Testing, One, Two: The Most Common Tests for NAFLD
Here’s a piece of irony, but one which most of us have experienced: fear of medical tests can actually keep us from going to the doctor in the first place.
Unfortunately, when we delay tests we really should have, our condition could be slowly progressing without or even knowing. So seeing your doctor is crucial if you suspect a condition, such as non-alcoholic fatty liver disease (NAFLD).
Don’t be afraid and don’t envision invasive, painful testing: today’s NAFLD diagnosis can be obtained in a number of ways, and your physician will probably be more than willing to work with you to find the ones that will be the most effective and that won’t scare you right off the table. Here is a list of the most common tests for NAFLD.
Though they are not definitive, certain blood tests called liver function tests can give doctors a clue as to the possibility of NAFLD. Many physicians start here in order to determine whether or not further testing is necessary, or the tests in conjunction with symptoms may deliver an official diagnosis.
Liver function tests measure enzymes that could point to issues with the liver and may include:
- ALT (alanine transaminase): an enzyme involved in the processing of proteins
- AST (aspartate aminotransferase): found within liver cells; an elevated level could have a number of causes including but not exclusive to NAFLD
- ALP (alkaline phosphotase): inappropriate levels could point to liver or bone disease, or malnutrition
- Bilirubin: bilirubin gives bile its yellow-green color. Raised levels of different constituents of bilirubin could point to a liver issue
Other tests, such as protein levels and serum albumin, can give your doctor clues as to the health of your liver and, along with other evidence, reveal an NAFLD condition.
Ultrasound is a highly preferred and potentially very revealing test for NAFLD, as it literally looks at an image of your liver and is non-invasive (it takes place on the outside of the body).
In order to receive your ultrasound, you will be asked to lie back. A conductor gel will be placed on your abdomen in the area of your liver and a wand or probe placed against the skin. An image of your liver will come up on the technician’s screen. By moving the wand around, the technician will be able to get views of your liver from various angles.
Fat will look different from muscle and bone on the ultrasound scan and in this way will be roughly measurable when your physician looks over the results of your scan. Greater than 5% fat is considered an NAFLD condition. Ultrasounds are not 100% reliable as they are not a literal look inside your abdomen, but they can give your doctor a much better idea of how your liver looks and whether or not excess fat appears to be accumulating.
CT or MRI scan
These scans are like three-dimensional x-rays in that they can “look into” what’s happening to your body without cutting or probing. Unlike ultrasound, they do not involve a wand or probe. You will lie down and a scanning device will be passed over your body, or you will lie down and enter a tube (MRI) in order for a full three-dimensional series of images to be taken of the area.
If you are claustrophobic or just worried about the idea of the MRI tube (which doesn’t hurt but can feel confining), tell your doctor. In some cases, a doctor can prescribe a light tranquilizer or relaxant to make the experience more pleasant for you.
It’s likely your doctor will start out with ultrasound and/or blood tests before proceeding to a procedure such as an MRI, which is usually reserved for cases where other results were unclear and a more detailed look is in order.
Don’t be afraid of this word – a biopsy is not usually ordered for NAFLD alone. Rather, it will be ordered by your doctor if additional conditions(s) are suspected.
However, if you do eventually receive a liver biopsy, know that these are less invasive than ever, with smaller incisions, a faster recovery time, and usually, an outpatient basis (you go home the same day).
Don’t dread your liver tests. See your doctor and speak to her about your concerns – including any fears you may have of specific tests. She will set your fears to rest, suggest alternatives and together, you can come up with a plan to detect, and treat, any issues you may have.