Question 1

What is Primary Biliary Cirrhosis (PBC)?

Accepted Answer

Primary Biliary Cirrhosis (PBC) is a chronic autoimmune liver disease that progressively destroys the small bile ducts within the liver. It is caused by an autoimmune response where the body produces anti-mitochondrial antibodies that attack the bile duct cells, leading to inflammation and scarring. The Mitochondrial Antibody with Reflex to Titer test is the most important test for diagnosis because it detects these specific antibodies in approximately 90-95% of PBC cases.

Question 2

What causes Primary Biliary Cirrhosis?

Accepted Answer

Primary Biliary Cirrhosis is caused by an autoimmune response where your immune system mistakenly attacks the small bile ducts in your liver. This attack triggers the production of anti-mitochondrial antibodies (AMA), which are found in over 90% of people with PBC. The ongoing immune assault leads to chronic inflammation and gradual destruction of the bile ducts, preventing bile from flowing properly out of the liver. Over time, this buildup of bile causes scarring (fibrosis) and can eventually lead to cirrhosis if left untreated.

Question 3

What is the best test for Primary Biliary Cirrhosis?

Accepted Answer

The Mitochondrial Antibody with Reflex to Titer test is the most important test for Primary Biliary Cirrhosis because it detects anti-mitochondrial antibodies (AMA), which are present in 90-95% of people with PBC. This test specifically identifies the M2 subtype of mitochondrial antibodies that target the bile duct cells. The reflex to titer feature provides additional information about the concentration of these antibodies, which helps confirm the diagnosis and may indicate disease activity. Your doctor will typically combine this test with liver function tests measuring alkaline phosphatase (ALP) and bilirubin levels to get a complete picture of your liver health and bile duct function.

Question 4

When should I get tested for Primary Biliary Cirrhosis?

Accepted Answer

You should get tested if you experience persistent fatigue that interferes with daily activities, unexplained itching (especially on your hands and feet), yellowing of your skin or eyes, or chronic dry eyes and dry mouth. Testing is also important if you have elevated liver enzymes discovered during routine blood work, especially elevated alkaline phosphatase. Women over 40 with a family history of autoimmune diseases should consider testing, as PBC predominantly affects women in this age group. Early detection through blood testing can help start treatment before significant liver damage occurs.

Question 5

What are the symptoms of Primary Biliary Cirrhosis?

Accepted Answer

Primary Biliary Cirrhosis often develops slowly, and many people have no symptoms in the early stages. The most common early symptoms include persistent fatigue that does not improve with rest and intense itching of the skin without a visible rash. As the disease progresses, you might notice yellowing of the skin and eyes (jaundice), darkening of the skin in certain areas, dry eyes and dry mouth, abdominal discomfort in the upper right side, and small yellow deposits under the skin around the eyes. Some people also experience joint pain, swelling in the legs and ankles, and unintentional weight loss.

Question 6

Who is at risk for Primary Biliary Cirrhosis?

Accepted Answer

Primary Biliary Cirrhosis primarily affects women, accounting for about 90% of all cases, typically between ages 40 and 60. Your risk increases if you have a family history of PBC or other autoimmune diseases like thyroid disorders, Sjogren syndrome, rheumatoid arthritis, or scleroderma. People of Northern European descent have higher rates of PBC compared to other ethnic groups. Smoking and urinary tract infections have also been associated with increased risk. If you have one autoimmune condition, you are more likely to develop another, making screening especially important for this group.

Question 7

What happens if Primary Biliary Cirrhosis is left untreated?

Accepted Answer

Untreated Primary Biliary Cirrhosis leads to progressive liver damage that worsens over time. The ongoing destruction of bile ducts causes bile to accumulate in the liver, creating chronic inflammation and extensive scarring (cirrhosis). This scarring prevents your liver from functioning properly, leading to complications like portal hypertension (high blood pressure in liver blood vessels), fluid accumulation in the abdomen (ascites), enlarged veins that can bleed (varices), and increased risk of liver cancer. Eventually, untreated PBC can progress to complete liver failure, which requires a liver transplant for survival. Early treatment with medications like ursodeoxycholic acid can significantly slow disease progression and improve long-term outcomes.

Question 8

Can Primary Biliary Cirrhosis be diagnosed with a blood test?

Accepted Answer

Yes, Primary Biliary Cirrhosis can be diagnosed primarily through blood tests in most cases. The presence of anti-mitochondrial antibodies (AMA) in your blood, combined with elevated alkaline phosphatase levels and typical symptoms, is usually sufficient to confirm a PBC diagnosis without needing a liver biopsy. The Mitochondrial Antibody with Reflex to Titer test detects these specific antibodies in about 90-95% of people with PBC. Additional blood tests measure liver enzymes, bilirubin, albumin, and clotting factors to assess liver function and disease severity. In some cases where antibody tests are negative but PBC is still suspected, a liver biopsy may be performed to examine the bile ducts directly under a microscope.

Question 9

How is Primary Biliary Cirrhosis treated?

Accepted Answer

Primary Biliary Cirrhosis is primarily treated with ursodeoxycholic acid (UDCA), a medication that helps improve bile flow and protects liver cells from damage. UDCA can slow disease progression and improve survival, especially when started early. If you do not respond adequately to UDCA, your doctor may add obeticholic acid as a second-line medication. Treatment also includes managing symptoms like itching with medications such as cholestyramine or rifampin, and addressing nutritional deficiencies, particularly fat-soluble vitamins A, D, E, and K. For advanced cirrhosis with liver failure, liver transplantation may be necessary and offers excellent long-term outcomes.

Question 10

How can I prevent Primary Biliary Cirrhosis?

Accepted Answer

Primary Biliary Cirrhosis cannot be prevented because it is an autoimmune disease with no known preventable cause. However, you can reduce your risk of complications and slow disease progression by avoiding alcohol completely, as it places additional stress on an already compromised liver. Maintaining a healthy weight, eating a balanced diet rich in nutrients, and avoiding smoking are important protective measures. If you have other autoimmune conditions or a family history of PBC, regular screening with blood tests can help detect the disease early when treatment is most effective. Early detection and prompt treatment with medications like UDCA offer the best chance of preserving liver function long-term.

Question 11

What can I do at home for Primary Biliary Cirrhosis?

Accepted Answer

At home, you can support your liver health by eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while limiting salt to reduce fluid retention. Taking vitamin supplements, especially vitamins A, D, E, and K, helps address deficiencies common in PBC, but consult your doctor about appropriate doses. For itching relief, try using cool, wet compresses, taking lukewarm baths with oatmeal, applying moisturizing lotions, and keeping your home cool and humid. Manage fatigue by pacing activities, taking regular rest breaks, and maintaining a consistent sleep schedule. Avoid alcohol completely and check with your doctor before taking any over-the-counter medications or supplements, as some can harm your liver.

Question 12

How’s this work?

Accepted Answer

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Question 13

How do I know which test to get?

Accepted Answer

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Question 14

When will my lab results be available?

Accepted Answer

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Question 15

Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?

Accepted Answer

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Question 16

Do you accept health insurance?

Accepted Answer

Only HSA & FSA is accepted.
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Question 17

Can I cancel my order?

Accepted Answer

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Question 18

How can I find a lab location near me?

Accepted Answer

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Primary Biliary Cirrhosis Blood Test

What is Primary Biliary Cirrhosis (PBC)?

What causes Primary Biliary Cirrhosis?

What is the best test for Primary Biliary Cirrhosis?

When should I get tested for Primary Biliary Cirrhosis?

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