I’m hoping someone can make sense of my google searches and my story so far...
For 10 years I have had raise ALT, highest 97 which levels out at 73.
I have right pain in my abdomen which radiates from my small intestine, back and under my right ribs.
I was discharged from a gastroenterologist in Nov, the diagnosis mild NAFLD. After Christmas my ALT went to 97 again and has now dropped to 68 however my bilirubin has gone up to 19 ( usually 12).
At this point I decided to take matters into my own hands and paid privately for a fibroscan, the results were 7.5 mild to significant fibrosis!
My question: my first gastroenterologist said he believed, only by bloods I had mild nafld
Do I now have NASH???
Is Nash scarring of the liver or inflammation which has to be determined by a biopsy?
Thanks in advance for your posts!
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NaffedoffXYZ123
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What is your other LFTs? The fibroscan suggests fibrosis but they can be skewed by inflamation. Which your ALT suggests you have. My fibroscan was 58.9 on my first test if that makes you feel any better. It also dropped to 38 on my second test 2.5 months later. I'd suggest repeating it in a few months and in the mean time talk to your docs about getting your enzyme levels down. High liver enzymes suggest inflamation and inflamation causes fibrosis.
Thanks PhoenixPalazzo, unfortunately I don’t have the rest of my LFT but they are all on the normal range. I’m still confused, is NASH inflammation of the liver or scaring, or both!
The doctor just looks at me blank about a high ALT, all they say is follow a Mediterranean diet.
They don’t mention purge sugar and saturated fats.
Nash stands for " Non Alcoholic Steato Hepatitis" . The word hepatitis is : Hepa-of the liver . Itis- inflamattion . The liver becomes inflammed temporarily for alot of reasons. For example take alcohol. Everytime we drink alcohol the liver becomes inflammed. But when we stop drinking the livers natural cells called " hepatocytes" rush to the scene and fix it all up nice and pretty with living tissue. No harm no foul. But When the inflamation is chronic however it can activate what are known as hepatic stellate cells. Hepatic stellate cells fix up the liver as well but they dont do it the same way. They use collagen to repair the injury which forms a scar tissue that is useless in function. Picture it this way. Hepatocytes are like fine cosmetic surgeons and hepatic stellate cells are like first responders to a car crash site. They will close the wound but it will be ugly and scarred. In order to stop the inflamattion and the subsequent stellate cell activation, the cause of the inflamation needs to be removed. With alcohol you stop drinking. With obesity you eat a better diet. Not all fatty liver is caused by diet though. It's important to identify the trigger causing the inflamation first and foremost. So to recap NASH is not fibrosis. NASH is chronic liver injury that causes fibrosis by inflamation and stellate cell activation. I hope that helps you understand it a bit better.
My problem seems to be finding the actual cause. About two years ago I was tested for all Hep, and all clear, no life changes since. Although I drank in my youth (great memories), I dont over indulge now, and havent for some time, other than the odd lads night out.
Im having my bloods done again tomorrow to look at my iron levels, and celiac and auto immune.
Reading down the familial hypercholesteremia could be a good thing to investigate as my cholestrol is quite high and doesnt seems to change very much when changing my diet.
Any advice ideas on what else could be causing my inflmamtion would be greatly appreciated.
I've been in a similar situation for the last 5 years, still under gastroenterologist, had ultrasounds and ELF tests too (9.8) . My ALT score has only just recently got down as far as 44 but has been up as far as 180 at times. Also had very high ferritin levels at times too Diagnosed with NAFLD and my kidney function also dropped to stage 3 CKD
Been eating Mediterranean diet and walking/exercising as much as possible for some time, no difference until my GP asked about my family history and heart disease as my Cholestrol was 7.8 total ... then diagnosed with FH (familial Hypercholesteremia) a genetic version of high cholesterol which is not diet related. Been on atorvastatin now for 3 weeks and along with cholesterol dropping my LFTs are now all in normal range.
The only other drug I take is low dose naltrexone which helps pain and inflammation (I also have fibromyalgia)
Had lots of mysterious muscle and nerve issues for years, since my mid 20s all tests came to nothing, had full MRI and neurological blood tests etc then in 2008 I lost my son to suicide and things obviously got worse with stress. By 2011 I was getting inflammatory issues all over my body and GP ran blood tests ANA and inflammatory markers to see if I had rheumatoid arthritis, then sent me to a rheumatologist who did more blood tests, inflammation was there but no rheumatoid or lupus patterns so was diagnosed with fibro.
I had blood tests for inflammation and RA markers .... my bloods showed inflammation but no obvious cause for it. Not lupus, not RA and my immune system was not low. In fact my immune system is overactive.
There is no blood test for fibromyalgia it is diagnosed on clinical symptoms and ruling out other causes. You name it, I've had the tests over time and most have turned out negative.
I am of the mind that the familial hypercholesteremia is behind my symptoms and issues as it was for my father before me and currently my brother, sister and nephew. However the inflammation is manifesting differently in all of us, with my brother and sister it's their heart. Myself, my brother and dad all have degenerative issues and calcium build up on our spines, and I have fat in my liver and suffer with inflammation in my liver so I've had Tests for hepatitis and heamachromtosis etc all come back negative .... I think it's the cholesterol build up and inflammation related to the calcified fats and my immune system kicks off at it wherever it has deposited itself. One time it was my circulation playing havoc and an immunologist told me it was a little sister of capillary leak syndrome. Again I just think cholesterol and immune response.
Dealing with the cholesterol and inflammation is my main aim now for me and for my family.
Low dose naltrexone is working great modulating my immune response and taking down inflammation, and the atorvastatin is lowering my bad cholesterol and also helping with inflammation in my arteries. So fingers crossed.
My sister who is 12 yrs older is not so lucky and currently struggling with athersclerosis and heart disease.
Just going over some posts and realised my last post was incomplete.
I would again like to thankyou for your responce and wish you and your family all the best and hope your sister improves, its upsetting to read she is going through so much at 12, I'm sure like you, she is very brave.
It’s significant that your reading went up after Christmas a time of indulgence, so you’ve had a warning to change your health lifestyle and stop putting your liver through tough times. Love your liver, cradle it in your body like it’s a new born.
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