Episode 158

Understanding the Intricacies of LFTs in Clinical Practice with Dr Chanika Ariyawansa

In this episode of The Good GP, hosts Dr Sean Stevens and Dr Tim Koh are joined by Dr Chanika Ariyawansa, a WA-trained chemical pathologist with additional training in genetic pathology. Dr Ariyawansa, who holds significant roles in the Australian Association of Clinical Biochemistry, delves into the nuances of liver function tests (LFTs), exploring patterns and implications of abnormal results.

Firstly, with an examination of the prevalence and general patterns of abnormal LFTs, highlighting the commonality of mild and transient abnormalities. Dr Ariyawansa clarifies common misconceptions regarding LFTs, emphasising that not all markers in the standard LFT panel are liver-specific or directly assess liver function.

They also explain in detail individual LFT components such as bilirubin, ALP, GGT, AST, and ALT. The guest expert also categorises potential abnormalities into hepatocellular, cholestatic, mixed, and non-hepatic causes, with practical insights on each. Special attention is given to non-hepatic causes, analytical causes, and how these might influence LFT interpretation.


Dr Ariyawansa's expertise shines as she discusses managing patient anxiety around abnormal LFT results and the practical aspects of educating patients about their liver health. She stresses the utility of resources such as the Pathology Tests Explained website for patient education.


Wrapping up with an engaging Q&A session addressing specific scenarios like non-drinking patients with isolated raised GGT and the impact of statins on LFTs. She answers with clinical relevance, offering listeners practical strategies for understanding and communicating complex test results in their practice.


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If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com.

About the Podcast

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The Good GP
The Good GP, the education podcast for busy GPs

About your hosts

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Tim Koh

Dr. Tim Koh is a General Practitioner and practice owner based in Perth, Australia, with over 20 years of experience. Throughout his career, Tim has been continuously involved in GP education and teaching GP registrars. As the host of The Good GP podcast, Tim provides expert insights and practical advice for GPs and other health professionals. Passionate about evidence-based medicine and teaching in general practice, Tim addresses a wide range of topics relevant to primary care, keeping listeners informed about the latest issues affecting the field.
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Krystyna de Lange

Dr Krystyna de Lange is co-host of The Good GP and dedicated General Practitioner with nine years of experience in primary care in Australia. Passionate about the full spectrum of medicine, she thrives on the opportunity to support her patients’ diverse health needs. She has a specific interest in the areas of Aboriginal and Torres Strait Islander health, womens health and chronic disease management.

Since joining The Good GP podcast team in 2019, her goal has been to empower fellow practitioners with the latest insights, best practices, and valuable discussions on essential health topics. With her approachable style and deep commitment to community health, she fosters an engaging environment that encourages learning and collaboration.
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Sean Stevens

Dr Sean Stevens, a seasoned General Practitioner with 27 years of experience, is a pioneer in medical education and podcasting. As one of the founding voices of The Good GP Podcast since 2016, he has personally contributed to over 60 episodes of their 170+ episode catalogue, sharing invaluable insights with the medical community. Recognised as Australian GP Supervisor of the Year, Sean combines his passion for education with a commitment to embracing new technologies. He is dedicated to empowering fellow GPs and promoting quality care in general practice.