Liver enzymes:

• Alanine aminotransferase (ALT) – an enzyme mainly found in the liver; the best test for detecting hepatitis
• Alkaline phosphatase (ALP) – an enzyme related to the bile ducts but also produced by the bones, intestines, and during pregnancy by the placenta (afterbirth); often increased when bile ducts are blocked or damaged
• Aspartate aminotransferase (AST) – an enzyme found in the liver and a few other organs, particularly the heart and other muscles in the body

Proteins:

• Albumin – measures the main protein made by the liver; the level can be affected by liver and kidney function and by decreased production or increased loss.
• Total protein (TP) – measures albumin and all other proteins in blood, including antibodies made to help fight off infections
• Bilirubin – two different tests of bilirubin often used together (especially if a person has jaundice): total bilirubin measures all the bilirubin in the blood; direct bilirubin measures a form that is conjugated (combined with another compound) in the liver.

Depending on your healthcare provider and the laboratory performing the testing, additional tests may be included in a liver panel. Examples include:

• Gamma-glutamyl transferase (GGT) – another enzyme found mainly in liver cells; it is a very sensitive marker for liver diseases, but it is not specific as it cannot differentiate between various causes of liver diseases. GGT is not recommended for routine use. It is used in conjunction with ALP to determine the source of increased ALP, either from bone or liver. High level of GGT can be found with alcohol consumption.
• Lactate dehydrogenase (LD) – an enzyme released with cell damage; found in cells throughout the body
• Prothrombin time (PT) – the liver produces proteins involved in the clotting (coagulation) of blood; the PT measures clotting function and, if abnormal, may indicate liver damage.
• Alpha-fetoprotein (AFP) – associated with regeneration or proliferation of liver cell and can be produced by certain types of tumors
• Autoimmune antibodies (e.g., ANA, SMA, anti-LKM-1) – associated with autoimmune liver diseases (autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC))