Cirrhosis-Exams and Tests Your doctor will do a physical exam and ask about your medical history to see if you have symptoms of liver disease and to help find out possible causes of liver damage.

If your doctor thinks you may have cirrhosis, you may have blood and imaging tests. You also may have a liver biopsy. This test can show for sure if you have cirrhosis.

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Blood tests to check liver function

Measuring the levels of certain chemicals produced by the liver can show how well your liver is working. Blood tests may be used to measure:

• Albumin and total serum protein. Albumin is a type of protein. Liver disease can cause a decrease in protein levels in the blood.
• Partial thromboplastin time or prothrombin time/INR. These tests measure blood-clotting factors that are produced in the liver.
• Bilirubin. This is produced when the liver breaks down hemoglobin, the oxygen-carrying substance in red blood cells. Cirrhosis may cause high bilirubin levels, which causes jaundice.

Blood tests to check for inflammation of the liver

You may have blood tests to check your liver enzymes. These can help show whether you have had liver inflammation for a long time. These blood tests include:

• Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH). An increased level of these enzymes may mean injury to the liver and the death of liver cells.
• Alkaline phosphatase (ALP). An increased ALP level may mean blockage of bile ducts.
• Gamma-glutamyl transpeptidase (GGT). An increased level can happen because of alcohol use or diseases of the bile ducts.

Some people with cirrhosis have normal liver enzymes.

Blood tests to diagnose a cause of cirrhosis

Tests to check for conditions that may cause cirrhosis include:

• Antinuclear antibodies (ANA). ANA testing and anti-smooth-muscle antibody (ASMA) testing may help find autoimmune chronic hepatitis.
• Antimitochondrial antibody test (AMA), which may help find primary biliary cirrhosis.
• Ferritin and iron tests. These may help diagnose iron overload, or hemochromatosis.
• Tests for hepatitis B and hepatitis C or tests for infection with hepatitis viruses. These tests may help diagnose infection with certain hepatitis viruses.
• Blood alcohol level (BAL) tests. These tests may show alcohol use, which can cause alcoholic cirrhosis.
• Serum ceruloplasmin testing, which may help diagnose Wilson's disease.
• Alpha1-antitrypsin level. This may diagnose a condition in which people lack this protein (alpha1-antitrypsin deficiency).

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