Your liver tests came back normal. That doesn’t mean your liver is fine.
Standard liver panels measure enzymes that only rise significantly when damage is already occurring. Fatty liver, early fibrosis, and metabolic stress can all be present while your ALT and AST look “normal.”
Does this sound familiar?
You drink socially. Your tests are always “fine.” But you wonder.
- You drink at networking events, client dinners, or after work — not excessively, but regularly — and your liver panel has always come back within normal limits
- You’ve had an elevated GGT flagged once and were told “it’s nothing to worry about” without further explanation
- You know fatty liver is common in Singapore and you want to know whether you have it — before it becomes a problem
You’re asking the right question. A “normal” liver panel does not rule out fatty liver, early fibrosis, or metabolic stress on the liver. It just means cell damage hasn’t reached the threshold that standard lab ranges are designed to catch.
What standard liver panels miss
ALT and AST are late signals. By the time they rise, the liver is already under stress.
A standard liver panel — included in most health screens in Singapore, including Screen for Life — measures liver enzymes (ALT, AST, GGT), albumin, and bilirubin. These are useful markers. But they have a critical limitation.
ALT and AST measure liver cell damage — enzymes that leak into the blood when hepatocytes (liver cells) are injured. They can remain within normal limits even when 20–30% of the liver is fatty. GGT is more sensitive to alcohol — it is essentially a biological dosimeter for regular drinking — but standard lab reports rarely explain what a trending GGT actually means in the context of your drinking pattern.
“A normal liver panel means your liver cells aren’t leaking enzymes at a detectable rate. It does not mean your liver is free of fat, inflammation, or early scarring.”
What standard panels do not assess: whether fibrosis is developing (FIB-4, calculated from your existing blood results, has a 90% negative predictive value for ruling out advanced fibrosis — yet is almost never calculated on a standard report), or whether insulin resistance is driving metabolic stress on the liver (HOMA-IR). Imaging — FibroScan or ultrasound — can add further clarity where clinically appropriate. These are the markers that tell you where your liver is heading — not just where it is today.
The Liver Composite Score
Four dimensions of liver health. Assessed together, not in isolation.
AMG’s Liver Composite Score evaluates your liver across multiple dimensions — because no single marker tells the complete story. Individual numbers in isolation can be reassuring when the overall picture is not.
Cell damage and synthetic function. GGT is the most alcohol-sensitive — essentially a measure of how hard your liver is working to process what you’re putting through it. The AST:ALT ratio adds further diagnostic signal.
Is scarring developing? FIB-4 is calculated from your standard blood results — no imaging required — and has a 90% negative predictive value for ruling out advanced fibrosis. Available at every AMG clinic.
What is driving fatty liver? Insulin resistance (HOMA-IR) is the primary metabolic cause of non-alcoholic fatty liver disease — now called MASLD. Ferritin reflects iron-related liver stress. Both are modifiable.
Liver stiffness measurement (FibroScan) and body composition imaging (DEXA) add further precision to the Composite Score. Available at selected AMG clinics. Your doctor will advise which clinic and assessment is most appropriate for your history.
The Liver Composite Score combines blood markers with imaging where clinically available. Your doctor will advise which clinic and assessment is most appropriate for your history.
Deep dive coming soon: What Your Liver Panel Is Actually Telling You
The good news
Fatty liver is reversible in early stages. Reduced alcohol intake, improved diet, regular exercise, and targeted weight loss can reverse hepatic steatosis before it progresses to fibrosis. The window for easy reversal is wide — but it requires knowing the problem exists. That is what screening is for. Not to scare you. To give you the information you need to make a change while the change is still straightforward.
The Advantage VITAL Longevity Screen
Two options. One recommendation for you.
AMG offers both standard health screening and the VITAL Longevity Screen. For patients who want a comprehensive liver assessment alongside their cardiovascular, metabolic, and physical function markers, we recommend the VITAL Screen — because the blood markers that form the Liver Composite Score are already included.
- Full liver panel — ALT, AST, GGT, albumin, bilirubin, with AST:ALT ratio calculated
- FIB-4 fibrosis score — calculated automatically from your blood results (no imaging needed)
- HOMA-IR + fasting insulin — the metabolic driver behind most fatty liver
- Ferritin — iron-related liver stress marker
- Liver imaging — FibroScan, DEXA, or ultrasound available at selected clinics as an addition
- ApoB + Lp(a) + hsCRP — cardiovascular risk markers assessed alongside liver health
- 60-minute physician consultation — your Liver Composite Score explained in context
Your liver result is reviewed in context — alongside your metabolic markers, your alcohol history, and your full clinical picture. Not just a number on a page.
You leave with a written Now / Next / Later priority plan. And you see the same doctor every time.
Pricing
Both tiers include every VITAL blood marker — including the liver markers that form the Composite Score — plus your full consultation.
- 70+ biomarkers across all 5 VITAL pillars
- Full liver panel + FIB-4 + HOMA-IR + ferritin
- Liver Composite Score (blood markers included; imaging at selected clinics)
- 60-minute physician consultation
- Everything in Core
- Lucense 6-marker multi-cancer blood test
- Screens for early signals of 6 cancer types
- Same visit — no extra appointment
Standard health screening
Not ready for the VITAL Screen?
AMG also offers standard health screening packages — a good starting point for general health.
- Core blood panel, lipid profile & HbA1c
- Kidney, liver & hepatitis screen
- Full blood count & iron studies
- Thyroid (TSH, FT4) & HSCRP
- 6 cancer markers (gender-specific)
- Everything in Foundation
- Apolipoprotein A, B & ApoB/A1 ratio
- Hs-troponin
- Vitamin B12 & folate
- Helicobactor & stool occult blood
- Everything in Dynamic
- ECG
- Ultrasound scans (abdomen + prostate / breast + pelvis)
- Hormone panel (testosterone / female hormones)
- HPV Pap smear (women)
All packages include basic liver enzymes (ALT, AST, GGT). For a comprehensive liver assessment including fibrosis risk and metabolic drivers, ask your doctor about the VITAL Screen.
Frequently Asked Questions
Your liver doesn’t send warning signs until it’s too late to easily fix.
The Liver Composite Score gives you the picture that a standard panel cannot — enzymes, fibrosis risk, metabolic drivers, and imaging, interpreted together by a doctor who knows your history.
Find the right screen for you.
Upload accepts most report formats — PDF, scans, photos. Or WhatsApp us directly →
Pilot programme. If the assistant ever falls short, you’ll be routed to our clinical team. You can also book a consultation with a doctor before committing to a screen.
Read more: Longevity Medicine in Singapore — From Research to Practical Screening →
Educational content. Not medical advice.