I found a really good site that explains a "Liver Panel Test" .... something I never quite understood, and I am sure there are many other people who don't quite understand how to read the test, either.

I found this on THIS PAGE. I want to give a huge THANK YOU to LabTestsOnline.com for explaining all of this... because even my husband's doctors never bothered to explain it!

Cirrhosis is just so overwhelming, I never had time to look all of these definitions before, and all the acronyms on Jake's charts just looked downright confusing... ALT, ALP, AST, TP.... and I kept getting Albumin and Bilirubin mixed up.... and then I had no idea which ones were supposed to be high, and which ones were supposed to be low!!! How to keep them all straight??? I could barely remember my own damn name when Jake was going through all this (there should be some kind of term for when someone is dealing with their spouse's cirrhosis... like how men start showing funny symptoms when their wives are pregnant... women start losing a few brain cells when their husbands become encephalopathic, just due to all the stress and lack of sleep!)

But here is the info I could have used a year and a half ago! Hope this helps some of you. Scroll all the way to the bottom (past the chart) to see all the definitions. This is a great list!!! You can see more info on THIS PAGE.

Liver Panel

Formal name: Hepatic Function Panel

The Test

How is it used?

A liver panel may be used to screen for liver damage, especially if someone has a condition or is taking a drug that may affect the liver. A comprehensive metabolic panel (CMP) which is often performed as part of a general health checkup, may be ordered instead of a liver panel for routine screening. This group of tests includes most of the liver panel as well as additional tests that evaluate other organs and systems within the body.

A liver panel or one or more of its component tests may be used to help diagnose liver disease if a person has symptoms that indicate possible liver dysfunction. If a person has a known condition or liver disease, testing may be performed at intervals to monitor liver status and to evaluate the effectiveness of any treatments. A series of bilirubin tests, for instance, may be ordered to evaluate and monitor a jaundiced newborn.

Abnormal tests on a liver panel may prompt a repeat analysis of one or more tests, or of the whole panel, to see if the elevations or decreases persist and/or may indicate the need for additional testing to determine the cause of the liver dysfunction.

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When is it ordered?

A liver panel, or one or more of its components, may be ordered when someone is at risk for liver dysfunction. Some examples include:

People who take medications that may potentially damage the liver
Those who are alcoholics or heavy drinkers
Those who have a history of known or possible exposure to hepatitis viruses
Individuals whose families have a history of liver disease
People who are overweight, especially if they have diabetes and/or high blood pressure

A liver panel may be ordered when a person has and of liver disease; however, most people who have liver disease do not have any of these symptoms until the disease has been present for many years or is very severe. Some of these include:

Weakness, fatigue
Loss of appetite
Nausea, vomiting
Abdominal swelling and/or pain
Jaundice
Dark urine, light-colored stool
Itching (pruritus)

Usually no one single set of liver tests is used to make a diagnosis. Often, several liver panels will be ordered over a few days or weeks to help determine the cause of the liver disorder and evaluate its severity.

When liver disease is detected, it may be monitored on a regular basis over time with the liver panel or with one or more of its components. A liver panel may also be ordered regularly to monitor the effectiveness of treatment for the liver disorder.

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What does the test result mean?

Liver panel test results are not diagnostic of a specific condition; they indicate that there may be a problem with the liver. In a person who does not have symptoms or identifiable risk factors, abnormal liver test results may indicate a temporary liver injury or reflect something that is happening elsewhere in the body – such as in the skeletal muscles, pancreas, or heart. It may also indicate early liver disease and the need for further testing and/or periodic monitoring.

Results of liver panels are usually evaluated together. Several sets of results from tests performed over a few days or weeks are often assessed together to determine if a pattern is present. Each person will have a unique set of test results that will typically change over time. A doctor evaluates the combination of liver test results to gain clues about the underlying condition. Often, further testing is necessary to determine what is causing the liver damage and/or disease.

This table shows examples of some combinations of results that may be seen in certain types of liver conditions or diseases.

Type of liver condition or disease	Bilirubin	ALT and AST	ALP	Albumin	PT
Acute liver damage (due, for example, to infection, toxins or drugs, etc.)	Normal or increased usually after ALT and AST are already increased	Usually greatly increased; ALT is usually higher than AST	Normal or only moderately increased	Normal	Usually normal
Chronic forms of various liver disorders	Normal or increased	Mildly or moderately increased	Normal to slightly increased	Normal	Normal
Alcoholic Hepatitis	Normal or increased	AST is moderately increased, usually at least twice the level of ALT	Normal or moderately increased	Normal	Normal
Cirrhosis	May be increased but this usually occurs later in the disease	AST is usually higher than ALT but levels are usually lower than in alcoholic disease	Normal or increased	Normal or decreased	Usually prolonged
Bile duct obstruction, cholestasis	Normal or increased; increased in complete obstruction	Normal to moderately increased	Increased; often greater than 4 times what is normal	Usually normal but if the disease is chronic, levels may decrease	Usually normal
Cancer that has spread to the liver (metastasized)	Usually normal	Normal or slightly increased	Usually greatly increased	Normal	Normal
Cancer originating in the liver (hepatocellular carcinoma, HCC)	May be increased, especially if the disease has progressed	AST higher than ALT but levels lower than that seen in alcoholic disease	Normal or increased	Normal or decreased	Usually prolonged
Autoimmune	Normal or increased	Moderately increased; ALT usually higher than AST	Normal or slightly increased	Usually decreased	Normal

If a person is taking drugs that may affect their liver, then abnormal test results may indicate a need to reevaluate the dosage or choice of medication. When a person with liver disease is being monitored, then the doctor will evaluate the results of the liver panel together to determine if liver function or damage is worsening or improving. For example, increasingly abnormal bilirubin, albumin, and/or PT may indicate a deterioration in liver function, while stable or improving results of these tests may indicate liver function preservation or improvement.

For individual tests:

Alanine aminotransferase (ALT)
A very high level of ALT is frequently seen with acute hepatitis. Moderate increases may be seen with chronic hepatitis. People with blocked bile ducts, cirrhosis, and liver cancer may have ALT concentrations that are only moderately elevated or close to normal.

Alkaline phosphatase (ALP)
ALP may be significantly increased with obstructed bile ducts, cirrhosis, liver cancer, and also with bone disease.

Aspartate aminotransferase (AST)
A very high level of AST is frequently seen with acute hepatitis. AST may be normal to moderately increased with chronic hepatitis. In people with blocked bile ducts, cirrhosis, and liver cancer, AST concentrations may be moderately increased or close to normal. When liver damage is due to alcohol, AST often increases much more than ALT (this is a pattern seen with few other liver diseases). AST is also increased after heart attacks and with muscle injury.

Bilirubin
Bilirubin is increased in the blood when too much is being produced, less is being removed, due to bile duct obstructions, or to problems with bilirubin processing. It is not uncommon to see high bilirubin levels in newborns, typically 1 to 3 days old.

Albumin
Albumin is often normal in liver disease but may be low due to decreased production.

Total protein (TP)
Total protein is typically normal with liver disease.

Gamma-glutamyl transferase (GGT)
A GGT test may be used to help determine the cause of an elevated ALP. Both ALP and GGT are elevated in bile duct and liver disease, but only ALP will be elevated in bone disease. Increased GGT levels are also seen with alcohol consumption and with conditions, such as congestive heart failure.

Lactate dehydrogenase (LDH)
This is a non-specific marker of tissue damage. It is usually not elevated with most liver disases, but it may be elevated with very acute liver disease or liver tumors. It is also elevated with a number of other conditions that do not affect the liver.

Prothrombin time (PT)
A prolonged or increased PT can be seen with liver disease, vitamin K deficiency, use of drugs to reduce risk of clotting (warfarin), and with coagulation factor deficiencies.

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Is there anything else I should know?

In order to diagnose a liver disease, a doctor will evaluate the liver panel test results, order follow-up tests such ashepatitis virus testing, and may order a liver and/or imaging scans to help confirm a diagnosis and determine the extent of liver damage.