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Liver disease refers to any disease or disorder that causes the liver to stop functioning as it should, examples of liver disease are cirrhosis . and hepatitis. For more information on the liver click here.
This liver test detects abnormal levels of bilirubin and urobilinogen in urine, raised levels can indicate liver disease. It is recommended that you take this test if you are feeling generally unwell or are experiencing any of the following:
Because of its strategic location and multidimensional functions, the liver is prone to many diseases such as hepatitis A, B, C, E, alcohol damage, fatty liver and cirrhosis. There are over one hundred types of liver disease and they affect over two million people in the UK. This figure may only be the tip of an iceberg as many cases of liver disease remain undiagnosed. This is because your liver is very resourceful and able to work well enough even when it may be damaged. This means that you may often not ‘present’ with clear symptoms, or show obvious sign of liver disease or illness.
This simple home screening test can help to identify if there is a problem by checking for Bilirubin and Urobilinogen levels in your urine.
How accurate is this test?
This test has proven 98% accurte in laboratory testing.
INTRODUCTION:
The liver is the largest glandular organ of the body. It weighs about 3 lb (1.36 kg). It is reddish brown in color and is divided into four lobes of unequal
size and shape. The liver lies on the right side of the abdominal cavity below the diaphragm (a muscular partition separating the chest and abdominal
cavities).
Having a problem with your liver, may cause one or more of the following symptoms:
Table 1
Symptom 1: Yellowing of the skin and the whites of the eyes. A condition
called Jaundice. Symptom 2: Pain in the right upper abdomen accompanied by pain in
the back Symptom 3: Abdominal swelling Symptom 4: Weakness and loss of muscle mass Symptom 5: Light color of feces and/or dark color of urine
The above are the first signs of a liver problem. Jaundice is considered as the most important
among them.
Jaundice is caused when excess amount of a compound called bilirubin dissolves in the fat layer
under the skin. Bilirubin is a compound that is formed due to the breakdown of Red Blood Cells.
It will be carried to the liver by blood vessels and then to the intestines by means of a small duct
connecting the liver with the intestine. This duct is called bile duct. Bilirubin can also be stored in
the gall bladder which is a very small sac-like organ extending out of the bile duct.
In the intestine, bilirubin can be converted to a compound called Urobilinogen by the act of
intestinal bacteria. A small percentage of this compound can be reabsorbed to the blood stream.
Increased levels of urobilinogen and/or bilirubin in blood will lead to its appearance in urine.
Conditions that may increase urobilinogen and/or bilirubin concentration(s) in blood are:
Table 2
Condition 1: Excessive breakdown of Red Blood Cells. This is common in newborns “Jaundice in newborns” Condition 2: Obstruction of bilary tract which is associated with gallstones, tumors or liver inflammation which will restrict the
movement of bilirubin to the intestine in its way out of the body. Condition 3: Liver diseases including Hepatitis infection, liver cancer and cirrhosis (a chronic disease that causes the scarring
of liver and interferes with the normal functionality of the liver. The major cause is chronic alcoholism).
By means of testing the presence of bilirubin and/or urobilinogen in your urine, which will reflect their concentrations in blood, you will be able to monitor
the health status of your liver.
INTENDED USE:
Atlas Liver Function Test provides a dip-and-read test strips that are intended for use to check for Bilirubin and Urobilinogen in urine specimens as an
aid in the diagnosis of Liver and gall bladder problems. The test provides results by the visual comparison with color chart printed on the pack.
KIT COMPONENTS:
1. Test strips individually pouched.
2. Package Insert.
STORAGE:
Store at room temperature between 15º-30º(59°F-86°F). Do not store the strips in the refrigerator or freezer.
Since the test strips are sensitive to specific environmental factors, such as moisture, heat and light, do not expose strips to these factors.
Use the strip immediately after removing it from the pouch.
SPECIMEN COLLECTION AND PREPARATION:
• Collect fresh urine sample in a clean and dry disposable container. The container has to be devoid of any detergent traces. Test the urine as
soon as possible after collection.
PROCEDURE:
This procedure MUST BE FOLLOWED EXACTLY to achieve reliable test results.
1. Check that the product is within the expiration date shown on the kit pack.
2. Prepare the urine specimen.
3. Remove the strip from the pouch. Familiarize yourself with the position of the reaction area of Bilirubin and Urobilinogens. Beige
reaction area is for bilirubin while yellow reaction area is for Urobilinogens. Also, familiarize yourself with the color chart on the pack
4. Dip the test strip in the urine until the reaction areas are completely immersed for no more than 1 second.
5. Remove the dipstick from the urine and tap the strip on the rim of the cup to remove excess urine and place it horizontally with the
reaction areas facing up.
6. Leave the strip for 30-60 seconds for the reaction to take place.
7. Read the results by comparing the colors of the reaction on the strip with those of the chart. While comparing, keep the strip in a
horizontal position to avoid possible mix of colors between the reaction areas on the strip.
8. Identify the best match color on the color chart and the correspondent concentration range. A change in color that appears only
along the edges of the reaction areas indicates that the reaction did not take place properly so we recommend redoing the test with
another strip. Results read after 60 seconds are not valid.
RESULTS:
The results are obtained by direct comparison of test strip with the color chart printed on the pack. See the table below for interpretation of the results.
HOW TO DETRMINE POSITIVE OR NAGTIVE VALUES:
Any color other than the color indicating negative result is considered positive. Refer to the results table below to see the clarifications of the obtained
result.
Bilirubin Result
Positive
Negative
Urobilinogen Result
Positive
You probably have one of the conditions mentioned in table 2.
By means of this test you will not be able to distinguish between
these conditions and so you are advised to seek medical advice
as soon as possible.
Normal urine specimens ordinarily give a light tan or slight pink
color. This should be considered normal.
Having high concentrations of Urobilinogen while bilirubin is
negative is a highly unlikely result. You are advised to repeat the
test using fresh urine sample and a new strip.
If the result is still the same, you are advised to test for Bilirubin and
Urobilinogen in a clinical lab to confirm the results.
Negative
Your probably have condition 2 in table 2 and particularly, the
cause will be the presence of stones in the bile tract. While
other conditions such as tumors and inflammation can cause
bilary tract obstruction, these conditions will also cause the
increase in bilirubin concentration too and therefore such
conditions can be excluded. Anyway, you are advised to seek
medical advice soon.
Normal.
You probably have no problem with your liver.
If you are still having any of the symptoms mentioned in table one
other than symptom 1, you are probably having a problem not
related to liver.
If Jaundice is appearing, repeat the test using new fresh sample and
new strip. If the result is still negative, seek medical advice soon.
LIMITATIONS OF THE TEST:
Substances that cause abnormal urine color, such as some drugs may affect the color development on the strip. The color development on the reagent
pad may be masked, or a color reaction may be produced on the pad that could be interpreted visually as a false positive. It is therefore recommended
that in case of doubt, the test should be repeated after stopping the medication.
Bilirubin: Since the bilirubin in specimens is sensitive to light, exposure of the urine specimens to light for a long period of time may result in a false
negative.
Ascorbic acid concentration of 25-50mg/dl may also cause false negatives. Even trace amounts of bilirubin are sufficiently abnormal to require further
investigation. False positive results may be obtained in the presence of diagnostic or therapeutic dyes in the test urine.
Urobilinogen: the strip cannot demonstrate a complete absence of Urobilinogen in the speci
PRECAUTIONS & WARNINGS:
Please read all the information in this leaflet before performing the test.
Do not use the test after the expiration date.
If the package is not completely sealed do not use the test.
Bilirubin Reaction Area (Beige)
Urobilinogens Reaction Area (Yellow) Test Strip
Do not open the test foil pouch until it has reached room temperature and you are ready to start the test.
The test should be performed in a well-lit area.
Use the test device immediately after opening it.
Do not touch the test area. This could affect results and may also impose personal hazards.
Use a disposable sample container to be discarded after performing the test.
The pouch contains a Silica Gel pack to absorb humidity. Do not open the pack. Throw it away with the remaining of the test.
Do not freeze.
At the end of the test, wrap every thing you have used in a plastic bag and throw away in the pin. Do not forget to wash your hands
properly.
The remaining sample should be discarded and flushed in the toilet.
Keep out of the reach of children.
For in vitro diagnostic and self-testing use. Not to be taken internally.
How do I read the test result?
The test results are easily read by comparing the colour of the test result against the colours shown on the box. The higher the level of Bilirubin and or Urobilinogen the darker the test result will become. The image below indicates the range of results possible:
QUESTIONS AND ANSWERES:
Q: If the colors of the reaction areas on the test strip are different than what they should be, what shall I do?
A: In such case you are advised not to use this strip since it will not give accurate results. You have to use a new strip. If the same problem is seen,
contact your local distributor.
Q: If results are read after more than one minute, are the results still reliable?
A: Best results are obtained at 60 seconds (1min.), if this time is exceeded, the results will not remain the same and may lead to false readings.
Q: At what time of the day the test should be performed?
A: This test can be done any time of the day. Try to minimize liquid uptake one hour before doing the test.
Q: Why should I use fresh sample for this test?
A: Bilirubin and Urobilinogen are sensitive to light and can be decomposed if left for long time. Accordingly, results may not reflect the actual concentration of these two compounds in the urine sample since they would have been partly decomposed.
Q: Is there any indication of urine color?
A: Presence of bilirubin in urine will make the color of urine quite dark. In this case the color is almost brownish orange. Other compounds and some
kinds of food may cause urine coloration. So, urine color should not be used as a sole criteria for testing bilirubin.
Q: What is hepatitis?
A: Hepatitis is an inflammation in the liver that can be caused by infections with various organisms including bacteria and viruses (Hepatitis A, B, C...etc.)
or parasites. Chemical toxins such as alcohol, drugs, and poisonous mushrooms can also damage the liver and cause it to become inflamed.
Q: What is “Bilary Tract Obstruction”?
A: Bilary tract obstruction involves the blockage of any duct that carries bile (Bilirubin and other salts) from the liver to the gallbladder or from the
gallbladder to the small intestine. This may be caused by bilary stones, tumor in the liver or inflammation of the liver. Jaundice and pain in the upper right
abdomen that is accompanied with a pain in the back are the most important symptoms of such condition.
Questions about liver disease
1. What is liver disease?
The term applies to many diseases and disorders that cause the liver to function improperly or cease functioning. An example of such a condition is hepatitis. For more information on the liver and diseases associated with it click here.
2. What are the typical symptoms of liver disease?
There are no obvious symptoms that indicate the initial onset of liver disease. Some people may feel like they have a cold or upset stomach. In combination,
fatigue, apocleisis (lack of appetite) and a yellowing of the skin and eyes can indicate a serious inflammation of the liver. If hepatitis is not cured, it can degenerate into chronic hepatitis, then into cirrhosis and possibly liver cancer.
3. How can I prevent developing liver disease?
a. Your diet should be balanced and nutritious. Eat plenty of vegetables, fruit, and food with rich albumen, while limiting the consumption of fats.
b. Limit your intake of foods containing aflatoxin, such as the fermented products of peanuts and beans, because aflatoxin is a known cause of liver cancer.
c. Limit your intake of alcohol.
d.Limit your intake of so-called‘patent medicines’; medicines or formations where the ingredients are unclear.
e. Get regular and adequate sleep.
f . In addition to an annual health checkup by a doctor, those who are unable to maintain a lifestyle according to the above advice should check the health of
their livers on a regular basis using the Quickcheck Liver Function Test.
g. Those who do not carry the hepatitis B antibody should be injected with the hepatitis B vaccine to avoid getting this disease. Check with your doctor.
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