Can You Have Cirrhosis With Normal Labs?

[inwonderment]

I’m baffled. I’ve been a heavy drinker the past one-two years. Skin tone is kinda ‘off’ and my mood/appetite is all up and down (depends on the day). Have joined AA, and will never drink again.

Had full bloodwork done, and everything is fine. As such the doctor doesn’t want to do further tests.

Should I push for imaging studies to see the extent of the damage? In some ways I don’t want to know, but I’m guessing knowing will be helpful at some point before more damage is done. What do you all suggest?

[Hidden]

With alcoholic cirrhosis it would be unusual to see normal labs across the board with advanced disease present, either in active drinkers or those in the early months (first 90 days) of recovery.

This said, I've seen those with a positive diagnosis of cirrhosis who's liver labs returned to normal later in recovery (6 to 12 months). Typically you'd still see something off elsewhere, like low platelets (in the cbc) or high bilirubin (in cmp).

With no symptoms of advanced disease (jaundice, swellings, bleeding) you should do well if you keep clean. If you do relapse, I'd want to see a secondary diagnostic like ultrasound or fibroscan to be confident I wasn't headed for a medical train wreck.

Best of Luck in your new life. There is life after alcohol, and it ain't all that bad.

[Hidden]

You can have cirrhosis with normal blood tests due to the liver compensating. If you've only drank heavily for two years then you probably don't have cirrhosis. Only about 10% to 15% of alcoholics get cirrhosis and it usually takes many years of heavy drinking before the liver becomes cirrhotic although some people are more susceptible to getting it than others.

For some people ignorance is bliss and they would be happy to go along with your doctor's suggestion but if I were in your situation I'd want an ultrasound and a FibroScan done to see if there was any damage and if there is damage how bad it is. My GP would be happy to send me off for the scans but I've also seen other GPs that would only send patients for a scan if a blood test came back significantly abnormal. The problem with this approach is that if a person has abstained from drinking for a time then a blood test might come back normal despite the liver being cirrhotic. The hepatologist I saw told me that he has several patients with cirrhosis whose blood tests are normal.

If a FibroScan showed some fibrosis you could use it as a wakeup call to never to go back to drinking and do what you could to help the liver recover or if the scan showed that your liver was normal then you could breathe easy and resolve to get the most out of the rest of your life!