Hepatic Function

Hepatic function tests—often called a liver function panel (LFTs)—evaluate how your liver is working and whether there is liver injury or bile-flow blockage (cholestasis). These blood tests are useful for people with abnormal screening labsmedication monitoringalcohol or hepatitis riskmetabolic/fatty liver disease, or unexplained symptoms like jaundice or fatigue.

A proactive plan starts with a panel of core markers (AST, ALT, alkaline phosphatase, GGT, total and direct bilirubin, albumin, total protein ± A/G ratio). As needed, add PT/INR (synthetic function), platelets/CBC, and cause-finding tests(hepatitis panels, autoimmune markers, iron/copper/A1AT studies). These labs support screeningdiagnostic triage, and monitoring, but they do not replace a clinician’s exam, ultrasound/elastography, or endoscopy when indicated.

Signs, Symptoms & Related Situations

  • Often silent early: abnormal liver enzymes on routine labs

  • Skin/eyes & digestion: yellow skin/eyes (jaundice), dark urine, pale stools, itching, nausea, poor appetite

  • Abdominal & systemic: right-upper-quadrant discomfort, bloating, fatigue, weakness

  • Medication & exposures: long-term acetaminophen or certain prescriptions, herbal/supplement use, alcohol exposure, occupational chemicals

  • Metabolic risk: central weight gain, diabetes, high triglycerides (fatty liver risk)

  • When to seek urgent care: vomiting blood or black stools, severe abdominal swelling/pain with fever, confusion, chest pain, or trouble breathing

All symptoms and risks should be reviewed by a qualified clinician.

Why These Tests Matter

What testing can do

  • Detect liver injury patterns (hepatocellular vs. cholestatic) and assess function (albumin, INR)

  • Guide next steps by pairing enzyme patterns with targeted cause-finding labs (hepatitis, autoimmune, iron/copper/A1AT)

  • Monitor trends over time to evaluate recovery, medication effects, or progression

What testing cannot do

  • Diagnose cirrhosis or cancer on labs alone—imaging/elastography (and sometimes biopsy) may be needed

  • Replace a clinician’s exam, medication review, or counseling on alcohol and metabolic risks

  • Provide treatment or dosing advice—discuss results with your clinician

What These Tests Measure (at a glance)

  • AST & ALT: enzymes released with liver cell (hepatocellular) injury; ALT is more liver-specific. Can rise with strenuous exercise or muscle injury (AST).

  • Alkaline Phosphatase (ALP) & GGT: cholestasis markers; ALP may rise from bone disease, so GGT helps confirm a liver source.

  • Bilirubin (total/direct): processing of bile pigment; direct (conjugated) bilirubin rises with cholestasis/obstruction; indirect may rise with hemolysis or Gilbert’s syndrome.

  • Albumin & Total Protein (± A/G ratio): reflect synthetic function and nutrition/inflammation context.

  • PT/INR (add-on): clotting proteins made by the liver; prolonged INR suggests reduced synthesis.

  • Platelets & CBC: low platelets can accompany portal hypertension; CBC adds anemia/infection context.

  • Context & cause-finding (as indicated): Hepatitis B/C panelsANA/ASMA/AMAferritin/iron/TIBCceruloplasminalpha-1 antitrypsin level/phenotypeA1c/lipids for fatty liver risk.

Quick Build Guide

Clinical goal Start with Add if needed
Abnormal enzymes on a wellness panel Hepatic function panel (AST/ALT, ALP/GGT, bilirubin, albumin/TP) PT/INR • Platelets/CBC • Hep B/C • Ferritin/iron
Jaundice or cholestatic pattern Liver panel with direct bilirubin & GGT AMA • IgM (PBC context) • clinician-directed imaging
Medication/alcohol monitoring AST/ALT • GGT • Bilirubin • Albumin PT/INR • CBC if concern persists
Metabolic/fatty liver risk AST/ALT • GGT • Platelets • Albumin A1c • Lipids • Ferritin; calculate FIB-4/APRI from routine labs
Suspected hepatitis AST/ALT • Bilirubin • Albumin • INR HBsAg/anti-HBc/anti-HBs • HCV Ab ± RNA
Follow-up of known liver disease Bilirubin • INR • Albumin • Creatinine/Na • Platelets AFP per program; trend MELD-type labs

How the Testing Process Works

  1. Choose the starting set: most people begin with a hepatic function panel; add PT/INR and CBC if there is concern for severity.

  2. Provide a blood sample: no routine fasting is required (fast only if lipids are added).

  3. Share medication/supplement use: some products affect liver tests; list them on your order.

  4. Get results securely: most values post within a few days.

  5. Review with your clinician: pair lab patterns with history and, when indicated, ultrasound/FibroScan or other imaging.

Interpreting Results (General Guidance)

  • AST/ALT predominant elevation: suggests hepatocellular injury (viral hepatitis, fatty liver, alcohol, medication).

  • ALP ± GGT predominant elevation: suggests cholestasis/bile-duct issues or infiltrative disease.

  • High direct bilirubin: supports cholestasis or impaired excretion; indirect favors hemolysis/Gilbert’s (clinical context required).

  • Low albumin / high INR: reduced synthetic function; trend closely with your clinician.

  • Normal labs do not exclude disease: compensated liver disease may have near-normal results—follow recommended monitoring.
    Always interpret patterns and trends with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Hepatic function panel (core): AST • ALT • ALP • GGT • Total/Direct Bilirubin • Albumin • Total Protein (± A/G)

  • Add for function/severity: PT/INR • Platelets/CBC • Sodium • Creatinine

  • Add for cause-finding: Hep B/C panels • ANA/ASMA/AMA • Ferritin/Iron/TIBC • Ceruloplasmin • Alpha-1 Antitrypsin • A1c/Lipids

  • Monitoring: recheck the same markers on the same method to compare trends reliably.

FAQs

Do I need to fast for liver tests?
No. Fasting is only needed if your order includes lipids.

Can alcohol or medicines change my results?
Yes. Alcohol and certain drugs/supplements can raise enzymes. List all products on your order.

Are AST and ALT specific to liver damage?
Mostly, but AST can also rise with muscle injury or heavy exercise. Context matters.

What if ALP is high but GGT is normal?
That can suggest bone rather than liver origin. Your clinician may add ALP isoenzymes or imaging.

Can I have liver disease with normal tests?
Yes—especially in early/compensated disease. That’s why risk-based monitoring and imaging are important.

What is the difference between direct and indirect bilirubin?
Direct (conjugated) bilirubin rises with cholestasisindirect with overproduction or reduced conjugation (e.g., hemolysis, Gilbert’s).

When should I add hepatitis or autoimmune tests?
When enzymes are persistently abnormal or risk/history suggests infection or autoimmune disease—your clinician will guide you.

Related Categories & Key Tests

  • Liver & Gallbladder Tests Hub

  • Cirrhosis Tests • Hepatitis B & C Tests • Fatty Liver (Metabolic) • Autoimmune Liver Disease • Hemochromatosis • Wilson’s Disease • General Health Panels

  • Key Tests: AST • ALT • Alkaline Phosphatase • GGT • Total/Direct Bilirubin • Albumin • Total Protein • A/G Ratio • PT/INR • Platelets/CBC • Ferritin • Iron/TIBC • Hepatitis B Panel • HCV Ab ± RNA • ANA • ASMA • AMA • Ceruloplasmin • Alpha-1 Antitrypsin • A1c • Lipid Panel

References

  • American Association for the Study of Liver Diseases — Guidance on evaluation of abnormal liver chemistries.
  • AASLD — Guidance on MASLD/NAFLD and cholestatic liver diseases.
  • European Association for the Study of the Liver — Clinical practice guidelines on liver disease assessment.
  • World Health Organization — Hepatitis B and C testing guidelines.
  • Clinical laboratory texts — Interpretation of liver enzymes, bilirubin fractions, and synthetic function tests.

Available Tests & Panels

Your Hepatic Function Tests menu is pre-populated in the Ulta Lab Tests system. Start with the hepatic function panelto profile injury and bile-flow patterns, then add PT/INRplatelets/CBC, and cause-finding tests (hepatitis, autoimmune, iron/copper/A1AT) as needed. Review results with your clinician to plan imaging, follow-up intervals, and monitoring.

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The LH-1 Liver Health panel is a focused diagnostic tool designed to assess the overall health and functionality of the liver. This panel includes tests for Gamma Glutamyl Transferase (GGT), Hepatic Function Panel, Lactate Dehydrogenase (LDH), and Prothrombin Time with INR, offering a snapshot of liver function, potential liver damage, and the liver's ability to synthesize proteins necessary for blood clotting.
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The LH-2 Liver Health panel is a comprehensive suite of tests designed to evaluate liver function, identify liver damage, and screen for specific liver disorders. This panel includes Quantitative Alpha-1-Antitrypsin, Alpha-Fetoprotein and AFP-L3, Fractionated Bilirubin (Direct, Indirect, and Total), Ceruloplasmin, Comprehensive Metabolic Panel, Gamma Glutamyl Transferase, Iron and Total Iron Binding Capacity, Lactate Dehydrogenase, and Prothrombin Time with INR. Each of these tests offers valuable insights into liver health, potential liver disease, and the liver's capacity to perform its vital functions.
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The LH-3 Liver Health panel is an extensive diagnostic tool designed to provide a comprehensive assessment of liver health. This panel includes a wide range of tests that evaluate liver function, screen for liver infections, and assess liver damage. It comprises Quantitative Alpha-1-Antitrypsin, Alpha-Fetoprotein and AFP-L3, Fractionated Bilirubin, Ceruloplasmin, Comprehensive Metabolic Panel, Copper, Gamma Glutamyl Transferase, Hepatitis A, B, and C antibodies and antigens, Iron and Total Iron Binding Capacity, Lactate Dehydrogenase, and Prothrombin Time with INR.
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The LH-4 Liver Health panel is the most comprehensive suite of tests tailored to provide an in-depth evaluation of liver health, function, and the presence of liver diseases, including liver cancer and viral hepatitis. It encompasses a broad spectrum of markers, from liver enzymes and proteins to specific tests for genetic conditions, liver cancer markers, and comprehensive screening for hepatitis infections.
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The Liver Health - Basic panel is a targeted set of tests designed to evaluate the essential functions and overall health of the liver. This panel includes Fractionated Bilirubin (Direct, Indirect, and Total), Comprehensive Metabolic Panel, Gamma Glutamyl Transferase (GGT), and the Lipid Panel with Ratios. These tests provide crucial information about liver function, bile production and flow, liver enzyme levels, and the liver's impact on lipid metabolism.
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The Liver Health - Basic Plus panel expands upon the foundation of liver function testing by adding a Complete Blood Count with Differential and Platelets and Lactate Dehydrogenase (LDH) to the core tests of Fractionated Bilirubin, Comprehensive Metabolic Panel, Gamma Glutamyl Transferase (GGT), and Lipid Panel with Ratios. This enhanced panel provides a more detailed overview of liver health, including liver enzyme levels, bilirubin processing, and the potential impact on blood cells and lipid metabolism.
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Blood Draw, Phlebotomist

The Liver Health - Comprehensive panel is the most inclusive test suite for evaluating liver function and health, designed to provide a thorough analysis of liver enzymes, bilirubin levels, liver's impact on blood and iron metabolism, and screening for common viral hepatitis infections. It combines a wide range of tests, including Fractionated Bilirubin, C-Reactive Protein (CRP), Complete Blood Count with Differential and Platelets, Comprehensive Metabolic Panel (CMP), Ferritin, Gamma Glutamyl Transferase (GGT), hepatitis panels, Iron and Total Iron Binding Capacity (TIBC), Lactate Dehydrogenase (LDH), Lipid Panel with Ratios, Prealbumin, Prothrombin Time with INR, and Transferrin.
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The Liver Health - Advanced panel is a comprehensive diagnostic tool designed for a deep dive into liver health, offering an extensive array of tests that evaluate liver function, screen for viral hepatitis, and assess related metabolic and systemic effects. This panel includes Fractionated Bilirubin (Direct, Indirect, and Total), C-Reactive Protein (CRP), Complete Blood Count with Differential and Platelets, Comprehensive Metabolic Panel (CMP), Ferritin, Gamma Glutamyl Transferase (GGT), a full suite of hepatitis markers, Iron and Total Iron Binding Capacity (TIBC), Lactate Dehydrogenase (LDH), and a Lipid Panel with Ratios.
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Blood Draw, Phlebotomist

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The Hepatic Function Panel Test measures liver enzymes, proteins, and bilirubin to assess liver health and function. It includes ALT, AST, ALP, albumin, total protein, and bilirubin levels. Abnormal results may indicate hepatitis, cirrhosis, fatty liver, or bile duct problems. Doctors use this test to investigate jaundice, nausea, abdominal pain, or fatigue and to monitor liver disease, alcohol use, or medication side effects affecting liver function.

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Also Known As: Liver Function Panel Test, LFT

The Liver Function Panel, also known as a Hepatic Function Panel, measures proteins, enzymes, and bilirubin to assess liver health and function. It helps detect liver disease, monitor liver conditions, and evaluate the effects of medications or other factors on liver performance.

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Also Known As: Hepatic Function Panel Test, HFP Test

The Hepatic Function Panel without Total Proteins Test measures key liver health markers, including albumin, bilirubin, alkaline phosphatase, ALT, and AST. Doctors use this panel to detect liver disease, monitor damage from hepatitis, alcohol, or medications, and evaluate bile duct function. By excluding total protein, the test focuses on specific enzymes and metabolites that provide insight into liver performance and overall function.

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Also Known As: Liver Function Panel Test without Total Proteins

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 The Hepatic Panel is a comprehensive set of blood tests designed to evaluate the function of the liver. This panel measures various enzymes, proteins, and substances in the blood that are either produced by the liver or released when liver cells are damaged. It provides crucial information about the liver's condition, aiding in the diagnosis, monitoring, and differentiation of liver disorders.
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The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

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Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 

The Albumin Test measures albumin, the main protein made by the liver that maintains fluid balance and transports hormones, vitamins, and medications. Low albumin may indicate liver disease, kidney problems, malnutrition, or chronic inflammation, while high levels may reflect dehydration. Doctors order this test to evaluate swelling, fatigue, or abnormal labs. Results provide key insight into nutritional status, liver and kidney function, and overall metabolic health.

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Also Known As: ALB Test

The ALP Test measures alkaline phosphatase enzyme levels in blood to evaluate liver, bone, and bile duct health. High ALP may indicate liver disease, bile duct obstruction, bone disorders, or certain cancers, while low levels may suggest malnutrition or deficiency. Doctors order this test to investigate symptoms like fatigue, abdominal pain, or bone pain and often pair it with other liver function tests. Results provide key insight into metabolic and organ health.

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Also Known As: Alkaline Phosphatase Test, Alk Phos Test, Alkp Test

The Alkaline Phosphatase Isoenzymes Test measures different forms of alkaline phosphatase (ALP) in the blood to determine their source, such as liver, bone, intestine, or placenta. Doctors use this test to evaluate abnormal ALP results, identify liver disease, bile duct obstruction, bone disorders like Paget’s disease, or certain cancers. It helps distinguish between conditions and guides accurate diagnosis and treatment planning.


The Alpha-1 Antitrypsin Random Feces Test measures levels of alpha-1 antitrypsin, a protein that normally remains in the bloodstream. Elevated amounts in stool suggest protein-losing enteropathy, intestinal inflammation, or gastrointestinal conditions that impair absorption. By evaluating protein loss through the digestive tract, this test helps assess intestinal integrity and overall digestive health.

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Also Known As: Alpha-1 Antitrypsin Test, A1AT Test, AAT Test, Alpha-1 Antitrypsin Feces Test

The Alpha-1-Antitrypsin Quantitative Test measures levels of alpha-1-antitrypsin (AAT), a protein that protects the lungs and liver from damage. Low levels may indicate alpha-1-antitrypsin deficiency, a genetic disorder linked to emphysema, COPD, and liver disease. Doctors use this test to investigate unexplained lung or liver problems, confirm hereditary AAT deficiency, and guide treatment or monitoring strategies for long-term health management.

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Also Known As: Alpha-1 Antitrypsin Test, A1AT Test, AAT Test, Alpha-1 Antitrypsin Serum Test

The Alpha-Fetoprotein (AFP) and AFP-L3 Test measures total AFP and the AFP-L3 fraction, which is more specific for liver cancer risk. Elevated AFP may indicate liver disease, germ cell tumors, or hepatitis, while AFP-L3 is strongly associated with hepatocellular carcinoma (HCC). Doctors order this test to assess liver function, screen high-risk patients, and monitor cancer treatment. Results provide critical insight into liver health and cancer detection.

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Also Known As: AFP Test, Total AFP Test, Alpha-Fetoprotein Tumor Markers, Alpha-Fetoprotein Test

More than fifty million people worldwide have chronic liver disease. These individuals deal with Wilson's disease, hepatitis, cirrhosis, and more.

Unfortunately, these kinds of conditions can lead to death if they're not diagnosed and treated early. The earlier you catch it, the better your outcome will be.

Even if you aren't a heavy drinker, you should worry about your liver health. Many non-drinkers still develop liver issues.

To check your liver health, you need a hepatic function panel. Hepatic function blood tests can help identify whether or not you have liver disease or are at risk for developing it.

Keep reading to learn more.

What Is Hepatic Function Decline?

Hepatic function decline refers to a decrease in your liver's ability to function properly. The liver is a football-sized organ that lies just under the rib cage on the right side of your abdomen. It's essential to digestion and filtering.

Your liver is the organ that filters toxins like alcohol out of your system.

Due to genetic and environmental conditions, some people take damage to their livers. Over time, too much damage can lead to liver failure. Unfortunately, this can lead to a decline in quality of life and may even lead to death.

Risk Factors for Hepatic Function Decline

Since liver function depends on your genetic and environmental factors, there are many risk factors that researchers have connected with hepatic functional decline:

  • A family history of liver disease
  • Exposure to toxins and chemicals
  • Unprotected sexual encounter(s)
  • Heavy alcohol use
  • Obesity
  • Type II diabetes
  • Tattoos
  • Body piercings
  • Injecting drugs (specifically while sharing needles)
  • Exposure to other people's bodily fluids
  • Having had a blood transfusion before 1992

If any of these risk factors apply to you, you should pay special attention to your liver function panels. Your primary care physician will perform a hepatic function blood test each year when you have routine blood work done.

However, you should let your physician know if have any of these risk factors. With more information, your physician can make better decisions about your health. 

Causes of Hepatic Function Decline

As we discussed, the liver is an essential organ. It performs a lot of jobs for the human body. Because of this, there are many causes that can lead to hepatic function decline:

  • Chronic alcohol abuse
  • Accumulation of fat in the liver, which is also known as nonalcoholic fatty liver disease
  • Infections such as Hepatitis A, Hepatitis B, and Hepatitis C
  • Genetic conditions such as alpha-1 antitrypsin deficiency, Wilson's disease, and hemochromatosis
  • Cancers and other neoplasms such as liver cancer, bile duct cancer, and liver adenoma
  • Immune systems problems such as autoimmune hepatitis, primary sclerosing cholangitis, and primary biliary cholangitis
  • The use of some prescription or over-the-counter medications
  • The consumption of some herbs or supplements

Since the liver is one of the primary filtering systems in the body, it's essential to note how important your consumption habits are. In other words, to protect your liver and other vital organs, you should be careful about what you eat and take. Too much alcohol, fatty foods, medications, and other substances can lead to hepatic function decline.

What Are the Signs and Symptoms of Hepatic Function Decline?

Unfortunately, liver problems don't always come with signs and symptoms until the disease is fully developed. As you may remember, time is of the essence with these kinds of conditions. So, you (and your physicians) should be working together to try to diagnose liver-related conditions as early as possible.

Since signs and symptoms don't show up until later in the disease course, you need to make sure that you're getting your regular checkups. Your primary physician is the first line of diagnosis for these kinds of conditions since they perform hepatic function lab tests at your regular appointments.

These liver function panels can let your physician know whether or not there is any damage to your liver. If they do find signs of damage, they can work with you on reversing current damage and/or stopping future damage.

If your liver condition were to advance, here are some signs and symptoms that you should look out for:

  • Jaundice, a condition in which your skin and eyes turn a yellowish tint
  • Itchy skin
  • Easily bruising
  • Chronic fatigue
  • Abdominal pain and swelling
  • Nausea or vomiting
  • Loss of appetite
  • Swelling in the lower legs and ankles
  • Urine that is dark in color
  • Stool that is pale in color

If you're experiencing any of these symptoms, you need to make an appointment with your primary care physician as soon as possible. If you're already experiencing jaundice (a sign that your condition has progressed to later stages), you should go to the emergency room.

How Is Hepatic Function Decline Diagnosed?

When you see your doctor, they're going to start by gathering an extensive health history. In addition, they're going to perform a physical examination.

During these two steps, they can detect any genetic markers or physical changes that may be associated with hepatic function decline.

Afterward, your physician will order blood tests to check your liver function. We will discuss more specific tests below.

In addition to these tests, your physician may order an ultrasound, CT, or MRI to visualize any changes to the liver.

Lastly, your physician may want to collect a biopsy of the liver to check for damage to the liver on the cellular or tissue level.

The Lab Tests to Screen, Diagnose, and Monitor Hepatic Function Decline

A full hepatic function panel test will check the following values:

  • Albumin
  • Globulin
  • Albumin/Globulin ratio
  • Alkaline phosphatase
  • ALT
  • AST
  • Bilirubin
  • Protein

All of these values are essential in detecting liver disease and understanding how far the disease has progressed.

Get a Hepatic Function Panel With Ulta Lab Tests

If you think that you may have hepatic function decline, you need to get your blood work done as soon as possible. Luckily, our hepatic function panel tests every biomarker of liver decline.

With confidential results and a quick turnaround, you'll know about your liver health within a few days. Other benefits of using Ulta Lab Tests for your testing needs include:

  • Affordable pricing on all tests
  • No insurance needed
  • No doctor’s referral required
  • 100% satisfaction guarantee

With confidential results and a quick turnaround, you'll know about your liver health within a few days. Take control of your health with Ulta Lab Tests!