The Sinclair Method and liver function tests

A liver blood test is part of taking naltrexone safely, because the medicine is processed by the liver and, rarely, can nudge liver enzymes. The test is useful for another reason too: heavy drinking itself can affect the liver, and a baseline shows where you are starting from.

A standard liver panel includes:

• ALT (alanine transaminase), released when liver cells are stressed

• AST (aspartate transaminase), similar, also found in muscle

• ALP (alkaline phosphatase), raised when bile flow is blocked

• Bilirubin, the yellow pigment the liver processes, raised in jaundice

• GGT (gamma-glutamyl transferase), a sensitive marker of alcohol's effect

• Albumin, a protein the liver makes, which falls in chronic liver disease

Heavy drinkers often show a raised GGT and a rise in ALT and AST, and these usually improve as drinking comes down. We tell you your numbers and what they mean; nothing is hidden from you.

• A baseline before you start, or a recent result from any provider in the last six months

• A recheck one to three months after starting

• Then occasionally, and yearly if you stay on it long term

However suits you:

• A finger-prick kit posted to your door

• A blood draw at one of our partner laboratories near you, or at our Westfield clinic, from £49

• A free NHS test through your own GP, which we are glad to use; just tell them you are starting a medicine that needs liver monitoring

We accept results from any NHS lab, GP or recognised private lab. Send us a recent one and we will use it, no charge.

Mildly raised enzymes are common in heavy drinkers and usually settle as drinking reduces. We would start you on naltrexone as normal, recheck at one and three months, and the trend almost always improves.

If your enzymes are significantly raised, we might move you to nalmefene, which is processed differently and needs no routine liver monitoring. In the rare case of severe liver impairment, we would not prescribe either and would get a liver specialist's input first.

Not keen on needles, or worried about your liver? Nalmefene works in much the same way and needs no routine liver monitoring at all. For some people that makes it the better choice from the start. Your doctor will talk it through.

The online assessment is quick. A doctor reviews it and, if naltrexone is right for you, prescribes it, dispensed and delivered to your door.

Begin your assessment →