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Liver Health Checks

Liver Health Checks

The liver is an important organ in the body that participates in essential functions of daily living. It is vital to keep the liver healthy so that the liver can process foods once it has been digested, purify the blood, destroy poisons and drugs including alcohol and control the amount of cholesterol.

Liver health is vital for overall health. Liver dysfunction can lead to liver disease, metabolic disorder, and even type 2 diabetes mellitus. Consuming a well-balanced healthy diet while avoiding certain foods can promote not only liver health, but also overall health. Foods to avoid include:

  • Fatty foods: Fried foods, fast food, packed snacks, chips, and nuts etc.
  • Starchy foods:  White breads, pasta, cakes and baked products
  • Sugar and Salt: Avoiding sweets and reducing salt in cooked meals
  • Alcohol: Consider reducing intake of alcohol or eliminating it from the diet completely

Preventive health checks aim to identify or detect a disease condition at an early stage. These checks are usually recommended above the age of 30 years of age. It is more significant if any risk factor for liver disease, such as family history or consuming large amount of alcohol, diabetes, hypertension, and obesity is present. Undergoing preventive check can provide timely intervention to protect liver health.

There are many causes of liver disease, but there are three main threats to protect the liver against:

  • Alcohol
  • Non-alcohol related fatty liver disease
  • Viral hepatitis

Liver screening packages include tests to check if the liver is functioning properly. If all parameters are normal, the tests are usually recommended to be repeated every year. Your doctor will increase the frequency of testing in case any abnormalities are detected. These results can determine any treatment you might need. Carry any previous medical records, if available, and a list of any prescribed regular medications that you may be taking.

The most recommended tests for liver disease screening include:

Complete Blood Count (CBC) with ESR

CBC is a routine test used to evaluate overall health and detect a wide range of disorders. A blood sample taken from a vein in your arm for the following tests:

  • RBC count indicates the number of red blood cells, which carry oxygen
  • WBC count indicates the number of white blood cells, which fight infections
  • Differential count is the percentage of each type of white blood cell present in the blood.
  • Hemoglobin (Hb) is the oxygen-carrying protein in red blood cells
  • Hematocrit is the proportion of red blood cells to the fluid component, or plasma, in the blood
  • Platelet count indicates ability of blood clotting; reduction is found in liver disease
  • Erythrocyte sedimentation rate (ESR) measures how quickly red blood cells (erythrocytes) settle at the bottom of a test tube that contains a blood sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may indicate inflammation in the body

Liver Function Tests

Liver blood tests are some of the most commonly performed blood tests. These tests check the levels of certain enzymes and proteins in the blood. Levels that are higher or lower than normal can indicate liver problems.The following tests help in the diagnosis of liver dysfunction caused by inflammation or damage to the liver. These tests measure the level of liver enzymes and proteins present in the blood.
The common liver function tests include:

  • Serum glutamic-oxaloacetic transaminase (SGOT) or Alanine transaminase (ALT) – an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, ALT is released into the bloodstream and levels increase.
  • Serum glutamic pyruvic transaminase (SGPT) or Aspartate transaminase (AST) – an enzyme that helps metabolize amino acids. An increase in AST levels may indicate liver damage, disease or muscle damage.
  • Alkaline phosphatase (ALP) – an enzyme found in the liver and bone and is important for breaking down proteins. Higher-than-normal levels of ALP may indicate liver damage or disease, such as a blocked bile duct, or certain bone diseases
  • Serum albumin and total protein – Albumin is one of several proteins made in the liver to fight infections and to perform other functions. Lower-than-normal levels of albumin and total protein may indicate liver damage or disease.
  • Serum bilirubin – Bilirubin is produced during the normal breakdown of red blood cells. Bilirubin passes through the liver and out of the body in the stool. Elevated levels of bilirubin (jaundice) might indicate liver damage or disease or certain types of anemia
  • Gamma-glutamyltransferase (GGT) – an enzyme in the blood, which is elevated in liver or bile duct damage, alcohol consumption as well as risk of coronary heart disease, type-2 diabetes, and stroke

Detection of Hepatitis Viral Markers

  • Recommended to assess the liver function and any exposure to Hepatitis B or C virus
  • Minimum 5 hours of fasting is required

Hepatitis B Panel

 HBsAg (Hepatitis B surface antigen)

  • Positive or “reactive” HBsAg test result hepatitis B infection is present
  • Positive result means further testing to determine if this is a new “acute” infection or a “chronic” hepatitis B infection
  • Positive test result means that the person can spread the hepatitis B virus to others

Anti-HBs or HBsAb (Hepatitis B surface antibody)

  • Positive or “reactive” anti-HBs (or HBsAb) test result indicates that a person is protected against the hepatitis B virus, is “immune” and cannot spread hepatitis B to others
  • Protection can be the due to receiving the hepatitis B vaccine or successfully recovering from a past hepatitis B infection

Anti-HBc or HBcAb (Hepatitis B core antibody)

  • Positive or “reactive” anti-HBc (or HBcAb) test result indicates a past or current hepatitis B infection This test can only be fully understood by knowing the results of the first two tests (HBsAg and anti-HBs)

Hepatitis C Panel

 Anti HCV test (combined HCV Antibody/Antigen test)

  • Positive test detects the presence of antibodies/antigens to the virus, indicating exposure to HCV
  • All positive results (weak or strong) are repeated to double-check or followed up by the RNA test

Imaging Studies

Ultrasound (USG) Abdomen

  • Uses sound waves to produce pictures and abnormalities, if any, of the structures within the upper abdomen
  • Is a safe and noninvasive procedure
  • Requires no special preparation
  • Wear loose, comfortable clothing to be able to expose the upper part of the abdomen for the procedure
  • Can detect abnormal size (liver enlargement) and fatty liver

 Fibro Scan

  • A type of ultrasound that can measure the degree of inflammation and fibrosis in the liver
  • Is a simple, painless test that uses high frequency sound waves
  • Do not eat or drink anything for two hours before the fibroscan
  • Wear suitable clothing so you can expose your upper abdomen for the procedure

Other Blood Tests

Other blood tests that may be included for liver screening include:

Lipid profile – a screening tool for abnormalities in lipids, such as cholesterol and triglycerides

  • Total Cholesterol
  • HDL Cholesterol
  • LDL Cholesterol
  • Triglycerides
  • HDL Ratio

HbA1c – average blood sugar levels over a period of weeks/months

 Thyroid Function Tests – To detect a thyroid disorder

  • TSH
  • T3
  • T4

Vitamin D levels

 Renal Profile

  • Urea
  • Creatinine
  • Uric Acid

 

Liver Check Packages

To keep you healthy and informed about your liver health, SRMC offers following liver health check packages:

 HBV Screening Panel      INR 2100

Labs: HBsAg, Anti Hbs and Hbc total

 HBV Staging Panel          INR 7500

Labs: HBeAg, Anti HBe, Anti HBc total and HBV DNA quantitative PCR

 Basic Package                          INR 3000

Labs: CBC, LFT with GGT, Creatinine, HBsAg, Anti HCV

Imaging: USG Abdomen

Consultation with Hepatology Expert

 Executive Package               INR 8000

Labs: CBC, LFT with GGT, RFT with electrolytes, HBsAG, Anti HBs, Anti HCV, Lipid Profile, HbA1c, Thyroid Function Test, Vitamin D levels

Imaging: USG Abdomen, Fibro Scan