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Liver & Kidney

Liver Function Panel (Hepatic Panel)

Comprehensive blood test evaluating liver health through measurement of enzymes, proteins, and bilirubin levels to detect liver disease, damage, or dysfunction.


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What this test measures

The Liver Function Panel measures a set of enzymes, proteins, and waste products that together reveal how well the liver is performing its critical roles: metabolizing nutrients, producing essential proteins, processing toxins, and generating bile for digestion. The panel includes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), two enzymes that rise in the bloodstream when liver cells are damaged; alkaline phosphatase (ALP), which elevates particularly when bile flow is obstructed; total, direct, and indirect bilirubin, which track how efficiently the liver processes and excretes the pigment produced by red blood cell breakdown; and albumin, total protein, and globulin, which reflect the liver's ability to synthesize proteins.

The diagnostic power of this panel lies in the patterns among these markers. When ALT and AST are elevated out of proportion to ALP and bilirubin, the pattern suggests direct damage to liver cells (hepatocellular injury). When ALP and bilirubin are disproportionately elevated relative to ALT and AST, the pattern points toward a bile flow obstruction (cholestatic injury). Albumin provides a longer-range view: because the liver produces it, persistently low albumin may indicate liver disease lasting longer than several weeks.

What's included

Alanine Aminotransferase (ALT)
Aspartate Aminotransferase (AST)
Alkaline Phosphatase (ALP)
Total Bilirubin
Direct Bilirubin
Indirect Bilirubin (calculated)
Albumin
Total Protein
Globulin (calculated)
Albumin/Globulin Ratio (calculated)

Who should consider this test

You might consider this test if you are experiencing any of the following:

  • Individuals with symptoms of liver disease such as jaundice, unexplained fatigue, abdominal pain, or nausea
  • Those with risk factors for liver disease including excessive alcohol consumption, obesity, or diabetes
  • People taking medications that may affect liver function or those exposed to hepatitis viruses
  • Individuals monitoring existing liver conditions or following up on previous abnormal liver test results
  • Those with family history of liver disease or genetic conditions affecting the liver
  • People seeking routine health screening to assess overall liver function and detect early liver problems

What to expect

Preparation

The test may be more accurate if individuals fast for 10 to 12 hours beforehand. Most healthcare providers recommend fasting, though some tests can be performed without fasting. Individuals should inform their healthcare provider about all medications, supplements, and herbal products they are taking, as these can affect liver enzyme levels.

Sample Type

The test requires a blood sample collected in a serum (preferred) or plasma tube, with a volume of 1 mL (minimum 0.5 mL). Collection uses a red-top tube, gel-barrier tube, or green-top (heparin) tube.

Collection

At the laboratory or collection site, a healthcare professional will draw blood from a vein, typically in the arm. The process takes just a few minutes and involves minimal discomfort. The sample is then processed and analyzed using automated laboratory equipment.

Turnaround

Results are typically available within 1-2 business days. Some laboratories may offer same-day results for urgent cases, while routine testing generally provides results the next business day.

Understanding your results

Results are interpreted as a panel rather than as individual values, because the ratio and pattern of abnormalities carry more diagnostic weight than any single elevated marker. A hepatocellular pattern (ALT and AST predominant) suggests different conditions than a cholestatic pattern (ALP and bilirubin predominant), and a mixed pattern in which both groups are elevated has its own set of clinical implications. Direct versus indirect bilirubin further refines the picture by indicating whether the issue lies in liver cell processing or bile duct drainage. Healthcare providers evaluate the overall pattern alongside symptoms, medical history, medications, and imaging studies to determine whether additional investigation is warranted.

PopulationReference RangeNotes
AdultsALT: 0-40 U/L, AST: 0-35 U/LLiver enzyme levels may vary slightly based on gender, age, and laboratory
AdultsAlkaline Phosphatase: 30-120 U/LALP levels can be elevated in bone disease as well as liver conditions
AdultsTotal Bilirubin: 0.1-1.2 mg/dLElevated levels may indicate liver dysfunction or bile duct obstruction
AdultsAlbumin: 3.5-5.0 g/dL, Total Protein: 6.0-8.0 g/dLReflects liver's synthetic function and overall protein status

Reference ranges shown are general guidelines. Your lab report will include the specific reference range used by the laboratory that processed your sample, which is the authoritative range for interpreting your results.

What does a “Low” result mean?

Low levels of certain markers may also provide important clinical information. Albumin is a marker of liver synthetic function; low levels may indicate liver disease of more than 3 weeks' duration. Decreased albumin and total protein levels can suggest chronic liver disease, malnutrition, or other conditions affecting protein synthesis. Low albumin levels may be associated with advanced liver disease, where the liver's ability to produce essential proteins is compromised. However, low liver enzyme levels are generally not concerning and may simply reflect normal individual variation. It's important to consider these results in context with other laboratory values and clinical symptoms.

What does a “High” result mean?

Elevated liver enzymes may indicate various forms of liver injury or disease. Elevated ALT and AST levels disproportionate to ALP levels indicate hepatocellular injury; elevated ALP and bilirubin levels disproportionate to ALT and AST levels indicate cholestatic injury. High ALT and AST levels can be associated with conditions such as viral hepatitis, fatty liver disease, medication-induced liver injury, or autoimmune liver disease. An AST-to-ALT ratio greater than 2:1 strongly suggests alcohol-related liver disease, while ratios less than 1 typically indicate non-alcoholic causes like viral hepatitis or drug-induced injury. Very high levels of both enzymes (>1000 IU/L) often indicate acute liver injury from toxins, medications, or severe viral infections. Elevated bilirubin levels may suggest problems with bile flow or liver processing of waste products.

Privacy & confidentiality

All test orders are authorized and results reviewed by an independent, board-certified physician who is not the patient's personal doctor. Your liver function panel results are completely confidential and protected by strict medical privacy laws. The results are <u>not reported to your doctor</u> unless you specifically choose to share them, and they are <u>not part of your medical records</u> maintained by your healthcare provider. This testing is also <u>not on insurance statements</u> or explanation of benefits (EOB), ensuring complete financial privacy. LevelPanel uses secure, HIPAA-compliant systems to protect your health information. Your test results are only accessible to you through your secure online account, and no doctor visit is required to order this test. The laboratory processes your sample with the same high standards used for physician-ordered tests, but the results come directly to you. This confidential approach allows individuals to monitor their liver health privately, whether for routine wellness screening or when concerned about potential liver issues. Your employer, insurance company, and healthcare providers will have no knowledge of your testing unless you choose to share the results with them.

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Last reviewed: April 2026

CPT Code: 80076

This test may not be available in: NY, NJ, RI

This page is for informational purposes only and does not constitute medical advice. Always consult with a healthcare provider regarding any health concerns. LevelPanel does not diagnose, treat, or prescribe.

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