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Blood Tests


Blood testing is an important part of managing liver disease, both for diagnosis and for monitoring. There is no single blood test that will say how healthy your liver is and all the blood tests are interpreted along with knowledge about your medical conditions, medication and previous results in order to get a clearer picture of how your liver is.

Routine bloods

  • Full blood count- this checks to see if you have evidence of anaemia, infection and to check your platelet levels. Anaemia and low platelet levels can occur in liver disease and can sometimes indicate the need for further investigations such as endoscopy or ultrasound scanning.
  • Liver function tests- these measure many aspects of how your liver functions. The main ones are:
    • Albumin- which is a protein created in the liver. Low levels can be a sign of worsening liver disease.
    • Bilirubin- this comes from the bodies natural recycling of blood cells. When the liver does not work properly or when there is a blockage in the bile ducts, the bilirubin may increase.
    • ALT- this blood test can be a sign of acute or chronic liver inflammation and is looked at along with many other blood tests to help the doctor assess your liver disease.
    • ALP- this blood test can be a sign of acute or chronic bile duct inflammation and is looked at along with many other blood tests to help the doctor assess your liver disease
  • Urea and Electrolytes- this is also known as a “kidney test” and looks at how much sodium and potassium salts are in your body and also how well your kidneys are functioning. These are particularly important when you are on “water tablets” as some medications can cause changes in your salt levels and kidney function.


Monitoring bloods

  • Patients with cirrhosis of the liver are at greater risk of liver cancer. A blood test known as AFP can act as a marker for liver cancer. In some cases of liver cancer, this blood test can be raised. Some patients with liver disease may be asked to have regular blood tests including an AFP to monitor for liver cancer.
  • Patients who are on regular medications for their liver, such as Azathioprine, may be asked to undergo regular blood test monitoring to check for side effects of the medication. The schedule of monitoring will be discussed with you when the medication is prescribed.
  • Medication levels. Some medications such as Tacrolimus, need strict control of the level present in the blood stream. They may require testing before a new prescription can be given. You should be told the best way to do this when you are prescribe the medication

If you are asked to do regular monitoring bloods, please make sure that you get them done before running out of your medications. They can take a few days for the results to come back and a further few days for a prescription to be available.



There are many different bloods that can be taken to look for different conditions. When you are first investigated for liver disease, your doctor or nurse may ask for a series of different tests depending on your symptoms and risk factors for liver disease.

These tests can include autoimmune screening and viral hepatitis screening, along with some rarer genetic tests if needed.

These usually do not require any special preparation (such as being a fasting blood sample) but results may take several weeks to come back depending on the request being sent.