Image of strong and healthy liver vs a weak and unhealthy liver.

A Simple Guide To Liver Function Tests

5 Minutes Read

Last updated: Jun 13, 2024

What is the liver and what does it do?

Our liver is about the size of a football and it is located on the right side of the abdomen, just below the rib. The liver is crucial for both food digestion and detoxifying your body of harmful toxins.

Cirrhosis, which is the permanent irreversible damage and scarring of the liver caused by various forms of liver diseases and conditions, can lead to liver failure. This can be fatal. With early detection and intervention, your liver can still recover before this happens.

Image of the liver in a human body.

Picture: iStock

What is a liver function test?

A liver function test measures particular proteins and enzymes in the blood. Any time one of these liver tests yields unusual results, more investigation is usually necessary to ascertain the reason why. Results that are even slightly high may indicate liver disease.

The components of a liver function test include:

  • Alanine transaminase (ALT) Test: Your body uses an enzyme called alanine transaminase to metabolize protein. ALT can be released into the blood if the liver is harmed or not working properly, resulting in raised ALT levels. From this test, a greater score than expected may indicate liver damage.
  • Albumin Test: Albumin is the primary protein produced by your liver. It serves a variety of vital bodily functions. For instance, albumin feeds your tissues and carries nutrients, hormones, and other chemicals all over your body. An albumin test evaluates the efficiency with which your liver produces this specific protein.
  • Albumin/Globulin (A/G) Ratio Test: An A/G ratio test is a measurement of the total amount of protein in your blood. The test also does a comparison of the amount of albumin to globulin in your blood, and this is termed the A/G ratio. A low A/G ratio could indicate the presence of an autoimmune disease, liver disease (including cirrhosis) or kidney disease, whereas a high A/G ratio could indicate certain types of genetic disorders or leukemia.
  • Alkaline phosphatase (ALP) Test: The enzyme alkaline phosphatase is found in your bones, bile ducts, and liver. Typically, an ALP test is ordered in conjunction with several other tests. An ALP test can be used to evaluate the liver's bile duct system.
  • AST Test: AST (aspartate aminotransferase) is an enzyme found mostly in the liver, including in muscles and other organs in your body. An AST blood test is a measurement of AST in your blood, and is commonly used to help diagnse liver damage/disease. High levels of AST in the blood could be an indication of hepatitis, cirrhosis, mononucleosis, or other liver diseases. Heart problems or pancreatitis can also be attributed to high AST levels.
  • Bilirubin Test: Bilirubin refers to a pigment that is yellowish in colour and is produced when red blood cells are normally broken down. It will pass through the liver and is eventually discharged from the body. A test showing higher than normal levels of Bilirubin may be an indication of problems relating to the liver or bile duct.
  • Gamma-glutamyl Transferase (GGT) Test: GGT is a type of enzyme found throughout the body (mostly in the liver). A GGT test is a measurement of the amount of GGT in the blood. A test showing high levels of GGT may be an indication of liver diseases or damage to the bile ducts, whereas a test showing low or normal levels of GGT could mean you don't have liver disease.
  • Globulin Test: Globulins refer to a group of proteins in your blood, and are made in the liver by the immune system. Globulins play a crucial role in liver function, blood clotting, and fighting infection. Tests to measure globulins include total protein test and Serum protein electrophoresis. Low globulin levels could indicate liver/kidney disease or malnutrition, whereas high globulin levels could be a sign of infection, inflammatory disease, immune disorders or certain cancers such as multiple myeloma, Hodgkin lymphoma or malignant lymphoma.
  • Total Protein Test: Proteins are essential for the health and growth of the body's cells and issues. A test showing low level of total protein may indicate a liver problem or protein isn't being digested or absorbed properly, whereas a test showing high total protein level may indicate dehydration or a certain type of cancer such as multiple myeloma.

When do I need a liver function test?

A person's liver may not be functioning normally if their liver enzymes are elevated.

These are some common causes for raised liver enzymes:

  • Fatty Liver
  • Frequent use of painkillers such as paracetamol
  • Consuming alcohol
  • Prolonged statin use
  • Nonalcoholic fatty liver disease, also known as NAFLD (unrelated to alcohol or other medications, there is an excessive buildup of fat (>5%) in the liver)
  • Hepatitis A/B/C
  • Obesity

Your doctor is the best person to discuss with you the follow up options in the event your enzymes level are raised.

Prevalence of raised liver enzymes in Singapore

An article contributed by Singapore General Hospital in 2017 stated the prevalence of Non-alcoholic fatty liver disease (NAFLD) in Singapore was as high as 40%. Obesity, hypertension, diabetes, and dyslipidemia are all metabolic risk factors that are strongly correlated with NAFLD. This is pertinent to our Asian setting because central obesity is prevalent in South Asians, especially those from the Indian subcontinent, which logically translates into a higher risk of NAFLD.

Numerous factors, such as liver illness and medication, can result in elevated liver enzyme levels. Speak with your doctor if your blood test results reveal elevated liver enzyme levels.

What can I do about it?

Here are some ways to keep your liver in good shape:

  • Refrain from drinking alcohol or drink in moderation
  • Adopt a balanced diet
  • Get vaccinated against hepatitis A and B
  • If you have diabetes, control your blood sugar
  • Exercise regularly and maintain a healthy weight
Image of a strong and healthy liver.

Picture: VectorStock

Liver Function Test & Ultrasound Liver Prices

We provide ultrasound liver scans and liver function tests at our one stop health screening clinic.

Test Price*
Ultrasound Liver $150.42
Liver Function Test A
- Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT
Liver Function Test B
- Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio
Liver Function Test C
- Total Bilirubin, Alkaline Phosphatase [ALP], ALT/SGOT, AST/SGPT, Gamma GT, Total Protein, Albumin, Globulin, A/G Ratio, LDH, Hepatitis Bs Antigen & Antibody, Hepatitis A Total IgG, Alpha Fetoprotein [AFP]

Health Screening Packages Prices

We also provide a variety of health screening packages which may include the liver function test and ultrasound liver test.

Screening Price*
Clinic Health Screening Packages Between $76 to $2289
Home Health Screening Packages Between $109 to $654
Allergy Testing From $63.22 for a single allergen blood test

*Prices are NETT and inclusive of GST.


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