What is normal?

[Veata]

Hi, I was diagnosed with cirrhosis last month and I’ve received my first blood test results from the hospital. They say some are raised, some are normal and some improved but give no indication of what normal should be. Does anyone know what the optimum levels should be for ALT. ALP, AST, bilirubin, albumin, IgA, ferritin and fibroscan score should be?

Thanks

[AyrshireK]

Each lab/hospital sets their own 'normal' range - usually these are printed alongside your actual result. If not then it's possible to look up coomon stated reference ranges on line.

As regards fibroscan it scores from zero to 75 kPa - it depends what the underlying liver disease is as to what any kPa score reflects as regards staging of fibrosis plus it must be noted that if inflammation markers [ALT, AST, ALP] are elevated at the time of the scan it can actually be a falsly high reading in that fibroscan can't tell the difference between actual fibrosis and inflammation.

Katie

Fibroscan score chart for most common underlying liver issues.

[Veata in reply to AyrshireK]

Thanks Katie.

[Cat-B]

If you ask for a print out of your blood results, the normal range is in brackets and the lab * anything that is high or low, some labs even write comments! If you ask your go for a print out they will do it. They are also on your NHS app. Good luck

[Ewife]

We do this, that CAT-B is recommended, but be aware Veata, that these numbers can rise and fall a lot, so doctors would often be looking for a trend rather than specific numbers. Just saying this because I have sometimes got a bit scared looking at my husbands numbers, but his consultant said that, for example, bilirubin can be different if they took it am, then again pm. He has his bloods done every 2 weeks, and I've learnt to tell what his general trend is, so that I know if he starts to improve or deteriorate.

Hope this helps, trying to avoid you some unnecessary panic

Also, my husbands are done every 2 weeks because he is on the transplant list, and initially had deteriorated very fast.Ewife

[kensimmons]

Normal Differs From Lab To Lab

Option one - You probably didn't notice it but "normal range" almost always (99 percent of the time) should be listed on whatever you have been given. Double check, you may have just missed it.

Option two - Get a rough idea. For example go to google whatever thing you want to look up. Google about six or seven different sources, webpages, write down what normal is at that lab. Probably no two labs will use identical "normal" numbers but you will get the idea of an approximate range. If one lab for one value says 10-40 is normal, another says 12-45, another says 16-42 and another says 12-38 you can probably get a rough idea that if you have a score of 31 you are in good shape but if your score is 289 then you have a problem.

Option three - Timesaver - Use this overview (linked below) from the Mayo Clinic in the United States, considered one of the best liver centers in the world. It has been said that if the President of the USA needed a liver or kidney transplant he would be taken here (rumour). Note that the numbers are a little bit more broad than in the UK, that is because UK and much of Europe want there to be 90 percent in the "range of normal" and most USA centers consider 95 percent good enough . It's an old USA docs vs Euro docs argument that has been going on for years.

Mayo Range (you have to scroll down to the bottom)

mayoclinic.org/tests-proced...

Here is another pretty good overview -

pathologytestsexplained.org...

Good luck and keep your chin up, progress is being made every day in the liver illness field!

[Veata]

Thanks to everyone for all the useful advice.

[vinylcollector]

Expect blood test to become a normal and regular thing every few months, they go up and they go down, it's all very vague and they'll sometimes ask for a repeat. I've no idea what mine are? I leave it to them. I think NHS has more of my blood, than I have. The thing is to change what you eat or drink, stay active and conserve energy. keeping warm or cool, is very important. Bowel movements need to be regular. So, the Normal levels, are best left to the medical people, the best thing you can do is make sure they don't go through the roof.