Liver Disease

Liver Disease Testing Near Me and health information

Do you have a problem with your liver?

Find out how healthy your liver is with Ulta Lab Tests liver function tests and liver blood chemistry tests that help determine the health of your liver by measuring the levels of proteins, liver enzymes, and bilirubin in your blood.

Liver disease is a condition that affects the liver and causes inflammation or damage. These conditions may also affect how the liver functions. Liver disease is categorized according to the cause and effect upon the liver. Causes can include infection, exposure to drugs, exposure to toxic compounds, injury to the liver, autoimmune processes, genetic defects, and other conditions due to deposits and buildup of metals in the liver, including iron and copper. 

The symptoms of liver disease vary depending on the cause and type of illness. Still, they often include fever, fatigue, nausea or vomiting, loss of appetite, abnormalities in blood clotting, inflammation, jaundice (yellowing of the skin), abdominal pain, or swelling in your abdomen due to fluid buildup. Some types of liver disease are silent for years before symptoms appear. This means that some people may not know they have a problem until their livers become severely damaged.

Liver disease is a serious condition that can lead to liver failure and death. If you suspect you may have liver disease, it's important to test and seek medical attention immediately.

If you want to learn more about liver diseases and the lab tests that can help you, click on the title of the articles below.

In addition to the most common types of liver disease that include hepatitis A through E, fatty liver, cirrhosis, and cancer there are many different types of liver diseases, including autoimmune hepatitis; fatty infiltration/steatosis; alcoholic hepatitis; cirrhosis from alcohol abuse or chronic viral infection such as HCV (hepatitis C) and HBV (hepatitis B); primary biliary cirrhosis; primary sclerosing cholangitis; hemochromatosis which causes iron overload in the body leading to damage in multiple organs including the pancreas and heart valves among others.; Wilson's Disease, which causes copper accumulation leading to brain dysfunction among other things.; alpha-1 antitrypsin deficiency leads to emphysema with no known cure at this time.; drug toxicity from medications such as acetaminophen overdose causing acute hepatic necrosis. While some forms of the disease are reversible with treatment or lifestyle changes, others may be fatal if not treated properly. If you have any concerns about your health or think you might have symptoms of liver disease, it's important to test immediately.

You don't want to wait until it's too late! Don't let something as simple as an infection go untreated because you were too busy or didn't know how serious the problem was. Get tested today so you can identify the condition and seek medical treatment before it gets worse! 

With over 2,000 discounted tests and locations around the country, we make it easy and affordable to get the lab testing you need to know your health. Plus, your results are safe and confidential so that you can trust us with your information. Most Quest Diagnostics tests return results in 24–48 hours. Why wait? Get your lab tests now!

Take control of your health by ordering your liver function blood tests from the list below. 

Name Matches

Acetaminophen is an analgesic agent that may be hepatotoxic when ingested in quantities exceeding 150 mg/kg.

Serum albumin measurements are used in the monitoring and treatment of numerous diseases involving those related to nutrition and pathology particularly in the liver and kidney. Serum albumin is valuable when following response to therapy where improvement in the serum albumin level is the best sign of successful medical treatment. There may be a loss of albumin in the gastrointestinal tract, in the urine secondary to renal damage or direct loss of albumin through the skin. More than 50% of patients with gluten enteropathy have depressed albumin. The only cause of increased albumin is dehydration; there is no naturally occurring hyperalbuminemia

Serum alkaline phosphatase levels are of interest in the diagnosis of hepatobiliary disorders and bone disease associated with increased osteoblastic activity. Moderate elevations of alkaline phosphatase may be seen in several conditions that do not involve the liver or bone. Among these are Hodgkin's disease, congestive heart failure, ulcerative colitis, regional enteritis, and intra-abdominal bacterial infections. Elevations are also observed during the third trimester of pregnancy.

When the Total Alkaline Phosphatase activity is increased, the Isoenzymes are useful in determining the source of the increased activity.

Description: The Alpha-Fetoprotein and AFP-L3 test is a blood test used to detect the protein alpha-fetoprotein which is produced by the liver.

Also Known As: AFP Test, Total AFP Test, AFP-L3 Test, Alpha-Fetoprotein Tumor Markers, Alpha-Fetoprotein Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alpha-Fetoprotein and AFP-L3 test ordered?

An AFP blood test may be ordered by a healthcare provider:

  • When abdominal masses are felt during a medical examination or imaging testing reveal possible malignancies, it is likely that someone has liver cancer or certain malignancies of the testicles or ovaries.
  • When someone has been diagnosed with and treated for cancer of the liver, testicles, or ovaries, the success of treatment is being assessed.
  • When someone is being watched for a recurrence of cancer
  • Patients with persistent hepatitis or liver cirrhosis should be followed up on.
  • When a person has chronic liver illness, an AFP-L3 percent is occasionally ordered to help evaluate the risk of hepatocellular carcinoma, test the efficiency of hepatocellular carcinoma treatment, or monitor for recurrence.

What does an Alpha-Fetoprotein and AFP-L3 blood test check for?

Alpha-fetoprotein is a protein produced predominantly by the liver of a developing baby and the yolk cavity of a developing embryo. When a baby is born, AFP levels are usually high and then rapidly drop. Liver injury and certain malignancies can drastically raise AFP levels. This test determines the amount of AFP in your blood.

When the liver cells regenerate, AFP is generated. AFP can be continuously high in chronic liver illnesses such hepatitis and cirrhosis. Certain cancers can produce extremely high quantities of AFP. Because of this, the AFP test can be used as a tumor marker. Many persons with hepatocellular carcinoma and hepatoblastoma, a kind of liver cancer that affects babies, have elevated levels of AFP. They're also discovered in certain persons who have testicular or ovarian cancer.

There are various different types of AFP. The normal AFP test measures total AFP, which includes all of the AFP variations. In the United States, this is the most common AFP test.

One of the AFP variations is known as L3 because of its propensity to attach to a protein called Lens culinaris agglutinin in the lab. The AFP-L3 percent test compares the quantity of AFP-L3 to the total amount of AFP and is a relatively recent test. Increased L3 levels are linked to a higher likelihood of developing hepatocellular carcinoma in the near future, as well as a worse prognosis, because L3-related malignancies are more aggressive.

AFP-L3 can be higher in people with hepatocellular carcinoma than in those with benign liver disorders who have low total AFP. In Japan, tumor markers such as total AFP and AFP-L3 are utilized in conjunction with ultrasound to monitor hepatocellular carcinoma. This procedure differs from that in the United States and Europe, but healthcare practitioners in the United States occasionally order the two tests.

Lab tests often ordered with an Alpha-Fetoprotein and AFP-L3 test:

  • CEA
  • CA-125
  • hCG Tumor Marker
  • DCP

Conditions where an Alpha-Fetoprotein and AFP-L3 test is recommended:

  • Ovarian Cancer
  • Testicular Cancer

How does my health care provider use an Alpha-Fetoprotein and AFP-L3 test?

The tumor marker alpha-fetoprotein is used to detect and diagnose malignancies of the liver, testicles, and ovaries. Despite the fact that the test is frequently done to monitor persons with chronic liver illnesses including cirrhosis, chronic hepatitis B, or hepatitis C who have an elevated lifetime risk of developing liver cancer, most current guidelines do not advocate it. An AFP test, together with imaging studies, may be ordered by a healthcare provider to try to diagnose liver cancer in its earliest and most treatable stages.

If a person has been diagnosed with hepatocellular carcinoma or another type of AFP-producing cancer, an AFP test may be done on a regular basis to assess treatment response and disease recurrence.

When comparing the amount of the AFP variation AFP-L3 to the total amount of AFP, an AFP-L3 percent is occasionally ordered. The AFP-L3 percent test is not extensively used in the United States, but it is becoming more popular in other nations, such as Japan. The test is used to assess the risk of developing hepatocellular carcinoma, particularly in people with chronic liver disease, as well as the response of the cancer to treatment.

What do my Alpha-fetoprotein test results mean?

Increased AFP levels can suggest the presence of cancer, such as liver cancer, ovarian cancer, or testicular germ cell tumors. However, not all cancers of the liver, ovary, or testicles produce substantial amounts of AFP.

Other malignancies, such as stomach, colon, lung, breast, and lymphoma, might sometimes have elevated levels, but it is rarely ordered to check these illnesses. Cirrhosis and hepatitis are two disorders that can generate elevated levels.

When using AFP as a monitoring tool, lower levels suggest a therapeutic response. If concentrations do not considerably drop after cancer therapy, usually to normal or near-normal levels, some tumor tissue may still be present.

If AFP levels start to rise, the cancer is most likely to return. However, because AFP levels can be deceiving in hepatitis or cirrhosis, AFP levels can be misleading. If AFP levels are not raised prior to therapy, the test will not be useful in monitoring treatment effectiveness or detecting recurrence.

People with chronic liver disease have a higher chance of getting liver cancer when their AFP levels rise from normal to moderately raised to significantly elevated. When total AFP and AFP-L3 percent are highly higher, the person is more likely to develop or have hepatocellular carcinoma in the next year or two. In persons with chronic hepatitis and cirrhosis, however, both AFP and AFP-L3 percent concentrations might be increased and fluctuate. In these circumstances, a significant increase in AFP is more essential than the test result's numerical value.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

IMPORTANT - The specimen for this test must be collected at a patient service center that can collect, store and transport frozen samples as outlined below.  

IMPORTANT: Before ordering this lab test, check and confirm with the selected patient service center to ensure that they can collect, store and transport frozen samples as outlined below.

Preferred Specimen(s) 

2 mL frozen plasma collected in an EDTA (lavender-top) tube

Collection Instructions 

Collect blood from stasis-free vein of patient (e.g., no tourniquet). Patient should not clench fist during collection, as muscular exertion often increases venous ammonia levels. Patient should avoid smoking prior to phlebotomy since smoking increases plasma ammonia levels. Tubes should be filled completely and kept tightly stoppered at all times. Place immediately on ice. Separate plasma from cells within 20 minutes and freeze plasma immediately.

Transport Temperature 


Specimen Stability 

Room temperature: Unstable
Refrigerated: Unstable
Frozen -20° C: 72 hours
Frozen -70° C: 7 days

Reject Criteria 

Hemolysis • Lipemia • Received thawed • PPT Potassium EDTA (white-top) tube

Clinical Significance

Ammonia is one of the by-products of protein metabolism. Elevated blood ammonia levels have been associated with severe liver dysfunction such as hepatic encephalopathy, coma resulting from cirrhosis, severe hepatitis, Reye's syndrome, and drug hepatotoxicity. Also, elevated blood ammonia has been reported in cardiac failure, azotemia, and pulmonary emphysema. Correlation between plasma ammonia and the degree of encephalopathy can be erratic.

Most Popular

Description: Amylase is a blood test that is used to measure the amount of amylase in the blood’s serum. It is used to assess for and detect a pancreatic disorder.

Also Known As: Amy Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Amylase test ordered?

When a person displays symptoms of a pancreatic disease, a blood amylase test may be conducted.

  • Abdominal or back pain that is severe
  • Fever
  • Appetite loss.
  • Nausea

A urine amylase test may be requested in conjunction with or after a blood amylase test. A health practitioner may conduct one or both of these tests on a regular basis to evaluate the success of treatment and see whether amylase levels are increasing or decreasing over time.

What does an Amylase blood test check for?

Amylase is one of numerous pancreatic enzymes that aid in carbohydrate digestion. This test detects the presence of amylase in the blood.

Amylase is produced from the pancreas into the duodenum, the first region of the small intestine, where it aids in the digestion of carbohydrates. Other organs, including the salivary glands, generate it as well.

Amylase is normally found in modest amounts in the blood and urine. Increased levels of amylase are released into the blood when pancreatic cells are harmed, as in pancreatitis, or when the pancreatic duct is obstructed by a gallstone or, in rare situations, a pancreatic tumor. This raises amylase levels in the blood.

Lab tests often ordered with an Amylase test:

  • Lipase
  • Trypsin
  • Trypsinogen

Conditions where an Amylase test is recommended:

  • Cystic Fibrosis
  • Pancreatic Cancer
  • Pancreatic Diseases
  • Pancreatitis

How does my health care provider use an Amylase test?

An amylase test is used to identify and track acute pancreatitis. It's frequently ordered in conjunction with a lipase test. It can also be used to detect and track chronic pancreatitis and other pancreas-related conditions.

A urine amylase test may be requested as well. Its level will usually correspond to blood amylase concentrations, but the rise and decrease will occur later. A urine creatinine clearance test may be ordered in conjunction with a urine amylase test to determine the ratio of amylase to creatinine filtered by the kidneys. Because poor kidney function might result in a decreased rate of amylase clearance, this ratio is used to assess renal function.

An amylase test on peritoneal fluid may be used to assist diagnose pancreatitis in some instances, such as when there is a buildup of fluid in the abdomen.

Amylase tests are often used to track the progress of pancreatic cancer treatment and after gallstone resection that has resulted in gallbladder attacks.

What do my Amylase test results mean?

A high level of amylase in the blood may suggest the presence of a pancreas problem.

Amylase levels in the blood often rise to 4 to 6 times higher than the highest reference value, also known as the upper limit of normal, in acute pancreatitis. The increase happens within 4 to 8 hours following a pancreas damage and usually lasts until the cause is effectively treated. In a few days, the amylase levels will return to normal.

Amylase levels in chronic pancreatitis are initially fairly increased, although they frequently decline over time as the pancreas deteriorates. Returning to normal levels may not signal that the source of damage has been rectified in this scenario. The size of the amylase rise does not indicate the severity of pancreatic illness.

Amylase levels may also be elevated in persons who have pancreatic duct obstruction or pancreatic cancer.

Urine amylase levels rise in lockstep with blood amylase levels and remain elevated for several days after blood levels have returned to normal.

A high amount of amylase in the peritoneal fluid can indicate acute pancreatitis, but it can also indicate other abdominal problems including a clogged intestine or poor blood supply to the intestines.

A low amylase level in the blood and urine of a person with pancreatitis symptoms could indicate that the amylase-producing cells in the pancreas have been permanently damaged. Reduced levels can also be caused by renal illness or pregnancy toxemia.

Increased blood amylase levels along with normal to low urine amylase levels could indicate the presence of a macroamylase, a harmless compound of amylase and other proteins that builds up in the bloodstream.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: An antinuclear antibody screening is a blood test that is going to look for a positive or negative result. If the result comes back as positive further test will be done to look for ANA Titer and Pattern. Antinuclear antibodies are associated with Lupus.

Also Known As: ANA Test, ANA Screen IFA with Reflex to Titer and pattern IFA Test, ANA with Reflex Test, Antinuclear Antibody Screen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

IMPORTANT Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge of $13.00

When is an ANA Screen test ordered?

When someone exhibits signs and symptoms of a systemic autoimmune illness, the ANA test is requested. Symptoms of autoimmune illnesses can be vague and non-specific, and they can fluctuate over time, steadily deteriorate, or oscillate between periods of flare-ups and remissions.

What does an ANA Screen blood test check for?

Antinuclear antibodies are a type of antibody produced by the immune system when it is unable to differentiate between its own cells and foreign cells. Autoantibodies are antibodies that attack the body's own healthy cells, causing symptoms like tissue and organ inflammation, joint and muscle discomfort, and weariness. The moniker "antinuclear" comes from the fact that ANA specifically targets chemicals located in a cell's nucleus. The presence of these autoantibodies in the blood is detected by the ANA test.

The presence of ANA may be a sign of an autoimmune process, and it has been linked to a variety of autoimmune illnesses, the most common of which being systemic lupus erythematosus.

One of the most common tests used to detect an autoimmune disorder or rule out other conditions with comparable signs and symptoms is the ANA test. As a result, it's frequently followed by other autoantibody tests that can help establish a diagnosis. An ENA panel, anti-dsDNA, anti-centromere, and/or anti-histone test are examples of these.

Lab tests often ordered with an ANA Screen test:

  • ENA Panel
  • Sed Rate (ESR)
  • C-Reactive Protein
  • Complement
  • AMA
  • Centromere antibody
  • Histone Antibody

Conditions where an ANA Screen test is recommended:

  • Autoimmune Disorders
  • Lupus
  • Rheumatoid Arthritis
  • Sjogren Syndrome
  • Scleroderma

How does my health care provider use an ANA Screen test?

One of the most often performed tests to diagnose systemic lupus erythematosus is the antinuclear antibody test. It serves as the first step in the evaluation process for autoimmune diseases that might impact various body tissues and organs.

When a person's immune system fails to discriminate between their own cells and foreign cells, autoantibodies called ANA are created. They attack chemicals found in a cell's nucleus, causing organ and tissue damage.

ANA testing may be utilized in conjunction with or after other autoantibody tests, depending on a person's indications and symptoms and the suspected condition. Antibodies that target specific compounds within cell nuclei, such as anti-dsDNA, anti-centromere, anti-nucleolar, anti-histone, and anti-RNA antibodies, are detected by some of these tests, which are considered subsets of the general ANA test. In addition, an ENA panel can be utilized as a follow-up to an ANA.

These further tests are performed in addition to a person's clinical history to assist diagnose or rule out other autoimmune conditions such Sjögren syndrome, polymyositis, and scleroderma.

To detect ANA, various laboratories may employ different test procedures. Immunoassay and indirect fluorescent antibody are two typical approaches. The IFA is regarded as the gold standard. Some labs will test for ANA using immunoassay and then employ IFA to confirm positive or equivocal results.

An indirect fluorescent antibody is created by mixing a person's blood sample with cells attached to a slide. Autoantibodies in the blood bind to the cells and cause them to react. A fluorescent antibody reagent is used to treat the slide, which is then inspected under a microscope. The existence of fluorescence is observed, as well as the pattern of fluorescence.

Immunoassays—these procedures are frequently carried out using automated equipment, however they are less sensitive than IFA in identifying ANA.

Other laboratory tests linked to inflammation, such as the erythrocyte sedimentation rate and/or C-reactive protein, can be used to assess a person's risk of SLE or another autoimmune disease.

What do my ANA test results mean?

A positive ANA test indicates the presence of autoantibodies. This shows the presence of an autoimmune disease in someone who has signs and symptoms, but more testing is needed to make a definitive diagnosis.

Because ANA test results can be positive in persons who have no known autoimmune disease, they must be carefully assessed in conjunction with a person's indications and symptoms.

Because an ANA test can become positive before signs and symptoms of an autoimmune disease appear, determining the meaning of a positive ANA in a person who has no symptoms can take some time.

SLE is unlikely to be diagnosed with a negative ANA result. It is normally not required to repeat a negative ANA test right away; however, because autoimmune illnesses are episodic, it may be desirable to repeat the ANA test at a later date if symptoms persist.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


  • ANA Screen,IFA, with Reflex to Titer and Pattern
  • DNA (ds) Antibodies
  • Scleroderma Antibodies (SCL-70)
  • Sm and Sm/RNP Antibodies
  • Sjogren's Antibodies (SSA, SSB)

If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge - $13.00


Testing for anti-neutrophil cytoplasmic antibodies (P-ANCA and/or C-ANCA and/or atypical P-ANCA) has been found to be useful in establishing the diagnosis of suspected vascular diseases, inflammatory bowel disease, as well as other autoimmune diseases.

Anion Gap Panel (Electrolyte Balance) includes the following test.

  • Anion gap 4
  • Sodium
  • Potassium
  • Chloride
  • Carbon dioxide

AST is widely distributed throughout the tissues with significant amounts being in the heart and liver. Lesser amounts are found in skeletal muscles, kidneys, pancreas, spleen, lungs, and brain. Injury to these tissues results in the release of the AST enzyme to general circulation. In myocardial infarction, serum AST may begin to rise within 6-8 hours after onset, peak within two days and return to normal by the fourth or fifth day post infarction. An increase in serum AST is also found with hepatitis, liver necrosis, cirrhosis, and liver metastasis.

An increase in serum bile acids concentration in the fasting state or postprandial is considered to be a specific indicator of liver disease. A decreased level indicates bile acid malabsorption, possibly due to ileal dysfunction.

Description: Bilirubin Fractionated is a blood test that is used to screen for or monitor liver disorders, hemolytic anemia, and neonatal jaundice.

Also Known As: Total Bilirubin Test, TBIL Test, Neonatal Bilirubin Test, Direct Bilirubin Test, Conjugated Bilirubin Test, Indirect Bilirubin Test, Unconjugated Bilirubin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a Bilirubin, Fractionated test ordered?

When someone shows evidence of abnormal liver function, a doctor will usually request a bilirubin test along with other laboratory tests. A bilirubin test may be ordered when a patient:

  • Evidence of jaundice is visible.
  • Has a history of excessive alcohol consumption
  • Has a possible drug toxicity
  • Has been exposed to viruses that cause hepatitis

Other signs and symptoms to look out for include:

  • Urine with a dark amber tint.
  • Nausea/vomiting
  • Swelling and/or pain in the abdomen
  • Fatigue and malaise which are common symptoms of chronic liver disease.

In babies with jaundice, measuring and monitoring bilirubin is considered routine medical therapy.

When someone is suspected of hemolytic anemia as a cause of anemia, bilirubin tests may be ordered. In this instance, it's frequently ordered in conjunction with other hemolysis-related tests such a complete blood count, reticulocyte count, haptoglobin, and LDH.

What does a Bilirubin, Fractionated blood test check for?

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. This test assesses a person's liver function or aids in the diagnosis of anemias caused by RBC destruction by measuring the quantity of bilirubin in their blood.

After roughly 120 days in circulation, RBCs generally disintegrate. Heme is transformed to bilirubin as it is released from hemoglobin. Unconjugated bilirubin is another name for this type of bilirubin. Proteins transport unconjugated bilirubin to the liver, where sugars are linked to bilirubin to produce conjugated bilirubin. Conjugated bilirubin enters the bile and travels from the liver to the small intestines, where bacteria break it down further before it is excreted in the stool. As a result, bilirubin breakdown products give stool its distinctive brown hue.

A normal, healthy human produces a tiny quantity of bilirubin each day. The majority of bilirubin comes from damaged or degraded RBCs, with the rest coming from bone marrow or the liver. Small amounts of unconjugated bilirubin are normally discharged into the bloodstream, but there is almost no conjugated bilirubin. Laboratory tests can measure or estimate both types, and a total bilirubin result can be presented as well.

A person may appear jaundiced, with yellowing of the skin and/or whites of the eyes, if the bilirubin level in their blood rises. The pattern of bilirubin test results can provide information to the health care provider about the ailment that may be present. When there is an exceptional quantity of RBC destruction or when the liver is unable to handle bilirubin, unconjugated bilirubin levels may rise. Conversely, conjugated bilirubin levels can rise when the liver can process bilirubin but not transmit the conjugated bilirubin to the bile for elimination; this is most commonly caused by acute hepatitis or bile duct blockage.

In the first few days after birth, increased total and unconjugated bilirubin levels are fairly common in infants. This condition is known as "physiologic jaundice of the newborn," and it develops when the liver of a newborn is not yet mature enough to handle bilirubin. Physiologic jaundice in newborns usually goes away after a few days. RBCs may be damaged in newborn hemolytic illness due to blood incompatibility between the infant and the mother; in these circumstances, treatment may be necessary since large amounts of unconjugated bilirubin might harm the newborn's brain.

Increased total and conjugated bilirubin levels in infants can be caused by biliary atresia, an uncommon but life-threatening congenital disease. To avoid catastrophic liver damage that may necessitate liver transplantation during the first few years of life, this problem must be rapidly recognized and treated, usually with surgery. Despite early surgical therapy, some children may require liver transplants.

Lab tests often ordered with a Bilirubin, Fractionated test:

  • CMP
  • ALT
  • ALP
  • AST
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Complete Blood Count (CBC)
  • Urinalysis
  • GGT
  • Reticulocyte Count

Conditions where a Bilirubin, Fractionated test is recommended:

  • Jaundice
  • Liver Disease
  • Hepatitis
  • Alcoholism
  • Hemolytic Anemia

Commonly Asked Questions:

How does my health care provider use a Bilirubin, Fractionated test?

A bilirubin test is used to detect an abnormally high quantity of the substance in the blood. It can be used to figure out what's causing your jaundice and/or diagnose illnesses like liver disease, hemolytic anemia, and bile duct blockage.

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. An increased blood level can be caused by any disorder that speeds up the breakdown of RBCs or impairs the processing and elimination of bilirubin.

Laboratory testing can measure or estimate two types of bilirubin:

Unconjugated bilirubin—unconjugated bilirubin is formed when heme is released from hemoglobin. Proteins transport it to the liver. Small levels of the substance may be found in the blood.

Sugars are attached to bilirubin in the liver, resulting in conjugated bilirubin. It enters the bile and travels from the liver to the small intestines before being excreted in the feces. In normal circumstances, there is no conjugated bilirubin in the blood.

A chemical test is usually done to determine the total bilirubin level first. If the total bilirubin level rises, a second chemical test can be used to detect water-soluble forms of bilirubin, known as "direct" bilirubin. The amount of conjugated bilirubin present can be estimated using the direct bilirubin test. The "indirect" amount of unconjugated bilirubin can be estimated by subtracting the direct bilirubin level from the total bilirubin level. The pattern of bilirubin test results can provide information to the healthcare professional about the ailment that may be present.

Bilirubin is measured in adults and older children to:

  • Diagnose and/or monitor liver and bile duct disorders.
  • Evaluate patients with hemolytic anemia
  • Distinguish between the causes of jaundice in babies.

Only unconjugated bilirubin is raised in both physiologic jaundice and hemolytic illness of the infant.

Damage to the newborn's liver from neonatal hepatitis and biliary atresia will also raise conjugated bilirubin concentrations, which is generally the first indication that one of these less common disorders is present.

Because excessive unconjugated bilirubin harms growing brain cells, it is critical to detect and treat an increased amount of bilirubin in a newborn. Mental retardation, learning and developmental impairments, hearing loss, eye movement disorders, and mortality are all possible outcomes of this damage.

What do my bilirubin test results mean?

In adults and children, increased total bilirubin, primarily unconjugated bilirubin, could be caused by:

  • Hemolytic or pernicious anemia are two types of anemia.
  • Reaction to a transfusion
  • Cirrhosis
  • Gilbert syndrome

When conjugated bilirubin levels are higher than unconjugated bilirubin levels, there is usually a problem with bilirubin removal by the liver cells. This can be caused by a variety of factors, including:

  • Hepatitis caused by a virus
  • Reactions to drugs
  • Alcoholic hepatitis

When the bile ducts are blocked, conjugated bilirubin is raised more than unconjugated bilirubin. This can happen, for example, when:

  • In the bile ducts, there are gallstones.
  • Damaging of the bile ducts due to tumors

Increased bilirubin levels can also be caused by rare hereditary illnesses that involve aberrant bilirubin metabolism, such as Rotor, Dubin-Johnson, and Crigler-Najjar syndromes.

Low bilirubin levels are usually not a cause for worry and are not monitored.

A newborn's high bilirubin level may be transient and diminish within a few days to two weeks. However, if the bilirubin level exceeds a crucial threshold or rises rapidly, the cause must be investigated so that appropriate treatment can be started. Increased bilirubin levels can be caused by the rapid breakdown of red blood cells as a result of:

  • Incompatibility of the mother's blood type with that of her child
  • Infections that are present at birth
  • oxygen deficiency
  • Liver disease

Only unconjugated bilirubin is elevated in most of these disorders. In the rare disorders of biliary atresia and newborn hepatitis, increased conjugated bilirubin is found. To avoid liver damage, biliary atresia necessitates surgical surgery.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstructive disease.

The BUN/Creatinine ratio is useful in the differential diagnosis of acute or chronic renal disease. Reduced renal perfusion, e.g., congestive heart failure, or recent onset of urinary tract obstruction will result in an increase in BUN/Creatinine ratio. Increased urea formation also results in an increase in the ratio, e.g., gastrointestinal bleeding, trauma, etc. When there is decreased formation of urea as seen in liver disease, there is a decrease in the BUN/Creatinine ratio. In most cases of chronic renal disease the ratio remains relatively normal.

Description: The CRP test is used to identify and/or monitor inflammation in patients.

Also Known As: CRP Test, Inflammation test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a C-Reactive Protein test ordered?

When a person's medical history and signs and symptoms indicate that they may have a significant bacterial infection, a CRP test may be recommended. When a newborn displays signs of infection or when a person has sepsis symptoms including fever, chills, and rapid breathing and heart rate, it may be ordered.

It's also commonly requested on a regular basis to check illnesses like rheumatoid arthritis and lupus, and it's routinely repeated to see if medication is working. This is especially effective for inflammation issues because CRP levels decrease as inflammation decreases.

What does a C-Reactive Protein blood test check for?

C-reactive protein is a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. After trauma or a heart attack, with active or uncontrolled autoimmune illnesses, and with acute bacterial infections like sepsis, markedly higher levels are reported. CRP levels can rise by a thousand-fold in response to inflammatory diseases, and their elevation in the blood can occur before pain, fever, or other clinical signs. The test detects inflammation caused by acute situations or monitors disease activity in chronic diseases by measuring the level of CRP in the blood.

The CRP test is not a diagnostic tool, although it can tell a doctor if inflammation is occurring. This information can be combined with other indicators like signs and symptoms, a physical exam, and other tests to establish whether someone has an acute inflammatory disorder or is having a flare-up of a chronic inflammatory disease. The health care provider may next do additional tests and treatment.

This CRP test should not be confused with the hs-CRP test. These are two separate CRP tests, each of which measures a different range of CRP levels in the blood for different purposes.

Lab tests often ordered with a C-Reactive Protein test:

  • Sed Rate (ESR)
  • Procalcitonin
  • ANA
  • Rheumatoid Factor
  • Complement

Conditions where a C-Reactive Protein test is recommended:

  • Arthritis
  • Autoimmune Disorders
  • Pelvic Inflammatory Disease
  • Inflammatory Bowel Disease
  • Sepsis
  • Vasculitis
  • Systemic Lupus Erythematosus
  • Meningitis and Encephalitis

Commonly Asked Questions:

How does my health care provider use a C-Reactive Protein test?

A health practitioner uses the C-reactive protein test to diagnose inflammation. CRP is an acute phase reactant, a protein produced by the liver and released into the bloodstream within a few hours following tissue injury, infection, or other inflammatory event. The CRP test is not a diagnostic test for any ailment, but it can be used in conjunction with other tests to determine whether a person has an acute or chronic inflammatory disorder.

CRP, for example, can be used to detect or track substantial inflammation in someone who is suspected of having an acute ailment like:

  • Sepsis is a dangerous bacterial infection.
  • An infection caused by a fungus
  • Inflammation of the pelvis

People with chronic inflammatory diseases can use the CRP test to detect flare-ups and/or see if their medication is working. Here are a few examples:

  • Inflammatory bowel disease
  • Arthritis, which can take many forms.
  • Autoimmune disorders, examples include lupus and vasculitis

CRP is occasionally requested in conjunction with an erythrocyte sedimentation rate, another inflammatory test. While the CRP test is not specific enough to diagnose an illness, it does serve as a broad marker for infection and inflammation, alerting doctors to the need for more testing and treatment. A variety of additional tests may be used to determine the source of inflammation, depending on the probable cause.

What do my C-Reactive Protein test results mean?

CRP levels in the blood are usually low.

CRP levels in the blood that are high or rising indicate the existence of inflammation, but they don't tell you where it is or what's causing it. A high CRP level can establish the presence of a severe bacterial infection in people who are suspected of having one. High levels of CRP in persons with chronic inflammatory disorders indicate a flare-up or that treatment isn't working.

When the CRP level rises and then falls, it indicates that the inflammation or infection is diminishing and/or responding to treatment.

Is there anything else I should know about C-Reactive Protein?

CRP levels can rise during pregnancy, as well as with the use of birth control tablets or hormone replacement therapy. Obese people have also been found to have higher CRP levels.

In the presence of inflammation, the erythrocyte sedimentation rate test will also rise; however, CRP rises first and then falls faster than the ESR.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

C4B is a complement binding protein that specifically binds 50% circulating protein S, a vitamin K dependent cofactor of protein C activation. Since C4B may be elevated in certain disease states, this may affect the available "free protein S" to engage in anticoagulant activity.

On the right side of the body, located on the upper side of the abdomen, is the liver. Approximately the size of a football, the liver weighs about 2 to 3 pounds and works to do a variety of functions in the body, including the following:

  • Metabolize and detox harmful substances in the body
  • Convert nutrients that are derived from food into the vital blood components
  • Regulate the body’s ability to clot blood
  • Produce proteins and enzymes
  • Maintain the hormonal balance
  • Store specific vitamins
  • Contribute to the factors that aid in fighting the immune system
  • Remove toxic bacteria from the blood
  • Create bile that is vital for digestion

Bile is a green-yellow fluid that is comprised of bile acids or salts that are created via waste products like bilirubin that are created as red blood cells break down. This then flows through the small bile ducts that are located inside of the liver. Bile moves from the smaller sized ducts into the larger ones much in the same way that streams flow into a river and eventually converge into the main ducts and then exit the liver as the streams exit into a river. Part of the bile will then flow into the duodenum; the rest of the bile will flow into a storage facility and concentrate in the gallbladder. After eating, the gallbladder will then release some of the bile into the smaller sized intestine where it will then digest fats.

Any condition that causes liver inflammation or damage is liver disease. These conditions may also affect how the liver functions. Liver disease is categorized according to the cause and effect upon the liver. Causes can include things such as infection, exposure to drugs, exposure to toxic compounds, injury to the liver, autoimmune processes, genetic defects, and other conditions that may be due to deposits and build-up of metals in the liver, including iron and copper. The residual effects of such exposure are inflammation, injury, obstruction, scarring, abnormalities in blood clotting, and eventual liver failure.

Signs And Symptoms

In the beginning, liver disease may not have any signs or symptoms. Other symptoms may be quite non-specific. Weakness, lack of energy, and other symptoms may also present.

The most typical signs of acute liver disease include the following:

  • Yellowing of skin due to issues processing the bilirubin. These include jaundice, light stools, dark urine, and loss of appetite.
  • Nausea
  • Diarrhea
  • Vomiting

In addition to the conditions mentioned above, Chronic Conditions of liver disease may also include the following:

  • Itching or pruritus
  • Abdominal swelling (ascites)
  • Unexplained weight gain or loss
  • Abdominal pain

These symptoms typically present at a later stage of the disease.

General Laboratory Tests For Liver Disease

The main goal in screening for liver disease is to detect injury to the liver, evaluate the severity of the injury, and diagnose the cause. With time, these will then be monitored to watch for changes.

Early detection and screening are vital to the severity of symptoms, and many can be controlled if caught in time. The more that healthcare professionals can determine the severity, the more they can plan a care plan for managing the symptoms. The liver is fully capable of repairing injuries and in resolving inflammation if the bile ducts aren’t blocked. Blocked bile ducts can lead to cirrhosis and be permanent conditions that will lead to progressive liver damage. It’s important to monitor the status with time to help take any steps that will preserve the function of the liver.

General tests in the laboratory will measure the enzyme levels, protein, bilirubin, and other symptoms if there is an injury present.

Taking a comprehensive metabolic panel or CMP is a series of tests that are done in conjunction with general health screening. This includes several tests that will show the liver function.

A liver panel may also be ordered if there are any abnormalities in the CMP testing process results. These are done if there is any question on liver function or if there has been a liver injury.

Whenever there are abnormal test results, these tests may be administered for further evaluation of the liver. All these tests may also be administered individually to monitor a person who has been diagnosed with a liver condition. These tests may include the following:

Alanine aminotransferase or ALT. This is an enzyme that is mainly located in the liver and can also detect hepatitis.

Alkaline phosphatase or ALP. This enzyme is located in the bile ducts and liver and will increase if they are blocked.

Aspartate aminotransferase or AST. This enzyme is in the liver and other areas of the body, including the heart.

Gamma-glutamyl transferase or GGT. This enzyme is sensitive to changes in the liver status if the bile ducts are blocked.

Total bilirubin will measure the amount of bilirubin in the blood. The levels will be higher for many liver conditions.

Direct bilirubin will measure the type of bilirubin that is combined with other compounds and increases if liver disease is present.

Albumin is the main protein that is manufactured in the liver. It will tell how the liver is doing.

Total protein will measure the amount of the protein in the liver as well as the antibodies that are present to help ward off infections.

Lactate dehydrogenase or LDH. This enzyme is released with damaged tissue and may raise if there is acute liver disease.

Select Tests

Several tests may be ordered to diagnose liver dysfunction. Some are used to monitor the condition and others to diagnose.

Liver Biopsy: Small samples of the liver tissue are taken to evaluate the liver and the cells.

Ammonia: This could be elevated in the later stages of cirrhosis and liver failure.

Viral Hepatitis tests (A, B, And C): to detect viral infections in the liver.

Alpha-fetoprotein or AFP: will elevate with liver cancer.

Des-gamma-carboxy prothrombin or DCP: will also elevate with liver cancer.

Prothrombin time or PT: will show clotting function.

Iron tests: Hemochromatosis or iron metabolism disorders

Copper and Ceruloplasmin: Wilson’s Disease is a genetic copper metabolism disorder

Alpha 1 antitrypsin: will test for deficiency.

Antimitochondrial antibody or AMA: will diagnose biliary cholangitis or PBC.

There are tests for autoantibodies that will help to diagnose autoimmune hepatitis, including antinuclear antibodies or ANA. Antismooth muscle antibodies or ASMA and the F-actin antibodies for both liver and kidney microsomes or anti-LKM1. Acetaminophen levels and other overdose drug tests or if the person is doing drugs will also show.

CBC or complete blood count will show elevated white and red blood cells as well as platelets.