AST (Aspartate Transaminase)

An enzyme found in your liver as well as your heart and muscles. On its own, AST is less specific, but compared with ALT it tells a story. In fatty liver disease, ALT is usually higher. When AST climbs to twice ALT or more, it often points to alcohol-related liver damage or more advanced scarring.

ALT (Alanine Aminotransferase)

The most liver-specific enzyme on this panel. ALT lives inside your liver cells and leaks into your blood when those cells are inflamed or damaged. It's usually the first marker to rise in fatty liver disease, which affects about 1 in 3 American adults, most of whom don't know it.

GGT (Gamma Glutamyl Transferase)

An enzyme on the surface of your liver and bile duct cells, and one of the most sensitive markers of alcohol's impact on your liver. GGT rises with regular drinking and usually falls within weeks of cutting back. It also flags bile flow problems and helps your liver recycle glutathione, its main antioxidant.

Albumin

The main protein in your blood, made only by your liver. Enzymes show whether your liver is damaged; albumin shows whether it's still doing its job. Because albumin lasts about three weeks in your blood, low levels reflect a longer-term problem with how your liver builds proteins.

Total Bilirubin

A yellow pigment from old red blood cells that your liver processes and clears into bile. When your liver or bile ducts aren't working well, bilirubin builds up and can cause yellowing of the skin and eyes. Mildly high levels are often due to Gilbert's syndrome, a common and harmless condition.

Fasting Insulin

The hormone that tells your liver to store sugar. When insulin runs high, it also tells your liver to turn excess sugar into fat, a major driver of fatty liver disease. Insulin often rises years before blood sugar does, making it one of the earliest warning signs.

Fasting Glucose

Your blood sugar after an overnight fast, which largely comes from your liver. A healthy liver slows its sugar release overnight. An insulin-resistant liver keeps pumping sugar into your blood, so high fasting glucose is a direct sign of how your liver is handling sugar.

Average Blood Sugars (HBA1C)

Your average blood sugar over the last 2 to 3 months. High blood sugar and fatty liver feed each other: sugar gets stored as liver fat, and liver fat makes blood sugar harder to control. Most people with type 2 diabetes also have fatty liver.

Lipid Profile

Your triglycerides, HDL, and LDL, all made or processed by your liver. A fatty liver overproduces triglycerides, so high triglycerides with low HDL is one of the most common patterns in people with fatty liver disease, often before liver enzymes rise.

Apolipoprotein B (ApoB)

A direct count of the cholesterol particles that build up in your arteries. A fatty liver releases more of these particles, which is why heart disease, not liver failure, is the leading cause of death in people with fatty liver disease. ApoB is a more precise risk marker than LDL alone.

Apolipoprotein A1 (ApoA1)

The main protein in HDL, made largely by your liver. ApoA1 helps carry excess cholesterol out of your arteries and back to your liver to be cleared. Comparing ApoB with ApoA1 gives one of the strongest predictors of heart disease risk.

Ferritin

Your body's iron storage protein, mostly stored in your liver. High ferritin can mean iron overload, but it also rises with liver inflammation and fatty liver. That's why it's measured alongside TSAT, which helps tell the two apart.

Iron

The amount of iron circulating in your blood right now. Your liver stores and regulates your body's iron, and excess iron damages liver cells over time. Serum iron varies throughout the day, so it's most meaningful read alongside ferritin, UIBC, and TSAT.

TSAT (Transferrin Saturation)

The percentage of your iron-transport protein that's carrying iron, and the best early screen for hemochromatosis. This inherited iron overload condition affects about 1 in 300 white Americans and can silently scar the liver for years before causing symptoms.

UIBC (Unsaturated Iron-Binding Capacity)

How much room your blood has left to carry more iron. Low UIBC means your iron-carrying proteins are already close to full, which can be an early sign of iron overload before it starts building up in your liver.