Hello, I am new here. I was wondering if anyone could shed some light.
My husband is 39, he doesn't drink or smoke and although he has been a poor eater (seems to go all day in work barely eating saying he is too busy) when he does eat at home it is a health meal at night. For years he ate poorly, he would live off fruit in work and come home shaking like he had low blood sugar, he would be bright white and sleep as soon as he ate his evening meal. Earlier this year it's what prompted me to get him to the GP, thinking they would just test diabetes and tell him off for his poor eating. He is 5ft 10 and about 15 stone so needs to lose a little weight. Weirdly he never loses weight despite his lack of food. Recently he has sorted his eating out as I have made sure he eats in work and before.
Anyway our GP ran big standard tests to give him an MOT as he's not one for the doctors. They were all clear but his ALT level was 51, the GP called him in to discuss it and quizzed him on his drinking and eating. They repeated the tests again a month later and the ALT had gone up to 53. All over results were normal. So they referred him for an ultrasound of his gallbladder, all ok but report said enlarged liver. His GP requested more detailed bloods and these were the ones that came back high or low
Serum ALT - 59 (<41)
Serum gamma GT level 63 (11-55)
Serum triglycerides 2.1 (<2.0) Total cholesterol 5.6
Serum caeruloplasmin 0.17 (0.20-0.60)
Serum A1 - antitrypain 1.07 (1.10-2.10)
All his other bloods were clear. Coleliac clear, hepititis clear, FBC, ferritin etc...
He has been called back to see the GP and they are seeing him on the 16th. This has been going on since the spring and we are still none the wiser. All they have said is it could be early stage liver disease. Can anyone shed any light as to why this would happen? his doctors don't explain, and he never asks much he is so laid back. He goes to the GP gets blood forms and goes away none the wiser as to why.
His blood numbers indicate that his Liver is inflamed, the Ultrasound also shows the Liver is enlarged, they are correlating. Inflammation is the enemy of the Liver, it causes scarring of the Liver which if left to carry on will go on to cause Cirrhosis of the Liver and eventual Liver failure.
His Alpha 1 antitrypsin is low, at the moment I would say the doctors might suspect a genetic condition called " Alpha 1 antitrypsin deficiency" Your partners is low, but its only just though, im not sure how sensitive this test is, some blood tests are much more sensitive than others, so how much medical value they have can very different from each other.
The Liver inflammation markers are a sensitive test, if they say it inflamed, its inflamed, the ALT is the main Liver enzyme and GGT is also found in the Liver, in the bile ducts, so from these tests, the whole Liver is inflamed. Quite often someone who is over weight with high enzymes has a condition called Fatty Liver Disease, but the Ultrasound isnt showing any fat, so that maybe ruled out and is probably why the doctors have started to go for more bloods, to widen the net in looking for the cause of the inflammation. Finding the cause is paramount, if you stop the cause the inflammation, you stop the damage from happening and this will allow the Liver to heal, hopefully before serious scarring has occurred, once the scarring reaches F3 there is no stopping it, even if you stop the cause of inflammation the scarring will spread.
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Thank you so much.
At his scan they said his liver was fatty bur the report says enlarged liver?
What can cause inflammation? He's changes his eating habits. Never ways cheese, no fatty meats, went veggie for a while but still these results are climbing.
its not fat that cause fatty liver-its sugar/carbs/alcohol. he may have fatty liver that doesnt show in the U/s. May be worth a fibroscan as you say he doesnt drink alcohol
yep inflammation can be caused by a lot of things-you can have fatty liver which is not enlarged. more tests required-it may take a while to establish a cause...? for the moment I would concentate on diet/exercise and weight loss which can make quite a difference.
Too much fat in the Liver causes swelling and in turn damage.
Some people just cant seem to process some fats very well and this collects in the Liver over time and causes swelling, swelling causes scarring,this can go on unnoticed until the Liver is about to fail.
Fatty Liver disease is on the rise in western cultures, probably because of all the crap we eat with all the fats and garbage, even young children are getting Liver Cirrhosis sometimes.
There is also the possibly that an underlying condition could be weakening the Livers ability to process fats, thats why I think you really need an answer as to the root cause, so he can be treated in the best way possible. It could be Alpha 1 antitrypsin deficiency that is starting to affect the Liver, which is then leading to fatty liver, which then leads to swelling and scarring. Obviously we not doctors, you need to ask his doctors about their train of thought and where they are going with these tests.
Until you get some more complete answers, the best way to reduce Liver fats besides diets is a proper excise plan, he needs to start getting the blood pumping and burn some off.
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Thank you for all your help.
He does an office job. He's a quantity surveyor so at a computer all day, long hours. He rarely works out. He has said he wants to start some cardio again. So I will support him with that and I've told him walking the dogs more frequently and not leaving it to me will help as walking is great exercise and I get a rest 😀
There are autoimmmune diseases that can also cause problems with the liver and cause inflammation. I'm afraid I can't interpret the numbers, but he may want to enquire if he has auto-immune hepatitis (I have it). You can't catch it, it is caused by a problem with the body's immune system and can be controlled with medication. Just a thought
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Do you know which test they do for that? He was tested for A, B & C and all were negative.
Auto-Immune liver diseases are normally picked up in a combination of full liver panel (various auto-immune antibodies might show up), biopsy and in the case of AIH (auto-immune hepatitis) by a treatment with a steroid & a positive response i.e. liver inflammation levels coming down might all contribute to confirming a diagnosis.
My hubby has cirrhosis due to AIH.
Biopsy which I mentioned earlier picks up where the inflamation is on a cellular level and can tell what is going on within the liver - if it is an auto-immune condition they will see the different responses of different immune cells.
The course i've mentioned on another thread details all this and is really good for giving you a bit of background knowledge on the liver.
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A,B and C are all viral i.e. they come from a virus. Auto-immune is totally different- it happens when your immune system goes wrong (MS, rheumatoid arthritis, lupus and others are all auto-immune). There will be a series of results which will confirm any diagnosis, so not one specific test to say AIH. Once they have ruled out other causes for the liver going wrong, then they will consider the alternatives. They will look at his LFT's (some of which you have quoted above), an ultrasound and if necessary do a biopsy. The ALT can be used as a guideline as to the level of inflammation going on, and whilst it is above normal, it is not very high. When I was diagnosed, mine was over 1000 and I had jaundice. Hopefully whatever is the cause is in the very early stages and will be treated effectively because of this. If it is AIH, then this is a lifelong condition- rarely do people get "cured", it is managed. Best of luck and at least now you know which conditions to ask about.
I see that your hubby is being called back in to see a GP - hopefully some consideration is going to be given to referring your hubby on for further investigation.
His liver is enlarged / inflamed as shown by both the ALT reading and the scan. They now need to find out why this is going on. As others have said it could be fatty liver, the anatrypsin deficiency or indeed an auto-immune condition. Normally a biopsy would be arranged to see what it going on at a cellular level within the liver and should be able to give a better diagnosis of what is actually going on.
Without knowing what is causing the inflammation they can't treat properly and without treatment things could just continue to get worse. Identifying the cause of inflammation needs to be the priority at this stage.
He is seeing the top GP at our practice next Friday so fingers crossed he will be referred and they can get to the bottom of what is going on as this has been going on for some time now.
Good nutrition is always appropriate. I think he should watch sodium carefully as that is recommended for all who have liver disease. 1500 mg to NO MORE than 2000mg a day of sodium. Also this is something my BF is doing that seems to help, although he has ALD and hemochromatosis. . . ncbi.nlm.nih.gov/pubmed/105.... Also, take B vitamins with this triple approach!! Very important. I think everyone should take probiotics as this will help clean out his gut and get it working better. Lots of complex carbohydrates; limit sugar and red meat and junk food fats. Try not to use artificial sweeteners except Stevia. Eat vegetable protein and vegetables!!! Flax seeds and cod liver oil once a day (put it in a protein smoothy with some fruit and you can't taste cod liver oil.) Organic Coconut oil and avocado/nuts (if he's not allergic) for the healthy fats. I think a lot of what is showing up in blood work will be improved with good diet and exercise. Get him walking!! Your husband is starving his body with bad eating habits. If nothing else, get him to eat green smoothies (fruits and vegetables with vegetable protein powder in a blender 3-4 times a day.)
My BF also keeps track of everything he eats on myfitnesspal.com. This is free and really helps to see your habits.
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Blood results
THE END OF THE ROAD
Only God knows, I guess
Update on hubby 31/7/2021
