Hepatic Function Panel
A liver workup that separates injury patterns from how well the liver is actually functioning.
Consider this test if:
- Fatigue, jaundice, dark urine, nausea, or right-upper-abdominal discomfort
- Taking a medication or supplement that can stress the liver, and monitoring for it
- Heavy alcohol use, viral hepatitis, or metabolic risk for fatty liver disease
- Family history of liver disease, or setting a baseline before a new treatment
- Following known liver disease or recovery from an abnormal prior result
- HSA/FSA eligible
- Typical results in 1 day · Reviewed by a real clinician
- Drawn at a CLIA/CAP-accredited lab near you ·
Pre-test considerations
No fasting is strictly required, though some providers prefer a morning draw. Heavy alcohol within a day or two and recent intense exercise can transiently raise enzymes, and AST in particular also rises with muscle injury, so note recent workouts. List any medications and supplements, since many affect liver chemistries.
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What this test is for
The hepatic function panel bundles the core liver chemistries: ALT, AST, alkaline phosphatase, total and direct bilirubin, total protein, and albumin (with globulin and indirect bilirubin calculated). ALT and AST rise with hepatocellular injury, while ALP and bilirubin rising disproportionately point toward cholestasis or bile-flow obstruction. Albumin and bilirubin reflect synthetic function, so a low albumin can signal liver disease lasting more than a few weeks. It is commonly run to investigate fatigue, jaundice, abdominal pain, or dark urine, and to screen people with viral hepatitis, heavy alcohol use, metabolic risk for fatty liver, or a family history of liver disease.
This is the broad panel. If you only need to track a single enzyme or follow bilirubin fractions over time, the standalone ALT, AST, ALP, or fractionated bilirubin tests are the more focused choice. Liver enzymes mark injury rather than measure function directly, so an isolated mild elevation often warrants a repeat draw before further workup.
Biomarkers tested
Includes 7 biomarkers
Albumin is the protein your liver churns out in the largest quantity, and it does double duty: it holds water inside your blood vessels (so fluid doesn't leak into tissue) and ferries hormones, fatty acids, and medications through your bloodstream. Low albumin points to liver disease, kidney protein loss, chronic inflammation, or poor nutrition, and often shows up alongside swelling, fatigue, or unexplained weight loss. Because it reflects both liver production and overall protein status, it's a useful baseline check and a quick way to see whether inflammation or malnutrition is quietly dragging your protein reserves down.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
- Specimen
- Serum or plasma
- Measures
- Enzyme activity
ALT is an enzyme that lives mostly inside liver cells, where it helps metabolize amino acids. When liver cells get inflamed or damaged, from alcohol, fatty liver, viral hepatitis, or certain medications and supplements, they leak ALT into the bloodstream, making it the most specific marker of liver cell injury on a standard panel. It's worth tracking as a baseline if you drink regularly, use supplements or medications processed by the liver, or carry extra weight, and worth investigating if you have unexplained fatigue, abdominal discomfort, or nausea, since ALT often rises well before symptoms do.
- Specimen
- Serum or plasma
- Measures
- Enzyme activity
AST is an enzyme that lives inside liver cells (and muscle and heart cells too), and it spills into your blood when those cells get damaged. High AST flags liver strain from alcohol, fatty liver, medications, or infection, though muscle damage from intense training can also push it up, which is why it's usually read alongside ALT to pinpoint the source. It's worth tracking as a baseline for liver health, before starting a new supplement or medication, or when investigating fatigue, abdominal discomfort, or unexplained changes in appetite.
- Specimen
- Serum or plasma
- Measures
- Enzyme activity
Direct bilirubin measures the conjugated fraction that your liver has already processed and packaged for excretion into bile, distinct from the unconjugated bilirubin still circulating unbound. When direct bilirubin rises, it points to a downstream problem: bile duct obstruction, gallstones, or liver cells struggling to excrete what they've already conjugated, rather than an upstream issue like excess red blood cell breakdown. It's the marker that helps separate liver and bile duct disease from other causes of jaundice, and it's worth checking alongside ALT, AST, and alkaline phosphatase if you're dealing with yellowing skin or eyes, dark urine, pale stools, or unexplained itching.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
Total bilirubin measures the pigment left over when your body breaks down old red blood cells, a job the liver clears by processing it into bile. High levels point to a liver struggling to keep up (hepatitis, fatty liver, bile duct blockage) or red cells breaking down faster than normal, and often show up as yellowing skin or eyes, dark urine, or fatigue. It pairs with ALT, AST, and ALP to pinpoint whether a problem sits in the liver cells, the bile ducts, or upstream in the blood itself, and mildly elevated results with otherwise normal liver panels usually reflect Gilbert's syndrome, a harmless and common genetic quirk.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
Total protein adds up albumin and globulins, the workhorses that hold fluid in your blood vessels, carry hormones and nutrients, and fuel your immune defenses. Low levels point toward liver disease, kidney loss of protein, malnutrition, or poor absorption, while high levels can flag chronic inflammation or dehydration. It's a quick baseline check within a metabolic panel, and if your levels drift off, it usually leads straight to albumin and globulin breakdowns to pinpoint what's driving it.
- Specimen
- Serum or plasma
- Measures
- Mass concentration
What to expect
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Frequently asked questions
View all FAQsHow does pricing work?
Every test shows the member price next to the standard non-member price, so you can see what membership saves you. The member price is our cost — covering the lab and what it takes to run the service — never a profit on the test itself; Mito makes its money on the $9 membership, not on marking up your tests. Membership is $9/mo, and you still pay the lab’s order fee. Prices are itemized before you pay, with no hidden fees.
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Is this eligible for HSA/FSA?
Yes. This test is HSA/FSA eligible, and you can pay with your HSA/FSA card at checkout.
When will I get my results?
Your results post to your dashboard once your lab completes them, then a clinician reviews them and your full analysis and personalized action plan (with clear next steps) follow. Turnaround varies by test: specialty assays and at-home kits take longer, and each test shows its expected turnaround before you buy.
Do I need a doctor’s order?
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