Hey everyone - new liver person and bo... - British Liver Trust

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Hey everyone - new liver person and boy am I lost lol

Latinsass profile image
19 Replies

Hey all, 29/female here...

My doctor said I have 'fatty liver' based on an ultrasound, although from all the things I have read online it seems like something a little worse. I have diabetes and hypothyroidism, nothing else diagnosed.

My question is, to those with cirrhosis, what did your labs look like or what tests did you get diagnosed/suspected of it with? Here is what I have:

Ultrasound: "Slightly coarse echotexture suggestive of fatty liver disease"

Bloodwork had high AST, normal ALT, slightly high bilirubin, high mch/mcv/mchc, low vitamin d.

I've felt horrible for literally months. Just really shakey, sniffy, tired and migraines.

Thanks and looking forward to getting to know everyone!

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Latinsass profile image
Latinsass
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19 Replies
Piggysqueak profile image
Piggysqueak

Hello there I'm also suffer with non alcoholic fatty liver disease

I have raised all phone 171 ( maybe due to pancreas problems)

Gamma gt72

Alt now28 much improved from losing 45pounds I think

My ultrasound showed BRIGHT LIVER

I had 2 liver biopsies as was on a trial where diabetic injection can improve bloods and Fatty liver no idea yet if I was even on the drug or placebo but I injected for a year almost called LEAN study but can't think what the drug used is how stupid sorry

I suffer with lots of other bits like fibromyalgia hpypothyroid very low bit d and worst of all sphincter of oddi dysfunction so not always sure what causes what .I'm 43 year old female was 39 when started with NAFLD .However a Go at my surgery is convinced I'm a big alcohol drinker I'm not my problem is food so when I ask what I can do to help I'm told STOP DRINKING ALCOHOL!!!

Anyway sorry not answered your questions just wanted to tell my story and say hello

Best wishes

Squeak xx

Latinsass profile image
Latinsass in reply toPiggysqueak

Hello :) That must be frustrating. I am a moderate drinker (was heavy in my past) so the liver fear is definitely there. My doctor is more of a 'everything is fine' kinda GP...even odd findings are dismissed!

He won't even tell me what high MCH means, but on every blood test I have ever had, it's been at least 8 points higher than normal, and when the normal range is only 10 points to begin with, it's kinda offputting!

How have you been feeling lately? How are you managing?

Piggysqueak profile image
Piggysqueak in reply toLatinsass

Well one GP looked at my bloods and said ok did nothing and my proper GP referred me to the heptobiliàry prof I was under anyway so made it easier now I had fibrous an twice once said cirrhosis other one said fibrosis . I never feel well are you type 1 diabetic if so look up lean study they found an insulin that may help reduce fatty liver . I do get annoyed when they say don't drink but then I think none of us are perfect I eat to much of the wrong foods so it's well one of those things although it not helped all medication I'm on . I think you have had some good replies love . I was scaried stiff about liver biopsy a ct is much easier but don't know if it will ease your fears . Best wishes squeak x x

I have autoimmune hepatitis that is now kept under control with immunosuppressants.

An initial scan showed a suspected fatty liver, but I was later told it had fact probably been an inflamed liver. I developed jaundice and was admitted to hospital with AST/ALT readings in the thousands, markedly raised IgG and anti-smooth muscle antibodies. A liver biopsy confirmed autoimmune hepatitis. AIH is unrelated to alcohol consumption and is not infectious.

Before I developed jaundice (I became sunflower yellow), I had muscular aches and pains (quite severe), felt shaky all the time, had night sweats and felt extremely tired and generally ill. I also had headaches.

It might be worth asking your doctor if you are at risk of developing it.

Latinsass profile image
Latinsass in reply to

I feel jealous...I've read a ton of posts on how peoples' doctors ordered biopsies just based on bloodwork, but my doc says no :(

in reply toLatinsass

A liver biopsy is not without risk and I found it rather unpleasant so they will only order it if it is the only way to confirm a diagnosis (as with my AIH). I was extremely ill at the time, needed high dose steroids to stablise me, and they needed confirmation of their diagnosis before they could administer these potentially dangerous drugs. Mu biopsy was ordered by a specialist when I was already in hospital.

Latinsass profile image
Latinsass in reply to

I tried to make a case for one (answers > pain/discomfort in my world) stating that 'coarse' could mean worse than just fatty liver, and that AST being higher than ALT can mean bad news also, but he just shrugged and said 'your AST and ALT are normal so that doesn't matter'

It's sad that it seems I've studied more about this than my GP :/

in reply toLatinsass

Then I really don't think you need to worry. Normal readings are up to 50, mine were in the THOUSANDS when they ordered my biopsy. I would have died without treatment. The liver is a very robust organ and can self repair, after all I went through even mine is back to normal readings now!

Caramberman profile image
Caramberman

Well it depends on the type of fatty liver. There is non-alcoholic fatty liver and alcoholic fatty liver....I understand that alcoholic fatty liver is reversible and Non Alcoholic FLD is not easily reversible. Diet is important to control a fatty liver which is basically your liver converting excess sugars into storage in your liver. Cut down on sugars, red meat and try and get some expert advice.

Bolly profile image
Bolly

Hi Latinsass. First of all, are you under a hepatologist while undergoing these tests? They will be better at explaining the results and reassuring you as to how healthy (or not) your liver is. A GP is not as well trained to explain liver test results.

Secondly there are a lot of things that can cause 'fatty liver' - the British Liver Trust website is a great source of information on this, britishlivertrust.org.uk/li...

Type 2 diabetes is a known cause of NAFLD, as are long term meds (ie possibly your medication for thyroid will have contributed).

Just because the ultrasounds results say 'slightly coarse' doesnt mean you have cirrhosis. So dont go googling cirrhosis and end stage liver disease or you will only make yourself ill, lol!

Remove the cause of the liver damage and early liver damage is reversible, so for example control the diabetes or stop drinking any alcohol, or improve your diet etc and you will improve your liver health.

The low Vit D you can do something about yourself - get some Vit D3 (not D2) from your local health food shop and take at least 1,000iu per day.

Your ALT being normal means your liver is in pretty good shape, bilirubin tends to go up and down (can be elevated if you are dehydrated) so more than one test is needed to spot a trend rather than one test in isolation making you anxious.

Lots of things can give you migraines and make you sniffy and tired. I wouldnt jump to the conclusion that you have cirrhosis, in fact I would bet money on you not having cirrhosis! Treat this as a wake up call to your overall health not being tip top, and discuss with your specialist what you can do to improve things. Good luck

Latinsass profile image
Latinsass in reply toBolly

Yeah, I did some research and 'coarse' doesn't usually mean 'fatty liver' which is what freaked me out. I'm not feeling great as of lately, so I'm just trying to find some answers.

I wish there were a test that could tell me more about how my liver's doing, but my doctor has only agreed to a CT scan to 'check things out more'

Eating healthy, and not drinking. Trying to stay active. Just wish they had some more precise tests out there for this kinda stuff! It's bugging me what 'coarse' could mean!

Cthulwhoo profile image
Cthulwhoo

For what it is worth, my ultra showed a 'coarse' texture to it, so I got a fibroscan. I got two just to be certain of the reading - and both were under 5 or 'mild to no fibrosis'. From what I am told (correct me if I am wrong, other members) but if the technician thought it were cirrhosis he would indicate it in his opinion.

I also read that there would be a lot more in the finding than 'slightly coarse' (ascites, portal hypertension, nodules, differing size, etc) if your symptoms are liver-related. By the time you start showing signs of liver disease, it's already progressed far enough to at least show something substantial.

I think your symptoms may be diabetes related, and diabetes can certainly cause fatty liver, so perhaps you need to control it better. Keep on your doc though if you keep feeling like rubbish - some doctors love to just brush patients off as 'fine' even when they are, in fact, not fine.

Bolly profile image
Bolly

A lot of medical training comes from text books and when I want to understand med-speak I look up those rather than 'google' the term. For example for your med-speak ""Slightly coarse echotexture" i would look in a book on teaching clinical radiography rather than Wiki answer type resources. Here they talk of echotexture, with typical ultrasound features of fatty liver including “bright” liver echotexture, rather than "coarse". Fatty liver, where triglycerides accumulate in the cells, has more echogenicity than a normal liver and this does show up on ultrasound.

Ultrasound is not brilliant at showing up cirrhosis unless it is well advanced, nor is a CT scan but a CT will rule out anything sinister or major.

If you want to find out if you have cirrhosis a fibroscan (as Cthulwoo) says, is your best bet but not all hospitals have one. You could do a Child Pugh score on yourself if you have bloodwork to hand: en.wikipedia.org/wiki/Child.... As you have neither ascites or HE and you probably dont know your INR so assume its normal, my guess is you will score 2 when you need 5 to have cirrhosis. You may well have fibrosis, which the fibroscan will register.

Dont forget both your diabetes and thyroid condition will make you feel crap if not under control, as will the medication for them if its not doing what its supposed to.

Latinsass profile image
Latinsass in reply toBolly

Interesting. My doctor informed me that 'coarse' could mean many things including fatty liver, and that if it were cirrhosis it would be suggested on the ultrasound report...

but googling it indeed is not the usual fatty liver finding. yikes :(

Latinsass profile image
Latinsass

Had a fibroscan today - 6.2 KpA or normal healthy liver. Had the test repeated three times, 6-6.2 KpA all three times so fairly accurate. Hmm. Now I am just confused :/ Some tests saying healthy liver, others saying unhealthy liver...

Bolly profile image
Bolly in reply toLatinsass

They should have taken 10 readings. Do you mean they took 30 altogether? Was the fibroscan one of the new models that can calculate the amount of fat in your liver or was it one of the original versions that just measures stiffness?

Latinsass profile image
Latinsass in reply toBolly

They took 30 readings altogether. 6.2 so no to mild fibrosis. It also measured CAP which I think is fat, and I'm at about 33% fat or grade 1.

Yet, ultrasound doesn't pick anything up until it's advanced, and it picked up echotexture....hrm. Should I just get a biopsy? It sucks advocating for myself so much but I swear to god doctors just do not care lol. Even a biopsy is gonna be a 'sing for my supper' fucking ordeal with my doctors despite abnormal readings that keep pointing to liver stuff. I can tell my body is telling me something...

Bolly profile image
Bolly in reply toLatinsass

I wouldn't fight for a biopsy, they are not without risk. I think 30 Fibroscan readings can reassure you they are accurate re the fibrosis/cirrhosis question. It's a good low score 6.2. I don't know anything about the grading of fat with a fibroscan but that sounds ok too. I would take this as a revelation that though there is nothing terribly serious with your liver it may well be struggling with the long term meds you take, and are there any lifestyle changes you can make to improve things.

Angiejohnson1421 profile image
Angiejohnson1421 in reply toLatinsass

What was your CAP score in dB/m? Mine was 273 dB/m but my kPa was only 3.9

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