Have a few questions but thought I would give a detailed background.
I had fatty liver start about 4 years ago. Only discovered it because i had some spider angioma appear and my constant googling led me to suspect liver issues. I had some spider angioma as a kid so there may be a genetic component as well. Have a couple on my hands and shoulders. I found that they can be caused by alcohol alone in drinkers. They can appear at the alcoholic fatty liver stage as well according to what I read in numerous books and studies.
I was never what I would call an 'alcoholic', but definitely never gave myself a proper break. I just got into the habit of drinking about 3 large beers most evenings after work. On the weekend i would drink more when i went out. Never had many nights off and probably averaged about 60 units a week. Never had issues with alcohol. I am pretty healthy and exercise a lot, have a normal life and maintain a good weight. I am 41.
My blood results have always been normal. GGT has never been above 18 although I always stopped drinking a few days before blood tests. All ultrasounds have always said mild fatty liver. The last one said near normal. My ast/alt have been reversed by a few points but it has never concerned the doctors. I put it down to an ongoing muscle injury. All other blood work has been ok.
I have been living and working overseas for ten years. The medical system here is great so I have had lots of checks. Had an arfi scan which was almost normal. This is a new type of scan similar to an ultrasound and fibroscan combined. Unfortunately, I didn't totally stop drinking when I first discovered fatty liver and carried on drinking even when I had some mild liver 'grumbling' although this waxed and waned. This liver ache has totally gone now. Had a few breaks after first told about fatty liver a few years back, and cut down to about 20-30 units a week up until this time last year.
Anyway, my main issue was this. According to the fibroscan scorecard, my 7.7 put me at the end of F1. My last score of 6.9 puts me in the middle. I know that fibroscan is good for diagnosing cirrhosis and totally healthy livers so my score puts me in the grey area a bit. I recently read an online study by a doctor called Mueller and he states that if AST is normal or below 50 then according to his study F3 fibrosis can be diagnosed at lower cut off levels. The high cutoffs for ALD are likely due to inflammation independent of fibrosis. In other words someone with 8kpa and normal blood results can be diagnosed with F3 according to his study. Many other studies have cut offs of about 9.5 for F3. This study says that cirrhosis can be suspected in an abstinent drinker with 12.5kpa. This got me worried as I had been abstinent for a month before my 7.7kpa score. My blood was normal. Does that mean I was so close to stage 3 fibrosis? Not sure.
After 4 months of abstinence my score had come down to 6.9kpa. My doctors said any mild fibrosis would regress or heal given time. I stayed totally abstinent for about 6 months but I did have a few weeks in nov and dec where i drank under ten units a week. Actually, i find it kind of easy to stop. Never had urges or withdrawal symptoms. Just find the social side difficult. I was mainly drinking shandy and light beer for those weeks I wasn't abstinent. Feel a bit bad about this and hope it hasn't worsened my condition. I also did the same earlier this year when my pet got sick and died and I was suffering. I have a follow up fibroscan in 2 weeks.
Sorry for the lengthy background. Just thought it would be easier to explain my position.
Have anyone ever heard anything else about fibroscan scores in recently abstinent drinkers? I know that scores can drop rapidly even after a week's abstinence. In that study I quoted it said that scores remained stable after a certain period of time. Mine didn't so no idea what to believe. It is all so confusing. My score fell over four months but my blood tests didn't indicate inflammation. Surely this wasn't fibrosis healing so quickly. I have read though that alcohol can stiffen the liver in other ways besides inflammation and fibrosis. Something about how it affects the cells but I cant remember where I read it.
Anyway, if anyone has any info about all this I'd love to hear it. I am always stressed about this. Just hoping that my initial 7.7kpa didn't indicate that I was close to severe fibrosis (according to that study). I read that back home (UK) they say that under 7 is normal, but what if you haven't drunk in a while? Would 6.9kpa still be normal in an abstinent drinker. I suspect not. I also wondered if anyone had fibroscan scores come down even though they were still drinking (a tiny bit). I am not really looking for an excuse to start again - it is more due to worry.