Fibroscan of 12.4: I had a fibroscan... - British Liver Trust

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Fibroscan of 12.4

B_RC profile image
B_RC
73 Replies

I had a fibroscan score of 12.4 on my liver. The doctor said he can see scar but it is not chirrotic. It would reverse if I cut down on alcohol. Does this sound about correct? I have been reading on here that anything over 12.2 is cirrhosis and it is getting me worried. Only other symptom is right side abdomen pain.

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B_RC
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73 Replies
Bolly profile image
Bolly

The doctor gave you the correct advice about alcohol. At that score, if it was me, I would completely abstain from alcohol rather than just cut down, until liver tests showed my liver had returned to normal.

B_RC profile image
B_RC

That's what I am planning to do. Then retest in a few months time. Because of the alcohol relation to the score I am now learning that it wasn't as serious as I first perceived it to be. The abdomen pain keeps me reminded of it a fair bit.

briccolone profile image
briccolone in reply to B_RC

take Bollys advice-a good 3 months off should make a difference

raikarsuhas profile image
raikarsuhas in reply to B_RC

Hiii, hope your health is good now.. my fibroscan report is 7.2 but pains lot. What happened further. Please let me know.

briccolone profile image
briccolone

what prompted the fibroscan? deranged blood results? high GGt? If you've been drinking recently-this can skew the fibroscan result but 12 is a bit of a wake up call-I had a 7.2 reading a while back and high GGt which showed fatty liver-I've moderated a lot since then.

raikarsuhas profile image
raikarsuhas in reply to briccolone

Same here 7.2. I consumed alcohol only one time within one and half month. How many days it takes to painless life. Please let me know

B_RC profile image
B_RC

I had a heavy drinking session in Scotland. Which prompted right sided abdominal pain from the drink. I have been a binge drinker for a good 8 years. Off the top of my head my last ALT was 48 but my GGT was 124. I was referred to the liver specialist who advised a fibroscan as I already had an ultrasound back in July which was normal. I decided to go private and get it done straight away with the result coming back at 12.4. I have only had 1 beer in the last month, the pain is always the same and doesn't change. All other bloods are fine except I have alpha 1 deficiency it should be 1.1 but it is 0.8. The doctor doesn't believe that this has an influence on the pain symptoms or to what is going on.

AKE1804 profile image
AKE1804 in reply to B_RC

Can i please ask where you had the private fibroscan test. Many thanks

in reply to AKE1804

This post is 4 years old so you may not get a reply. These days more NHS Trusts are offering FibroScans as a standard test if you are referred to a hepatologist, although at the moment they will be limited due to Covid.

You may want to discuss with your own GP.

AKE1804 profile image
AKE1804 in reply to

Many thanks

Bolly profile image
Bolly

I would take a diagnosis of Alpha-1 anti trypsin deficiency seriously and be asking for further advice.

alpha1.org.uk/

B_RC profile image
B_RC

Thanks for the info. I will enquirer about it when I can. The GP is pointing to alcohol. I have had pain for 2 months in the liver area, had 1 beer in the last month and the pain doesn't seem to be getting any lighter. It could well be that the alpha deficiency is the real cause.

B_RC profile image
B_RC

Doctor convinced it is liver inflammation causing the "pain" and will die down when it is ready to.

briccolone profile image
briccolone in reply to B_RC

It can take quite a time for inflmammation to subside although in my experience 6 weeks should start to see some improvement.

B_RC profile image
B_RC

Is that 6 weeks where you are alcohol free? If that's the case I have only had 1 drink in the last 4-5 weeks so should start to feel better soon

Bolly profile image
Bolly in reply to B_RC

I think it was Kimberley who reminded us it's one month for every year drinking, so B_RC it's 8 MONTHS you need to abstain, not 4-5 weeks.....sorry 🙃

briccolone profile image
briccolone

well I had been drinking a long time so I was getting twinges up to 10 weeks but also ha d digestive issues-eventually subsided after 12-stick at it-everyone's different

B_RC your results indicates you are getting close to F3 Fibrosis which is progressive and leads to F4 Fibrosis which is also known as Cirrhosis. The Liver can usually recover from F1 and F2 scarring or atleast if there is some scarring left it wont progress if the cause is stopped, in your case Alcohol.

I would also look deeper because 8 years is a short time to get where you are, you would have to be drinking huge amounts every day to get serious Liver problems in 8 years. I was a binge drinker for 20 years and my blood tests were normal and I had a Fibroscan of 4.2kpa, my drinking would be 2 or 3 sessions a week of 6,7 pints or a couple of bottles of wine. I would say around 40-60 units a week.

B_RC profile image
B_RC in reply to

Would you say that the scarring could completely go? I have had 1 beer in 7 weeks, still with abdominal pain. 12.4 is touching F3. But I would say that I am more F2 with that going up to 12 and F1 is 8. In comparison to F4 being 23?

in reply to B_RC

F4 is 19.5 I think. The fibroscan is a good test, but F2/F3 overlap and its difficult even for a Fibroscan to give an exact result. at 12.4 you are in great danger of dying from Liver disease eventually, if you dont stop drinking. You cannot have ANY more alcohol, you are putting fuel on the fire.

Can you not see how your addiction is controlling you? even in the face of a test confirming you have Liver disease and its getting very serious, that you "might" be F2 and can there fore have a couple of beers? Can you not see how insane that is?

F2 doesn't heal over night and your Liver will now be sensitive to further alcohol even if you are lucky enough to have F2.

For the sake of your life get some help to keep sober.

B_RC profile image
B_RC in reply to

I'm off the drink and don't need any help to stay off. I was just asking the question of the scarring can be repaired from this score as you seem to have good knowledge reading some of your posts.

in reply to B_RC

The Fibroscans highest accuracy is detecting F0 and F4, inbetween it is still a good test, but not as accurate.

Its difficult to say if you can fully recover, keep sober eat healthy and get another Fibroscan in 3 or 4 months time, hopefully you will see some improvement. As already touched on, keep an eye on alpha 1 deficiency.

Although you dont state the amounts you were drinking, the last time I read about someone having Cirrhosis in 8 years they were drinking a bottle of vodka a day.

B_RC profile image
B_RC in reply to

Just heavy weekend drinking is what has been the problem. Never been a regular day drinker. There is no way I will danger myself by drinking while I record a score this high. My blood tests suggest my liver is working very well with only the ALT now raised at 48. I appreciate your advice and will fully take it on board

in reply to B_RC

That is what is puzzling me, weekend drinking does not usually lead to Liver problems in 8 years. Imagine all the people in the UK alone who drink at weekends, MILLIONs for longer that 8 years and they arent dropping dead from Liver disease. My dad has drunk 3 or 4 pints everyday for 50+ years and he is 72 and can still cycle 100 miles, just had health check, all Liver enzymes normal etc.

I think you have something else going to be honest. Do you take any medications?

Have you discussed your drinking levels with your doctor?

B_RC profile image
B_RC in reply to

Yeah. I used to drink 50-60 units maximum a week. I don't know if I have just inflammed the liver after a binge and that is what has given this reading because it is still inflammed. The doctors and liver specialist don't seem concerned at all. Doctors are saying that the pain is muscle related. I was taking omeprazole but have since stopped. It is really puzzling me as to why I have this. My mates have drank toe to toe with me for years and don't have anything like this. Is there a possibility the fibroscan could be inconclusive? I say this because I have no other symptoms of a liver disease other than right sided pain and occasional orange urine in the mornings. The doctors have not diagnosed me despite seeing this test result!. I am very confused, this site is fantastic for advice

B_RC profile image
B_RC in reply to

Come to think of it, we had a lot of difficulties getting a reading, he did say that it was a bit erratic but come to the conclusion of a score of 12.4. I paid privately to have this done as well, £200. Maybe I should get some clarification about the test itself??. I am fit and healthy training in the gym everyday for 2 hours!!!

in reply to B_RC

For clarity the Fibroscan will see Fibrosis better than an ultrasound, CTscan, MRI. The only test that is better is an MRE which is pretty similar but sends the wave through the whole Liver so you get a complete picture.

elevated enzymes(inflammation) can cause the Fibroscan to give a stiffer reading than normal but, but that would be up to 2kpa and that would be a couple of hundred on ALT. so you would still be looking at around 10kpa in the best base scenario.

Im not sure what doctors you are seeing but ignoring and 12.4kpa Fibroscan reading is a mugs game.

The fact that you feel good and go to the gym is no way to measure Liver scarring. The terrible symptoms you read about mostly happen when the Liver is entering the "de-compensated" stage. Thats why its called the silent killer.

My drinking would have been about at your level, going to the pub or cracking open some wine 2 or 3 nights a week. I had my Fibroscan 6 months after stopping and it did find a tiny amount of fat above normal, but it was 4.2kpa.

Im not trying to scare you but you need to see a Liver specialist as soon as you can and get to the bottom of this. The Fibroscan is highly unlikely to be that far out, there is almost certainly "something" going on.

B_RC profile image
B_RC in reply to

The specialist advised to cut down on alcohol and retest in 6 months time as you had previously said earlier. I've done as much as I can. I have been told there is scarring evident but it is not chirrotic and it will repair if the alcohol intake is limited/stopped. I don't know how much further I can go with this to be honest.

B_RC profile image
B_RC in reply to

My CAP score was 284. I have looked everywhere for guidelines about this in regards to my test results. Do you know what this means?

Bolly profile image
Bolly in reply to B_RC

I know I keep going on about this but B_RC has Alpha-1antitrypsin deficiency which causes an excess of the AAT enzyme to build up in his liver and, in some cases, lead to cirrhosis.

Even without drinking ever again there is still the underlying genetic condition which may be the cause of his persistently elevated ALT in his liver results. His level of fibrosis or early cirrhosis can't improve if he has an underlying condition constantly present. I would imagine the overindulgence in alcohol over the years has speeded up the liver damage, which perhaps a non drinker with the same genetic condition would avoid.

The way you are now B_RC may be the way you will always be, and I would definitely avoid alcohol completely with alpha-1 as a diagnosis.

To avoid further damage I would recommend as healthy a lifestyle as possible. Difficult, but possible.

I've not heard of a CAP score, was that part of the fibroscan reading? Oh i see it's a measure of steatosis or fat in your liver. Had a quick look at some research and what I found in one study was that patients with your CAP score had fat visible in around 34% of their liver cells.

ncbi.nlm.nih.gov/pmc/articl...

B_RC profile image
B_RC in reply to Bolly

Yeah it was part of the fibroscan reading. Bolly I can only think that what you are saying is correct about the alpha 1 deficiency. I'm no more a drinker than the normal working man and don't see anyone else suffering like this. I think having another scam done in a few months time will confirm what the situation is and how it may have escalated so quickly. Probably a mixture or drink and the alpha 1 deficiency has done me over in the end.

in reply to B_RC

The CAP score is fat. The upper limit is 400db\m, 220db\m is the limit for normal fat content of the Liver or 5%. Mine was 233db\m. You have a fatty liver but its not too bad.

I agree with Bolly too, when I went for my Fibroscan and said I drank 40-50 units a week and feared I had Cirrhosis, the doctor actually went "ppffffftt" and then added "youve been on google havent you"

He said 99% of the time its atleast 100 units a week to get to end stage at my age and most full alcoholics are on double that and more. So as you assert something else is happening here i suspect

B_RC profile image
B_RC in reply to

Thanks for clarifying the CAP score. That's got me at piece of mind on that side of things. Now the task is to stay off the drink and get my Kpa down as much as possible. Thanks guys

in reply to B_RC

Im sure you will be fine with alcohol. I pushed it because I get a bit emotional when drinkers come here and stop for a couple of months and expect to then go back to drinking with a fully recovered Liver, thats obviously not how it works.

Alcohol is not the root cause im sure, so dont feel guilty about it. Like you have already said alot of young guys drink exactly what you were drinking. I have grown up around everyone drinking the same and living into the their 70,80's and not dying of liver problem. It could have happened to me or anyone. In a way its lucky you have found this out now, another couple of years of drinking and you would have been in very serious trouble and it could have happened in the middle of street with you being unaware.

You do have a chance to pull this back in, so good luck.

B_RC profile image
B_RC in reply to

I could feel your frustration and acknowledged that but I think you have assumed it a different way to how I was putting it across!! The thing that really hurts is that I never knew about the deficiency earlier, don't get me wrong it's great I am now aware of it and can take action appropriately. You would think such a serious condition would be included in a full blood count at the very least. Disappointed, drained and determined and 3 good words to sum up the current situation

Bolly profile image
Bolly in reply to B_RC

I thinks it's fairly rare, some statistics say 1 in 3,000, so not a routine blood tests type of condition I suspect, hence being missed. On presentation to a GP the patient is usually asked about their medical and family history, so if the patient knows about genetic disorders that's the time to say so. Or if you are lucky the GP will spot something you tell them that makes them suspect. But first line tests with liver issues are more commonly for alcohol, fat and viral hep rather than the more weird and wonderful!

B_RC profile image
B_RC in reply to Bolly

Despite my claims about the deficiency being there, 0.8 is my blood result, they still say that this has no effect on the liver problems. Confused a plenty to be honest

Bolly profile image
Bolly in reply to B_RC

0.8 what. Is this a quantity of serum?

Reference ranges are baffling me:

"Most hospital laboratories report serum alpha1-antitrypsin levels in milligrams per decimeter, with a reference range of approximately 100-300 mg/dL. Levels less than 80 mg/dL suggest a significant risk for lung disease. Reference laboratories usually report the serum levels in micromolar concentration, with a reference range of 20-60 µmol/L and a threshold level for emphysema at 11 µmol/L" (Medscape)

Mayo clinic have their normal range at 100-190 mg/dL with, quote "Patients with serum levels <70 mg/dL may have a homozygous deficiency and Low alpha-1-antitrypsin (A1A) levels may result from liver disease".

B_RC profile image
B_RC in reply to Bolly

My guide was between 1.1 and 2.1 and was 0.8.

Bolly profile image
Bolly in reply to B_RC

Ok so are we saying that "normal" is between 1.1 and 2.1 (whatever the volume per litre we don't know) in which case your 0.8 is below normal and what the Mayo and other places publish is that someone with a lower than normal level is the person who is showing signs of liver disease caused by the low levels?

B_RC profile image
B_RC in reply to Bolly

That is correct, although doctors don't see the deficiency as a cause. Not drinking and still suffering sharp shooting pains all on the right side. I'm doing what has been required of me and not seeing any results. It's a depressing issue. Doctors believe it can't be the liver because it doesn't give you any pain. But it's not a muscle feeling because it's happening randomly.

Bolly profile image
Bolly in reply to B_RC

Docs are right about the liver not causing pain but there is a capsule that surrounds it called the Glisson Capsule which stretches if the liver is inflamed or enlarged and that does cause pain.

"Glissons capsule: The capsule of the liver. A layer of connective tissue surrounding the liver and ensheathing the hepatic artery, portal vein, and bile ducts within the liver. Named for the British physician, anatomist, physiologist, and pathologist Francis Glisson (1597-1677)". So probably not a pulled muscle. I can't find enough about the A1AT levels to make sense of your result, it needs the quantity in the serum to make sense, like g/L or iu/L or whatever unit of measurement they use.

B_RC profile image
B_RC in reply to Bolly

Sounds like an inflammation pain then. The liver certainly isn't enlarged it has been checked numerous times for that. Looks like a classic inflammation that will die down in its own time. Providing I don't inflame it anymore

B_RC profile image
B_RC in reply to Bolly

Little Google check suggests the level is at 85. Don't know if this means I'm just slightly in the "safe" barrier or not

Bolly profile image
Bolly in reply to B_RC

Well I'm blowed. I have been trawling through my old blood tests results as Im due in clinic this week to review some problems, and i see that in 2010 i had a test for the Alpha-1-antitrypsin and the reference range for normal, as you say, is 1.1 to 2.1 g/L. My result was 1.82 g/L so deemed ok. But i have a handwritten note which i made at the time, trying to understand some of my results which says "low levels = higher risk of cirrhosis".

0.8 is a 'low' level and could explain the fast track to fibrosis/early cirrhosis/highish Fibroscan score especially when you add in the stress caused to the liver by the alcohol consumption and the fat deposits.

B_RC profile image
B_RC in reply to Bolly

Looks like we have found a solution that the combination of the deficiency and alcohol consumption have caused this situation. Didn't think my alcohol intake was chronic, something else had to influence what was happening and this seems to be the cause

B_RC profile image
B_RC

1 pint in 5 weeks doesn't seem to be a bad start for me. The pain is just unbearable at times. I hope that the scarring can recover if it means the whole year of the booze then so be it. Ralph 2014 it was after a heavy binge that caused the original pain, so it may be inflammation that will calm down when it decides to.

I would sugest you cut right down , don't stop compleatly strait away, you need to wein off , otherwise you could have fits , but I sugest you stop , it's later in time you will regret ! Trust me , the damage is there don't make it worse ! I ended up having a transplant , you don't want that!! Good luck!!!!!!

B_RC profile image
B_RC

I have stopped completely. I don't need to cut down then stop as I'm not an addict. I'm just concerned that I'm at a stage where I have no chance of recuperation. The doctors seem to think it will do if I abstain, but does the pain get worse before it gets better?

AyrshireK profile image
AyrshireK

You could be t-total and still suffer damage due to the Alpha-1 anti trypsin deficiency - I would seriously be requesting some further feed back on that situation - there have been posters on here previously who have suffered cirrhosis and required transplant due to Alpha-1 anti trypsin deficiency. It can also impact on the lungs I believe.

Bolly profile image
Bolly

It could take months. It took years to get this bad remember. The first thing to improve should be your blood results. A few months on your symptoms should improve. And a few months after that your liver histology should show an improvement. Probably around September.

And as Katie has just reminded you (and I said 4 days ago) you need to follow up the Anti trypsin diagnosis.

B_RC profile image
B_RC

They believe that the alpha 1 deficiency has no reflection on the pains I am getting. It is all being blamed on alcohol consumption. Like you say Bolly it will take time to heal it's just such a pain at the minute it is effecting everyday life so much

Bolly profile image
Bolly in reply to B_RC

Despite the doctors reassurance that your pain is nothing to do with the Alpha 1 deficiency, it in itself is not a benign condition and can lead to liver damage and scarring. I would educate yourself about it and what you can do to limit its damage to your body.

It's genetic. Have other members of your family been tested?

B_RC profile image
B_RC

Nobody else has been tested for this. My dad has been a big drinker for 40 years and had no problems. So my guess would be its my mothers side (non drinker). So far the doctors have been liars and guessed things so it wouldn't surprise me if they were wrong

matt137 profile image
matt137

Hi BRC

I stopped drinking 5 weeks ago now, and my pain is also still there.

Sometimes its just a dull ache, that just reminds me where my liver is, other times extremely uncomfortable.

I was drinking around 60-70 units a week for a number of years.

Feel a lot better in myself since I stopped, but havent managed to shake the pain.

Hope you feel better soon

briccolone profile image
briccolone in reply to matt137

has the pain moderated at all or become more sporadic-that's what I found after stopping.

matt137 profile image
matt137 in reply to briccolone

Hi Briccolone

Yes it has improved a lot and isn't constant any longer.

It does have its moments though.

Fatty foods definitely irritate so I'm trying to avoid them. :)

briccolone profile image
briccolone in reply to matt137

yep another 3-5 weeks and it should cease-I imagine you're feeling better now you're seeing some improvement.

in reply to matt137

Hi Matt137-

I stopped drinking 13 weeks ago. It took about 6 weeks for the ache on my right side to go away. I still get a twinge on that side once in awhile. Definitely nothing like it was. I was a binge drinker for about 10 years. Pretty heavy binge drinker at that usually whiskey and lasting around 5 days at a time. After my last binge I had a lot of swelling and right abdominal pain. Blood work was normal. Ultrasound showed a Fatty liver. I have read that it can take sometimes a year or more for things to completely settle down. I drink nothing now but water and my morning coffee. Eat super healthy and exercise. Try to make sure I get ample sleep too. Hang in there you will feel better. Good job on stopping drinking.

matt137 profile image
matt137 in reply to

Thanks for your advice Wendy, and very well done to you aswell.

Its not easy... i know.

Ive been having my morning coffee and water with fresh lemon squeezed in. Thats my new beer! :)

Stay in touch x

in reply to matt137

I like it...that means morning coffee is definitely my new whiskey.

I have a question for you since you've recently quit drinking such as myself; do you dream that you've drank? I have recently had dreams that I started drinking again...they are pretty damn vivid too. It takes me a few seconds upon waking to realize that I didn't. It's such a relief to know it was a dream too. Tuesday is day 100 for me, so maybe the anticipation of hitting that goal has triggered it. Apparently quitting was a little hard for me :-)

I hope you're feeling well and everyday is getting better for you!!!

matt137 profile image
matt137 in reply to

Hi Wendy, sorry for late reply.

I dont dream about drinking but i am having extremely vivid dreams.

I think that your mind has been used to being under the influence, so hasnt had the proper ability to get into a dream state.

Some morning Im quite enjoying the experiences Ive had the night before!

B_RC profile image
B_RC

I'm exactly the same feeling as you Matt. Doctors are saying it will go in time providing i abstain from drinking. Which I plan to do but sometimes the pain is unbearable. Yet when I tell the doctor he says liver pain is not that severe it must be muscle related. Sometimes I wonder if these doctors just read from the internet like we do because they seem to be clueless

briccolone profile image
briccolone in reply to B_RC

re GPs they're not immune from the internet that's for sure and most are not liver specialists but they should be able to explain blood results when asked.

matt137 profile image
matt137 in reply to B_RC

I read in a previous post somewhere that it's actually the membrane around your liver that is causing the discomfort.

When the liver becomes inflamed it's puts pressure on this membrane and pushes it against other organs.

That's where the pain is coming from.

Mine has been quite severe at times.

Enough for me to hols my side.

Sometimes it feels warm / hot even. Or maybe that's just me imagining it, I'm not sure.

matt137 profile image
matt137

My GP also seems pretty clueless.

To him it's either cirrhosis or wind!

B_RC profile image
B_RC

Bricollone mine is getting worse but no other real dangers signs. Orange urine when I wake up is about the only other symptom that accompanies this pain. I am doing a lot of swimming lately and like Matt said it could be the membrane pushing against other organs that is increasing it because I'm doing regular exercise. But I want to get a flat stomach so I'm not carrying extra weight, I need to lose about 2 stone to be flat solid

Bolly profile image
Bolly in reply to B_RC

Cant remember B_RC, did the docs scan you for gallstones as a possible source of the pain?

B_RC profile image
B_RC

No they have not done a scan for gallstones specifically. From what I hear an ultrasound would show this up whilst the liver one was being done? I don't have any pain urinating either. I'm not quite sure of the symptoms.

Bolly profile image
Bolly

It's kidney stones that would affect urinating.

Symptoms of gallstones: nhs.uk/Conditions/Gallstone...

B_RC profile image
B_RC

Urine varies all day. But mostly yellow/orange. Pain varies all day as well full/severe. Have no symptoms of nausea or vomiting. Just pain in right side abdomen and right side shoulder/back. I'm just fed up, only blood elevators 2 weeks ago was an ALT of 48. Everything else was OK apparently. Don't know if fibrosis scar would cause this kind of pain, like it may hurt as it is trying to heal?

dannyfruz22 profile image
dannyfruz22 in reply to B_RC

I think you may have a kidney stone/stones

People confusingly interchange the words fibrosis and cirrhosis. Cirrhosis is a permanent and severe amount of fibrosis. The scoring system on a fibroscan has different cutoff values depending on the disease. For alcohol a score of 12.5 would put you in the F2/F3 stage. Cirrhosis cut off value on a fibroscan (F4) for alcohol starts in the 20's kpa range.

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