Liver blood tests
A blood test that measures enzymes and proteins to give a snapshot of how the liver is working and whether it may be inflamed or damaged.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Liver blood tests are a snapshot that can flag a possible problem; they do not give a diagnosis on their own.
- Mildly abnormal results are common and often settle, so a single abnormal test is usually repeated before further action.
- Normal results do not completely rule out liver disease — significant scarring can exist with normal blood tests.
- What matters most is the pattern over time and the reason for testing, which your clinician will interpret alongside other information.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
A quick, low-risk way to check for signs of liver inflammation or damage
As a stand-alone way to rule out liver disease — normal results do not exclude scarring or all conditions.
A brief scratch as the needle goes in, then pressure on the spot for a minute or two to stop bruising.
Clear interpretation of the result in the context of your history.
A brief scratch as the needle goes in, then pressure on the spot for a minute or two to stop bruising.
You can return to normal activities straight away. Keep the plaster on for a short while and report any ongoing...
Results are usually back. Some services report the same day; others take a little longer.
A mildly abnormal result is often repeated, frequently after a few weeks, to see whether it settles before any...
What are liver blood tests (LFTs)?
Liver blood tests, often called liver function tests or LFTs, measure a group of enzymes and proteins in a single blood sample. They usually include ALT and AST (enzymes that rise when liver cells are irritated or damaged), ALP and GGT (which can rise with bile duct problems or alcohol), bilirubin (a pigment that causes jaundice when high) and albumin (a protein the liver makes).
The name 'liver function tests' is a little misleading. Most people with abnormal results still have a liver that is working normally, which is why many specialists now prefer the term 'liver blood tests'. The results are a clue, not a diagnosis.
The test can flag that something may be affecting the liver, and the pattern of which values are raised gives hints about the cause — for example liver cells versus bile ducts. It cannot, by itself, say what is wrong, how much scarring there is, or how the liver will do in future.
Mildly abnormal results are very common and often settle on a repeat test, so a single abnormal result usually needs repeating before anyone worries.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
What raised results may point to
| Pattern | Often suggests | Common cause |
|---|---|---|
| High ALT/AST | Liver cell irritation | Fatty liver, alcohol, viral hepatitis, medicines |
| High ALP/GGT | Bile duct picture | Gallstones, blockage, alcohol |
| High bilirubin alone | Often harmless | Gilbert's syndrome, fasting |
| Low albumin / high INR | Reduced function | More advanced liver disease |
These are general patterns, not diagnoses. Results overlap, and a specialist interprets them alongside your history, examination and other tests.
Preparing for your test
- Ask whether you need to fast; many liver blood tests do not require fasting, but some bundled tests, such as glucose or lipids, do.
- Tell whoever takes the blood about all medicines, supplements and herbal remedies, as several affect liver results.
- Be honest about alcohol in the days before the test, as recent drinking can change the results.
- Mention recent strenuous exercise, which can raise some enzymes.
- Bring previous results if you have them, so trends can be compared.
- Stay well hydrated and wear a top with sleeves that roll up easily.
What happens
A small blood sample is taken from a vein, usually in the arm, by a nurse, phlebotomist or doctor. A tight band is placed around your upper arm, the skin is cleaned, and the sample is drawn into one or more tubes. It takes only a few minutes.
The sample goes to a laboratory, where the enzymes and proteins are measured. There is nothing for you to do afterwards, and you can carry on as normal.
Results are compared against a normal range, but small variations are common and the laboratory's range is a guide, not a hard line. Your clinician interprets the results in the context of why the test was done.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- As a stand-alone way to rule out liver disease — normal results do not exclude scarring or all conditions.
- As a one-off 'liver MOT' without a plan for what an abnormal result would mean.
- When the real question is the degree of scarring, which needs a FibroScan or other fibrosis assessment, not just blood tests.
- As a substitute for assessing alcohol intake, weight and medicines, which often explain the results.
Delay or rearrange if…
- You have a short-term illness, recent heavy drinking or strenuous exercise that could distort the results.
- You have just started a new medicine that may temporarily affect liver enzymes, unless monitoring is the aim.
- A previous mildly abnormal result has not yet been repeated as advised.
- Fasting is needed for bundled tests and you have eaten recently.
Alternatives to discuss
- Repeating the test after a few weeks rather than escalating straight away.
- A non-invasive liver screen to look for specific causes when results stay abnormal.
- An ultrasound of the liver to look at its structure.
- A FibroScan or other fibrosis score where the concern is scarring.
- Specialist referral when results are markedly abnormal or persistently unexplained.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A quick, low-risk way to check for signs of liver inflammation or damage
- Can pick up a problem before you have any symptoms
- The pattern of results gives clues to the likely cause
- Useful for monitoring a known condition or the effect of a medicine over time
- Helps decide whether further tests, such as a scan or liver screen, are needed
- Reassuring when results are normal and stable in the right context
Risks & complications
- Mild discomfort, bruising or a small lump where the needle went in
- Feeling faint or lightheaded during or after the blood draw
- A mildly abnormal result that turns out to be harmless or temporary
- Anxiety about an abnormal number while waiting for it to be repeated or explained
- Needing repeat or additional tests because of an unexpected result
- An incidental finding unrelated to your original concern
- False reassurance from normal results when a problem is still present
- Infection at the puncture site
- A larger bruise (haematoma), more likely if you take blood thinners
The biggest pitfalls are over-reacting to a single mildly abnormal result and being falsely reassured by a normal one. UK guidance is that mildly abnormal results are usually repeated, often after a few weeks, before further investigation. Ask what the pattern is, whether it needs repeating, and what a normal result does and does not rule out.
Published figures to discuss
Liver blood tests are very low risk to perform. The important uncertainty is interpretation: results overlap between conditions, mildly abnormal results are common and often settle, and normal results do not rule out significant scarring. Whether an abnormal result reflects real disease depends heavily on the reason for testing, so no single figure applies.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| ALT or AST elevation from liver-cell injury | Common and non-specific | ALT and AST are injury markers, not direct measures of how well the liver is functioning. | NHS Specialist Pharmacy Service — Assessing liver function and interpreting liver blood testssps.nhs.ukSource-linked context |
| True liver-function impairment | Suggested by abnormal bilirubin, INR/prothrombin time, albumin and clinical context | The phrase 'liver function tests' can mislead; clotting and albumin often matter more for function. | Guide sourcesClinical context |
| Isolated gamma-GT elevation | Common with alcohol, fatty liver, medicines and enzyme induction | It needs context rather than automatic assumption of severe liver disease. | Guide sourcesClinical context |
| Normal blood tests despite fibrosis | Recognised | Fibrosis risk scores and elastography may be needed when risk factors are strong. | NHS Specialist Pharmacy Service — Assessing liver function and interpreting liver blood testssps.nhs.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from a blood test. What matters afterwards is getting the result, understanding what it means, and knowing whether it needs repeating or acting on.
- A small bruise or tender spot where blood was taken
- No symptoms at all from the test itself
- Waiting a day or two for results
- Being asked to repeat the test before anything else is done
- Uncertainty until the result is interpreted with your history
Aftercare
- Keep pressure on the puncture site briefly and the plaster on for a short while.
- Make sure you know how and when you will get your results.
- Do not assume no news is good news — check that results have been reviewed.
- If asked to repeat the test, book it for the suggested time.
- Continue any medicines unless told otherwise, and mention them when discussing results.
- Note any symptoms to raise when the results are explained.
- Ask for a copy of your results so you can track trends over time.
- Checked whether fasting is needed for any bundled tests
- List of all medicines and supplements ready
- Honest note of recent alcohol intake
- Previous results brought for comparison
- Top with easy sleeve access worn
- Clear on how and when results will be given
- Plan agreed for repeating the test if needed
⚠ Get urgent help if…
- Yellowing of the skin or whites of the eyes (jaundice)
- Dark urine with pale stools
- Severe or persistent tummy pain, especially over the upper right side
- Vomiting blood or passing black, tarry stools — seek emergency care
- Marked drowsiness, confusion or disorientation
- A rapidly swelling tummy or new leg swelling with breathlessness
- Fever and feeling very unwell alongside abnormal results
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A normal, stable set of liver blood tests is reassuring in the right context, but it does not guarantee a completely healthy liver — significant scarring can be present with normal results. An abnormal result flags that something may be affecting the liver and, by its pattern, hints at whether the issue is more with liver cells or bile ducts.
Results are most useful when seen over time and alongside your history, examination and other tests. A single abnormal value is often repeated before anyone acts on it. Ask your clinician what your pattern suggests, whether it needs repeating, and what each possible result would change.
A liver blood test reflects the liver at one moment. Results can change with weight, alcohol, medicines, infections and other conditions, so they are often repeated over weeks to months to show a trend. How often you need them depends on why they were done and whether you have a known condition; your clinician will advise.
Related tests, treatments or support
Liver blood tests are often done alongside a non-invasive liver screen (extra blood tests looking for specific causes), an ultrasound of the liver, and sometimes a FibroScan to assess scarring. Together these build a fuller picture than the blood tests alone. Other routine bloods, such as a full blood count and kidney tests, are frequently checked at the same time.
Follow-up & long-term care
Persistently or significantly abnormal results usually lead to repeat testing, a liver screen, imaging or a specialist referral. You should be told who is reviewing your results and what the plan is. If you are not contacted within the expected time, chase the result rather than assuming it is normal.
- Periodic repeat tests to track a trend where results are abnormal
- Monitoring tests if you take a medicine that can affect the liver
- Regular checks if you have a known liver condition
- Repeat testing after lifestyle changes, such as reduced alcohol or weight loss, to see the effect
Repeat, follow-on and what comes next
- A mildly abnormal result is usually repeated before further action.
- Persistently abnormal results lead to a liver screen, imaging or referral.
- Interpretation may change as the trend over time becomes clear.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear interpretation of the result in the context of your history.
- A defined plan for repeating mildly abnormal results.
- A copy of your results and a record you can track over time.
- A named route to discuss abnormal results and arrange next steps.
- Clear advice on when to seek urgent help, such as jaundice or dark urine.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the test is a single panel or part of a wider blood profile
- The clinic or laboratory used and how quickly results are reported
- Whether a phlebotomy (blood-draw) fee is charged separately
- Whether a clinician reviews and explains the results, or only reports the numbers
- Add-on tests, such as a liver screen, requested at the same time
- Repeat testing if results need confirming over time
- Exactly which tests are included in the panel
- Whether the blood-draw fee is included
- Whether a clinician's interpretation of the results is included
- How and when results are delivered
- Whether a copy of results is provided for your records
- The cost of repeat or follow-on tests if needed
- What happens, and what it costs, if results are abnormal and need review
On the NHS? Liver blood tests are routinely available on the NHS when clinically indicated; they are also offered privately and within health-check packages, but any result still needs proper interpretation.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Treating a single abnormal value as a diagnosis rather than repeating it.
- Implying normal results guarantee a healthy liver.
- Reporting numbers without interpreting the pattern or the reason for testing.
- No clear plan for who reviews the results and what happens next.
- Selling a panel as a 'liver check' without explaining its limitations.
Marketing red flags
- Offering a 'liver MOT' that implies it can rule out all liver disease.
- Bundling liver tests with unproven 'detox' treatments or supplements.
- Reporting raw numbers with no clinical interpretation.
- Suggesting normal results mean alcohol or weight are no concern.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What does the pattern of my results suggest, and what does it not tell us?
- Does this need repeating, and if so when?
- What would a normal, abnormal or borderline repeat result change?
- Could any of my medicines or supplements explain this?
- Do I need a liver screen, a scan or a FibroScan as well?
- How will I get my results, and who is reviewing them?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Do I need to fast before liver blood tests?
My result is slightly abnormal — should I be worried?
If my liver tests are normal, is my liver definitely healthy?
Can medicines or supplements affect the results?
Will alcohol the night before change my results?
Are these tests available on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: British Liver Trust — Liver blood tests (formerly LFT) British Society of Gastroenterology — Guidelines on the management of abnormal liver blood tests NHS Specialist Pharmacy Service — Assessing liver function and interpreting liver blood tests NICE NG49 — Non-alcoholic fatty liver disease (NAFLD): assessment and management British Liver Trust — Tests A to Z
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Liver screen (non-invasive liver assessment) · Liver ultrasound scan · Fatty liver disease assessment · Liver specialist (hepatology) appointment · MRI liver scan (including MRCP)