Can Liver Function Tests Be Normal With Cirrhosis?
Cirrhosis is a serious condition caused by long-term liver damage, which eventually causes liver failure. Although blood tests for cirrhosis of the liver, including private liver function blood tests, are available, they are rarely used in isolation to diagnose cirrhosis. That’s because liver function tests can sometimes come back as normal even if you have cirrhosis, or you can receive abnormal liver function results but not have cirrhosis.
As a result, doctors often use a comprehensive medical history, physical examination, and further testing alongside blood tests to check liver function to diagnose cirrhosis. Below, we explain cirrhosis, its symptoms, and the tests used to diagnose.
What is cirrhosis?
Cirrhosis is scarring of the liver caused by long-term liver damage, which prevents the liver from working correctly. It is sometimes referred to as end-stage liver disease because it happens after other stages of damage from conditions that affect the liver, like fatty liver disease, non-alcoholic fatty liver disease, and hepatitis.
Initially, your liver can continue working when you have cirrhosis, but eventually, the condition will lead to liver failure, and you can get serious complications that can be life-threatening.
What are the symptoms of cirrhosis?
In the initial stages of cirrhosis, you may not experience any symptoms, and you might not realise you have the condition until you have abnormal liver function results during a routine checkup.
However, as your liver becomes more damaged, it’s likely you may:
- Feel very tired and weak
- Experience nausea
- Lose weight and muscle mass
- Get red patches on your palms and spider-like blood vessels on your skin above waist level
As cirrhosis gets worse, the symptoms and complications can include:
- Jaundice - yellowing of your skin and the whites of your eyes
- Vomiting blood
- Dark urine and tarry-looking poo
- Bleeding or bruising easily
- Swollen abdomen or legs from a build-up of fluid
- Loss of sex drive
If you experience any of the above symptoms, it’s important to speak to your GP to check liver function levels.
Can you get a normal liver function result and have cirrhosis?
If you are experiencing symptoms of cirrhosis or are known to be at higher risk of developing the disease, your doctor may recommend blood tests for cirrhosis of the liver.
However, the results from liver blood tests alone can often be unclear because:
- Results can come back normal even in advanced stages of cirrhosis
- Abnormal liver blood tests don’t always indicate the extent of liver damage
- Abnormal liver function results can occur when you don’t have liver disease
- Some blood test results are short-lived and resolve themselves
As a result, doctors will often also use other diagnostic tests to help them diagnose cirrhosis alongside your medical history.
What tests are used to diagnose cirrhosis?
To diagnose cirrhosis, doctors will often use a series of diagnostic tests alongside your medical history. The range of tests includes:
Physical examination
One of the first checks a doctor will make if they are concerned you may be at risk of cirrhosis is a physical examination. They’ll talk to you about your medical history to understand more about whether you are likely to be at risk of the condition and carry out a physical exam looking for signs of liver disease, including:
- Jaundice
- Clubbing – a physical deformation of the fingernails
- Gynecomastia – the enlargement of breast tissue in males, which is seen in around two-thirds of cirrhosis patients
- Spider nervi – clusters of dilated blood vessels on the skin
- Testicular atrophy – in male patients, testicular wasting can be a sign of decreased androgen levels due to cirrhosis
- Caput medusae – these are distended and engorged veins visible on the abdomen
- Palmar erythema – a reddish skin on the palms
- Dupuytren’s contracture – A flexion deformity of the fingers
- Muscle wasting
- Neurological symptoms
Blood tests
Common blood work for cirrhosis of the liver includes:
- Alanine transaminase (ALT) and aspartate transaminase (AST) - both help your body break down protein and amino acids. Levels of ALT and AST are usually low. High levels can mean your liver is leaking these enzymes because it’s damaged from cirrhosis or another disease. However, levels can sometimes be normal, even if you have cirrhosis.
- Albumin test – this test measures levels of albumin, a protein made by the liver. When the liver is damaged, the levels of albumin in the blood falls.
- Bilirubin level – this is a yellow pigment left over when old blood cells are broken down. The liver normally filters bilirubin from the blood and removes it in your stool, but when not working correctly, the bilirubin in your blood can cause jaundice.
- Creatinine – a waste product made by muscles, your kidneys normally it out in your blood. High creatinine is a symptom of kidney damage, which can occur in the late stages of cirrhosis.
- Prothrombin time or international normalised ratio – this test measures how well your blood clots. As your liver makes substances that help your blood clot, slow clotting blood can be a sign of cirrhosis.
- Sodium blood test – if sodium levels in your blood are low it can indicate cirrhosis.
Imaging tests
If physical tests and abnormal liver function tests indicate liver cirrhosis, you may be referred for imaging tests, such as an ultrasound, CT, or MRI.
Liver biopsy
Doctors may also refer you for a liver biopsy. During this procedure, a fine needle is inserted into your liver to remove a small sample of liver cells, which are then examined under a microscope. If the results from your tests indicate you have cirrhosis, you will be referred to see a hepatologist, a doctor who specialises in liver problems.
Private liver function tests
At Bluecrest Wellness, our private liver function test evaluates the health and functionality of your liver. This comprehensive test measures how well your liver performs its normal functions, producing protein and clearing out bilirubin, a blood waste product. Other test markers include the presence of enzymes released by liver cells in response to damage or disease to give you a more complete picture of your liver health.
You can book a private liver function blood test at locations across the UK at a time to suit you. Plus, you can be confident that we will deliver fast, efficient and accurate results as we have established links with leading UK laboratories and are fully accredited for a wide range of private blood checks.
Book your private Liver Function Test today.
