Scared I have cirrhosis: Hello, I am a... - British Liver Trust

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Scared I have cirrhosis

Hybreko
Hybreko
17 Replies

Hello,

I am a 33 years old man in fairly good shape.

I started drinking when I was around18, like a lot of young people I would drink during the week ends, get drunk and stay off the booze for the rest of the week.

I never considered myself an alcoholic, I enjoy drinking but I never thought I had a problem with alcohol.

A few years ago when I moved to the US from europe I started drinking a little more, I would get drunk a couple of times a week but never everyday. That lasted a year or 2 and since then I almost completly stopped drinking.

I have a few beers maybe once a week and that’s about it.

Anyway in august I had a routine blood exam for my insurance (they require that every year) and the results scared the living shit out of me...

My ast was 142 (normal range between 10 and 40)

my alt was 54 (normal between 9 and 46)

The doctor told me that it was probably nothing and to wait a couple of weeks to redo the test.

When we did the test again everything came back normal.

A couple of days ago I noticed what looks like spider veins on my chest and since then all I can think about is that I have cirrhosis...

I also started to have pain in my chest like if someone was stabbing me in the heart when I breave but I don’t know if that’s related or if it is just the stress that is causing that....

Could I have damaged my liver at 33 with my drinking history? I know the inversion I had suggests that with the ast being 3 times the alt...

17 Replies
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Link227

Doesn’t matter that much how much you drank, just if it was enough for your liver to be damaged. Different for each person what that limit is... The limit can actually be quite low if you’re a woman, obese, already have fatty liver or other damage, if you have hep as well, or if you have a certain ethnicity or genetic genotype....

Additionally, bloodwork doesn’t tell the whole story. Do you have anything else going on? Like unexplained weight loss or nausea or anything like that?

It’s a serious condition, but better to catch early if you do have it...

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Hybreko
Hybreko
in reply to Link227

I don’t have any other symptomes no.

I am far from obese (more on the skinny side) and white.

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Metanoia

Exercise and exertion can pop AST briefly high as the AST enzyme is found in muscle tissue as well as the liver. The De Ritis inversion (AST floating double or more over ALT) associated with alcoholic liver disease is usually persistent over a number of labs and often never completely resolves with alcoholic cirrhosis (even with abstinence).

I'm not a doctor, but if I saw an isolated spike in AST that normalized swiftly in a patient with no other signs or symptoms, I'd assume this was muscle related rather than chronic/advanced alcoholic disease. Do you remember if you were working out, working hard (manual labor) or had bruised a large muscle in the week or so leading up to the bad lab?

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Hybreko
Hybreko
in reply to Metanoia

I did just start working out a few weeks before the test. I had a 45min to one hour session a few days before the blood test.

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Edward1952

To be on the safe side I'd want an ultrasound and FibroScan. Don't drink alcohol again until the scans clear you of liver damage. As someone else has pointed out strenuous exercise could account for the raised AST & ALT in the ratio you had. Alcohol abuse is another possible cause but you don't drink enough for it to be the reason.

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Chris884
Chris884
in reply to Edward1952

I got a question if someone had cirrhosis with portal hypertension. Would a abdominal ct/pelvis with iv contrast show it.

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AyrshireK
AyrshireK
in reply to Chris884

Chris I have got to ask, why do you keep asking the same question over and over? We've given you the answer to this several times before in that yes a CT with contrast would show changes in your liver to the extent of cirrhosis with P/H. The only problem with your abdominal ultrasound is that it was several years ago now and whilst it might have been normal then there is always the possibility it isn't now.

I know you are in the US and have no funds for medical assessment but no one on here can help and we are just going round and round in circles. Somehow you need to get a current and up to date scan and monitoring.

Katie

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Hidden
Hidden

Whatever the reason for your blood results, I would hope that since then you have realised your drinking habits will have contributed to any damage you may have done to your liver and hope you have taken steps to at least cut down with a view to stopping completely?

There's no point suddenly deciding to exercise, eat healthily but continue to chuck alcohol down your neck.

By abstaining completely, you are giving your liver a chance to recover. If you don't it will get worse and the complications are devastating.

Look after yourself. Take care

Laura

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Hybreko
Hybreko
in reply to Hidden

I did cut down on alcohol long before those results, at the time I didn’t think I could have damaged my health, I just didn’t feel like drinking anymore, guess I got older and the all “getting drunk for the week end” thing got old.

After the results I stopped completely for about a month.

Once my results came back negative and the doctor seemed to thing it was nothing I started drinking again but very moderately. I would have a beer or 2 once in a while with friends and that’s about it.

Now that I noticed what looks like spider veins on my chest (not even sure that’s what it is or if it is just regular veins and I’m getting paranoid) I stopped completely.

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Metanoia

True liver spiders have a central, raised "arteriole", with legs radiating out from it. When you press on the central dot with a pencil eraser (or something similar), the legs disappear.

Lots of drinkers develop vascular lesions on their face & chest, but they don't all have liver disease.

Glad to hear you were working out the week before your spooky labs were drawn. I'm betting you're OK.

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Hybreko
Hybreko
in reply to Metanoia

Thanks, I think I just freaked myself out for no reason... whatever I had I can’t find anymore on my body now so I kinda feel stupid now but thanks a lot for all your replies!

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Hybreko

So I took an appointment with the doctor on monday.

I’m still freaking out about the spider veins, it’s weird depending on where I stand and the light they are barely visible or I can see them well.

I tried to take a picture:

noelshack.com/2018-43-4-154...

Not sure if they are actually spider veins or just regular veins (I have a very white skin and I’m very skinny so a lot of my veins are visible)

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Edward1952

There's no point in worrying. If they are spider veins they are very early ones barely visible. The raised AST/ALT ratio you had & the feint blood vessels could be signs of a problem or they may be nothing. I exercise hard most days & I've have never had a raised AST/ALT ratio like yours in any of the many blood tests I've had. I'd ask to be referred to a hepatologist for assessment. The GPs I've seen have only had a rudimentary knowledge about liver disease. The raised AST/ALT ratio you had plus the feint veins are sufficient reason to have an ultrasound & FibroScan done.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"The ratio of the ALT and AST may also provide useful information regarding the extent and cause of liver disease. Most liver diseases are characterized by greater ALT elevations than AST elevations with two important exceptions. Both cirrhosis and alcohol abuse are associated with higher AST levels than ALT levels, often in a ratio of approximately 2:1.

Elevations of the transaminases occur as a result of so many causes that they give the doctor only a vague clue of the diagnosis. Additional testing is required in order to determine more precisely what is wrong with the liver. Some possible causes of elevated transaminase levels include the following:

• Viral hepatitis

• A fatty liver

• Alcoholic liver disease

• Drug/medication-induced liver disease

• Autoimmune hepatitis

• Herbal toxicity

• Genetic liver diseases

• Liver tumors

• Heart failure

• Strenuous exercise"

"Enlarged blood vessels found on the upper chest, back, face, and arms, resembling little red spiders, are known as spider angiomatas. They characteristically blanch (turn white) if light pressure is applied to their centers."

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Hybreko
Hybreko
in reply to Edward1952

That’s what scares me so much...I don’t drink that much anymore so if it’s not alcohol abuse it’s gotta be cirrhosis...

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Edward1952
Edward1952
in reply to Hybreko

Based on your description of how much you've drank you'd have to be very unlucky to have cirrhosis. Alcoholics typically drink far more than you did and the majority still don't get cirrhosis. You'd have to have a susceptibility to it or other things stressed your liver without you knowing it.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"... only about 25 percent of alcoholics develop alcoholic liver disease, and only 10 to 15 percent of alcoholics are found to have cirrhosis during autopsy. So why are some people more likely than others to develop alcoholic liver disease ? There is no single answer to this question, as many variables contribute to the development of alcoholic liver disease. "

As a worst case scenario if it is cirrhosis it's at the very earliest stage & by being careful you could live a normal life span with few problems.

Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease:

"Some people with cirrhosis feel perfectly normal or have vague symptoms, such as fatigue, decreased appetite, nausea, and loss of libido. These individuals are known as having compensated cirrhosis. People with compensated cirrhosis often live a normal life span with relatively few health-related consequences due to cirrhosis."

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Hybreko
Hybreko
in reply to Edward1952

Thanks, I guess I’ll see what my doctor says on monday.

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Hybreko

So I went to the doctor, turns out my “spider veins” are just caused my shaving with a razor.

I think I just need to stay off the internet...

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