A Liver Function Test (LFT) is a panel of blood tests that measures enzymes, proteins, and substances produced or processed by your liver. It's one of the most frequently ordered test panels in Pakistan — critical for detecting hepatitis (which affects 15-20 million Pakistanis), monitoring medication effects, diagnosing fatty liver disease, and evaluating overall liver health.
This guide explains every value in your LFT report in plain language, with Pakistan-specific context including hepatitis prevalence, common causes of abnormal results, and when to seek medical attention.
LFT Values: Complete Reference Table
| Test | Full Name | Normal Range | What It Measures |
|---|---|---|---|
| ALT (SGPT) | Alanine Aminotransferase | Male: 7-56 U/L Female: 7-45 U/L | Liver cell damage (most specific) |
| AST (SGOT) | Aspartate Aminotransferase | 10-40 U/L | Liver + heart + muscle damage |
| ALP | Alkaline Phosphatase | 44-147 U/L | Bile duct obstruction, bone disease |
| GGT | Gamma-Glutamyl Transferase | Male: 8-61 U/L Female: 5-36 U/L | Bile duct damage, alcohol use |
| Total Bilirubin | — | 0.1-1.2 mg/dL | Red blood cell breakdown product |
| Direct Bilirubin | Conjugated Bilirubin | 0.0-0.3 mg/dL | Processed bilirubin (liver function) |
| Indirect Bilirubin | Unconjugated Bilirubin | 0.2-0.7 mg/dL | Unprocessed bilirubin (hemolysis marker) |
| Albumin | — | 3.5-5.5 g/dL | Protein made by liver (nutrition marker) |
| Total Protein | — | 6.0-8.3 g/dL | All blood proteins (albumin + globulin) |
| PT/INR | Prothrombin Time | PT: 11-13.5 sec INR: 0.8-1.1 | Blood clotting ability (liver produces clotting factors) |
Understanding Each Value in Detail
ALT (SGPT) — The Key Liver Damage Indicator
ALT is the most liver-specific enzyme in the LFT panel. It's found primarily in liver cells (hepatocytes), so when these cells are damaged or inflamed, ALT leaks into the bloodstream and levels rise.
How to interpret ALT levels:
- Normal (7-56 U/L): Liver cells are healthy.
- Mildly elevated (1-2x normal, up to ~100 U/L): Most commonly caused by non-alcoholic fatty liver disease (NAFLD) in Pakistan. Affects an estimated 15-20% of urban Pakistanis due to high-carbohydrate diets, obesity, and sedentary lifestyles.
- Moderately elevated (2-10x normal, ~100-500 U/L): Suggests active liver inflammation — could be viral hepatitis (B or C), autoimmune hepatitis, or medication-related damage. Needs further investigation with hepatitis serology.
- Severely elevated (10x+ normal, >500 U/L): Indicates acute liver injury — viral hepatitis flare, drug toxicity (common with paracetamol overdose), or ischemic hepatitis. Requires urgent medical evaluation.
AST (SGOT) — Liver Plus More
AST is found in the liver, heart, muscles, and kidneys. It's less specific to the liver than ALT, but the AST/ALT ratio provides diagnostic clues:
- ALT > AST (ratio < 1): Typical of viral hepatitis and fatty liver. Most common pattern in Pakistani patients.
- AST > ALT (ratio > 1): Suggests alcoholic liver disease or cirrhosis. In Pakistan (where alcohol consumption is less common), this ratio often indicates advanced liver disease or cirrhosis from chronic Hepatitis C.
- AST > ALT (ratio > 2): Strongly suggests alcoholic hepatitis.
Bilirubin — Why You Turn Yellow
Bilirubin is the yellow pigment produced when red blood cells break down. The liver processes (conjugates) it for excretion. High bilirubin causes jaundice — yellowing of the skin and eyes.
- High indirect (unconjugated) bilirubin: Red blood cells are breaking down too fast (hemolysis), or the liver can't process bilirubin efficiently. Common in newborn jaundice and Gilbert's syndrome (a harmless genetic condition affecting ~5% of the population).
- High direct (conjugated) bilirubin: Liver is processing bilirubin but can't excrete it — suggests bile duct blockage (gallstones, tumor) or severe liver disease.
- Both elevated: Liver damage affecting both processing and excretion.
Albumin — Your Liver's Production Capacity
Albumin is a protein made exclusively by the liver. It keeps fluid in your blood vessels and transports hormones, vitamins, and drugs. Low albumin is a sign of chronic liver disease (the liver isn't producing enough) or severe malnutrition.
- Normal (3.5-5.5 g/dL): Liver is producing protein adequately.
- Low (below 3.5 g/dL): Chronic liver disease, malnutrition, kidney disease (nephrotic syndrome), or chronic inflammation. Can cause swelling in legs (edema) and abdomen (ascites).
Common Causes of Abnormal LFT in Pakistan
| Cause | Prevalence in Pakistan | Typical LFT Pattern |
|---|---|---|
| Hepatitis C | ~5% of population (10M carriers) | ALT 2-10x elevated, AST elevated |
| Hepatitis B | ~2.5% of population | ALT elevated, HBsAg positive |
| Fatty liver (NAFLD) | ~15-20% of urban adults | ALT mildly elevated (1-2x), AST normal or mild |
| Gallstones | Common (especially women >40) | ALP elevated, bilirubin elevated, ALT/AST normal or mild |
| Medications | Common (TB drugs, paracetamol, statins) | ALT elevated, dose-dependent |
| Autoimmune hepatitis | Rare | ALT/AST very high, globulin elevated |
| Cirrhosis | End-stage of chronic hepatitis | Low albumin, high bilirubin, prolonged PT/INR |
When to See a Doctor Urgently
Seek immediate medical attention if your LFT shows:
- ALT or AST above 500 U/L (10x normal)
- Total bilirubin above 3 mg/dL with jaundice (yellow skin/eyes)
- PT/INR above 1.5 (blood not clotting properly)
- Albumin below 2.5 g/dL with swelling
- Any combination of high bilirubin + high ALT + low albumin (suggests acute liver failure)
LFT Costs at Pakistani Labs
| Lab | LFT Panel Price (2026) |
|---|---|
| Chughtai Lab | Rs. 2,000-2,500 |
| Agha Khan Laboratory | Rs. 2,500-3,000 |
| Excel Labs | Rs. 1,500-2,000 |
| IDC / Al-Razi | Rs. 1,200-1,800 |
| Local labs | Rs. 800-1,200 |
Understand Your LFT Results Instantly
Upload your LFT report to MedVault. AI explains every value, flags abnormals, and tracks your liver enzymes over time across multiple reports.
Try MedVault Free →Frequently Asked Questions
What is a Liver Function Test (LFT)?
An LFT is a blood test panel measuring liver enzymes (ALT, AST, ALP, GGT), bilirubin, albumin, total protein, and clotting factors. It helps detect hepatitis, fatty liver, bile duct problems, and monitor medication effects. Costs Rs. 1,500-3,000 at Pakistani labs.
What is the normal ALT (SGPT) range?
Normal ALT is 7-56 U/L for males and 7-45 U/L for females. Mildly elevated ALT (up to 2x normal) commonly indicates fatty liver disease. Moderate elevation (2-10x) suggests active hepatitis. Very high levels (10x+) indicate acute liver damage.
How common is hepatitis in Pakistan?
Approximately 7-8% of Pakistan's population (15-20 million people) carry Hepatitis B or C. Hepatitis C alone affects an estimated 10 million Pakistanis. Many are undiagnosed, making routine LFT screening important.
What causes elevated liver enzymes?
The most common causes in Pakistan are: fatty liver disease (15-20% of urban adults), Hepatitis B and C, medications (paracetamol, anti-TB drugs), gallstones, and autoimmune conditions.