I saw my GP on Monday (3 days ago) and he tried to reassure me that I do not have cirrhosis.
However, I have continued to feel very unwell - as well as being very worried about the visible physical symptoms that developed on 30 August (now mostly gone).
So, I arranged a private upper abdominal ultrasound (including the liver) today.
It is not good news.
Everything is fine - except for the liver. The radiographer told me that it was bright and slightly enlarged.
Her report was brief, but reads as follows: "The liver appears of raised echogenicity. It is bright and fatty in appearance. No free fluid".
I knew I wasn't well and my instincts are seldom wrong. It's a pity they were not in this case.
I am devastated and kicking myself.
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GavBelfast
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Presumably the ultrasound was reviewed by a doctor and the you discussed the findings with a doctor? Otherwise what you have is raw data...
Anyway, that said, what the report indicates is fatty liver.
A completely predictable an unsurprising result of the intake of huge quantities of alcohol - basically causes fat globules to infiltrate the liver.
Fat infiltration is not the same as cirrhosis. It's not even fibrosis, although if you carry on drinking it can lead to fibrosis and then cirrhosis.
Fatty liver is common in people who drink a lot of alcohol. When you stop drinking the fat should start to clear out from the liver over a period of time.
Which is why you need to stop drinking and do all the other things as discussed on the other thread.
It's not a death sentence.
You should probably go and discuss it with your GP but I'm pretty confident he'll advise you to stop drinking completely and let it sort itself out. It may be something to recheck in a year or two to see if there is any improvement in the fat infiltration - but you should discuss with him.
I just want to absolutely clear in case there's any misunderstanding ......
Echogenicity is NOT usually indicative of fibrosis (cirrhosis is fibrosis). It's indicative of fat.
As long as you don't drink you should be fine. At this moment in time your doctor still sounds like he was completely right to me.
Hope that helps. Despite your misgivings I'd say that was still good news rather than bad.
No, I was just talked through this by the radiographer as she was conducting the ultrasound and quoting her brief report. There was no doctor input.
She didn't think it was bad news either - but she couldn't rule-out cirrhosis, only that I DO have a fatty liver.
Before the ultrasound was done, I told her that I had been drinking too much for a lot of the past year, with occasional short but heavy binges. I also told her that I had been feeling unwell lately and had several liver function tests very soon after heavy drinking episodes and these showed considerably raised AST and GGT levels.
It's very difficult to get appointments at my GP surgery - but I've managed to get one with my regular GP for next Friday. However, I'll ring and see if he'll agree to speak to me tomorrow.
I'd already got very worried by the suspicious and unpleasant visible, physical symptoms that I suddenly developed on 30 August (now mostly gone, except for the thinning of hair) and by reading about my AST:ALT ratio being more than 2:1 (apparently indicative of cirrhosis) in the blood tests taken soon after my binges.
Even though my drinking was down to depression and not something I've enjoyed over the past year, I am furious with myself.
Well the radiographer shouldn't be in the business of ruling cirrhosis in or out anyway, that's the job of a specialist gastroenterologist / hepatologist and it's not diagnosed by just looking at an ultrasound. I had an ultrasound and a CT scan and a liver biopsy and load of blood tests and drugs.
Having said that what you indicated from the ultrasound doesn't even indicate a good starting point to investigate fibrosis at all, let alone diagnose cirrhosis - and your symptoms don't fit - including the sudden ones that appeared and disappeared within a few days when you stopped drinking.
You said....
"showed considerably raised AST and GGT levels."
I'd definitely take issue with the word "considerably" and I wouldn't volunteer that info without mentioning that they fell pretty quickly once alcohol was removed. In any case - and without any disrespect to a radiologist- what they can make of that information is severely limited - they don't have the training.
In any case why would you not expect raised AST and GGT following huge drinking sessions? You can't imagine that the alcohol only damages liver cells but no other cells. Again AST is NOT liver specific although in combination with GGT they both go up when you've been drinking excessively.
I don't understand the bit about AST:ALT ratio 2:1 being indicative of cirrhosis. It's not that simple.
I do understand your worry regarding the odd symptoms. I can't connect them directly to liver damage though. More likely the direct result of sending alcohol to those cells when they're expecting nutrients and such I would think.
I just want to be clear again. You are making a distinction between inflammation and damage aren't you? You drink alcohol you may inflame a load of liver cells but they don't then instantaneously become fibrotic and the entirety of your liver doesn't suddenly become cirrhotic.
Hi again, Mister X, and thanks so much for your time and for your thoughtful replies. It is very good of you to bear with me.
I'm probably not making a distinction between inflammation and damage, because I'm guessing that both are very serious and causing me to feel ill.
The best way I can describe how I'm feeling is that it's like having the flu, without the cough and runny-nose.
It was probably unfair of me to ask the woman who did the ultrasound if she could rule-out cirrhosis, when she could only rule-in what she saw (fatty liver and slight enlargement) and not what she couldn't see.
I'm afraid I've probably been reading too much about liver function tests and this AST:ALT ratio keeps cropping-up - and 2:1 or more seems to indicate advanced alcoholic liver disease.
Well you really do need to distinguish between inflammation and damage - it's pretty important and you can't treat them as interchangeable. There's no doubt that drinking so much may have inflamed your liver - as well as the rest of your body - but that doesn't mean damage. When you talk about cirrhosis you're talking about damage.
A radiologist ruling anything out would be pretty risky and unprofessional. It's not their job and they don't have the qualifications to do that. The report indicates what they see.
The ALT:AST ratio you're citing is incorrect. It is a way for a doctor to tell if alcohol might be involved where there are other indicators of liver problems - so if your AST is 500 and ALT is 250 you might investigate alcohol instead of other causes of live inflammation.
My best advice to you is to take the ultrasound and discuss with your GP. And do stop googling. You're not helping yourself one bit.
Cheers.
PS - It's now now one week and 4 days since your last binge. I'm completely unsurprised you feel rough, and I'll remain unsurprised for another 4 - 5 weeks.
There's not a lot for me to take to the doctor: I don't have any pictures or anything, just a brief report indicating that my organs (kidneys, pancreas, gall bladder, ducts and prostate) looked normal, except for the liver, and the short paragraph about it from the radiographer.
I'm really not exaggerating (nor am I looking for sympathy) when I say how crap I am feeling.
After my first and second ever serious (but short) binges on alcohol, last October, I felt rough for a couple of days each time - then fine. Then I reverted to moderate drinking (just a bottle of beer or glass of wine most days) for 3-4 months.
In March this year, I started to drink more heavily again - I got more depressed over a few things in life - and the occasional heavier binges started. But I still felt physically OK.
It was in June/July when, in spite of the poor summer, I started to experience regular, profuse sweats, I grew intolerant of heat, and my skin was mostly clammy. I started to sense something was up. Unfortunately, my drinking tended to cover-up these symptoms, so I drank more.
But it was only in August that my energy levels dropped, and I started to lose weight. Then there was the episode at the end of August and those sudden weird symptoms, mostly now gone apart from the odd bruise and apparent thinning of hair. But the feelings of fatigue, weakness, light-headedness and lack of appetite have grown.
So, it's really been 5-6 months of heavy drinking, with occasional short, heavier binges, that seems to have brought me to where I am now - wherever that is.
Hopefully the GP will agree to speak to me tomorrow.
I have read your comments and I am afraid I beg to differ slightly on some them.
My husband was ill for months and attending an endocrinologist having various blood tests. She found lots of those tests were outside the normal range but could not link any of them together to make a diagnosis. The only liver test that showed there was a problem, which was way over, was GGT. This as you know is not only attributed to liver issues.My husband didn't and still doesn't touch alcohol.
She was so confused that in the end she ordered an abdomen CT. Within a couple of days she rang us to go straight in, unusual for NHS.
The CT had shown my husband had Cirrhosis, she was not a Hep or Gastro and the diagnosis was made by the Radiologist in his/her report. I still have it somewhere.
Obviously he went on to have a biopsy for full confirmation and diagnosis for the reason that it had occurred. (A1ATD)
Unfortunately not everybody's results conform. There is a blood test called AFP which is the marker for HCC. Mike had normal readings. On explant they found over ten tumours. Lucky they weren't found before transplant, as he was actually outside the criteria for it.
So I have got to the point now where I don't accept a lot of test results when they say nothing is wrong. I push hard and have been right at every turn.
He has had joint issues for years and we have been fobbed off by various medics. I am like a dog with a bone and don't let go. We finally have diagnosis' for three joints. They all need surgery.
So I say to anybody out there. If you truly feel there is something wrong get another opinion
Thanks for posting and hope your husband is now doing OK.
I don't know if your reply was directly in response to me or other posters.
Anyway, I agree with you. No one knows their body as well as oneself or, failing that, those closest to them.
I have not felt right, physically, since June/July, then I felt continually under the weather in August, even when I had limited my alcohol intake. My instincts have simply been that something was/is wrong.
My GP told me on Monday (4 days ago) that I did not need scans, I just needed to stop the heavy drinking.
Nonetheless, I continued to feel unwell, so I arranged the private ultrasound - where the liver showed-up bright, and indicated that, at the very least, I have fatty liver disease.
So, the GP was wrong - which has me thinking: what else could he (or the doctor in the hospital) be wrong about?
The visible, unpleasant symptoms that I suddenly developed on 30 August - painful skin rash on chest, extensive bruising, red spots under the skin, red palms, and darkening of skin on backs of hands and testicles - have not been explained by any medical professional, so I can only attribute them to heavy alcohol consumption and/or liver disease.
I feel like I am in limbo and even being seen by medical professionals as a bit of a nuisance because all this appears to have been caused by excessive alcohol intake. But I wasn't drinking the alcohol recreationally or because I was enjoying it. I was drinking, foolishly I know, to try to cope with depression, other mental health difficulties and other adverse situations in my life, and because it was becoming addictive. I know no one forced me to drink, but it's a powerful drug where addiction is concerned.
Earlier today, after relaying the ultrasound findings to the same GP, he said it was in line with our discussions last Monday (though we never mentioned 'fatty liver' on Monday) and is nothing to worry about.
I am due to have repeat blood tests done next week and then discuss the results with him next Friday.
I am still convinced that I have developed advanced liver disease after my year of heavy drinking, on and off. As I said, my instincts, knowing how much I drank, and the strange symptoms are my evidence for that - and I haven't been wrong so far.
Actually Gavin I think that Carmik is referring to my post above. Obviously I can't speak to her experiences.
I did want to add a point about AFP as marker for HCC (Liver Cancer) though in case anyone's interested.
It's been known for a while - i.e. it's been the subject of research - that it's not a very satisfactory marker of Hepatic Cell Carcinoma (HCC) as it can vary depending on the underlying liver condition and other factors - to the point where it indicates only 60-80% of the time where cancer is present.
As a result it's used in combination with ultrasound (in my case) or possibly even CT scans - although even this combination isn't brilliant. There's a lot of work being done on finding a better advanced warning.
We may be unique on this planet Carmik in that we can say that we're really happy the hospital missed your husband's HCC! Not many people are ever going to say that.
How I wish they could have overlooked my husbands two small tumours which have now increased to outside of transplant criteria. Very Fortunate for you and it just goes to show that the number of tumours doesnt really affect the benefits of a transplant!
Whilst its a worry, i dont think you need to be devastated at this time; so, it seems you have a fatty liver/ enlarged slightly; but this does not mean you have cirrhosis; it appears you do not have cirrhosis; if you were to continue drinking it could turn into cirrhosis; so the best thing you can do is don't drink alcohol, ever again. The fear you are experiencing may be enough for you to give up drinking; a bit of a wake up call perhaps. This will not be easy though; but you sound determined and have got scared by what the drinking has done.
Wait to get the full results on paper and perhaps ; if its required, try and get a referral to a Heptologist? They can explain everything to you (much better than your GP) and if needed you could have more tests (though it may not be necessary)
I'm not an expert, but if i was that worried i would ask the GP to refer me to a Heptologist. Do you live in London?
Very good advice by MrX. Don't be too hard on yourself; also it sounds like the depression led to the drinking as i said before, and this happens in many cases i would think; i consider alcoholism to be a disease; just think to the future and try and make positive changes; as Mr X said; this does sound like good news; but as you say cirrhosis wasn't ruled out, and due to your worry; a Heptologist can reassure you. The gp may not want to refer you and think its not necessary; but due to your levels of worry and anxiety/ depression; i think its best if you do see one; otherwise its seems you will remain convinced you are at deaths door.
The thing is (and I know no one forced me to drink heavily - I did it to myself, whatever the causes): my instincts are rarely wrong and I've been sure that something was/is wrong for a couple of months. I started to sweat profusely and be intolerant to heat in June/July. Then, several very unpleasant, visible, physical symptoms suddenly appeared on 30 August, with 24-48 hours of my most recent heavy (80-100 units in 24-48 hours) binge.
My regular GP told me on Monday past that I do not have cirrhosis or hepatitis and that I did not need any scans - just to avoid binge drinking. Despite that, I went ahead and arranged a private ultrasound - which he might not be too happy about.
I'd hoped-against-hope that the ultrasound would allay my fears, but it's just raised them even more than they were - and I still actually feel ill: fatigued, weak, light-headed and with a very poor appetite.
I'm convinced that my liver is not just fatty - but cirrhotic, too.
"I'm convinced that my liver is not just fatty - but cirrhotic, too."
Can I ask a question?
Just for the sake of argument assuming that despite the overwhelming lack of evidence you get in front of a hepatologist who decides, for whatever reason, that you have cirrhosis..
What do you expect to happen then, or what will you do?
It's been difficult enough living with depression, anxiety and insomnia for the past 2 and a bit years, that would make everything even more challenging.
It wasn't supposed to be like this - I was talking to my dad about how my life has been turned upside-down since 2013.
Nothing will happen. They'll tell you to stop drinking, get healthy and they'll keep an eye on you. That is no different what you have to do anyway.
Look, I totally understand, but I think you may be looking at the wrong thing here. Go to the doc with the ultrasound and have a chat with him. If he decides to refer you then see a specialist. IF he doesn't decide to refer you though - which I think is more likely - it will be because it would make no sense based on this evidence.
The issue here is more likely your anxiety than anything liver related (although you should take fatty liver seriously when you decide what to drink or what to eat or whether to take the lift or the stairs). It's probably exacerbated by the alcohol and alcohol withdrawal and I suspect you'll feel rough for weeks, but nevertheless you may want to discuss that with the GP.
The thing is, I didn't think a fatty liver (alone) caused any symptoms, apart maybe from vague discomfort or a bit of sluggishness.
Again, for the sake of argument, is it possible that a whole load of liver disease-related symptoms would appear suddenly 24-48 hours after a short, but severe, drinking binge? And then mostly go away within a week or so later?
I know I'm now hyper-sensitive and hyper-vigilant about every twinge or thing that I notice, but here goes anyway. I have not shaved for 5 days, but my 'beard' seems much less than it did the last time - a couple of months ago - I went without shaving for the same sort of period. It may seem minor, but I've read so much about hair loss, hair thinning and male body hair reduction in cirrhosis, that it's just one of the things that has me convinced that I've developed the condition.
"Again, for the sake of argument, is it possible that a whole load of liver disease-related symptoms would appear suddenly 24-48 hours after a short, but severe, drinking binge? And then mostly go away within a week or so later?"
No. It's not likely. It's not how liver disease works. and in any case you didn't have "a load of liver disease symptoms". You had a couple of enzymes raised a bit in response to drinking a load of alcohol - and completely consistent with that - and a few other issues which are mostly better explained by the alcohol withdrawal and anxiety and have mostly quickly cleared once you stopped drinking.
Incidentally fat infiltration of the liver can also increase substantially when you have had a fast loss of weight, so that may explain some of it.
Regardless, right now what you need to do is to deal with the fat in your liver. That means don't drink, eat healthily and get exercise. Whatever the state of your liver you have to do this.
Do draw the ultrasound report to your GPs attention.
I don't mind discussing things at all - so please don't feel like you're imposing. I'm more concerned about what you're doing to yourself though.
I wonder if this will help. The reason you are seeing symptoms that you may be suffering in lists of liver symptoms is because the liver is your main chemical processing plant in the body and because of the vast scope of its operations. It doesn't mean that those symptoms are primarily liver symptoms so selecting them from the list and saying "that means I have cirrhosis" isn't very rational. For example why would you consider sudden hair loss to be a symptom of cirrhosis rather than stress - it's a primary symptom of stress, not of
cirrhosis. I've got loads of hair! :).....
.....And especially when you're ignoring all the more relevant symptoms you don't have and the fact that the symptoms you do have are more closely associated with other conditions - Anxiety /stress being one. Alcohol being another.
I didn't get to speak directly with my GP this morning - his morning surgery was running late and he was too busy, apparently.
But I did relay the brief conclusion in the ultrasound report to him and he left a message for me that it was in keeping with our discussion on Monday (though I'm sure the term "fatty liver" was never mentioned). I am to get repeat bloods taken next week and then see him once the results are back from the labs.
I suspect one of the reasons he avoided speaking to me was because he told me on Monday that scans, etc, were not necessary - but I went ahead and arranged one and the outcome vindicated me doing so.
I haven't so much got hair loss as its appearance seeming less dense than it was compared to upto a few weeks ago. The change has been quite sudden.
As I've said elsewhere on the thread - and I don't say it to seek sympathy - I think the medical professionals I've encountered see me, even if not deliberately on their part, as a bit of a nuisance because this all seems to be down to excessive alcohol use. The consultant who discharged me from hospital ten days ago was quite dismissive when saying as much. That's even though the alcohol use wasn't recreational or out of enjoyment (though there have been occasions over the past year where I enjoyed a few pints with friends). The excessive drinking was to try to cope with depression and other mental health difficulties (though, being a depressant, it was a foolish drug to get hooked on for that reason). Then I also kept drinking, even on a moderate basis, to avoid withdrawal symptoms.
I also keep beating myself up because I feel like I have wasted the last year, as well as a fair amount of money, through drinking, and now I have convinced myself - my instincts again - that I have needlessly ruined my physical health, while still having the same mental health issues that drove me to drinking excessively in the first place.
"But I did relay the brief conclusion in the ultrasound report to him and he left a message for me that it was in keeping with our discussion on Monday (though I'm sure the term "fatty liver" was never mentioned). I am to get repeat bloods taken next week and then see him once the results are back from the labs.
I suspect one of the reasons he avoided speaking to me was because he told me on Monday that scans, etc, were not necessary - but I went ahead and arranged one and the outcome vindicated me doing so."
Hi there,
I think you're being a little unfair to your doctor at this stage, fatty liver is absolutely expected in cases like yours - and given that the way to reverse it is to stop drinking what is the scan telling him that he doesn't know already? That you have fatty liver? That was quite likely from the start.
Having said that though, you'll want him to look at the report in case it changes his mind in some respect. You really should be hoping not.
There is nothing to show him - no pictures or anything.
All I have is the very brief report that I quoted at the beginning of this thread.
The term "fatty liver" never passed either the GP's or my lips when I saw him last Monday.
I simply can't believe that I would be feeling so unwell just because of a fatty liver. After all, most sources of information on this condition say that fatty liver mostly has no symptoms.
Incidentally, I also found this on the NHS's website.
I will - it's just a series of ticks in boxes (= appears normal) against various parts of the upper abdomen, then a couple of lines about the appearance the liver.
Can I please ask you something specific, because this is troubling me.
I feel like there is discomfort and pressure in my throat. Would/could the presence of eosophagal varices cause that feeling?
Varices would be way down in the oesophagus close to the hepatic vein. You can't "feel" them.
They're a serious complication of cirrhosis (not fibrosis) identified by endoscopy (Not enjoyable) and potentially life-threatening in that a bleed can't be seen but can be quick and severe enough to kill you.
Stress however causes constrictions in the muscles of the throat. It's a classic first-line symptom of anxiety.
Oh yes, I know all about how anxiety and stress can cause a tightness in the throat.
Looking around this forum, I'm obviously far from alone in being scared that alcohol excess, or other unfortunate causes, have led to liver problems.
I'm also obviously not alone in a feeling of limbo, where GPs in particular, but sometimes also more specialist medical practitioners, seem to look at LFTs, see that they are normal, near normal or are normalising, and feel that that's that.
Meanwhile, patients remain stressed-out because they have unpleasant symptoms, know about their drinking (where relevant), may have had abnormal LFTs or scans, and then end-up having to come to places like this to seek advice and support from helpful people who've "been there".
So MIster X, thanks so much for your time and for bearing with me.
The trouble with cirrhosis is that it can be symptom-free until it's very advanced, so you can randomly select someone from the population who is perfectly well, disect them and find a cirrhotic liver.
Likewise someone can be ill, have a problem that is unrelated to cirrhosis but also then be found to have cirrhosis in the subsequent investigation even though their symptoms were unrelated.
So if you randomly select someone and check, without taking evidence of cirrhosis into account then you may well find cases of cirrhosis.
If however you take the evidence into account and diagnose, then you would follow certain methods to find out whether someone does or doesn't have cirrhosis. This forum is exactly the place where you will find people who have cirrhosis where their doctors didn't make the connection or couldn't see the wood for the trees. They will be here and for the long term.
And I've been in exactly that situation myself.
You will not find anywhere near as many people who went to the doctor with symptoms, the doctor followed an appropriate diagnostic path and found that they were fine, or where for example as happens with alcoholic fatty liver - he told them to stop drinking and it quickly cleared because then they have little reason to discuss what happened here.
In your case, from everything I know - and 'm not a doctor - I agree with what your doctor is saying and I haven't seen anything to contradict the notion that his plan of action is completely appropriate to the situation - but of course I'm not in your shoes and feeling your symptoms, which is why it's eminently sensible to consider your own condition and to consider the advice and experiences of all those here who have been through it.
So obviously for your sake I hope you're very wrong.
Hope you've enjoyed the break from me annoying you for a few days.
Today has been difficult for me. I haven't been sleeping at all well for the past few nights, since the ultrasound in fact, in spite of a night-time sleep med.
I am sure that my body hair, including on my head, is less and thinner than it was only 3-4 weeks ago (before my most recent binge). I am scared that this is a sign of advanced liver disease.
My skin, particularly on my face, forehead and neck, also feels oily. Can this be a symptom of liver problems?
I am ever more concerned that the medication I have been taking over the past year, along with the alcohol intake, has contributed to the problem. In partiular, it seems that Quetiapine and Trazodone can cause liver damage/problems.
Can I ask you another question, Mister X? In the ultrasound report, the radiographer wrote "No free fluid". Would this refer to there not being any ascites visible in my abdomen? I should have asked when I was there last Thursday, but it was all so quick.
I went for blood tests today: liver function tests, complete blood count, and clotting. The nurse said they would call me if there was a problem, probably tomorrow, but I'm not due to see my GP (doctor) again until Friday.
I don't mind the annoyance . I'll take each part in turn...
i) Sleep - I mentioned in one of the threads another thread where I refer to melatonin/seratonin and light in the regulation of sleep - might be an idea to take a look. Other than that you're feeling a huge amount of stress and you have to find some way of calming that as it's bound to be having an effect.
ii) My view is that if you have enough liver damage to be affecting your the thickness of your hair (not the first thing I'd look for) in a matter of a few weeks then there would be other manifestations of liver dysfunction in blood tests (NO not the ones you've already mentioned) and other complications. You might mention it to your doctor.
iii) Many medications can cause liver damage. It doesn't mean that they do. I have medications prescribed to me by my hepatologist for my liver condition. One of the major possible side effects of at least two of the medications I take is liver damage and cirrhosis.
iv) Ultrasound. In this case no free fluid means no ascites. Ascites in the absence of other indications of hepatic dysfunction would be extraordinary in any case.
v) Blood tests. Obviously wish you the best with these. It might be an idea to have a think about what you're going to do if they come back normal or at least not indicative of liver issues. I'm not sure from where you are at the moment that you think that will matter.
I just feel very emotionally fragile at the moment and am kicking-myself over some mistakes and choices I have made in recent years that have brought me to where I am. Life used to be nice and care-free, I worked hard and seemed strong.
Every day seems to bring new symptoms. I went for a walk at the coast earlier. It was 8 miles. I magaed it, but it was hard work. I used to do this walk reguarly and routinely and used to hardly break sweat.
Today, I was covered in an oily sweat - very strange. When I got home, I took off my sweatshirt and there was some body hair (from my chest) stuck to the inside of the shirt. Again: very strange.
The hair on my head has also definitely thinned, though that isn't "male" hair, so I don't know what's going on.
Where excessive alcohol use is concerned, everywhere I've read talks of years of heavy alcohol intake to cause serious liver damage/disease, not several months - with gaps - as in my case, unless there are other factors involved. That's why I'm so concerned that some of those meds I mentioned, when taken along with alcohol, make for a dangerous combination compared to either meds or alcohol taken separately.
I guess I don't have long to to wait to talk to the doctor. I hope it's a productive consultation for I just feel like I'm in limbo, waiting for bad news, which is why I keep resorting to sites like this for reassurance and because people like you understand what I'm going through.
"Where excessive alcohol use is concerned, everywhere I've read talks of years of heavy alcohol intake to cause serious liver damage/disease, not several months - with gaps - as in my case, unless there are other factors involved."
This isn't really in accordance with my understanding of liver damage and alcoholic liver disease.
Based on what you've said so far - and I've read all of it what you seem to have is some fatty liver which was entirely to be expected. Fatty liver usually reverses once you stop drinking, eat better and exercise.
With regard to the rest, if you don't mind my saying, it's gone. You're not going back, no turning back the clock.
You only have one reasonable rational option....
Take stock of ....
what you have,
where you are and
what you are like
....and then move forward. If you have any idea which of those three things you wish to change then decide what you're going to do to change them. IF you can't decide on changes then take each day as it comes and make the best of that without looking further.
There's nothing to look back at. It's gone - and to anyone who says you should look back to see what you did wrong - ask yourself the question; did you really not know it was wrong at the time? Deep down? I'd say you probably did. Most people do - which means it's better to be mindful of what you're doing in the moment than looking to the past for lessons.
When I was talking about serious liver issues, I meant those caused by alcohol, not other factors as, for example, with your good-self.
I'd have generally thought of myself as a fairly intelligent person with basic common sense. Of course I knew that binge drinking was not going to be doing my heath any good, but it honestly never occurred to me that I might be seriously damaging my liver until last month. More fool me!
Naively, from alcohol use, I thought it took years and years of sustained, heavy drinking. How I wish I had been better educated on the subject but, as you suggest, we are where we are.
The terminology of your US report shows you have fatty liver deposits and inflamed (slightly enlarged) liver which is more than likely as a result of your heavy drinking. At this stage the damage and blood results are probably reversible if you remove the cause of the inflammation (the booze and medication) and look after yourself better - improve your fitness regime and good diet.
These are some snippets of the US reports we have received in past three years for my hubby who has known cirrhosis (due to Auto-Immune Liver Disease). You can see that cirrhosis is very clearly identified in US scans and these include terms such as:-
"Irregular Contour of the Liver, Atrophic" (dead, shrunken and shrivelled),
"the liver has an irregular contour, with patchy mixed echo pattern and disturbance of internal architecture, all consistent with cirrhosis",
"liver appears markedly coarse in echo texture and irregular margins, consistent with cirrhosis of the liver",
"the liver demonstrates a coarse, lobulated appearance in keeping with cirrhosis.
A cirrhotic liver looses it's bright fleshy appearance and becomes shrivelled and shrunken. Hubby's gastroenterologist describes his liver as looking like a dried raisin - the edges have all wrinkled up and even the cells within have all collapsed and shrivelled up.
You've had fairly conclusive results to date your liver is grumbling owing to the abuse it has had. It is up to you now to turn this around while you can. Trust the results you've had and help to heal your liver - if you continue to abuse your liver the fatty liver can progress as Mr X has very thoroughly described.
It's good of you to reply and to even include some info related to your husband's situation. I hope he is doing OK.
I used to think that only people who had been drinking very heavily for years and years got cirrhosis. I'm being educated that that is far from the case - and your husband is clearly a case in point.
As for me, I've been taking a statin for 10-15 years and my liver function tests were low end of normal in all that time - until the heavy drinking started just over a year ago, so I think the excessive alcohol has to take all the blame.
It just never occurred to me that I could cause myself trouble with months of heavy drinking, rather than years. I wish I had educated myself sooner.
For just over a month now, I've been feeling like I have the flu but without the runny-nose or cough - low energy, weak, light-headed, brain-fog, and poor appetite. Then there were those suspicious, unpleasant, visible symptoms that suddenly appeared on 30 August, just 24-48 hours after my most recent binge. Most of them have improved or gone now, but they really scared me - and most of them fit with symptoms of cirrhosis.
I just don't get that all those visible symptoms, and the continuing feeling of malaise, fit with merely a fatty liver. I'm sure it's much worse than that.
Hi how are you doing now with the alcohol and your liver . Your symptoms are very much same as mine/ fatty liver red palms known as palmer erythema very weak spaced out like I can't focus and feel like I'm not here most of the time
Random thought here but have you had your thyroid function tested ?
Your depression, anxiety, temp changes and so on could all be connected to thyroid disorder and as discussed in another thread the two do seem to crop up together for some people.
I don't think I've had my thyroid tested in years, but not sure.
The depression, anxiety and insomnia set-in due to a health scare in summer 2013 and got worse due to other negative life-events. I started drinking heavily to self-medicate. (I have been drinking socially for 25 years and, while I'm not saying I never did it to excess on 'special' occasions, it was generally moderate and controlled.)
Can I just say, it's not good to read a bunch of stuff on the Internet, and seek advice from non medical personnel ..please do not be offended, as I'm sure your not feeling well, but your symptoms seem more like the flu to me, and an enlarged liver is NOT liver disease. Period.
My doctors forbade me from reading this on the Internet, except for NIH website after my diagnosis, saying it would confuse and upset me. They were right. Everyone is an individual, and I am in end stage liver disease, 3 types of cirrhosis, hep C, massive ascites, varacies and waiting on the transplant list. It would be very easy for me to read a lot more into the bloodwork results they do every week, or when they drain me every 10 days, fluid from my belly.
And, had I reallu understood how sick I was or would be, I'm not sure where I'd be today.
I say all this because I see many people on here furious with doctors and GP and thinking they know better than them. They get positive or healthy results and are angry. Now, you'll forgive me when I say that is utter crazy. I would kill for good blood work, or to be able to walk any distance instead Of using a wheelchair,
You may very well be sick..and you should go and maybe get a complete testing done, but coming on here or other websites looking for answers when you have no actual test results that say anything is wrong is premature, and it makes he nervous when people do that. What if your so focused on your liver and it's something else serious?
I really do not mean to discount you, or to be mean, but it seems like someone should say this to you.
What if it's just allergies? Or another organ? Or a lingering flu? The Internet cannot help you with this, real testing and doctors can.. Mister Ex is right, as usual, lol..raw data is what you have. Take it to a new GP and see what they say. Then go from there.
Good luck d gni only saying this because I'd hate you to think all the sudden you have cancer or HIV from reading things and advice from the interwebby.
I'm only a patient also, albeit a well informed one..but that's from being sick and getting numerous tests, procedures, medicines, hospital stays etc. and listening to my doctors.
Cheering you, and your good health on!
Kimberly
Ps. Why did you think it was cirrhosis to begin with? Unless your a really heavy drinker? In that case, quit drinking. A doctor will tell you that also. I'm just curious how you related the flu symptoms to serios liver disease?
Oops, sorry, just read all the other replies. I'm a recovering alcoholic. Please stop drinking all together now. If your an alcoholic, you most likely will develop liver disease, many of us do. Go to the nearest 12 step meeting you can. There's an app called 'steps away' that can show u your nearest AA meeting and when they are. AA can also help with depression etc. as long as you quit drinking now, you may be able to stop any more damage occurring. Alcoholism is a serious disease that kills everyday..it's not a weakness. You can also call the AA hotline for meeting directions.
Most people who drink heavily, their livers go back to normal afterwards, if caught in time..yours sounds like it is. But I'm not doctor, and I meant what I said about not getting info from these sites. That advice won't change,
But, please stop now. I am one of the unlucky few who quit, and three years later, got sick. But I am a not normal case. If you continue down this route, you will really hurt yourself.
It's not your fault you have the disease of alcoholism, if in fact you do, but, once you know you have a problem, you now are responsible
for your choices. Most of us suffer from serious depression, at first, but many of us go on to have wonderful, productive, amazing lives!
Good luck! Get to a meeting. Today if you can!
Xx
Kimberly
Ps no kidding , today is the 11th right? Today I have 7 years sober! Yay! And even though I'm I'll, I'm still sooooooo grateful for the life I live!
It sounds like you were desperately unfortunate to get sick three years after stopping drinking - which suggests that damage was continuing to be done to your liver after you stopped, or maybe there were other intervening causes?
I really couldn't say if I'm an alcoholic or not. My problem has really been one of occasional, short but very heavy binges, interspersed with long periods of more moderate drinking. I was doing it, foolishly as it's a depressant, to block-out depression, etc, and also out of boredom because I've not been able to get back into my profession. However, I am sure that it is alcohol that has now affected my physical health.
I guess I do come here for advice, support and also understanding of what I'm going through.
I haven't had a great experience with medical professionals with regard to the drinking and my fears that there is a liver problem. I think I should have been detoxed properly on more than one occasion, but I think a lot of them, even if not deliberately, see a patient who has been affected by alcohol and see them as a bit of a self-inflicted nuisance.
My GP, four days ago, told me that I did not need any scans. I continued to feel very unwell, so I arranged an ultrasound privately. It showed that, at the very least, I have a fatty liver. So, my arranging the scan was vindicated (ie. the GP was wrong).
Anyway, I could carry-on, but that's enough for now.
Gavin, hi there, and I'm sorry if I seemed tough on you, I just can never tell who for sure is looking to be sick, or who genuinely needs help, but, hey, who am I to judge. Really, I have no business doing that. Binge drinking is often harder to pin down as alcoholism, but you mentioned needing to be detoxed..the only folks I know that need that more than once have a drinking problem. And your right, it seems here in the UK drinking is treated differently than my nation of birth, which is the US. There, the doctors are prepared, have a questionnaire they all use, and will refer you to the appr. 12 step program, therapy, or often, to detox then a rehab. Then we have aftercare programs also. Maybe the US has a better program in place to help those with our illness..sorry, my illness. Only you can decide if your an alcoholic. If you have blackouts, and such, only alcoholics get those. It's a relation in the brain that we seem to only get. Of course, you don't have to get one of those either.
In the program, we learn, it's now how often ,or how much, it's WHY we drink that shows the illness. If that makes sense. The book also mentions that there are heavy drinkers who can quit if something big happens in their life, maybe a driving and drinking charge, or loss of a job or spouse, etc.
anyway..if it were me, I'd check out a meeting or 2 anyway..just to see if you can relate. And hey, I could be way off base.
I am sorry you don't feel well, and I really hope you are not I'll, like many of us here. And to your question, yes, I have had Hep C for over 20 years, and even though I quit everything, the Hep C finally just got to my liver. 13 months before I was diagnosed, my blood tests were all great, then BAM, they said it was too late..they didn't catch it. At the time, there was no treatment for me for the Hep. A new drug has just come out and I'm blessed to have gotten to take it..now my blood tests are showing no Hep C anymore..it's a miracleTruly! I'm so grateful. Sadly, it's not enough to stop my need for transplant, as I was already too far gone, but it means my new liver won't get sick, and I should take the new organ better (from what all the specialists say)
Again, please don't think I'm heartless, and I am mindful you might be frightened..I pray you only get good news. But, just to be safe, maybe don't drink for now. And do a really low sodium diet. Fatty liver cirhossis can cause serious issues also. My best friends mother had that too, and had to have a transplant. Alas, she did not survive the surgery, but she was in her 70s and had many other serious health issues.
I have just caught up with your posts. I'm glad you had US scan and although results not as you wished you do know to some extent what you are dealing with.
Firstly can I apologise if I repeat anything others have said- I don't have much time this morning so haven't read all your replies.
From Dr Sandra Cabot's book 'Fatty Liver - You Can Reverse It', some of the symptoms of Fatty Liver:
Fatigue
Headaches with nausea
Indigestion
Overheating of body/excessive sweating
Itchy skin/skin rashes
High blood pressure
High cholesterol
It's an informative book and somewhere to start, rather than googling, which just scares and confuses you. It took 18 months for my US scans to show 'normal' liver.
I'm sure the main culprit is alcohol, but I would ask your GP to look at meds you are on. 15 years is a long while to be on statins (which can irritate the liver) - was your cholesterol that high? Or was it that back then they were seen as a wonder drug? Side effects of statins - now becoming well documented - muscle weakness,joint pain, memory problems (foggy brain).
Thanks for that. My 'bad' cholesterol and blood pressure were raised, and there is a family history of cardiovascular problems. The statin and ACE inhibitor normalised my cholesterol and blood pressure. Last Monday, my GP showed me historic liver function tests and they were always in low normal range (in the 10s or 20s).
I got in touch with my GP this morning and passed-on the brief report from the radiographer, saying that my liver was bright on the ultrasound, slightly enlarged and fatty in appearance.
He said that that was in line with our discussion on Monday, my liver function tests, and that it was nothing to worry about.
I am to go back to get the various blood tests repeated next week and go back and see him once the results are back from the labs.
I guess I should find this reassuring, but I can't get the elevated liver enzymes, those horrible, visible symptoms that suddenly appeared on 30 August, and just feeling like I have a constant flu (without the cough and runny-nose) out of my head.
I'm going to go for a good walk soon and see how I get on.
You don't have advanced liver disease, but you are physically and mentally fragile at the moment. Perhaps you shouldn't try 7 mile walks at the moment, just a couple of short strolls a day to get some fresh air and exercise.
How's your appetite now? Probably not that good, but instead of googling liver symptoms try looking up healthily diets and try planning some meals you fancy. Towards the end of my stay in hospital (5 weeks) I just wanted a fillet steak with sauté potatoes and bernaise sauce!
I went for the long walk yesterday to challenge myself and also to take my mind off my ailments. It's a walk I've done dozens and dozens of time, it's all on the flat (along a path converted from a old railway line) and not at all hard. I did it last Saturday with no difficulty at all so, to feel so faint, weak and light-headed during it yesterday was not good.
I rarely feel hungry, but I'm forcing myself to eat: cereal most mornings, a sandwich for lunch, and various things for tea, with fruit snacks, mostly apples, in-between. I'm also trying to drink plenty of clear fluids and the occasional cup of tea or coffee.
I love sweets called midget gems (I'm sure you know them) and was getting too keen on comfort-eating them for a few days, but have stopped now.
Also, my last drink was exactly two weeks ago. Even if this all does turn-out to be benign, which I obviously doubt, it will be a long time before I have another one (it's not something where, after a year or excess and growing dependence, I would be so bold as to say the urge won't ever come over me again).
I'm only Googling because I feel so unwell that I cannot concentrate on anything. I went for that walk yesterday to get some exercise and try to take my mind off my liver, but felt awful during it and thought I was going to faint several times.
My instincts have, unfortunately, been correct so far and I fear they will continue to be.
Gav, have you read the British Liver Trust page on Alcohol and the liver? - particularly the downloadable leaflet at the bottom of the page. There is a detailed list of 'early symptoms' of alcohol related liver disease & fatty liver - which your test are showing you have. The list includes many of those you are currently experiencing and indeed experienced during your exertions yesterday such as :-
Early symptoms can include:
• feeling some pain in the liver (place your right hand over the lower right hand
side of your ribs and this will cover the area of your liver)
• having a general feeling of poor health and fatigue
• flu like symptoms
• loss of appetite
• a sick nauseous feeling, especially in the morning and often accompanied by
diarrhoea
• pale stools
• dizziness
• breathlessness
• a rapid heart rate
• increased sensitivity to alcohol or drugs.
You really are making yourself sick with the anxiety, the leaflet also details what you can do to look after yourself going forward to hopefully prevent it getting worse or getting to the stage you are convincing yourself you have already reached.
Most patients with cirrhosis could only dream of walking 7 miles - their body just doesn't fuel them sufficiently to do so and it would leave them absolutely wiped out. My hubby was an avid, super fit long distance walker until his health declined and now a trip to the supermarket can leave him requiring bed rest and perhaps one good day in numerous bad where he might draw on energy from somewhere to possibly manage a stroll out for some 3-4 miles but even that exhausts him. (This was a guy who used to walk challenge walks - 100 miles in less than 48 hours, 'holiday walks' of 400 miles in 20 days etc. Literally thousands of miles on the hills and working 12 hour shifts welding in the interim).
You are convincing yourself you are worse than ALL the tests are showing. Please take a look at the British Liver Trust leaflet rather than googling odd symptoms which are really asymptomatic. By your previous statements you have had a history of some cardio issues hence the statins etc. so it is highly likely your fainty feelings yesterday are due to this and just the exertion - I am supposedly fit and healthy but going for a trot out leaves me puffing and panting at times.
The BLT leaflet and information on alcohol & the liver (including effects of binge drinking) are all at:- britishlivertrust.org.uk/li...
Your anxiety is getting the best of you here, RELAX, start looking after yourself and you'll be amazed how those blood numbers should start improving. God knows there are lots of folk on here who WISH they COULD do something to stop their livers deteriorating but they can't because their condition is untreatable or can't be helped or the causal factor can't be removed. You HAVE that chance so rather than fretting and convincing yourself that every test is wrong please start looking after yourself instead. Yes I know you are going to point out odd cases where the tests for some have been wrong but yours are all conclusively backing each other up. Trust them!!
Right I have said my bit, this is up to you now to look after yourself, stay off the booze, eat healthily - the information is all in the mentioned leaflet.
You've had lots of advice from fellow patients and carers on here plus your doctors please take it and begin to mend yourself.
I read the leaflet. It's not specific if those early symptoms relate just to fatty liver, or early signs of more serious disease.
I'm not exaggerating, though: I really do feel awful.
My drinking over the past year and a bit - from July to October 2014, and then from March to August this year, has been shocking. I would say that, on average, I was drinking approx 4 litres of wine and a large bottle of spirits every week. That's about 100 units each week, with hardly a day when I didn't drink. That obviously compares to the recommended limit of 21-28 units per week for a man.
Now, I wasn't drinking out of enjoyment - it was to try to cope with depression and anxiety.
I started to think that something was up in June, as I started to sweat profusely on a regular basis, but I didn't connect it with liver issues.
It was only in August, when I started to feel tired, energyless, dizzy, and lacked appetite, that I started to worry about the liver. Then all those horrible, visible physical symptoms suddenly appeared on 30 August. Most of these have now gone, but my hair still looks and feels thinner than it was, and my nails also seem whitish.
Last Saturday, I did that 7 mile walk without any difficulty. But, yesterday, it was a real struggle: several times, I thought I was going to pass-out or collapse.
I am sure there is something seriously wrong - a mere fatty liver surely can't have me feeling as unwell as I am.
I'll mention it to the doctor next week, but I don't think my symptoms fit - and I am intolerant to heat, not cold; I have lost weight, not gained weight; and I am not constipated.
Symptoms vary for everyone, hyper and hypo symptoms cross over and you dont have to have all the symptoms.
I am hypo and very intolerant to heat, I have never gained any weight either.
The list of symptoms is massive so can apply to many diseases but when you present with so many it is worth ruling it out.
A point to remember is that thyroid results can be classed as normal if they fall within the range but in reality they more often than not show thyroid distinction, sadly most GP's are not sufficiently experienced in thyroid disease to recognise this.
It's entirely possible that there's something else going-on in my body, bantam, but when I had been a moderate, social drinker for 25 years, then drank on average about 100 (UK) units of alcohol per week from August to October last year, and from March to August this year, and with raised liver enzymes after the drinking, and a fatty liver showing-up on ultrasound, I don't think there's any doubt that excessive alcohol intake and binge drinking are what have brought me to where I am right now.
My liver enzymes (AST and GGT) were high when measured very soon after bouts of heavy drinking, and fell sharply towards normal when measured when I had been drinking much less.
We may have a thyroid problem in common, but heavy alcohol consumption over the best part of a year and a fatty liver are what we don't.
Gavbelfast I know how you feel. I have a lot of symptoms but the my blood tests and ultrasound show normal except bilirubin. I have horrible anxiety about it. The doctors tell me not to worry but with my drinking I cant help it!!!!
That said, I would feel better if my liver function tests and ultrasound were normal. They were not (though my bilirubin has been OK, as far as I know).
It's not even as if I was drinking heavily recreationally or in an enjoyable way. It was due to depression and trying to block things out.
Do you have any symptoms? I had horrible, visible symptoms which appeared within 24-48 hours of my last serious binge on 28-29 August. These have now mostly gone, except for some hair loss/hair thinning and possibly whitish nails, but I have been left with bad fatigue, some weakness, dizziness, loss or appetite and even worse sleeping problems.
Unfortunately, my GP has looked at my various LFTs and saw that some enzymes rose soon after I drank, then fell when I was drinking much less, and just sees this as showing that I do not have serious liver disease. He didn't seem bothered by the physical symptoms I've been having. He also told me last Monday that I did not need scans, but then I arranged and paid for an ultrasound myself, and that showed a fatty liver.
I had repeat bloods taken this morning for the following tests: liver function tests, full blood count, and clotting.
I have been reflecting more on my heavy drinking since August last year. It was quite sporadic - I would drink heavily or very heavily for a few days, and then stop or drink much less. I also generally drank a lot less from November to February.
Even from March to August, when I was drinking a lot, there were periods of days or weeks when I drank little or nothing. I don't know whether these gaps would have been good for my liver or not, when I was drinking so much at times.
But I've also been taking various prescribed medications over the past year, and I am concerned that these, in conjunction with often high alcohol intake, have caused me a problem. The drugs concerned are: Simvastatin (I've taken this for 10-15 years for high cholesterol), Pregablin, Quetiapine, Temazepam and Trazodone.
I mentioned these to my doctor last Monday, and he said the medications were not the problem, but I'd only been taking Simvastatin before the alcohol became a problem - I've only been taking the other drugs (above) since approximately the same time as I've been drinking.
As for how I feel, I'm tired and weak, feel bloated and still have loss of appetite and indigestion. My sleep is also terrible and I feel depressed and anxious. However, I haven't lost any more weight and am trying to eat regular meals.
That doesn't sound right m8.If the doc's have said you havn't got cirrhosis and your ultrasound says bright and fatty i would suggest changing your diet and stopping any drink if you do.
If you can do these two things,youre future looks bright pal.
People keep telling me that I wasn't drinking heavily for long enough to cause a permanent problem, but I fear that my situation has been made worse by taking those various medications along with heavy alcohol consumption.
I gather it's pretty unusual for even a fatty liver to develop after "only" several months of heavy drinking, but I got that at least.
I'm terrified - as if trying to deal with depression, anxiety and some rotten negative life events wasn't bad enough.
still think you're not giving yourself enough time mate...it'll be a few weeks yet before the alcohol out of the system-give yourself-25% of the country probaly has fatty liver of some sort....keep on the decent diet stay off teh booze and a bit of exercise and things will improve...
I probably do seem to be impatient, but every day seems to bring another symptom - the latest problem is excessively oily skin. I gather that can also be a symptom of liver disease.
I am on at least three different meds that are implicated in possible liver problems: Quetiapine, Simvastatin, and Trazodone. It seems that these meds taken with alcohol are much worse for the liver than if the meds or alcohol are taken without the other.
My insomnia also seems to be getting even worse, in spite of using a sleeping med.
I've been thinking more about my drinking: it wasn't every day, it was regular and heavy, with occasional very heavy binges. I would have thought all the alcohol would be well out of my body by now.
Hi Gav...I`ve read some but not all of the replies ( there`s some good advice and information given) so forgive me if this is repeating information...I`m not a doctor but have lived with cirrhosis for 20 years...I have chopped away a huge amount of what I was going to write because the following is the most important thing to say to you...you will do yourself an utter dis-service by attempting to read medical diagnosis etc online or in medical books about a condition that you do not know you have...all you will do is scare yourself and end up with sleepless nights...there is ONLY one way to determine the actual condition of the liver or whether liver cirrhosis (of which there are 6 grades of severity) is present and that is by liver biopsy..tests and scans may point one way or another but are not a substitute or definitive..the spider naevi are a concern as they can be (but NOT always !! ) a sign of actual liver damage or disease...has your doctor or hospital told you they are spider naevi ? ..IF they are spider naevi then you need to ask for an appointment with a liver specialist.
Like I have mentioned above,there is much much more I want to say...but will leave it there for now...try not to worry yourself... you`re already taking the best step you can and that is by not drinking alcohol...keep it up.
Like most others here I have my own experiences etc and will gladly share them but for now the most important point I would pass on is stop gleaning information online and relating it to yourself...sorry if this seems harsh..I mean it sincerely and with warmth.
Good of you to post - another sleepless night here.
I'm not sure if I had a spider naevi or not. It was on the inside of my elbow joint, and was more like a blotch. A doctor said it was a bruise. I had several other bruises which suddenly appeared just over two weeks ago, but they've all gone.
I had several, acute visible symptoms that all appeared together on 30 August but, apart from thinning of hair, they've all gone. I do remain tired, a bit weak, foggy-brain, bloated, mild diarrhoea and lacking appetite, and my insomnia has got worse. My heart also seems to beat fast when I get up or stand, and I get dizzy easily.
As I said, my heavy drinking over the past year has been sporadic - steady drinking on many days, then occasional heavier binges, but very little between November and February, and two heavy binges last month: one at the start and one at the end.
I really wouldn't have thought about serious liver disease occurring over a matter of months of heavy drinking, and didn't start thinking about the liver until August, but thinking about liver-unfriendly meds I am on and taking them at the same time as the alcohol, I fear that the combination has caused me trouble. I'm just hoping it's reversible.
Like Steve I haven't read all the posts, but I have had a quick look at the meds you take (to which you say you have now added a sleeping pill). A number of them are for anxiety and depression and I assume you have been diagnosed with these as conditions by your GP. Can I ask how long have you been taking these medications? My advice would be to look at the cause of your anxieties and depression, which may need you to go back a long time and try and understand them. Alcohol,I am guessing was another "pill" to add to the mix. It concerns me how quickly you turn to pills to solve problems - I.e you add in sleeping pills for this recent bout of insomnia, which don't work anyway.
Worrying about whether you have cirrhosis or not is achieving only one thing, more anxiety. We can all say to you "stop worrying so much" but it will be pointless, as that's your personality. If you weren't worrying about this you would focus on something else to worry about.
My advice would be to ask for some counselling to try and resolve your anxieties and your need for medication or alcohol to try and block them out.
As a PS, if you can solve your worries with talking therapy and remove the medication therapy, your liver will thank you for it.
I had a different health scare just over two years ago, and quickly developed insomnia, depression and anxiety from that. I was abroad when this happened, and must have lay-awake all-night most nights for two weeks. I became haunted by the ending of a relationship (my fault) and other negative life events.
I've gradually been put on the various medications by a psychiatrist.
I have been on various different sleeping pills for over two years. Generally, they have worked, but have not done so for the past week - really since I had the ultrasound.
I have tried counselling and talking therapies, after which I've actually felt worse. I drank more alcohol since starting the cognative behavioual therapy earlier this year.
My body feels drained. My skin feels oily and greasy. My hair is lifeless. My eyes are bloodshot. I have lost a stone in weight inside a month. I know, from last week's ultrasound, that I at least have a fatty lver and am convinced that the mix of excessive alcohol and the prescribed meds over the past year, and especially the past 5-6 months, has seriously damaged my liver.
No, it was a scare. I had an exposure and suspicious symptoms a few weeks later. By the time I was certain it was just a scare, I had been affected mentally.
I am scared-stiff that, when I blow my nose, clear my throat or go to the loo, a lot of blood is going to appear, or that I have fluid in my abdomen. I have lost weight, but my belly doesn't seem to have lessened - it seems out of proportion.
For a few weeks, my instincts have been that something is seriously. Unfortunately, my instincts have been right so far.
Ok. So,your instincts 2 years ago convinced you that you had "caught" something nasty, but you hadn't.
Your instincts now are convincing you that you have cirrhosis, but science and your doctors are saying you don't.
Your instincts are convincing you now, that not only do you have cirrhosis you now have side effects of decompensated cirrhosis, such as varicies which you are convinced are about to burst, but your medical tests say you don't.
Two things occur to me. One is that earlier you said that talking therapies/counselling/peer to peer type support didn't help in the past. Have you noticed how long this thread has been going, how much you have communicated (or "talked") and how you have responded to the feedback. Seems to me that you manage "talking" therapy quite well.
Second thing that occurs to me is that the main health problem you have, the one that is preventing you from enjoying your life, is your mental health. If it wasn't a "liver" problem worrying you and triggering all thes anxiety symptoms, such as nausea, insomnia etc, it would probably be another health problem?
I don't think we can help you here with your "liver" problem because clinically there doesn't seem to be a significant liver problem.
Can we help with the mental health/talking therapy problem?
I'm not denying that I have mental health issues, stemming from the HIV scare (and other things that started to go wrong at the same time). Just so you know, with the HIV scare, I started to have night sweats - something common in HIV patients in both new and established infections. It took 3 months after the possible exposure to definitively prove that I did not have HIV, so I had a lot of worrying time.
Anyway, back to the here and now. I know how much I have drank over the past several months: at least 80 UK units per week, on average. I've also been on several liver unfriendly prescribed meds. I know I've had several liver function tests with elevated enzymes (though these weren't brought to my attention until June). I've also had an ultrasound that showed fatty liver (and I understand that it has to be considerably fatty for this to show-up on ultrasound). And I've also had umpteen symptoms, including on-going fatigue, weakness, muscle and joint pain, hair loss and hair thinning, bloating, profuse sweats, loss of appetite and weight loss of a stone in the past month.
I simply feel ill, and have done since the start of August, and just find it extremely hard to believe that "only" a fatty liver would cause all of this - when most medical sites state that fatty liver, or even early stage cirrhosis, often or mostly don't produce any symptoms at all. Really, apart from the excessive sweating that I think started in about June, this ill feeling has really been quite sudden - as I say, from the start of August.
I wish I shared your confidence that there's nothing seriously wrong. In fact, I'd give anything for that to be the case.
Just a quick reply as I'm going out. Let's for the sake of this thread say that, yes, you do have cirrhosis. What will you now do about it?
Cirrhosis caused by viral hepatitis or autoimmune hepatitis or PBC, well there is not a lot people can do about that apart from take medication designed to suppress the inflammatory activity.
Cirrhosis caused by drinking - there is no magic pill, people have to stop drinking.
Cirrhosis caused by medication - there is no magic pill, people have to remove the medication. I cant say for sure that any of your meds damage the liver to the extent of causing cirrhosis, but on top of alchohol they will have put your liver under stress.
If you have mental health issues and are under a psychiatrist who feels you need all the medication they have prescribed in order to stay well, then there is nothing you can do? Or is there ..................... ??
I started a new thread as there's an update - which is encouraging.
My doctor conceded that some of the meds I'm on are not liver-friendly, and some liver enzymes had already started to rise last year after I was put on them, and before I started drinking heavily, so the meds have certainly hot helped my liver.
(I've taken a statin for many years, and liver function tests over the years have shown enzyme values all over the place, though within normal ranges - some of the values actually higher than after I first started the regular heavy drinking last August.)
However, as they are psychiatric meds, my own doctor doesn't want to change them because it is a specialist (ie. the psychiatrist) who put me on them, not my GP. I'm not due to see the psychiatrist again until 19 October. I do plan to tell her I want to gradually reduce or come-off some of them. Long term, there's not much point staying-off or severely restricting alcohol intake alone if meds, with limited help to my mental health, are also toxic.
I'm impressed with 2 things. First that you are planning to discuss with your psychiatrist reducing some of your medication.
Second that you have started a new thread, I think it's positive that you continue to post (talk) to us on here and that you get feedback.
I am not impressed by your attitude to alcohol. I have chronic hepatitis B and what you say about there being no point in staying off the booze or even restricting it would be akin to my saying the same. There is no way I would drink alcohol while I have another "thing" stressing my liver. I can't control the damage the Hep B causes except by medication (same as your anxiety/depression meds are needed to an extent my hep b meds are needed). But I can do something about what I eat and drink. If you can do that too, your liver will be under a lot less stress and you will be a lot less anxious about cirrhosis.
Remember even vehicle exhaust and pollution is toxic to our livers, so work on what you can do something about, drink, food, exercise etc, while acknowledging that for some of us with liver damage we can't do anything and are not so lucky.
Firstly there isn't any evidence at the moment that the meds have caused any damage to your liver - and in fact no evidence of any damage anyway. Again, and I cannot stress this enough, it's unhelpful to mash inflammation and damage together.
The change in enzymes before meds and after may (and it's speculative) indicate that the meds were making your liver work a bit harder - but that's true of any toxins as Bolly said - and it's ONLY a problem for you if the amount of liver cells sacrificed in dealing with the meds is greater than the liver can repair or regenerate. Essentially it's doing its' job dealing properly with the meds.
So taking the alcohol out may be enough even on its own. Do discuss the meds with your docs and if you can be healthy without them then that is always preferable, but don't assume that the meds have caused a problem for which there is no evidence.
"Long term, there's not much point staying-off or severely restricting alcohol intake alone if meds, with limited help to my mental health, are also toxic."
I think you should take a bit of time and read through your threads. You seem like a really nice and sincere person, but you're not great at coping - which is why you have the meds in the first place.
The alcohol became a coping mechanism for you. Notwithstanding the fact that you like it and in your mind drank reasonably for a time I think it's a red flag for you.
In summary;
i) You have a fatty liver.
ii) You gave yourself alcohol poisoning from excess alcohol to cope with issues.
I have to agree with Mister X here. I think you are raising your hopes thinking you may be able to make significant changes to your medication. Its a risk/benefit scenario. What are the risks of the medication compared to its benefits for your overall wellbeing (not the same as health).
The easiest thing for you to remove from the risk side, is the alcohol. There are no health benefits to binge drinking alcohol or relying on it for mental health reasons.
You can also remove unhealthy food from the risk side; thats sugar, salt, saturated fat, convenience food (hidden sugars and salt), fizzy drinks. For those of us that supermarket shop this is surprisingly difficult, as it restricts you to the fresh food aisles, but it does improve your culinary skills, lol! I confess to have aimed high when first diagnosed with liver cancer and failed long term in that 5 years on I still eat sugary breakfast cereal rather than porridge (bleuch without golden syrup, yum).
There will be another health anxiety or life crisis coming up in your life I would guess. There have been others before this havent there. What you could do now is work on acquiring some better coping mechanisms for the tough stuff life throws at you, so that you dont need to resort to things like pills and alchohol to get you through.
Don't know if you've tried it - and it may not work for you - but if it helps, we have a "porridge station" with tupperware filled with nuts - peanuts, walnuts, almonds, pecans, raisins and sultanas and some alternative grains like barley. We also have peanut butter and chocolate spread and fresh fruit as well as dried fruits. So we can mix and match those in various combinations with the porridge to take the edge off.
The good thing about it is that if you don't feel like porridge you can add the same ingredients to jazz up bran flakes or Weetabix or whatever.
The logic being that a small amount of sugar in raisins etc is offset by their nutritional benefit and that of the nuts etc.
Indian shops stock all of this stuff as a matter of course so it's easy to stock up. Harder to avoid scarfing all the nuts between meals though.
Great..... now I've given myself the idea I'm going to go and get some. I'm very auto-suggestible. Good thing I wasn't writing about burgers..
I do like dried fruit and nuts. I will try your idea Mister X. Hubby (who is generally well but was advised to lose weight due to high BP) eats plain porridge oats with water for breakfast sprinkled with cinnamon and ginger - yuk! Mind you, on physically busy days he eats bacon and eggs, yum. I am eating breakfast at 6am when I am not really hungry and dont have time for something healthy like an egg. Home-made muesli sounds a good idea.
PS Did you know how much sugar in a serving of bran flakes? Much more than you would think. I think i need to rethink breakfast cereal entirely as the only low sugar versions are disgusting in my view, ie even shredded wheat has 6.2g per servings and now we are advised to limit daily intake to 7g. What can I eat at 6am, hmmmmm Any ideas? I'm then 'on the road' til about 11am when i have egg, toast, beans, tomatoes and mushrooms on a good day.
I find making sure there is a wide variety of ingredients available makes it all less tedious and it's nice to come up with combinations. I quite like apple, walnut raisin and peanut butter for example. And you can cook them with the porridge or add them in cold depending on mood.
And the extra effort is only adding a few spoons of things in. Also good tip - do use a teaspoon or tablespoon measure - it's easy to overdo adding ingredients and sometimes a bit less actually tastes better - like raisins for example.
Muesli works really well - there's also bircher style muesli as well where the ingredients are soaked overnight.
I know All bran is about 18% sugars, or about 7g per 40g serving.
The advantage of having the nuts and seeds and other grains is that you can add them to reduce the amount of bran etc in the bowl if you want to.
I thought he daily rda for sugars was 90-120g? Bran flakes will normally have about 1g of salt - so worth taking that into account.
Breakfast is a difficult one. My breakfast of choice is a cup of tea and half a packet of chocolate digestives, but apparently I shouldn't do that (I have yet to see definitive evidence I'm willing to accept on this subject), so I usually alternate between bran flakes with things thrown in and porridge with things thrown in. Toast with peanut butter and fruit is good too - esp bananas but thin apple slices work well. Most things do in fact.
We should start a breakfast thread where people swap recipes for what they had....
Yup you are sort of right and I am very wrong. I got carried away watching Jamie Olivers 'Sugar Rush' documentary where they said 7 teaspoons a day, not 7g, equates to no more than 30g of 'free' sugar so a lot lower than published RDA and doesnt include natural sugars.
There are a few companies that do 100% peanut butter - or close to 100%. The one I remember is called Meridian.
It's a shame supermarkets here don't have nut grinders, they do in the US for peanut and almond butter so you just press a button and have fresh nuts ground into butter for you - no additives and usually cheaper than jars.
Re sugar -and this is just for anyone who happens to read this - 90-120g total sugar with a maximum of 30g coming from sugar added to food, the rest being naturally occurring sugars as found in fruit, milk etc.
Bought Whole Earth 3 Nut Butter (peanut, cashew, hazelnut) with a tiny 3.2g of 'naturally occurring" sugar per 100g. The jar is 227g so each tsp of spread must have a tiny amount of sugar. It tastes great, so thanks for that idea. High fat though, but only a tiny % of saturated fat.
Also Rude Health muesli which has no sugar but oat, barley and rye flakes, apricot mangoes pumpkin seeds Brazil nuts dates almonds Apple and cinnamon. Just had a bowl with warm milk and its delicious. Not sweet at all but the apple and cinnamon gives it enough sweet taste. So many thanks for your tips, I shall enjoy.
Yes, I know I keep using inflammation interchangeably with damage and one isn't the same as the other, but inflammation eventually leads to damage, right?
My doctor did not seem concerned about the GGT still being 70 (normal: 8-61) because it had fallen from over 100 in just a few weeks. He said it would continue to normalise with continued abstinence.
But it was the fall of the AST from 100 to a mid-range normal value of 23 (0-40) that impressed him the most. He said this showed there was no lasting damage (he did use the word damage). That's when I spoke to him about fearing that a badly damaged liver wouldn't produce many enzymes to leak into the blood, and where he, like yourself, said that would just not happen without severe symptoms and other aspects of the blood tests being highly abnormal.
I'm still disappointed that there was not, and never has been, an ALT reading. I thought it was standard in liver function tests and, as it was never mentioned to me, just assumed it was normal.
"but inflammation eventually leads to damage, right?"
No not necessarily at all. It depends on what the cause of the inflammation is and whether it is acute or chronic.
Even if prolonged or acute liver inflammation leads to fibrosis, as soon as the cause of the inflammation is eliminated or reduced to a level below that of the liver's ability to regenerate and repair, the liver will regenerate and repair faster than any damage.
"I'm still disappointed that there was not, and never has been, an ALT reading. I thought it was standard in liver function tests and, as it was never mentioned to me, just assumed it was normal."
That's probably the difference between proper medical training and random googling I'm afraid.
I'm treated at King's College Hospital which is one of the world's leading centres for liver issues. The measure they have been focussed on from my first appointment has been AST and for the first 12 months they didn't take an ALT reading at all. They did take one when I asked out of curiosity but it wasn't necessary.
In any event historical ALT readings won't help you anyway. The liver will have been working hard to undo any possible damage the alcohol did so it won't tell you anything relevant. I've got some old spectacularly high ALT readings. They're completely irrelevant to my current and future prognosis.
You've been quite lucky. There isn't any evidence of inflammation or fibrosis of your liver. As long as you can stop the drinking and embrace a healthy diet and exercise you should be fine. You liver is now hard at work getting itself into shape.
I was very serious about the drinking though. Based on what you've said you need to end it.
I forgot to say that I got a print-out of all of the LFTs that my GPs have done on me since 2010: 12 tests in all.
The five measures on it are: Albumin, Total Bilirubin, AST, GGT and Alk Phos.
In all of them, the Albumin, Bilirubin and Alk Phos have always been inside the normal range.
I've been looking at the figures, so please bear with me.
GGT - normal range 0-61 - had been in the 20s, but started to rise last year (though still in normal ranges in all of last year's tests, the highest being 54 in November, a few week's after a binge). Interestingly, the AST reading the same day was just 15.
I don't appear to have had another LFT until 15 June this year, when GGT had risen to 120. However, I'm sure that, had I had LFTs in March, April or May, GGT would have been similarly elevated, as my drinking had increased again from March.
GGT was 107 on 20 June and 121 on 4 August, before reducing to 72 on 17 August and 70 on 15 September.
Do all of those elevated readings indicate inflammation that you have been talking about? If so, that would be about 5-6 months of harm.
The AST readings are less clear. It was first elevated - to 47, normal range 0-40 - in an LFT on 27 Aug 2014, just after I had started to drink heavily and take a liver unfriendly drug called Quetiapine. But, the same day, GGT was only 49 - ie. within normal ranges.
In all of the other LFTs since, AST was only above normal twice: 42 on 15 June (and then down to 32 again on 26 June), then it spiked badly to 96 on 4 Aug (after a week of heavy drinking and a binge), but dropped back rapidly to 25 on 17 Aug, and has now dropped back further to 23.
So, AST does not look to have been elevated for long periods of time. I assume that is good news and why the doctor was so keen to reassure me yesterday?
Thanks again for your time and thoughts. Hope you've been enjoying the rugby - especially Japan!
The Japan - South Africa match was fantastic! Really enjoyed that one.
I'll start from the top if it helps but before I do there is no evidence of any inflammation or any fibrosis of your liver.
If the person I love most in the world showed me those numbers I would not be concerned that they had any liver damage.
GGT. The normal readings indicate normal function.
The elevated GGT numbers you cite indicate alcohol. Isolated rises in GGT are not considered significant but can indicate the presence of alcohol.
"However, I'm sure that, had I had LFTs in March, April or May, GGT would have been similarly elevated, as my drinking had increased again from March."
There is no basis for this statement - it's pure speculation. You may as well toss a coin.
Where is this 5-6 months you mention? All I see that's relevant are 15th June - 4th August (7 weeks) GGT at 120 to 121.
The GGT at 72 and 70 are very close to the upper normal limit.
So to answer your question - ignore all the normal GGT figures. The rise in GGT is consistent with alcohol, not of significant liver inflammation.
AST. 47 against a 40 upper level is piddly as is the 42.
The only figures of note are the 96 and the 25.
So there is one single blip in AST to 96. which resolved within 2 weeks. That is a really short time. Really really short and consistent with what the alcohol would have been doing to cells around your body.
So in summary. No evidence from that of inflammation or damage. You do have evidence of fatty liver from your ultrasound and because it would be likely from all the ingestion of alcohol.
Please understand that in the context of your liver these slightly above normal historical results are rapidly becoming irrelevant. Since you stopped drinking the liver has been hard at work repairing and regenerating cells - as it is all the time. Bear in mind that had someone cut half of your liver off at the start of August your body would be well on he way to completely regenerating it by now.
So what were your last results? Normal?
These are now the only results that count.
The only thing you need to deal with henceforth is the fatty liver. There isn't anything in those numbers that would alarm anyone.
"However, I'm sure that, had I had LFTs in March, April or May, GGT would have been similarly elevated, as my drinking had increased again from March."
You're right - that is pure speculation, but I'm a worrier, and worried that the elevation had started last Autumn, was continuing through the Winter and Spring, and so on to the triple digit readings in June.
Thanks for explaining everything so well.
Nite-nite and hope Sunday's games are as enjoyable.
Just to be clear the GGT on it's own doesn't indicate anything - it's only useful in the context of other readings from a diagnostic point of view. So the only time GGT would have been relevant from a liver perspective was when your AST blip happened - and even then all it did was to indicate that you'd been drinking excessively. Which you knew.
The only thing you should be worrying about is sorting out the causes of the fatty liver. Worrying about your 3 month old liver function tests is rather like me worrying about scraping my knee when I was a kid. Those rises (such as they were) have been superseded by events.
Your liver has moved on. So should you. You do have fatty liver to deal with though and you should put all of your focus on dealing with that. You definitely do not want that to continue.
Having felt unwell over the weekend, I felt even worse on Monday (no appetite, drinking a lot of fluids but still dehydrated, achy, serious discomfort in the pelvic region, light-headed, faint, and drained), so I phoned the out-of-hours GP in the early evening.
He said I should go to the hospital, tell them he had told me to go there, and get checked-out.
I had an ECG done, blood and urine samples taken. A doctor then gave me a physical examination.
Later, he said that all of the blood (including LFTs) tests and urine test were normal. He then did a lactate test and said it was normal, too. He also ruled-out diabetes.
At one point, he speculated about hepatitis (I don't know whether he was talking about the virus or inflammation) and had me really worried, but then reverted to talking about fatty liver.
He said there was no reason to be kept-in, but to go back to the GP for referral to specialists as there was obviously something wrong - not least due to continuing weight loss, loss of appetite and the other things I told him about.
It's a real shame you're having to spend so much time with your doctors and can't be getting on with your life in a positive fashion.
One thing to bear in mind is if all of this is preventing you from dealing effectively with your fatty liver through diet and exercise then that condition may be getting worse.
It would probably be a good idea to start a new thread once you have something diagnosed - I think this one's getting rather unwieldy and in the absence of anything diagnosed completely speculative.
I feel a bit better today and have eaten, but I felt awful yesterday and it is very frustrating not to have an explanation because everything was normal in the tests done.
I hate going to and from different doctors and medical sources because it is not me - I was used to having a problem, going t see a doctor, getting it treated or taking regular medication, and getting on with things.
I guess I should get my thyroid checked and take it from there.
"I'm a worrier", you certainly are! You say you are or have in the past taken Pregablin, Quetiapine, Temazepam and Trazodone. Which are in turn for anxiety, psychosis, insomnia and depression. You also say you have a psychiatrist and that you have scared yourself in the past with non-existent health concerns.
I think the issue for you is not your liver, but your mental health. If you can get to the bottom of why life makes you so anxious and if there is a way you can become less scared of what life throws at you, then hopefully you wont need so much medication... and your body will thank you for it. However you need to be guided by your psychiatrist on this, its not one for us, as we have no idea of your mental health history and how you got to where you are now being so over anxious about things. Best of luck in the future and in the nicest possible way I hope you dont need to post on health forums for support once you have found a happier path in life.
It's really very complicated, but a lot of negative life events have brought me to where I am and, had they not, I wouldn't have been put on so many medications or resorted to heavy drinking.
I have never felt so physically unwell in my life. I also now have blood in my urine.
Its not all in your head Gavin I agree. The symptoms manifest in tangible ways. Its how you deal with them that is in your head though.
I remember watching some weird programme that someone like Michael Mosley - the BBC "Trust Me I'm a Doctor" guy or another medical presenter who went to see people in remote villages in South America or Uzbekistan or somewhere where the nearest doctor or dentist was about 3 days away. They had learned techniques on how to control their mind's reaction to pain, so they could have teeth extracted and mentally switch off the pain responses. The mind is an amazingly clever and strong thing. Some of us have a lot of negative life events (how does my list of mother dying of cancer when I was 24, diagnosis of chronic incurable illness at 26, father dying, cancer diagnosis myself, miscarriage of a twin stack up as 'negative life events') but not all of us turn to alcohol or become very anxious or depressed and medicate ourselves to cope. Thats why some people who have a traumatic event suffer from PMT and some dont, its all about how your brain/mind processes the trauma and how quickly you come to terms with it.
I'm in the same boat Gavin. I'm a woman who drink for 3 years 80 units maybe a little less a week and woman are more prone to liver disease from drinking. I feel like a hypochondriac. All my tests were normal but bilirubin and ast 12 alt 11. 2 clear ultrasounds. I've read stories were cirrhosis was missed on these tests which scares me to death!! I feel I'll too. I have pale skin dark circles bloodshot eyes nausea aching joints. Something is wrong and I can only point it to my alcohol intake. There's not much more I can do doc says not to worry about my liver
I am not a doctor or a nurse or any way medically trained, just someone who, over the past several weeks, has read more and more about issues concerning liver health.
I had a 25 year history of regular but mostly moderate drinking. The heavy stuff started just over a year ago. Like you, it was 80-100 units on average per week, with some gaps of much less, but a few occasions when it was more.
I used to think that it took years and years of very heavy drinking to cause alcoholic cirrhosis, but it can depend on several factors, not least genetics and concurrent use of medications, even over-the-counter ones. Age is also likely to be a factor - a 50 year old liver is probably less robust than the average 25 year old one. It's the same with smoking: some spoke 80 cigarettes a day for decades and don't get lung cancer or heart disease, others smoke a few and do get those conditions.
Put it this way: if my numbers were as good as yours seem to be, and I had had two clear ultrasounds, I would have felt a lot happier than I have been.
That said, I think we all know our own bodies because we experience symptoms that were not there before - that has certainly been the case for me, and it seems like it is the case for you.
I had a long consultation with my regular GP this morning. My blood results were better. In fact, everything was normal except for the GGT enzyme, and even that has fallen close to the upper range of normal.
My GP assured me several times that the results show that the liver has been irritated - and we know from last week's ultrasound that it is fatty - but it seems to be repairing. I still don't feel well - it's a bit like the flu without the cough and runny nose - but I have been somewhat reassured.
All I - and perhaps you - can do now is to continue to avoid the heavy drinking, try to eat healthily, drink plenty of clear fluids, and get some exercise as our bodies allow us to.
Then, maybe get bloods repeated in a few weeks. I don't know about getting more scans - my doctor says I don't need any, and I guess I should have faith in him.
I hope you can relax a bit more and also get - and push for if you need to - the answers you need.
The alcohol problem has ebbed & flowed, I tried rehab but hated the confinement, then Acamprosate, which didn't work, then Naltrexone, which my liver doesn't seem to like.
I have also been in hospital several times, either directly or indirectly related to alcohol.
Yet the Doctor have all said that, despite raises GGT levels, liver function is fine & I am actually eating like a horse. It is not fluid - just fat & lack of exercise.
An awful or of this is due to insomnia, lonlieness & boredom -but I guess only I can do something about that.
Sorry to hear that Gavin, keep fighting, drink is hard to overcome for some people, I just stopped because I could feel my body telling me it couldn't take it anymore, I lived in that culture of hard physical work/hard drinking and I was fine for a few decades like that, but I suppose wear and tear and age will catch up with is all,
I am also very worried about my liver and general health and I am waiting on test results, please God it's not too serious and I can fix some of the damage I've done and enjoy life again, but I'm an awful worrier and insomnia isn't helping either,I have had a very bad year with a lot of health issues. roll on 2018.
Have you had a ferritin blood test for Haemochromatosis, this is not covered by a full blood test. Google it and then you will see how many of your symptons are covered.
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Some good news
Some really good news and some really bad news.
Hubby's First appt with Hepatology earlier today
Good news
Good news 
