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Liver fibrosis tests (FIB-4)

Also called: FIB-4, Liver scarring score, ELF test, FibroScan

FIB-4 is a score calculated from routine blood tests and age. It estimates the chance of liver scarring, especially in fatty liver disease.

SampleA small tube of blood from a vein in your arm
Fasting?Usually not needed
ResultsSame as routine labs
Good to knowOne result rarely tells the whole story. Your provider looks at your results together with your symptoms, exam, and other tests.

What the test is

A high or unclear score is usually followed by an elastography scan (like FibroScan).

Why it's done

  • Fatty liver, diabetes, or obesity
  • Hepatitis B or C
  • Abnormal liver tests

Getting ready and what happens

  • None beyond routine blood tests.

How the test is done

  • Calculated from AST, ALT, platelets, and age.

What the results mean

ResultTypical range for adults
Low risk of advanced scarringFIB-4 below 1.3
Unclear1.3 to 2.67
Higher riskAbove 2.67

Normal ranges vary from lab to lab and can differ by age, sex, and pregnancy. Your report lists your lab's own range next to each result. A result a little outside the range is often not a problem.

Unclear or high

An elastography scan or specialist referral is often next.

Questions to ask your provider

  • What do my results mean for me?
  • Do I need to repeat this test or have other tests?

Risks

A blood draw is very safe. You may have slight pain or a small bruise where the needle went in.

Related conditions

Related tests

Sources

Last updated 2026-11-13.