Dry mouth liver disease?

[linzenilss22]

I have a terrible dry mouth almost for a year now. I have read early stages of alcoholic liver disease are dry mouth fatigue loss of appetite itchy weight loss light colored stools. When I first started feeling sick I had all of these. The dry mouth fatigue right quadrant pain and nausea I still have everyday. I don't understand how my Dr says don't worry about my liver when I have all the symptoms. I had 3 lfts first one was when I was experiencing all these symptoms and everything came back normal. I even went to the hospital lft cbc and ultrasound came back normal. Does anyone know if ast alt and alp are under normal value if thats a concern? Also I have a low BUN and read this can be due to liver diseasr!!

[RodeoJoe]

I'll start by saying that I've had blood results that went to my GP of bilirubin levels of over 300 and that didn't even get flagged and I wasn't told. My consultant had no explanation how it slipped through the net. I do get the feeling sometimes GP's ask for bloods as routine and nobody ever checks them. I think this can happen when the GP is expecting the hospital to check and vice versa.

However if you know what your bloods were then someone must have looked and told you it wasn't a concern. There are a lot of people that come to this forum terrified that they have alcoholic liver disease. If you're getting normal LFT's and ultra sound's I think you can relax. Even if unidentifiable damage has been done it will probably repair, or at worst stop progressing. You need to just change your life style and stop worrying.

I don't know what the answers to your questions about the bloods are or even what a low BUN is, but surely if they were of any concern your Dr would investigate. If you don't trust him you have to get a second opinion

[Bolly]

I think BUN looks at urea and kidney function. Low levels can indicate poor nutrition. I understand in people who substitute alcohol for food then poor nutrition is not uncommon . How is your diet linzenilss

[Stourie]

I don't know anything about your liver but you should always get a copy of your bloods and post here for advice. xx

[linzenilss22]

Here is a copy of my lft

SODIUM 139 (136-144) MEQ/L Z

POTASSIUM 3.9 (3.6-5.1) MEQ/L Z

CHLORIDE 109 (98-109) MEQ/L Z

CARBON DIOXIDE 22 (22-32) MEQ/L Z

ANION GAP 8 (3-15) MEQ/L Z

GLUCOSE 114 (70-99) MG/DL H Z

BUN 11 (8-20) MG/DL Z

CREATININE 0.9 (0.6-1.1) MG/DL Z

CALCIUM 9.6 (8.9-10.3) MG/DL Z

PROTEIN,TOTAL 7.6 (6.0-8.2) G/DL Z

ALBUMIN 4.5 (3.4-5.0) G/DL Z

BILIRUBIN,TOTAL 1.8 (0.2-1.2) MG/DL H Z

AST (SGOT) 12 (15-41) U/L L Z

ALT (SGPT) 11 (11-54) U/L Z

ALK PHOSPHATASE 33 (35-126) U/L L Z

GFR, WHITE (MDRD EST.) >60 (>60) ML/MIN Z

Calculation assumes a body surface area of 1.73 sq meters.

GFR, BLACK (MDRD EST.) >60 (>60) ML/MI

[MisterX]

You're in a difficult position here I think. The blood tests don't scream out that there is a liver problem. The isolated increase in bilirubin should have an eye kept on it but many people do have higher than normal bilirubin. There isn't anything else in the blood results to attach the bilirubin to.

The BUN you mention is in the normal range - what made you think it was low?

The ALT is at the bottom of normal and the AST very slightly below. I think your docs would see that as a problem if it were - it looks to me like the low AST is probably within a margin of error - but if it's persistently low then you should ask your docs to explain why they're not concerned about it.

Other than that, the bloods look fine and function looks ok. The difficulty you have is that on the one hand you are...

a) Getting assurances from your doctors that all is well

on the other hand

b) Asking people without medical training to judge if your symptoms can be diagnosed as liver disease.

For b) when there is something obvious then yes, people here with experience can say - "well actually I know that this measure indicates this and you should ask your doctor". The trouble is is that nothing you are referring to is obviously a sign of liver issues per se and so notwithstanding your symptoms, if your consultant in full knowledge of everything you are saying here says there is not a liver issue than my view is that he/she is probably correct. IF your physical symptoms are such that you don't feel they should be ignored then you should consider getting a second opinion.

I don't necessarily think googling symptoms of liver disease is going to help you. The liver affects almost everything in your body so a person with advanced liver disease will get many odd symptoms, but nearly always the obvious ones come first - like jaundice, blood test results, spider nevi etc etc. I've not heard of cases where a person has some of the advanced secondary consequences of a failing liver or some obscure consequence without any of the primary ones. Doesn't mean it's not possible but I've not heard of it.

Some of the things you mention can be causes to investigate liver disease but once investigated if there is no evidence there may come a point where it may be better to look for some other cause.

Very best regards.

[dckimberly in reply to MisterX]

Well said and well read Mr.X. I get concerned when we start acting like doctors on here, and that people actually think we have the answers. All we have is experiences, personal ones, and liver disease can vary greatly from one person to the next. I was forbidden in the US and the UK to look up info via Google, especially webMD. I was given two different sites that I could trust for information, but not advice.

It's important that people get a second opinion if they are truly concerned. We are, to a great extant, responsible for our own health..therefore, seeking extra help is never a bad thing, but going to a professional is what needs to happen first and foremost.

Because yes, things can get overlooked and missed..it does happen, but not often.

Cheering you on and thank you, I do always enjoy your posts very much and your responses.

Kimberly

[linzenilss22]

Thank you for that my ast is always low on 3 different tests. Do you know what that could indicate? I do not have jaundice but do seem to have pallor. I do not see spider nevi I have red pin pRick dots but no vessels radiating from them.

[MisterX in reply to linzenilss22]

Hi,

Depends what you mean by low - if low but within range then that's normal. If a bit lower than the normal range then that could well be your normal - the normal range varies by sex, person and even time of day or within the margin of error.

I'm afraid I don't have any specific information that a persistently low AST level slightly below the normal range is of concern - the normal range is a statistical distribution anyway so there will always be outliers, but I don't think it would hurt to ask in case they think it's important.

You'd know if you have jaundice - the whites of your eyes are a good place to check, but the last person I saw with jaundice looked like they'd been painted with a yellow highlighter. Unlikely with your levels of bilirubin to be honest - you'd need many multiples of that and obviously you should be relieved you don't have spider nevi.

The evidence seems well stacked against you having a liver problem to be honest. The blood results are nearly all normal or close, ultrasounds are picking up no fibrosis (did they pick up any fatty liver?), you don't have jaundice, blood in stools or pale stools (historical instances don't count if they're not persistent), you're not bleeding from the oesophagus.

You do have fatigue and right quadrant pain. Right quadrant pain is more associated with gallbladder issues - but I presume those have been checked. Possibly something intestinal?

If you do have fatty liver then obviously that can be caused not just by alcohol but also lifestyle so you do need to get your diet and exercise under control.

Other than that I'm out of answers I'm afraid.

Best regards.

PS which part of the US are you in?

[linzenilss22 in reply to MisterX]

Hi no fatty liver shown on ultrasound. Normal size free of fluid normal spleen. My other lft showed a bun at 9. 3 years ago my bilirubin wad 1.0 higher end of normal before my daily drinking. These symptoms just point me to the liver. I had a hidascan that showed gallbladder working properly. They can't seem to find anything wrong. I'm about 45 minutes from Philadelphia.

[MisterX in reply to linzenilss22]

Hi,

Sorry but now I'm even more confused. Reading this post you're saying...

........"These symptoms"

No fatty liver - Ultrasound

Normal size liver

Normal spleen

Free of fluid

BUN at 9 (presuming limits are still 8-20) so normal

Bilirubin 1.0 in old LFT - also normal

.... "just point me to the liver"

How exactly?

Good news about the gallbladder by the way.

Obviously if you're still unwell it's a matter for your doctors but I can't see what liver problem they would need to investigate based on your symptoms and overwhelmingly normal blood results.

[linzenilss22 in reply to MisterX]

I guess I worried since last October I vomited and had light colored stools. When I Google it I saw liver disease. I went straight to my dr. For an lft all was normal even bilirubin. Than in January I had an ultrasound for right quadrant pain all normal. Than I was reading on many sights people have liver disease with totally normal bloods and cirrhosis was not found on ultrasound even though they had it. I was advised by my dr. To go to the hospital since quadrant pain loss of appetite weight loss fatigue and weakness were going on for a couple of weeks. Lft there bilirubin 1.8 and normal ultrasound. Cbc also normal. Did a follow up 2 weeks later lft normal bili down to 1.3. I am just worried I was a 3 year mostly everyday drinker. I am a woman and I have read of heavy social drinkers getting cirrhosis particularly woman. I'm just terrified labs and ultrasound missed something since I see you can have cirrhosis with normal bloods. Sorry for the long post just wanted to tell you how I got to this point. Also at the very least I thought I would have fatty liver I've read 90% of drinkers do!!!

[MisterX in reply to linzenilss22]

Hi,

On the fatty liver front first - yes it's common from drinking but also from lifestyle - especially in the US although we're not far behind. The drinking can accelerate fatty liver from lifestyle issues but if you deal with both it reverses pretty quickly - there's not much a doctor can do to help that that is better than what you can do yourself.

Rapid weight loss can also cause fat accumulation in the liver, but again this reverses itself quickly.

On the subject of cirrhosis, for the most part cirrhosis is associated with cause and effect - so usually a doctor can work out where it came from. If you randomly selected someone off the street who when asked said that they felt fine, you could cut them open and find an undiagnosed cirrhotic liver - i.e. they haven't experienced any symptoms yet - and many people live for years with cirrhosis both known and unknown.

In your case your concern is that your drinking has given you cirrhosis. Firstly you have no evidence of any liver dysfunction, nor of any hepatitis nor of any fibrosis let alone cirrhosis.

Even if you had cirrhosis the treatment would be EXACTLY the same as you are already hopefully undertaking, namely...

Stop drinking

Eat a healthy diet

Get exercise

Keep an eye out for liver dysfunction and complications (ascites, oedema, encephalopathy, portal hypertension).

So it's not as if the doctors are holding out on you and preventing you from getting some sort of treatment that would help you. And bear in mind that the liver can reverse significant fibrosis including the early stages of cirrhosis. The later stages of cirrhosis would be marked by decompensation, which you definitely don't have.

There is no treatment that is more effective than the liver's amazing ability to repair and regenerate itself. This is also why you can't rely on old blood test results to tell you what's been happening. By now they are irrelevant - as is the incidence of pale stools from whenever that was almost a year ago - If you cut half of your liver off today it will have mostly regenerated within a few weeks, so your old test results are unhelpful in assessing the current state of your liver unless in the context of a chronic liver problem,

I really can't see what your doctors are doing wrong in the situation you've described. You should consider getting a second opinion if you think it would help but short of getting someone to cut you open, take a look, diagnose cirrhosis and then advise you to stop drinking, eat healthily and get exercise there really doesn't seem to be anywhere you can take this.

Hope that helps a bit.

Best of luck.

[scottyboy40 in reply to linzenilss22]

Goodluck to you Linzenilss. All the best and I hope you get to the bottom of this hon. Xx

[Hidden]

You need to tell the doctor exactly how you feel. I can tell you are getting yourself in a state x

[linzenilss22 in reply to Hidden]

Yes I have explained to my dr. And told her my drinking history. She said if there was any damage it would show but I've read different. I was told by her she doesn't think it's my liver causing problems.

[RodeoJoe]

I think the main problem with your diagnosis of liver disease is that your symptoms are normally only associated with pretty far gone liver disease. And if liver disease is not showing up in bloods and an ultra sound I think most consultants would count that out. I think you have to go back to your GP, as your symptoms could be something else. But I can't help but think that the anxiety caused because you think you have liver disease is causing these symptoms.

[linzenilss22]

Thanks rodeojoe Ive been dealing with this anxiety about my liver for almost a year. I'm on other health sites and when I read people's stories of them having an ultrasound it showed remarkable even though they have it and there bloods are in normal range. I felt pretty cofident after my tests until I read these stories. I thought normal lft and ultrasound great I'm in the clear!!!

[RodeoJoe]

My advice is to leave it to the professionals. It's well documented that googling health symptoms causes anxiety. If you can get into a mindset that worrying won't help you're almost there. Alcoholic liver disease in the early stages, it's not even treatable. So I'd just take the Docs advice and a few life style changes will be all that's needed.

Ironically all this anxiety is probably doing you more harm than social drinking ever would

Good luck

[Hidden]

I was exactly the same as you for over a year I was worried I'm having counselling which is helping .

X

[Hidden]

You need to move on I know that's easier said than done .

The only other option is a biopsy but not sure they will that x

[linzenilss22]

Thanks so much everyone!!! I really appreciate you taking time to answer my questions. This is a great site with many supportive people!

[Hidden]

Keep strong x x

[Zelda5]

I did notice your glucose was a lil high. Was this a fasting test? Even still, probably only in the prediabetic range.

[linzenilss22 in reply to Zelda5]

Hi jean. I didn't have anything to eat that morning but did drink some coffee so I'm sure that may had an effect on it

[linzenilss22]

Forgot to mention my palms are very red. I also have prominent blue veins showing all over my body including fingers chest legs arms shoulders and noticed some appeared on my temples

[catchcoolrj]

linzenilss22, Thanks for all this conversation