Friday, February 3, 2017

Update - New Liver Test Guidelines

Anyone living with chronic liver disease is all too familiar with a simple blood test called a "liver function test." When my own test results are good - it's a huge relief.

An Update
If you haven't heard, the American College of Gastroenterology (ACG) has issued new guidelines on the evaluation of abnormal "liver chemistries."

A Big Change
According to Medscape; The new guidelines state that the normal ALT range is 19 to 25 IU/L for women and 29 to 33 IU/L for men. The article is patient friendly, an easy read, start here.

Don't Call It A Liver Function Test
As for "liver function tests" the ACG now suggests that "liver function tests" be referred to as "liver chemistries" or "liver tests.

The reasoning behind the name change is simple "Liver Function Tests" are not true measures of hepatic function. If you skipped the Medscape article, listen to this short podcast hosted by Arefa Cassoobhoy, MD, MPH to learn more about the liver test guidelines.

Here is a quick summary from Consultant 360;
ACG: Guidelines for Evaluating Abnormal Liver Chemistries
Among the recommendations:
  • Men who consume more than 210 grams of alcohol per week and women who consume more than 140 grams of alcohol per week and have higher levels of serum aspartate aminotransferase (AST) than ALT  should be considered at risk for alcoholic liver disease and receive counseling for alcohol cessation.
  • Screening for alpha-1 anti trypsin deficient with alpha-1 anti-trypsin phenotype is highly recommended for patients with persistently elevated AST or ALT.
  • Patients with abnormal liver chemistries should be asked about prescribed and over-the-counter medications, non-prescribed complementary or alternative medicines, and dietary or herbal supplements that may be associated with drug induced liver injury.
  • Liver biopsy is recommendation if serologic testing and imaging fails to explain a diagnosis, to stage a condition, or if multiple diagnosis are possible.

For more information read the complete - ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries (CME) available @

Enjoy the weekend!

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