In need of help

[Nikki666]

My son is 23 he is over weight 3 stonish he has been told fat on liver abnormal liver results showing 120 he has totally changed life style no alcohol involved mainly weight and diet he has only been having fresh fruit and veg but new results 2weeks later showing 240 he is walking hour day also about 12000 steps scan arranged for day after I fly for 2weeks Dr said I don't need to cancel holiday I just am so worried any advise please

[Porphyrogennetos]

If your son's doctor said you do not have to cancel your flight, you should trust him. Your son is young, so there is a very good chance he can reverse whatsoever damage has been done so far to his liver by an unhealthy lifestyle.

From what you write has he taken the right steps. Exercise, a healthy diet and no alcohol are cornerstones of recovery.

Liver disease is a rather slowly progressing one, and your son was diagnosed early on, as it seems.

Does he have symptoms?

Good luck,

P.

[Nikki666 in reply to Porphyrogennetos]

Hi thanks for answer all other tests are fine no high blood pressure chlorestral ok no diabetise everything fine she said feeling him it's not swollen he has more bloods to do Tuesday then scan 29th but she said I'd probably be back off hols before she gets results he says I'm being daft as he says he feels fine I keep checking his skin and eyes I carnt see any yellow tinge and I think she would have acted well I hope she would of if she had noticed just why have they gone up to 240 in 2 weeks when he is doing all good

[Nikki666 in reply to Nikki666]

The only sort of symptom he had was a bit pain for 2 days and tiredness but now eating not so tired

[Porphyrogennetos]

why have they gone up to 240 in 2 weeks when he is doing all good

Imagine the liver is a freight train. It is speeding alone under heavy weight. Now throw out some of the cargo while the locomotive is still powering along.

What happens? The train picks up speed. Only when the machinist sees that he does not need all that power and slows down, the train will lose speed. Can take some time.

It will take some time until the liver adapts and learns that it needs less enzymes.

Just a guess.

P.

[Nikki666]

A good discription I understood that more than anything I've read or been told I hope so thank you so much I will calm down and just see what comes of tests I will let you know but what you have said makes sense thank you

[kurtymac]

There are plenty of reason liver enzymes can spike especially when it is healing. First of foremost, you say he has changed his lifestyle, when did he stop drinking? If it was recently, this can cause a syndrome known as PAWS, this increases the autoimmune activity in the liver and will cause a spike in enzymes for a few months before the liver heals from the insult. If he hasn't drank in a while, it is probably due to hepatic steatosis (liver fat). He is taking the right precautions to treat it, the biggest thing is staying on top of it and monitoring his enzymes. A fibroscan thrown in to get a "baseline" is also good to see where his KPA (Fibrosis) and CAP (Hepatic Steatosis) is at. The enzymes comes from cell replication or injury. If he is getting healthier, the liver is probably attempting to shed the damaged hepatocytes (liver cells) that have steatosis infiltration. It normally takes up to 18 months for the liver to heal. 6 months for enzymes to look better, 6 months to feel better, 6 months for liver histology to go back to normal. My liver took a good year to get better after pain medication regiment put me in the hospital. It isn't a fast process, but keeping an eye on it is the thing to do.

[Nikki666 in reply to kurtymac]

He doesn't drink so would be I think more over weight case and the junk food he used to eat he is at the moment loosing between 2 to 3 pound a week which I read that is a healthy weight to loose in a week is that true thanx kurtymac for replying x

[kurtymac]

Yes, 2 pounds is optimal. There are many studies showing that losing weight too rapidly can cause the liver more stress and cause a greater amount of damage. It sounds like he is doing what he needs to do. I still believe a fibroscan would be a good test, this way he can have a baseline. For example, my fibroscan in March was 4.8 KPA and 170 CAP. Actually are good numbers, but I want to have another in November, because I have had a few ALT spikes here and there since. Also, after the damage last year which was pretty significant, I want to ensure that the number is staying the same or dropping because there were some suspicions of autoimmune activity. Eggs are good, they increase HDL and lower LDL. They also contain large amounts of lechin and choline, which the liver needs. Without Choline the liver is more susceptible to damage. Artichoke has natural selenium, beets are great they restore glutathione, the bodies largest antioxidant. The largest concentration of glutathione is found in the liver, it helps restore hepatocytes and helps the detoxify toxic substances that bypass the P450 enzymes. Coffee has also had positive results in many studies for helping the liver. Lastly, turmeric is a natural anti-inflammatory, proven to reduce fibrosis by deactivating rouge Hepatic stellate cells, which cause fibrosis. These are some dietary tricks to add to the treatment plan. Hepatic Steatosis can cause ALT and AST increase, as the hepatocytes become damaged by fatty infiltrations. I agree, he needs to get it under control now at 23, it can turn into cirrhosis down the road. That is a pathway he doesn't want to take. He should be checking his BMI daily, there are Body Mass Index scales that he can look at to figure out what a healthy weight is for his stature. Be careful if the doctors offer him statins for his cholesterol as they can cause further liver damage. It will be a delegate balance, but if he can lower bad cholesterol, lose the weight and get healthy without statins, that is the best course of action.

[Nikki666 in reply to kurtymac]

His bmi has dropped from 35 to 32 and is dropping from what I've calculated he needs to be 18 but under 25 his cholesterol is ok no signs of any rise im exhausted with daily research on this i work nights then coming in and doing the hour walk with him i will do whatever is needed i want him in a good routine before i go on holiday im cooking all his food and freezing his meals before i go so he just has to get them out and keep up his walking he will he is a good kid he is doing all ive said and following all the advise every day im so thankfull for your comments this has been the only place i seemed to bave recieved any form of srraight answer which is understanding thank you

[kurtymac]

No problem, he sounds like he is in good hands. Is your main concern about going on the trip is that he won't stick to the regiment? I am sure he knows the seriousness of the situations, I would just call in for daily reports if he is staying back. If the doctor hasn't I would call him in and say, "hey, this can either go North or South". NAFLD can turn into cirrhosis if it isn't put in check, I had Drug Induced Liver Injury, where my stomach blew up, umbilical hernia, linea alba tore. The sad thing is I knew my pain managed doctor was trash, I should have listened to myself. However, I didn't I trusted a very bad doctor. I know firsthand how a bad liver can mess up your entire life. I was a U.S Army Officer, I always took care of myself, liver damage let me incapacitated in bed for 4 months. Couldn't even muster up the strength to send a phone text. It seems like things are looking up again, ALT and AST will spike before it heals. Also, keep an eye on a Del Rios inversion an out of normal range AST higher than the ALT. As that normally is the signal for more serious damage. This is how I knew I was in bad shape even before I got really sick. Don't worry, I believe in straight answer, beating around the bush doesn't help anybody. My doctor kept sayin oh your labs are no big deal stay on the medication regiment. Well those bad labs turned into an AST that was almost 200 points over my ALT. I still think a fibrosure or fibroscan would be good to get a baseline on exactly how fatty his liver is. MRI, US, CT can give an image but it deosn't measure fibrosis or hepatic steatosis, no finite number.

[Nikki666 in reply to kurtymac]

He knows it's bad but doesn't understand he is autistic also but very independent at the moment they have arranged for a normal scan like you get when pregnant so I will push for one of these fibroscans I work in nursing and I honestly didn't know anything about this fatty liver

[kurtymac]

I also work in medicine and the liver seems to get a pass when it comes to Medical School. It is astonishing how little most medical professionals know about the liver. Hence, why liver disease is can be missed many times. Ultrasound is a good first step and will show hepatic steatosis, the liver will have a bright texture. The issue with an ultrasound is that it has issues determining the stages of fibrosis and sometimes can confuse liver fat and F2-f3 fibrosis. This is why an ultrasound along with a fibroscan can give a good picture of the liver. They also have the Magnetic Resonance Elastography, which is the best test, also the hardest to find and have approved by insurance. Not sure how it works in the UK. I wholeheartedly believe a fibroscan should become a normal test that many get after the age of 30 like an ECG/EKG, CMP/CBC Labs, colonoscopy, because liver disease is so silent. Many have fatty livers and have no clue, therefore, they don't change their diet and end up in trouble. I have an autistic son as-well, I know what you dealing with. They are very intelligent, but do need a higher level of supervision when it comes to following through with certain courses of action as they can become easily distracted.

[Nikki666 in reply to kurtymac]

I feel guilty about going away and any results coming back not good but gp said results probably will take couple of weeks to come back and all his vital signs are spot on its litually only the alt showing high other than him over weight everything else is ok and he doesnt feel bad

[Nikki666]

Yes I feel quite guilty for not knowing and I made my Scott's life as independent as I can I've always let him have his own money and that's been problem I think cause all he has done is bought sweets takeaways and MacDonald s rubbish bad foods as extras awell as his meals at home he is well in himself but then again he doesnt communicate much so i have to guess because if i ask he will always say he is ok