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Abnormal Liver Tests

Comprehensive care for digestive disorders by Dr. Akeel Alisa

Understanding Abnormal Liver Tests

Liver function tests (LFTs) are blood tests that measure different enzymes, proteins, and substances produced by the liver. They are often requested during routine health checks or when investigating symptoms such as fatigue, abdominal pain, or jaundice.

An abnormal liver test result does not always mean you have serious liver disease, but it is a sign that the liver may not be working as well as it should. Sometimes mild changes are temporary and harmless, but in other cases they may indicate an underlying liver condition that requires treatment.

What Do Liver Tests Measure?

Typical blood markers include:

  • Alanine aminotransferase (ALT): High levels may suggest liver inflammation or damage.
  • Aspartate aminotransferase (AST): Another enzyme that rises with liver injury.
  • Alkaline phosphatase (ALP): May indicate bile duct problems or liver disease.
  • Gamma-glutamyl transferase (GGT): Often raised with alcohol-related liver injury or bile duct issues.
  • Bilirubin: High levels can cause jaundice and signal problems with bile flow or liver processing.
  • Albumin and clotting tests: Assess how well the liver is producing essential proteins.
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Causes of Abnormal Liver Tests

Abnormal results can be caused by a wide range of conditions, including:

  • Fatty liver disease (alcoholic and non-alcoholic)
  • Viral hepatitis (Hepatitis B or C)
  • Alcohol-related liver disease
  • Cirrhosis or advanced liver damage
  • Autoimmune liver conditions
  • Gallstones or bile duct obstruction
  • Medication side effects (including painkillers, antibiotics, or statins)
  • Metabolic conditions such as haemochromatosis (iron overload) or Wilson’s disease (copper overload)

Sometimes, lifestyle factors such as obesity, excessive alcohol intake, or recent illness can also temporarily affect test results.

Symptoms That May Accompany Abnormal Tests

While many people with abnormal liver tests feel completely well, others may notice:

  • Fatigue and low energy
  • Abdominal discomfort or swelling
  • Jaundice (yellowing of skin or eyes)
  • Dark urine or pale stools
  • Easy bruising or bleeding
  • Nausea or loss of appetite

Because liver conditions can develop silently, abnormal blood results often provide the first warning sign.

When to See a Gastroenterologist or Hepatologist

You should seek medical advice if:

  • You have persistent abnormal liver test results
  • You experience symptoms such as jaundice, swelling, or unexplained fatigue
  • You drink alcohol regularly or have risk factors for liver disease
  • You take medications that may affect the liver
  • You have a family history of liver conditions

Diagnosis

Investigating abnormal liver tests usually involves:

  • Detailed medical history and lifestyle review
  • Repeat blood tests to confirm persistence and check for viral hepatitis, autoimmune conditions, or metabolic disorders
  • Ultrasound scan to assess the liver’s structure
  • Fibroscan (elastography): A non-invasive test to measure liver scarring or stiffness
  • CT or MRI scans in selected cases
  • Liver biopsy if further clarity is needed

Treatment and Management

Treatment depends on the cause:

  • Lifestyle changes: Reducing alcohol, losing weight, and improving diet can normalise results in many patients.
  • Medication adjustments: If drugs are contributing, alternatives may be recommended.
  • Specific therapies: Such as antiviral medication for hepatitis or immunosuppressants for autoimmune conditions.
  • Monitoring: Some patients only need regular follow-up to ensure no progression.

Why Specialist Care Matters

Abnormal liver tests are common, but interpreting them requires expert knowledge. A hepatologist can:

  • Identify the root cause of abnormal results
  • Provide early intervention to prevent progression to cirrhosis or liver failure
  • Tailor advice on diet, lifestyle, and long-term monitoring
  • Offer reassurance if the changes are minor and not a cause for concern
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My consultation with Dr Akeel Alisa was highly satisfactory and he was very thorough. The Gastroscopy procedure was performed satisfactorily with no pain or discomfort at all. I am very pleased with treatment received so far.

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I was fully vaccinated investigated by Dr Akeel Alisa and I was reassured. My endoscopy and colonoscopy were straight forward and painless. I am very happy with the care I received.

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Dr Akeel Alisa and Nursing team at Cromwell Hospital Endoscopy team offered me great care and all was perfect. Well pleased.

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