All Liver Tests

Your liver is one of the most important organs in your body, and it's important to run routine tests, like a hepatic function panel, to keep healthy.

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

Myasthenia Gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. This assay aids in the differential diagnosis of MG-like muscle weakness, in differentiating between generalized MG and ocular MG, and in monitoring therapeutic response. If binding antibodies are negative, assays for blocking and modulating antibodies should be considered.

Myasthenia gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. This assay is most useful when the acetylcholinesterase receptor modulating antibodies are positive. The assay for blocking antibodies is useful in monitoring response to therapy.

Myasthenia gravis (MG) is a neuromuscular disorder characterized by muscle weakness, most commonly due to autoantibody-mediated loss of functional acetylcholine receptors (AChR) in the neuromuscular junction. Modulating Antibody to AChR causes weakness by inhibiting or modulating binding to the receptors.

Actin is the major antigen to which smooth muscle antibodies react in autoimmune hepatitis. F-Actin IgG antibodies are found in 52-85% of patients with autoimmune hepatitis (AIH) or chronic active hepatitis and in 22% of patients with primary biliary cirrhosis (PBC). Anti-actin antibodies have been reported in 3-18% of sera from normal healthy controls.

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

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Aids in the diagnosis of primary disease of skeletal muscle myocardial infarction and viral hepatitis.

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.

This assay is intended for use in the assessment of risk for the development of hepatocellular carcinoma (HCC) in patients with chronic liver disease.

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.

Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

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

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.

BNP is increased in congestive heart failure, left ventricular hypertrophy, acute myocardial infarction, coronary angioplasty, and hypertension. Elevations are also observed in pulmonary hypertension (indicating right ventricular dysfunction), acute lung injury, hypervolemic states, chronic renal failure and cirrhosis. Decreasing levels indicate therapeutic response to anti-hypertensive therapy.

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.

Nearly 4.5 million Americans — almost 1 in every 50 — live with liver disease. Are you one of them? If you're not sure, it might be time to order a liver function test.

A hepatic function panel tests how well your liver is working. Taking the initiative to check your liver function before noticing a problem could help you avoid serious health issues. 

Keep reading to learn what a hepatic function panel is, how it can help you catch health issues early, and how you can order it yourself online. 

What is a Decline in Hepatic Function?

Your liver is your body's hard-working multitasker. It performs many crucial functions, including:

  • Monitoring and regulating chemicals in your blood
  • Cleaning toxins from your blood
  • Performing functions with your immune system
  • Storing energy in the form of glycogen
  • Helping break down fatty food
  • Breaking down old red blood cells

Your liver is important to almost every function in your body. When your liver works poorly, your whole body can be affected. In medicine, this is known as a decline in hepatic function. 

Declining hepatic function can lead to serious health complications. That's why it's important to check your liver health as soon as you suspect that there may be a problem. 

Risk Factors for a Decline in Hepatic Function

You should watch for signs of liver problems if you have any risk factors for liver damage, including:

  • Traveling without being vaccinated against Hepatitis
  • Drinking more than the recommended maximum amount of alcohol per day
  • Being in contact with needles that aren't clean
  • Taking more than the recommended amount of medication that can harm your liver

While none of these risk factors guarantee that you will have a decline in hepatic function, they make it more likely that you will have liver problems.

Causes of a Decline in Hepatic Function

A decline in hepatic function is usually caused by liver damage or disease, such as:

  • A virus that damages the liver (such as Hepatitis A, B, and C)
  • Naturally occurring toxins
  • Excessive drug use (both street drugs and prescribed drugs)
  • Alcohol-related liver damage (alcoholic cirrhosis)
  • Liver cancer

A chronic disease like alcoholism can damage your liver slowly over a long period of time. Other diseases, such as viruses, can damage your liver quickly and leave you with lasting liver problems.

Signs and Symptoms of a Decline in Hepatic Function

If your liver is damaged, you'll need to get help immediately. Symptoms of low hepatic function include:

  • Jaundice (yellow color of your skin and eyes)
  • Light-colored stool and dark-colored urine
  • Nausea, vomiting, and diarrhea
  • Pain in your lower abdomen
  • Fatigue

If you see any of these symptoms of liver failure develop, you could be at risk for serious illness from liver damage and should have your liver function assessed right away.  

How is Decline in Hepatic Function Diagnosed?

A lab can analyze your hepatic function using blood tests. When you order your liver test online, you'll go to a patient service center to get a blood draw. They will take a sample of blood on which to perform tests.

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

Because your liver performs so many functions, a hepatic function panel includes a wide range of tests. These blood tests check how well your liver is doing its various tasks.

There are so many possible liver function tests that they are usually bundled together into a liver function panel. The most common tests included in a liver function panel are:

  • Aspartate transaminase (AST)
  • Alanine transaminase (ALT)
  • Bilirubin
  • Albumin and total protein
  • Blood creatinine 
  • Ammonia

Once you've been diagnosed with a decline in hepatic function, you can continue to order liver function panels to monitor your liver's status. 

You can also get lab tests to diagnose the cause of your liver problems, including:

These tests can help you narrow down the source of damage to your liver.

Frequently Asked Questions About Decline in Hepatic Function

Fortunately, testing hepatic function involves straightforward tests. However, you may still have questions. 

Are There Any Risks Involved in a Hepatic Function Panel?

When you get your hepatic function tested, the only risks involved are the normal side effects of getting a blood test. You may see some bleeding and bruising around the blood test site. To minimize bruising, put a bandage over the site and hold it on with firm pressure for several minutes after the blood test. 

Should I Fast Before My Hepatic Function Tests?

It depends on which tests you order. Some tests do not require you to fast before you have your blood drawn, but others do. Make sure to ask your doctor or online medical professional about the specific tests that you have ordered.

Keep in mind that you may want to order other tests in addition to your hepatic function panel, like a comprehensive metabolic panel, and have them all done at once. If you are ordering other tests, you may need to fast for those ones, even if you don't have to fast for your hepatic function tests.

To fast, avoid eating for 12 hours before the test. Avoid drinking anything other than water. 

Do I Have To Wait For a Doctor to Order Hepatic Function Tests For Me?

When you order your lab test online, you don't have to wait for a doctor's referral. This saves you time and money.

Catch Liver Disease Early With a Hepatic Function Panel

Your liver is one of the most essential organs in your body. If your liver is damaged, you should know about it right away. 

Ulta Lab Tests lets you order lab tests with no need for a physician referral, so you can be proactive about your health. You'll get your confidential results in as little as 24 to 48 hours.

Take control of your liver health today with a hepatic function panel test from Ulta Lab Tests.

Jaundice, also called icterus, is a condition where the skin, the whites of the eyes, and even body fluids turn significantly yellow following an increase in the levels of bilirubin in the blood. Bilirubin is a yellowish substance that forms from the normal breakdown of red blood cells (or RBCs). Red blood cells normally live for about 120 days before being broken down by the body, a process that results in the formation of bilirubin. Bilirubin is then transported to the liver where it is metabolized and excreted in bile. Bile is a yellow-green-to-brown fluid that is released into the duodenum to help in the digestion of lipids and the elimination of waste substances like bilirubin and excess cholesterol. Changes to the normal metabolism process or overproduction of bilirubin may lead to jaundice. 

Jaundice is not an illness, per se. Rather, it is a medical condition that may indicate an underlying liver, pancreas, or gallbladder problem. Jaundice can be caused by several factors, including infections, cancer, use of certain drugs, gallstones, blood disorders, inherited conditions, congenital disabilities, among other medical conditions.

Generally, the causes of jaundice may be categorized into these three groups: 

  • Conditions that arise from the inability of the liver to metabolize and eliminate bilirubin 
  • Conditions that cause shortened life for red blood cells, which in turn leads to increased levels of bilirubin 
  • Conditions that inhibit the elimination of bilirubin from the body 

Common Causes of Jaundice 

Acute hepatitis: inflammation of the liver due to various reasons, including hepatitis A, B, C, D, and E, alcohol abuse, viral infections, toxins, and some medicines such as acetaminophen. 

Blockage of the bile duct, which may be caused by: 

  • Damage and Scarring 
  • Biliary atresia, a congenital condition linked to the abnormal development of the bile duct, which results in the backup and pooling of bile and an increase in the level of bilirubin in the blood. 
  • Gallstones 
  • Pancreatic cancer may sometimes lead to the blockage of the bile duct. 

Conditions that result in a significant increase in the rate of red blood cell destruction cause an increase in bilirubin production. Such conditions include hemolytic anemia, due to an abnormal variant of hemoglobin, autoimmune disorders, malaria, or hemolytic disease of the newborn (or HDN). 

Gilbert syndrome: an inherited condition that is associated with reduced bilirubin metabolism due to decreased enzyme activity. Individuals with Gilbert syndrome may have passing jaundice during times of sickness or stress and times of increased levels of unconjugated bilirubin. 

Cirrhosis: jaundice can occur in the late stages of cirrhosis. 

Laboratory Tests 

Some of the tests used to assess liver function and detect liver damage include: 

Liver panel, which often comprises: 

ALT (or Alanine aminotransferase) 

AST (or Aspartate aminotransferase) 

ALP (or Alkaline phosphatase) 

Bilirubin, Total (conjugated and unconjugated), Direct (conjugated) and Indirect (unconjugated) 

GGT (or Gamma-glutamyl transferase) 


Prothrombin time (or PT): the liver produces essential proteins for blood clotting/coagulation. The PT measures the clotting function, which may indicate liver damage if abnormal. 

Urine bilirubin, which often falls under a urinalysis 

Some tests are important for the detection of infections that affect the liver, including: 

Tests that come in handy in detecting reduced red blood cell survival include: