I am totally confused about my NASH diagnosis of 8 months ago. My doctor is even saying that she may not have diagnosed me correctly, as no biopsy was done.
I will try to make this short and to the point. Over the past several years, I gained quite a bit of weight. Much was due to depression and a sedentary lifestyle. I also wasn't eating a healthy diet and was not exercising. In February of 2014, I fell down from the top of our hardwood stairs and landed on my head at the bottom. I remember nothing of the accident, the ambulance ride, hours in the ER with tons of blood drawn, x-rays and CTs. During this visit to the ER, I was given a copy of all of my blood test results. My liver enzymes were slightly higher than they should have been.....about 30 points higher on both my AST and my ALT. About three weeks later, I went to my internist and we followed up on the enzymes. By this time, my AST and ALT were even higher...but in the low 100s. She immediately tested me for Hepatitis, HIV, etc... and everything came back negative. Next, I had a liver ultrasound which came back with results that terrified me. Moderate to severe fatty infiltration of the liver, with no other remarkable findings.
My doctor said that the combination of elevated ALT and AST along with the fat in my liver meant that I had NASH. I did NOT have a biopsy. I freaked out and immediately started a very healthy, liver friendly diet and started exercising every day. Within 4 months, my enzymes were back to normal and have remained that way.
Here's where things get weird. We discovered that a medication that I started taking for my anxiety, about 2 1/2 weeks before my fall, actually caused me to be clumsy, and thus, my plunge down the stairs. My psychiatrist was horrified and read the drug monograph. It is indeed known to cause elevated ALT and AST. So now....the delimma. Have my AST and ALT levels gone down so rapidly because I stopped the respective medication at the end of March or have they gone down because of my new dietary and exercise routines? I eat very well and have lost 60 pounds. I have not had a follow up liver scan, as my doctor said that it's too early.
My question? Do liver enzymes elevated by NASH appear and elevate very quickly and then go back down within a few months with lifestyle changes? I was under the impression that it took longer than that. So, I am totally confused as to weather I have NASH at all, but GI won't do biopsy because she said treatment for NAFLD and FLD were the same and that the biopsy could be dangerous. My internist has now said that she doesn't think I have NASH, as did my GI, my OBGYN and my own father who is a physician. What symptoms would I be having if I have NASH other than elevated enzymes? I am so confused.
Can someone who knows more about this than I do, please help me? Thank you all...I really appreciate your input!