Can LFTS be normal in cirrhotic liver

[mahhe]

Hii everyone, I would very much like to get some advice on liver cirrhosis diagnosis. It all started four years back. I developed lot of changes in the bowel movements like irritation to dairy, wheat and non vegetarian foods and slowly to processed foods,fruits and spices. The stools are pale and I have started losing skeletal muscles. I was diagnosed for colitis and food allergy. All the tests results were normal except for ANA.

Further investigations were done to rule out autoimmune liver disease as I developed pain in liver area with prominent red blotches in palms. Fibroscan was done and the score was 12.6 kpa. Liver biopsy was also done and it was normal. My rheumatologists feels I have a mild form of mixed connective tissue disorder which needs no treatment. Hepatologists thinks I don't have any problem with the liver as the lfts are normal.

I have almost all the symptoms of a sluggish liver and I take mostly nutritional supplements to maintain an average health. I am totally confined at home as I become completely tired even after a short walk. What I am supposed to do at this stage, I feel I have betrayed myself and my family. At 12.6 kpa ,what symptoms one can expect and How come the LFT's be still normal. Please help me...

[Bolly]

In answer to your first question, yes LFTs can be 'normal' with a damaged liver. This was explained to me by a gastro doc as only the 'healthy' part of the liver produces the enzymes, so the levels appear lower. LFTs on their own don't give a complete picture of liver health.

What is more puzzling in your case is a 12.6kpa fibroscan (which indicates advanced fibrosis/early cirrhosis) but your biopsy result contradicts that. Did you discuss the biopsy results with your hepatologist and if so how did they explain a normal biopsy with an abnormal fibroscan. Any decent hepatologist would have taken a whole raft of bloods, not just LFTs before putting you through a biopsy, what other tests did you have and what were the results before you had the biopsy. Have they ruled out ME/CFS which presents with similar symptoms to many other illnesses including viral hepatitis.

[Hidden in reply to Bolly]

im reading a few instances LFTs being normal but cirrhosis is present, any ideas as to how many are like this, it seems to me most LFTs are useful tools but some can slip the net? Also although a damaged liver can eventually get back to normal it would also depend on how soon after someone has stopped drinking the test was done, 6 months after a serious issue it could normalise I don't think it were done 1 month after that a damaged liver would slip the net?

[briccolone]

hi Bolly and others on this forum far more qualified than me on this but the biopsy is supposed to be the "gold standard"-so the biopsy is normal and the diagnosis is cirrhosis based on the fibroscan? As Bolly says-very puzzling-your symptoms are quite indicative of fatty liver though but there are treatments for this.

[SunnySideUpDawn]

Have you been tested for Chrones Disease?

[Tatjana]

Both Bolly and Briccolone are correct in what they say. You do not have to have abnormal LFTS to be diagnosed with liver problems. I know for certain because my liver function tests are always normal. There are some people who have abnormal LFTS if they are below par and they do not have liver disease. What makes me so angry is that I read that your Heptologists say that your liver is ok because your LFT was normal. They KNOW this is not always the case and they can't use that as a marker. Fibroscan of 12.6 needs further investigation and as Bolly says contradicts what your Heptologist told you. I have learned that if you do not ask you do not get so I suggest you go back to a heptologist and request some answers.