthy liver function is an integral part of the digestive system and reportedly performs upwards of 500 different functions within the human body. Most all of those have to do with metabolism, the process of breaking down foods and turning them into usable energy [1]. (Take an at-home metabolism test to check three hormones that can influence your metabolism.)

A healthy liver can take quite the beating in everyday life, so ensuring the liver’s health can dictate overall health. This can be done with a handful of liver tests, such as CMP blood tests. Learn more about the liver and how to check its health below.

What does your liver do?

All the blood that leaves the intestines and stomach passes through the liver. The organ then processes that blood and breaks down and creates nutrients within the blood. It also turns any medications that you have taken into nontoxic forms that are easier for your body to use [2].

Along with regulating chemical levels in the blood, the liver also secretes a liquid called bile. Bile is a digestive liquid that appears thick and yellow-green in color. Bile helps to break down fat into fatty liver acids, which are easily absorbed in the digestive tract [3]. When the liver enzyme breaks down harmful substances in the blood, the waste products are excreted into the biliary tract. Waste products in the biliary tract then enter the intestines and are removed from the body in the form of feces [2].

Those are just some of the main functions of the liver. Remember, this organ performs about 500 vital functions within the body. A non-exhaustive list of other functions include:

  • Filtering out drugs, alcohol, and other poisonous substances from the blood
  • Regulating the body’s blood clotting
  • Storing iron and processing hemoglobin (a protein found in red blood cells that carries iron and oxygen)
  • Producing cholesterol and proteins that carry fatty liver acids through the body
  • Removing bacteria from the blood and synthesizing immune factors [2]

Tests for liver health

There are several tests available to identify potential inflammation, injury, disorders, or damage to the liver. These tests can also determine the general function and performance of the liver. A healthcare provider may order a liver test to:

  • Screen for specific liver disease and infections
  • Monitor the side effects of medication
  • Identify the severity of liver scarring (cirrhosis) and other diseases
  • Determine the effectiveness of certain treatments [4]

Liver function tests typically work by measuring the levels of certain substances in the blood.

Bilirubin

Red blood cells naturally die, leaving room for new, fresh blood cells. As red blood cells break down, one of their byproducts is bilirubin. This yellowish pigment passes through the liver and leaves the body. Testing for bilirubin levels can provide insight into liver diseases or bile duct problems. High bilirubin levels may also indicate a higher rate of red blood cell death (hemolysis) [5].

Liver Enzymes

Your provider can test for three liver enzymes:

  • Alanine transaminase (ALT) helps to break down proteins and convert them into usable energy [4].
  • Alkaline phosphate (ALP) also helps to convert proteins into energy and is also found in bone [4].
  • Aspartate transaminase (AST) works to metabolize amino acids [4].
  • Gamma-glutamyl transferase (GGT) is an enzyme that is mostly found in the liver but is present throughout the body.

All three of these enzymes are produced in the liver. While some small amounts are found in the blood, high amounts of these enzymes in the bloodstream typically point to liver problems. This is because liver damage can cause these enzymes to leak into the blood. It may also indicate certain bone diseases or a blocked bile duct [4].

Albumin

Albumin is a protein that keeps fluid in the bloodstream, which prevents it from leaking into other tissues. Albumin also carries enzymes, hormones, vitamins, and medicines through the body [6]. Measuring albumin levels may indicate liver or kidney problems. Albumin can leak into the urine when the kidney fails, which can result in low albumin levels in the blood [7].

Total Protein

A total protein test measures two proteins found in the blood: albumin and globulin. Globulins are a part of the immune system and help to fight infections and clot blood. Any abnormalities in a total protein test can indicate kidney and liver problems or nutritional deficiencies [8].

Prothrombin Time

A prothrombin time test measures the amount of time it takes for blood to clot. Prothrombin is a protein that is produced in the liver. Combined with other enzymes, prothrombin ensures that blood clots properly. Increased time to clot blood may point to liver problems, but that time can also go up if you are taking warfarin or other blood-thinning drugs [9].

Types of tests

While you can get each of the above substances measured and tested on its own, you can also get tests, such as a basic metabolic panel or comprehensive metabolic panel, that check for several of the substances at once. A basic metabolic panel is a blood test that measures eight different substances in the blood. A comprehensive metabolic panel takes it a step further and measures 14 substances (including many of the above) involved with your metabolic health [10].

What to expect and how to prepare for these tests

Otherwise, these tests require little preparation. Your blood samples get sent to a lab for analysis. If the lab is onsite, you may get results back within hours. If the lab is offsite, you can typically expect to get your results in a few days. If the tests note any abnormalities, your healthcare provider may recommend further testing, examination, and evaluation to detect and diagnose the underlying condition [4].

What's the Difference: Basic vs. Comprehensive Metabolic Panel

What Is a Basic Metabolic Panel?

What Is a Comprehensive Metabolic Panel?

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References

1. What Does the Liver Do, and How Do I Keep Mine Healthy? Michigan health. URL. Accessed June 27, 2022.

2. Liver: Anatomy and Functions. Johns Hopkins Medicine. URL. Accessed June 27, 2022.

3. What Is Bile? VeryWell Health. URL. Accessed June 27, 2022.

4. Liver function tests. Mayo Clinic. URL. Accessed June 27, 2022.

5. Bilirubin test. Mayo Clinic. URL. Accessed June 27, 2022.

6. Albumin Blood Test. Medline Plus. URL. Accessed June 27, 2022.

7. Albumin(Blood). Rochester Health Encyclopedia. URL. Accessed June 27, 2022.

8. Total protein. UCSF Health. URL. Accessed June 27, 2022.

9. Prothrombin time test. Mayo Clinic. URL. Accessed June 27, 2022.

10. Comprehensive Metabolic Panel (CMP). Medline Plus. URL. Accessed June 27, 2022.

11. Basic Metabolic Panel (BMP). Medline Plus. URL. Accessed June 27, 2022.

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