Liver enzymes, proteins and the FIB-4 scarring score. 7 markers, each with the guideline behind it, the ranges, what can affect it, what Passion Health does if it's out of range and when to retest.
Medically reviewed by Anantha Chentha, MD, Co-Founder and Chief Quality Medical Officer · October 30, 2026. Meet our cliniciansNext review: October 2027
Liver enzymes, proteins and the FIB-4 scarring score.
Liver enzyme that rises with liver inflammation, including fatty liver.
Why it matters: Used in the FIB-4 score.
Ranges: Your lab's range applies.
What can affect it: Fatty liver, alcohol, medicines, hepatitis and hard exercise.
If it’s out of range: Persistently high results get a cause work-up.
When to retest: In 3–6 months if mildly high.
Condition guide: Fatty liver care online
Enzyme from the liver and muscles.
Why it matters: Used in the FIB-4 score.
Ranges: Your lab's range applies.
What can affect it: Liver conditions, alcohol and muscle injury.
If it’s out of range: Read with ALT and FIB-4.
When to retest: With ALT.
Condition guide: Fatty liver care online
Enzyme from the liver and bones.
Why it matters: Part of the metabolic panel.
Ranges: Your lab's range applies.
What can affect it: Bile-duct conditions, bone growth or disease, pregnancy.
If it’s out of range: A high value is followed up with other liver or bone tests.
When to retest: As your clinician advises.
Breakdown product of red cells.
Why it matters: Mild isolated rises are often harmless (Gilbert syndrome).
Ranges: Your lab's range applies.
What can affect it: Fasting, red-cell breakdown and liver conditions.
If it’s out of range: Persistent rises are evaluated.
When to retest: As your clinician advises.
The main blood protein, made by the liver.
Why it matters: Reflects nutrition and liver function.
Ranges: Your lab's range applies.
What can affect it: Nutrition, liver and kidney conditions, inflammation.
If it’s out of range: Low values prompt a look at nutrition, liver and kidneys.
When to retest: As your clinician advises.
All proteins in the blood.
Why it matters: Part of the metabolic panel.
Ranges: Your lab's range applies.
What can affect it: Hydration, nutrition and immune conditions.
If it’s out of range: Read with albumin.
When to retest: With your metabolic panel.
Liver scarring risk from your age, AST, ALT and platelets.
Why it matters: The AASLD 2023 practice guidance uses FIB-4 as the first step to find liver scarring from fatty liver.
Ranges: Below 1.3 is low risk; 1.3 or higher calls for a liver stiffness scan.
What can affect it: Age and the inputs above.
If it’s out of range: A score of 1.3 or higher leads to a FibroScan at our North Texas clinics or a partner site.
When to retest: Every 1–3 years with metabolic risk.
Condition guide: Fatty liver care online
Education only. Your clinician interprets results with your history. Reference ranges vary by lab; your report shows ours.