Alpha-1-Antitrypsin Deficiency Blood Test

What is Alpha-1-Antitrypsin Deficiency?

Alpha-1-Antitrypsin Deficiency (AATD) is a genetic disorder that prevents the body from producing enough alpha-1-antitrypsin enzyme to protect the lungs and liver from damage. It is caused by inherited mutations in the SERPINA1 gene that reduce production of this protective protein. The Alpha-1-Antitrypsin, Quantitative test is the most important test for diagnosis because it directly measures enzyme levels in the blood to confirm the deficiency.

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What causes Alpha-1-Antitrypsin Deficiency?

Alpha-1-Antitrypsin Deficiency is caused by inherited genetic mutations in the SERPINA1 gene that you receive from both parents. These mutations prevent your liver from making enough alpha-1-antitrypsin enzyme, a protein that normally protects your lungs and liver from inflammatory damage. When you lack this protective enzyme, your lungs become vulnerable to damage from smoking, pollution, or infections, and abnormal protein can accumulate in your liver causing scarring and disease.

What is the best test for Alpha-1-Antitrypsin Deficiency?

The Alpha-1-Antitrypsin, Quantitative test is the most important test for Alpha-1-Antitrypsin Deficiency because it measures the exact amount of protective enzyme in your blood. Low levels below 11 micromoles per liter typically indicate a deficiency, while levels between 11-20 suggest you might be a carrier. This test is essential for diagnosis because it directly detects the missing enzyme that causes lung and liver problems. If your quantitative test shows low levels, your doctor may order genetic testing to identify which specific mutations you have and assess your risk of developing serious complications.

When should I get tested for Alpha-1-Antitrypsin Deficiency?

You should get tested if you develop emphysema or chronic lung disease before age 45, especially if you are a non-smoker or light smoker. Testing is also important if you have unexplained liver disease, chronic hepatitis, or cirrhosis at any age, or if you have a family member with confirmed Alpha-1-Antitrypsin Deficiency. You might also consider testing if you have asthma that does not respond well to standard treatments or if you experience shortness of breath and wheezing without an obvious cause.

What are the symptoms of Alpha-1-Antitrypsin Deficiency?
Lung symptoms include shortness of breath during physical activity, wheezing, chronic cough, and frequent respiratory infections that develop in your 20s to 50s. Liver symptoms can appear in infancy with jaundice and poor feeding, or in adulthood with fatigue, swelling in the legs and abdomen, yellowing of the skin, and unexplained weight loss. Many people with this deficiency have no symptoms for years, particularly if they avoid smoking and lung irritants, which is why family screening is important.
Who is at risk for Alpha-1-Antitrypsin Deficiency?
People of Northern European, Scandinavian, and Iberian Peninsula descent have the highest risk, with about 1 in 1,500 to 3,500 people affected in these populations. You are at risk if both your parents carry the defective SERPINA1 gene, even if they show no symptoms themselves. Family members of someone diagnosed with AATD should be tested regardless of symptoms. Smokers and people exposed to secondhand smoke, air pollution, or occupational dust and fumes face significantly higher risk of developing severe lung disease if they have this genetic deficiency.
What happens if Alpha-1-Antitrypsin Deficiency is left untreated?
Untreated Alpha-1-Antitrypsin Deficiency can lead to progressive and irreversible lung damage, including chronic obstructive pulmonary disease and emphysema that worsens over time and causes severe breathing difficulty. Your liver can develop cirrhosis, liver failure, or liver cancer, particularly in adults over 50. Without treatment, lung function steadily declines, leading to disability, oxygen dependence, and significantly shortened life expectancy. Early diagnosis and treatment, including enzyme replacement therapy and avoiding smoking, can slow disease progression and prevent many of these serious complications.
Can Alpha-1-Antitrypsin Deficiency be diagnosed with a blood test?
Yes, Alpha-1-Antitrypsin Deficiency is diagnosed with a simple blood test that measures the level of alpha-1-antitrypsin enzyme in your bloodstream. The quantitative blood test is the first step and can be done without any special preparation. If your levels are low, genetic testing from the same blood sample can identify the specific SERPINA1 gene mutations you carry. Blood testing is more accurate than symptom assessment alone because many people have the deficiency without obvious symptoms, and lung or liver problems can be mistaken for other conditions.
How is Alpha-1-Antitrypsin Deficiency treated?
Treatment includes weekly or monthly intravenous infusions of purified alpha-1-antitrypsin enzyme replacement therapy to raise protective enzyme levels in your blood and slow lung damage. Avoiding smoking and secondhand smoke is absolutely critical, as smoking dramatically accelerates lung destruction in people with this deficiency. Your doctor will prescribe bronchodilators, inhaled steroids, and antibiotics for lung infections, while liver disease may require monitoring and potentially liver transplantation in severe cases. Regular vaccinations for flu, pneumonia, and COVID-19 help prevent respiratory infections that can worsen lung function.
How can I prevent complications from Alpha-1-Antitrypsin Deficiency?
Never smoke and avoid all exposure to secondhand smoke, which is the single most important action you can take to prevent lung disease. Maintain a healthy weight, exercise regularly within your breathing capacity, and avoid environmental irritants like air pollution, chemical fumes, and occupational dust. Get all recommended vaccinations to prevent respiratory infections, practice good hand hygiene, and see your doctor promptly for any breathing problems or respiratory infections. Regular monitoring with pulmonary function tests and liver enzyme checks helps catch complications early when they are most treatable.
What can I do at home for Alpha-1-Antitrypsin Deficiency?
Practice breathing exercises and pulmonary rehabilitation techniques to strengthen your respiratory muscles and improve lung efficiency. Use a humidifier to keep airways moist, stay well-hydrated to help thin mucus secretions, and perform chest physiotherapy or percussion to clear mucus from your lungs. Eat a nutrient-rich diet with plenty of protein to support liver function and maintain healthy weight, and consider air purifiers with HEPA filters to reduce indoor air pollutants. Join support groups for people with AATD to learn coping strategies, and work with your healthcare team to create an action plan for managing symptom flare-ups at home.
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Alpha-1-Antitrypsin, Quantitative
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What's included
Fast & easy, results by email & SMS
No need to visit a doctor
Private & confidential
No insurance needed
Results explained
No extra fees paid at the lab

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