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If you have primary biliary cholangitis (PBC), you know that your liver health can worsen over time, even if you feel fine now. PBC is chronic and progressive, meaning it’s lifelong and can lead to serious complications. The good news is that managing the disease with medication can slow PBC progression and help prevent liver failure.
In the early stages, PBC often has no symptoms. Regular liver health tests can give you an idea of how well your liver is working. You might consider home tests because they’re quick, easy, and private.
In this article, you’ll learn everything you need to know about the benefits of liver testing, how home tests work, and their limitations.
Doctors diagnose and monitor PBC by measuring specific enzymes and antibodies in your blood. They may also use imaging tests to check for liver damage.
Monitoring liver health with PBC is important because it can:
Regular liver health monitoring can help slow the progression of PBC and manage its symptoms. Getting a PBC diagnosis early and tracking its progression can help you delay or avoid the following PBC complications.
Cirrhosis happens when scar tissue replaces healthy liver tissue, causing your liver to lose function. PBC used to be called primary biliary cirrhosis, but the name was misleading — having PBC doesn’t always mean you have cirrhosis.
Liver failure means your liver has shut down entirely and can’t perform important functions like removing toxins from your blood. It’s the final stage of PBC and other liver diseases. Without a liver transplant, liver failure is fatal.
Getting regular liver health tests from your doctor gives the most accurate picture of how well your liver is functioning. Doctors use several types of tests to monitor PBC and check for other related conditions.
Blood tests for liver health measure various substances that come from your liver, like enzymes and antibodies. Their levels can tell you how well your liver is functioning.
To diagnose PBC, doctors use blood tests to measure antibodies such as antimitochondrial antibody (AMA) and levels of specific liver enzymes such as alkaline phosphatase.
About 5 percent of people with PBC test negative for AMA in blood tests but still have other signs of PBC. In these cases, doctors perform a liver biopsy (removing a small tissue sample with a needle) to confirm the diagnosis.
To track PBC progression, doctors may use the enhanced liver fibrosis (ELF) test. It measures three markers of liver scarring: hyaluronic acid (HA), type III procollagen peptide (PIIINP), and tissue inhibitor of metalloproteinase (TIMP-1).
Regular blood work for PBC might also check:
Imaging tests like ultrasound and magnetic resonance imaging (MRI) let your doctor see your liver without surgery. These painless procedures help monitor your liver health.
An abdominal ultrasound creates images using sound waves that bounce off your liver tissue. This test allows your doctor to look at your liver and its blood vessels while diagnosing or monitoring PBC.
Liver stiffness tests (also called FibroScan or liver fibrosis tests) show how much scarring is on your liver. Like ultrasound imaging, liver fibrosis tests bounce sound waves off your liver to create a picture of your liver.
One MyPBCTeam member shared, “My doctor believes a FibroScan gives more information than a biopsy because more area of the liver can be checked, and it is noninvasive.”
A bone scan or DXA scan is a type of X-ray imaging test that shows if your bones are getting thinner. Since about half of people with PBC experience bone loss, doctors typically recommend bone scans once every 2 to 3 years.
As PBC progresses, you’ll need more frequent blood tests and ultrasounds. Your doctor might recommend other blood tests to see how well you can absorb vitamins from food.
You might wonder if home liver tests can save you time and expenses by allowing you to visit the doctor less often. At this time, no home imaging tests exist, but you can buy liver blood testing kits online.
Like the tests you get at the doctor’s office, home liver function tests analyze blood samples to evaluate the levels of enzymes, proteins, and bilirubin in your blood. This includes chemicals used to measure PBC progression, like AMA and alkaline phosphatase. Some home liver tests use urine samples, but they can’t gather as much information and are usually less reliable than blood tests.
Home liver tests include detailed instructions for collecting and handling your sample. Usually, collecting a blood sample involves pricking your finger with a sharp, sterile device called a lancet, which would be included in the kit.
Depending on the specific testing kit and what it measures, you may receive immediate results or need to mail your sample to a lab for analysis. Many tests also require you to provide basic information about your health so that a medical team can review your results.
Home liver tests typically label results as either “normal” or “outside of the normal range.” If your results are outside of a normal range, you should follow up with your doctor for more comprehensive testing.
While some home test companies offer professional interpretation of your test results, their assessment might be limited. They might not have all the information they need to diagnose PBC or know if it’s getting worse.
While home liver health tests may offer convenience and quick results, they have important limitations. These tests can give you a basic snapshot of your liver function, but the information isn’t as thorough or accurate as professional medical testing.
The accuracy of home liver tests can vary between companies. Even with reputable brands, it’s hard to say whether a home test will be reliable. These tests can be costly and, based on their limitations, may not be worth the investment.
Sometimes, home liver tests don’t pick up on problems with your liver health and give you false reassurance (false negative). In other cases, home tests indicate a problem when there isn’t one (false positive), which can cause unnecessary worry.
Although blood tests given at the doctor’s office can give you a better idea of your liver function, members of MyPBCTeam have shared experiences that highlight the limitations of blood tests. “Personally, I’d believe a liver biopsy and liver doctor over a blood test,” one member said.
Another shared, “They did a liver biopsy that was positive. My blood work didn't become positive for several more years.”
Never rely on home tests alone for monitoring PBC. PBC is a complex autoimmune disease that requires careful, expert management to monitor progression and prevent complications.
Work with your hepatologist or gastroenterologist for ongoing PBC management and monitoring. These specialists can monitor your liver function with tests in their office and explain your results in detail. They can help you manage your PBC based on your test results and avoid complications. When test results are unclear, they can order additional tests to make sure your liver health information is complete, accurate, and up-to-date.
MyPBCTeam is the social network for people with primary biliary cholangitis and their loved ones. On MyPBCTeam, members come together to ask questions, give advice, and share their stories with others who understand life with primary biliary cholangitis.
Have you used home tests to monitor your liver health? How has home monitoring helped you manage PBC? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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