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 Lactate Dehydrogenase (LDH) Test measures LDH enzyme levels in blood to assess tissue damage and overall health. Elevated LDH may indicate conditions such as liver disease, heart attack, anemia, infections, or certain cancers, while low levels are uncommon. Doctors use this test to help diagnose disease, monitor treatment effectiveness, and track cell damage. It provides valuable insight into metabolic activity and organ function.

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Also Known As: LD Test, LDH Test, Lactic Acid Dehydrogenase Test

The Lactate Dehydrogenase (LDH) Isoenzyme Panel measures total LDH and separates it into isoenzymes (LDH-1 to LDH-5) to identify tissue damage. LDH-1 is linked to heart, LDH-2 to blood, LDH-3 to lungs, LDH-4 to kidneys, and LDH-5 to liver and muscle. Elevated levels may indicate heart attack, liver disease, anemia, or cancer. Doctors order this test to pinpoint tissue injury, monitor disease progression, and guide treatment strategies.


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The Lipid Panel with Ratios Test measures seven key markers: total cholesterol, HDL, LDL, non-HDL cholesterol, triglycerides, Chol/HDL ratio, and LDL/HDL ratio. This advanced panel evaluates cardiovascular risk by assessing cholesterol balance and fat metabolism. Doctors use it to detect high cholesterol, atherosclerosis risk, and heart disease, and to monitor treatment. Often part of routine exams, it provides insight into long-term heart and metabolic health.

Also Known As: Lipid Profile Test, Cholesterol Panel Test, Lipid Blood Test

The Liver and Kidney Function Panel measures blood sugar, electrolytes, proteins, and markers of liver and kidney health. It helps detect disease, monitor conditions, and guide treatment decisions.

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The Mitochondrial Antibody with Reflex to Titer Test detects antimitochondrial antibodies (AMAs), most commonly linked to primary biliary cholangitis (PBC), an autoimmune liver disease. If antibodies are present, reflex titers measure their level for greater diagnostic detail. Doctors use this test to investigate unexplained liver abnormalities, chronic fatigue, or jaundice, helping confirm autoimmune liver disease and guide long-term management.

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Most Popular

The Prealbumin Test measures levels of prealbumin, a protein made by the liver that reflects short-term nutritional status. Low levels may indicate malnutrition, liver disease, inflammation, or chronic illness, while high levels may be linked to kidney disease or steroid use. Doctors use this test to assess protein-calorie nutrition, monitor patients receiving nutritional support, and guide treatment for conditions affecting metabolism and recovery.

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Also Known As: Thyroxine-binding Prealbumin Test, Transthyretin Test

The PBC Diagnostic Panel detects autoantibodies associated with primary biliary cholangitis, including AMA (with reflex titer), ANA (IFA with pattern), SMA (IgG), SSA/SSB, TPO, and LKM-1. By assessing a comprehensive autoimmune profile, this panel aids differentiation of PBC from overlapping autoimmune liver or systemic conditions and supports accurate diagnosis in suspected cholestatic disease.

Also Known As: PBC Diagnostic Test


The Protein Total and Protein Electrophoresis Test with Scan measures total protein in blood and separates it into albumin and globulin fractions to evaluate liver, kidney, and immune function. The scan identifies abnormal protein patterns linked to multiple myeloma, Waldenström’s macroglobulinemia, or chronic inflammation. Doctors order this test for unexplained fatigue, weight loss, or anemia. Results support diagnosis, monitoring, and treatment planning.


The Protein Total Serum Test evaluates total protein concentration, reflecting both albumin and globulin, which play key roles in immune response, liver function, and nutrient transport. Abnormal findings may signal malnutrition, kidney or liver disease, or chronic inflammatory conditions. This test aids in assessing protein metabolism, systemic health, and overall physiological balance.

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The Prothrombin Time with INR Test measures how long it takes blood to clot and calculates the international normalized ratio (INR) for accuracy. It is commonly used to monitor patients on blood-thinning medications like warfarin and to evaluate bleeding disorders, liver disease, or vitamin K deficiency. Doctors order this test to investigate easy bruising, frequent nosebleeds, or prolonged bleeding and to ensure safe and effective anticoagulant therapy.

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Also Known As: PT with INR Test

Most Popular

The Sed Rate Test, also called the ESR Test, measures how quickly red blood cells settle in a sample of blood. A faster rate may signal inflammation caused by infections, autoimmune diseases, arthritis, or other chronic conditions. Doctors use this test to investigate unexplained fever, joint pain, or muscle aches, and to monitor inflammatory disorders such as lupus or rheumatoid arthritis. The Sed Rate Test provides important insight into overall inflammatory activity.

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Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

The Sedimentation Rate Blood Test, also called the Erythrocyte Sedimentation Rate (ESR) Test, measures how quickly red blood cells settle in a sample. A faster rate can signal inflammation linked to arthritis, autoimmune disease, or infection. Doctors order this test when patients have symptoms like joint pain, fever, or fatigue. While not diagnostic alone, results provide valuable insight into inflammatory activity and help guide further evaluation and treatment.

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Also Known As: Sed Rate Test

Most Popular

The Transferrin Test measures transferrin, a blood protein that transports iron, to evaluate iron status and nutritional health. High levels may suggest iron deficiency anemia, while low levels may indicate liver disease, malnutrition, or chronic illness. Doctors use this test alongside iron and TIBC to investigate fatigue, weakness, or anemia symptoms. Results provide vital insight into iron balance, red blood cell production, and overall metabolic function.

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The Zinc Protoporphyrin (ZPP) Test measures ZPP levels in red blood cells to detect iron deficiency and lead exposure. When iron is low or lead interferes with hemoglobin production, ZPP accumulates, making it a sensitive early marker. Doctors use this test to screen for iron-deficiency anemia, monitor occupational lead exposure, and evaluate unexplained anemia, helping guide diagnosis, prevention, and treatment strategies.

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Also Known As: ZPP Test, ZP Test, Free Erythrocyte Protoporphyrin Test, FEP 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!