Liver Health & LFT — Your Body's Silent Chemical Factory
AASLD Practice Guidelines & ILBS Clinical Protocols
Educational content only. This information is for general awareness and does not constitute medical advice. Please consult a qualified healthcare provider for any medical concerns or before making health decisions.
Key Facts
500+
Functions performed by liver
Including detoxification, protein synthesis and bile production
2.6 lakh
Liver disease deaths in India annually
Among the world's highest — largely preventable
~38%
NAFLD prevalence in urban India
Non-Alcoholic Fatty Liver Disease linked to metabolic syndrome
75%
Liver damage threshold before symptoms
You can lose 75% of liver function before feeling unwell
Why the Liver Is So Hard to Read Without a Test
The liver has extraordinary regenerative capacity and compensatory reserve. Unlike the heart or lungs, it can sustain significant damage — up to 75% loss of functional tissue — before symptoms become apparent. By the time jaundice, abdominal pain, or fatigue appears, disease is often advanced.
This makes proactive testing through a Liver Function Test (LFT) critical. An LFT is a panel of blood tests that measure specific liver enzymes, proteins, and bilirubin — giving an early snapshot of liver health before symptoms emerge.
The LFT Panel — What Each Marker Tells You
SGOT / AST (Serum Glutamic Oxaloacetic Transaminase):: Released when liver cells are damaged. Normal: 10–40 U/L. Also elevated in heart muscle damage.
SGPT / ALT (Serum Glutamic Pyruvic Transaminase):: More specific to the liver than AST. Best early marker of hepatocellular damage. Normal: 7–56 U/L.
SGOT:SGPT Ratio:: A ratio > 2 (AST > ALT) suggests alcoholic liver disease. When ALT > AST, viral hepatitis or NAFLD is more likely.
ALP (Alkaline Phosphatase):: Elevated in bile duct obstruction, cholestatic liver disease, and bone disorders. Normal: 44–147 U/L.
GGT (Gamma-Glutamyl Transferase):: Sensitive marker for alcohol use and bile duct disease. Elevated GGT + elevated ALP strongly suggests biliary disease.
Total Bilirubin:: Bilirubin is a breakdown product of haemoglobin. High levels cause the yellowing of skin and eyes (jaundice). Normal: < 1.2 mg/dL.
Serum Albumin:: Protein made exclusively by the liver. Low albumin in chronic liver disease reflects reduced synthetic function. Normal: 3.5–5 g/dL.
PT/INR (Prothrombin Time):: Liver produces clotting factors. Elevated PT/INR in liver disease means impaired clotting — a sign of severe hepatic dysfunction.
Fatty Liver (NAFLD) — India's Growing Epidemic
Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most common liver condition in urban India, affecting approximately 38% of urban adults. It is directly linked to obesity, diabetes, and metabolic syndrome.
NAFLD progresses silently:
1. **Simple steatosis (fatty liver):** Fat accumulation, usually reversible with lifestyle changes
2. **NASH (Non-Alcoholic Steatohepatitis):** Inflammation begins; some LFT values become abnormal
3. **Fibrosis and Cirrhosis:** Irreversible scarring; liver function declines
4. **Liver failure or hepatocellular carcinoma** in advanced cases
Early detection through LFT + ultrasound can catch NAFLD at stages 1–2, where lifestyle intervention is highly effective.
Viral Hepatitis — Know Your Status
India is endemic for both Hepatitis B and Hepatitis C, affecting tens of millions. Both are blood-borne and sexually transmitted — and both can cause chronic liver disease, cirrhosis, and liver cancer.
Hepatitis B surface antigen (HBsAg):: Detects active Hepatitis B infection
Anti-HCV antibody:: Screens for Hepatitis C exposure
Hepatitis B core antibody (Anti-HBc):: Distinguishes past from active infection
Vaccination against Hepatitis B is available and highly effective. Screening is recommended for all adults — especially healthcare workers, those with multiple sexual partners, and anyone who has received blood transfusions.
Who Should Get an LFT?
LFT screening is recommended for:
• Adults over 30 annually (especially with diabetes, obesity, or metabolic syndrome)
• Anyone who drinks alcohol regularly (even moderately)
• Those taking long-term medications (statins, paracetamol, TB drugs, antifungals)
• People with jaundice, right upper abdominal discomfort, or unexplained fatigue
• All pregnant women (to check for gestational liver conditions)
• Anyone with a history of Hepatitis B or C exposure
Related Insights
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Your kidneys filter 200 litres of blood every day. The Kidney Function Test (KFT) checks if they're doing that silently and efficiently — long before symptoms appear.
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