Worry about cirrhosis

Hi all

I am 35 years old, non drinker. All of my lab results for AST, ALT, BILIRUBIN, ALBUMIN, INR, ALP, CREATININE came out normal. However, the ferritin level is very high 850, and the PLATELETS count is 445x1000/mlc. I will have an ultra sound on tuesday. Right now i am really worry because of the ferritin level is sky high. I do not have hemochromatosis. Cirrhosis is likely to be the cause right now, isn't it? Any comment, idea, advise is greatly appreciated!

12 Replies

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  • The two indicators for liver damage are AST and ALT, if those are within the normal range do not jump into the conclusion of having cirrhosis until further testing. If the platelet count is low, there is another possibility that one of the coagulant factors may be weak (not an expert on this). Also low levels of vitamin K contribute to low levels of platelet, I think.

  • Morning

    The Liver function tests measure inflammation and how the Liver is able to carry out its tasks at the time the blood was taken.

    Your tests are not showing anything wrong, this is exactly where you want to be, normal is always better than abnormal, so enjoy those numbers. 95% of the time a serious Liver problem will show something with the Liver function tests, whilst its true there are exceptions where a problem can be very difficult to detect, like a Hep-c infection slowly nibbling away at the Liver whilst the ALT, AST stay within or top end of normal.

    Your Platelets are part of another test called the complete blood count and they are at the top end of the scale, with Cirrhosis the Platelets drop because they get caught in the spleen, the spleen will normally start to swell too. In Cirrhosis platelets often drop to 40-50k and thats when some blood transfusions come in into the treatment plan. You have plenty of Platelets !

    There is nothing to suggest your Liver is struggling at this point in time, but of course you need to carry on and try and get to the bottom of the high Iron. But high Iron is usually an easy fix, just give whole blood is what is normally done.

    Besides bloods its a good idea to get a visual of the Liver, an Ultrasound will be able to add some more information to the pot for a diagnosis and to decide further treatment, has this been suggested yet?

  • Great reply Ralph! Especially when you mentioned the high end of normal with Hep C. I think that was my issue. My liver tests where great, but I was sick. They never did a biopsy on me. And the liver did not look bad on the ultrasound. It showed ridges, etc, but nothing crazy. But then one of my consultants said my liver was very cirrhotic when they went it for transplant.

    I also like the way you explained the blood tests, the wording! I'm going to file that away, lol. "how the Liver is able to carry out its tasks at the time the blood was taken.". Excellent!

    Ttmmkk001

    Where you ill with anything beforehand? Meaning was there a reason for the testing in the first place?

    Sorry your stressed!

    Good Luck!

  • cirrhosis is suspected when the ratio of AST is > 1.0 to ALT you do not have cirrhosis lay off the iron rich foods. any hypochondria in your family history ?

  • Not a particularly helpful reply Drpeter - people are coming on here scared because they know their own bodies and that perhaps something isn't right.

    At the moment this member has only got a set of blood results one of which is obviously very abnormal and further imaging that is going to be done later this week might reveal further details. It isn't very helpful to suggest someone is a hypochondriac when they have come on here for assistance.

    I don't understand your ratio description above. I have a set of blood results here for my hubby, taken last week - the only ones out of range (just) are his AST (57 - range 10 - 45) , Monocytes (1.3 - range 0.2 - .0.9 U) and Basophils (0.2 - range 0 - 0.1 U). Everything else is totally normal and yet he has known well established cirrhosis due to to auto-immune hepatitis.

  • The comment was made on a person who had high amounts of Iron. So I do not understand your rebuttal . In any case I do apologize and will be more sensitive in the future.

  • You may have typed the wrong word in that you asked the person was there any hypochondria in the family? (basically insinuating this was all in his/her head).

    You may have meant to ask was their a family history of haemochromatosis (which is obviously the genetic condition whereby the liver stores too much iron) but you didn't you came out with "You don't have cirrhosis, is there any hypochondria in your family?" which is what I pointed out as a not very helpful reply.

    Maybe an automated text sort of error but it could have had a very negative effect on the poster.

    All the best.

    Katie

  • drpeter

    the AST and ALT inversion is not always a problem and it doesn't mean Cirrhosis, the patients presentation and symptoms, medical history, scan results, historical blood results all come into it.

    No doctor would confirm Cirrhosis with a single blood test with an AST/ALT inversion , infact its used more to determine the cause of inflammation, the inversion can just mean damage from Alcohol.

  • What about fibro-scan is it as conclusive as a biopsy. I think it is the most noninvasive method of diagnosing and staging liver damage what do you think?

  • Both tests have advantages and disadvantages.

    A biopsy covers an area of 1/50000th of the Liver, this is obviously a tiny amount and in sporadic scarring like Hepc-c, this can be a problem. Infact with Hep-c the chances of a false negative can be as high as 30%. There is also risk of complications because its an invasive procedure. But, getting some actual Liver cells can give information no other scan or tests can give, in cases where the cause of raised numbers is not apparent a biopsy would be a good choice.

    A FIbroscan covers an area of 1/500th of the Liver, an index finger sized piece right in the middle of the right lobe. This is a great test for Alcohol damage in particular because the scarring is more uniform and you have a large area being tested. But a Fibroscan will not help determining the cause of any damage and can be a little unreliable when inflammation is present. Its a better way to monitor Hep-c patients too, it non invasive and can be done at anytime, its quick and painless. It has been described as a game changer by Liver doctors because its gives an instant number to work with for little effort.

    There is a better test than the FIbroscan called an MRE, its pretty much the same idea, but sends a wave through the whole Liver. Its incredible, a 3D image of any scarring that covers the whole Liver!

  • Thanks everyone for the response!

    Hepatitis B, C already came out negative.

    Autoimmune hepatitis is the only thing that really worry me right now since i already had another autoimmune disease. I could have had AH for a long time, and did not even know. I wonder if there is any way to make sure that i do not have AH beside liver biopsy.

  • Hi all

    Just want to update on my condition!

    The ultrasound came out normal. This is what the doctor said

    "The recent ultrasound of the liver did not show cirrhosis, no cancer, no damage. The recent liver ultrasound only shows a build up of fat in the liver. No other problems. This may sometimes cause the liver enzyme (ALT) to be slightly high. Sometimes the ferritin level may be elevated due to the fatty liver or from inflammation from another source. The actual liver enzymes on 8/18 blood test was within normal limits. No further workup will be needed for this since the liver enzymes are normal. No ascites on the ultrasound. Liver size was normal, not enlarged. No signs of inflammation on ultrasound."

    Still, for the last 3 weeks, i have been having itchy sensation all over my body, upper abdominal pain, and bloating. Should i need more testing? Or that is it.

    Thanks all ! Wishing best to all of you!

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