Please help

[JABRAN1]

Hi I'm 29 years old male height is 5 8" and overweight 14 stones. i had a routine blood text about 5 months ago everything came normal apart from liver enzymes, alt 109 then had another test after few weeks time and they were 126 then I went for ultrasound scan they told me I have a fatty liver my GP sent me for fibroscan , and the result was 6.9 kpa and doctor told me it's normal and wants my further blood tests to find out what causing high liver enzymes .im freaked out really worried 😰😨 Please tell me what to expect ? I'm having negative thoughts all the time what's gonna to happen .please help me thanks

[MisterX]

Hi,

What happens is that whenever your liver is aggravated - from any cause - it becomes inflamed. the inflammation is called hepatitis (hepatitis means inflammation, don't confuse it with the viruses called Hepatitis that give you hepatitis!!).

If the liver is inflammed then the levels of certain enzymes - ALT being one of them - are raised in the bloodstream.

If the inflammation continues over a period of time or is very very intense (like that caused by an overdose of painkillers for example). The inflammed area of the liver becomes scarred. Usually the liver has a remarkable ability to repair itself and regenerate lost tissue - did you know that if you cut half of the liver off it will grow back? - but if the cause of the liver inflammation is not stopped then more and more scarring will happen. The scarring is called fibrosis. There are several stages of fibrosis as it gets more extensive. The final one is called cirrhosis where almost all the liver is scarred.

So in your mind separate the inflammation (hepatitis) from the scarring (fibrosis).

The raised ALT is always something for your GP to consider seriously as it indicates possible (and I mean possible) liver inflammation (hepatitis). There are other indicators of liver function and other enzymes which would hint toward a cause of the inflammation.

So it looks like your GP has done the right thing by monitoring your ALT over time. A single incidence of abnormal ALT doesn't say much as the liver is a working system so at any given time it's always possible something may be upsetting it - it is after all dealing with toxins etc. The purpose of the fibroscan was to get an idea of how much fibrosis has taken place. My understanding is that your score is at the lower end of the scale.

I mentioned the liver's unique opportunity to recover, repair damage and regenerate. This is especially true if the cause of the hepatitis is removed. In your case fatty liver is a reasonable starting point - essentially as humans we're doing to ourselves exactly what people used (hopefully) to do to geese to get foie gras - and the way to remove the fat from the liver is to gradually remove it from your diet and to get exercise. It may take some time. A person can liver perfectly normally with only 20% of their liver working and even when fibrosis is at the stage of cirrhosis. It doesn't sound like you're anywhere near that yet so you have every prospect of being able to do something about it. It'll be a bit of a journey though so you do have to be patient.

If the cause is not fatty liver then investigation will hopefully pinpoint the cause. There are many treatments available for liver conditions and so as long as it's discovered in time (usually before cirrhosis) quite a lot can be done and as long as it's controlled so that the liver can regenerate tissue faster than it is inflammed, it can heal quite well.

Hope that helps. Regardless of what happens though it's not too early to address diet and exercise if you can.

Best regards.

[JABRAN1 in reply to MisterX]

Thanks for your detailed reply

Another thing is on second test they have checked for hepatitis and they all came negative , when I have done my ultrasound the sonogrpher told me that you have a fatty liver, so just want to know can a fatty liver elevate liver enzymes as mush as mine are? Thanks

[MisterX in reply to JABRAN1]

Yes it can. It may seem like a high number (and certainly it's a result your GP is taking seriously), but its not a result that says doom - especially because it's the amount of fibrosis that tells you where you are and if your scan result is accurate you would seem to have lots of functioning liver cells. He/She will see people with ALT much higher than that in the several hundreds and even thousands.

As I mentioned the liver is constantly regenerating itself, so even with the hepatitis, the liver is constantly repairing damage. Also other "insults" (medical term) to liver tissue will raise ALT like medications, alcohol etc.

But the answer is yes, it can be raised by fatty liver that much. Key now, especially as you've eliminated Hepatitis viruses, is to get on top of the reasons for the fatty liver. There's quite a lot of information in this site so I'd encourage you to read around a bit. I would discourage researching liver issues on Google at this stage it won't help much until your GP has a definitive reply for you and liver issues span a really wide range so it's very easy to get unnecessarily spooked.

If it is indeed fatty liver then it should be something you can do something to eliminate.

Keep your chin up.

[Hidden]

hi

The FIbroscan doesn't measure scarring directly it measures stiffness which is then translated into a likely level of scarring, its a very good test probably about the best available to you. Raised enzymes can also make the Liver appear stiffer and thus give a higher kpa and indicate more scarring than there actually is.

You have stated you are over weight which is probably the root cause, but many over weights don't get inflamed liver too, you may be one of the unlucky people that have metabolic issues through not fault of your own its just down to genetics.

If you drink booze, its time to stop for a very long time. Fatty liver in itself doesn't usually cause alarm bells with the doctor, but when it starts to inflame and raise the enzymes its time to act pretty quick. Different causes of Liver issues have a different threshold for Liver scarring, fatty liver is one of the lowest kpas on Fibroscan. Your 6.9 does indicate its starting to scar up(F1), but consider it could be up to 2kpa over estimated by the fact its slightly inflamed, so you probably don't have much scarring if any, yet.

scarring if the Liver is in 5 flavours:

F0 - no Fibrosis

F1 none or mild peri-portal fibrosis

F2 peri-portal fibrosis with/without extension and portal-portal bridging

F3 portal-central bridges but no nodular formation

F4 probable or definite cirrhosis

F3 and F4 are considered permanent and also progressive, but can be slowed down if the cause is removed.

F1 and F2 can be reversed in a couple of years if the cause is removed and your Liver will be like new. Misterx is correct, the Liver is designed to take a beating, its wants to repair, its designed to repair!

here is a scaring card, your numbers relate to NAFLD:

upload.wikimedia.org/wikipe...

Even hard alcoholics for decades can make a complete recovery if they remove the cause, alcohol.

So you need to get rid of your cause, this fat, avoid eating it and don't eat sweets and sugars etc and most important is exercise. also drink plenty of water.

You are worried because of google I should think, you may want to calm down researching via google, it will tell you any cough is cancer and your going to die, no matter what you put it!

[Hidden]

I can't add anything further than the excellent comments above except my best wishes 😘😘😘😘❤️❤️❤️❤️❤️ good luck - I am sure it will not be as bad as you think xxxx

[Hidden]

Definitely take any thing u read on Google with a pinch of salt. One site I looked at about weight loss, said that at 5 foot 6 and 71 kilo's I was clincly obese. Mean while my consultant and dietitian say I'm malnourished. I know who I believe and it ain't Google