Spotlights

Choose Health Launches Most Comprehensive At-Home Liver Function Test with 20+ Biomarkers and Clinical Risk Scores

New Test Brings Fatty Liver Risk Screening Home as Roughly 100 million Americans Live with Liver Disease, Most Undiagnosed

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Dr. Alan Farrell
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September 1, 2026
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4 min
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Austin, Texas August 28, 2026

Choose Health, an at-home blood testing company, announced the launch of the Comprehensive Liver Function Test, a self-collection blood test measuring more than 20 liver health markers for a disease that affects roughly one-third of U.S. adults but remains significantly underdiagnosed.

“Fatty liver disease is arguably the most underdiagnosed condition in America. The tragedy is that it’s largely preventable and often reversible when identified early, but without universal screening, cases slip through until the damage is done. We built this test to change that.”

Mark Holland, Founder of Choose Health

A silent epidemic

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects an estimated 38% of adults globally and is projected to exceed 55% by 2040. In the U.S., roughly one-third of adults may be affected, with only a fraction diagnosed.

38% Estimated global adult prevalence of MASLD.
55%+ Projected global adult prevalence by 2040.

Its trajectory can often be changed. AASLD guidance indicates that 3% to 5% weight loss can improve steatosis, with greater weight loss, typically above 10%, generally needed to improve steatohepatitis and fibrosis.

What does the Choose Health Comprehensive Liver Function Test measure?

The test measures AST, ALT, GGT, Total Bilirubin and Albumin; Fasting Glucose, HbA1c, Fasting Insulin and HOMA-IR; LDL, HDL, Triglycerides, VLDL, ApoA1 and ApoB; and Iron, UIBC, Ferritin and Transferrin Saturation, alongside calculated scores including the Fatty Liver Index, Hepatic Steatosis Index and AST:ALT Ratio.

Core liverAST, ALT, GGT, Total Bilirubin and Albumin
MetabolicFasting Glucose, HbA1c, Fasting Insulin and HOMA-IR
Lipid and cardiovascularLDL, HDL, Triglycerides, VLDL, ApoA1 and ApoB
IronIron, UIBC, Ferritin and Transferrin Saturation
Calculated scoresFatty Liver Index, Hepatic Steatosis Index and AST:ALT Ratio

“These calculated scores are what actually matter clinically. One elevated ALT reading doesn’t say much. But when you combine multiple biomarkers into published indices like the Fatty Liver Index, patterns of steatosis and metabolic risk become much clearer.”

Dr. Alan Farrell, MB BCh BAO MSc, Chief Medical Officer at Choose Health and preventive medicine expert

Why does a liver test include metabolic and lipid markers?

Liver enzymes alone give an incomplete picture. Glucose, HbA1c, Insulin and HOMA-IR add context on insulin resistance, which is commonly associated with MASLD. Lipid markers characterize cardiometabolic risk, and iron markers can surface results warranting clinical follow-up. The Fatty Liver Index and Hepatic Steatosis Index combine select measurements with personal characteristics to estimate the likelihood of hepatic steatosis.

“We’ve been focused on liver health since 2018 because we saw this epidemic coming. With the rise of GLP-1 medications and awareness of metabolic health, now is the moment for consumers to take liver health as seriously as cholesterol or blood sugar.”

Mark Holland, Founder of Choose Health

Availability

The Comprehensive Liver Function Test is available across 48 states, excluding New York and Rhode Island. The test uses a finger-prick sample collected at home and returns physician-reviewed results in days.

Availability 48 states, excluding New York and Rhode Island
Collection A finger-prick sample collected at home
Results Physician-reviewed and returned in days
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Frequently asked questions

What does the Choose Health Comprehensive Liver Function Test measure?

Core Liver BiomarkersAST, ALT, GGT, Total Bilirubin and Albumin
Metabolic MarkersFasting Glucose, HbA1c, Fasting Insulin and HOMA-IR, an insulin resistance score
Lipid and Cardiovascular ProfileLDL, HDL, Triglycerides, VLDL, ApoA1, ApoB, ApoB:ApoA1 Ratio and LDL:HDL Ratio
Iron MarkersIron, UIBC, Ferritin and Transferrin Saturation (TSAT)

Calculated Clinical Risk Scores:

  • Fatty Liver Index (FLI): a validated screening tool for hepatic steatosis.
  • Hepatic Steatosis Index (HSI): a screening tool for the presence of fatty liver.
  • AST:ALT Ratio (De Ritis Ratio): a widely used liver enzyme ratio that helps distinguish patterns of liver injury.

“These calculated scores are what actually matter clinically. A single elevated ALT reading doesn’t tell you much. But when you combine multiple biomarkers into published indices like the Fatty Liver Index, patterns of steatosis and metabolic risk become much clearer.”

Dr. Alan Farrell, Chief Medical Officer at Choose Health

Why did Choose Health include these markers?

Choose Health selected these biomarkers to provide a broader picture than liver enzymes alone:

  • Liver-related markers such as ALT, AST, GGT, Bilirubin and Albumin can help characterize liver-related biochemical patterns and should be interpreted in clinical context.
  • Glucose, HbA1c, Insulin and HOMA-IR provide context on glycemic control and insulin resistance, metabolic factors commonly associated with MASLD.
  • Lipid markers, including Triglycerides, HDL, LDL, ApoB, ApoA1 and related ratios, help characterize cardiometabolic risk.
  • Iron markers, including Ferritin, Iron, UIBC and Transferrin Saturation, can provide useful context because abnormal iron results may warrant clinical follow-up.
  • Calculated indices such as FLI and HSI combine select measurements with personal characteristics to estimate the likelihood of hepatic steatosis. They are screening and risk-stratification tools, not diagnostic tests, and they do not determine the degree of inflammation, fibrosis or cirrhosis.

Who should take an at-home liver test?

The Choose Health Comprehensive Liver Function Test may be useful for adults who want a broader view of liver, metabolic, lipid and iron-related biomarkers, particularly those with cardiometabolic risk factors such as overweight or obesity, prediabetes or type 2 diabetes, abnormal cholesterol or triglycerides, high blood pressure, a family history of liver disease or regular alcohol use.

It can also support routine monitoring over time for people making lifestyle changes or working with a clinician on metabolic health, and can be a resource for those looking to monitor their AST:ALT Ratio easily from home.

How does an at-home liver test work?

The Choose Health Comprehensive Liver Function Test uses a simple finger-prick sample collected at home. The test is shipped directly to you and can be dropped off at your nearest USPS location after collection. Many people who have an aversion to needles or having their blood drawn at a lab find the method preferable.

What do I do after getting my results from Choose Health?

Testing frequency should depend on your results, risk factors and lifestyle habits. Choose Health recommends quarterly testing to monitor how lifestyle and environmental changes may be affecting your markers. Liver markers in particular can be responsive to change, making recurring liver function testing useful for monitoring trends over time.

What other tests does Choose Health offer?

Choose Health offers more than 20 at-home blood tests across nine categories of health. Every test is collected at home, processed in a CLIA-certified laboratory and returns physician-reviewed results in days.

Liver and digestiveLiver Function, Comprehensive Liver Function and pancreatic panels covering ALT, AST, Albumin, GGT, Bilirubin, Amylase and Lipase.
KidneyCreatinine, BUN, eGFR and related markers of renal filtration.
MetabolicThree testing tiers covering Glucose, HbA1c, Insulin and Electrolytes.
HeartA full Lipid Panel including LDL, HDL, Triglycerides and ApoB, plus inflammatory markers.
ThyroidTSH, Free T3, Free T4 and Thyroid Antibodies, with or without paired metabolic markers.
AdrenalCortisol and related stress hormones.
Vitamins and methylationVitamin D, Homocysteine, Vitamin B12 and Folate.
Hormones and fertilityFemale and male panels covering Estradiol, Progesterone, FSH, LH, Testosterone and SHBG, plus an ovarian reserve test measuring AMH.
GLP-1 monitoringTwo panels tracking metabolic, liver, kidney and nutrient markers relevant to people taking semaglutide or tirzepatide.

Choose Health expands its catalog in direct response to what customers ask for, with new panels added regularly based on demand. View the full at-home blood testing catalog.

About Choose Health

Choose Health is an Austin, Texas-based health technology company specializing in at-home blood testing for liver and metabolic health, founded in 2018. Choose Health has conducted more than 200,000 tests processed through CAP-accredited and CLIA-certified laboratories, with results reviewed by licensed physicians.

The indices and calculations discussed in this article are not intended to diagnose a medical condition. Individuals with elevated or unexpected results should consult a qualified healthcare professional. This content is for educational purposes only and is not a substitute for medical advice, diagnosis or treatment.

This announcement was distributed on August 28, 2026. View the original press release on PR Newswire.

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