Straight answer

[Casinobo]

How in Gods Green earth can so many have normal LFT’s and still have compromised livers?I mean, how is one ever to know if their livers are a problem when you can’t get a straight answer? Being in this fabulous forum makes me think I have liver disease ,whether I do or not. It is called liver function test right? How can you have normal with abnormal? Seems as the other tests are unreliable as well. The Drs. In the States are not willing to do further tests when your LFT’s and ultra sounds aren’t a big enough issue. By the time you wait for more symptoms, it can be too late to fix it. Drives me Nutz!

[Hidden]

Sometimes things can be grey, seek a second opinion?

[Peter_Plymouth]

The liver is an amazing organ and even in it's most distressed state can still manage to produce normal (otherwise known as fully compensated) liver function tests. Get a second opinion if you have reason to believe your liver is damaged whatever the reason.

[Casinobo]

I agree with that 100%. Eat right, exercise, no drinking, smoking, drugs, or breathing lol. I had my Gallbladder out last March and had noticed I had a fatty liver. I have had off and on RUQ pain for probably 10-15 years. The pain more of an irritation I guess. I have had a few friends and an uncle die from Cirrhosis and it has scared me sorta straight. I still drink occasionally but wish I knew, if I should not drink at all. I have been on a diet too. Lost 25 lbs. Still get the pains whether I drink or not. Well under the two drinks a day, I might have 5 beers a week. I do enjoy a cold beer on a golf course on a sunny day. I really don’t have any other symptoms, but am very conscious of liver disease symptoms. I have also learned a lot in this forum. Great people! Thanks for your reply.

[Hidden in reply to Casinobo]

Hi Casinobo

Was your fatty liver noticed by the surgeon during the gallbladder removal or on ultrasound?

Either way, be very cautious drinking alcohol with a fatty liver.

When alcohol is metabolised it results in overproduction of fat in the liver. A healthy liver should have little or no fat but if you drink more than your liver can cope with,

fat can build up, leading to fatty liver disease. This condition can also be

caused without drinking, which is called non-alcohol related fatty liver disease

(NAFLD). This stage is often asymptomatic (has no symptoms) and can be

addressed by reducing the amount of alcohol you consume or abstinence,

which means you stop drinking completely.

Maybe you could discuss your stage of fatty liver a little more with your own doctors? Possibly have a fibroscan?

Very best wishes

Trust1

[Casinobo in reply to Hidden]

Thank you for that information. It is the nafld. It was confirmed as mild in a CT scan when I had a gallbladder episode. I have had it for at least 10-12 years when I go back on my labs. I did drink heavy for at least 20 years. I do count the drinks I have now to make sure I do not over do it.

[Casinobo]

Yes, two of them. I got concerned when I had the Gallbladder surgery. I have had minor elevations in AST and ALT that’s about it. They are normal last ultrasound sound. Dr. Says no concerns with Ultra sounds.

[Garyvh]

In this context I think we are usually talking about LFTs returning to within normal ranges following recovery, or partial recovery, from some kind of symptomatic decompensation event - esophageal bleeding, onset of ascites etc etc.

Often this will have been preceeded by warning signs that are easily picked up on in LFTS.

If your LFTs have been consistently more or less within normal ranges for a reasonable period, you're probably good.

[Hidden in reply to Garyvh]

Exactly!

[Marydel63]

You can still have normal liver labs and still have cirrhosis. As I do and from nafld

[Casinobo in reply to Marydel63]

Yes, I get it. My point was two fold. First off, How the hell do you ever know if you have a bad liver if you LFTs and your Ultrasound and MRIs are not reliable? I’ve heard all these tests aren’t accurate. You seem to be maybe be one of those that couldn’t get accurate info.

[Marydel63 in reply to Casinobo]

I was always told oh your liver is fatty not to worry. The diagnosis of cirrhosis came from liver biopsy. All the cat scans and ultrasounds over the years showed fatty liver . So I was always told fatty liver not to worry

[Casinobo in reply to Marydel63]

Maybe NAFLD is the big problem. Certainly my Doc doesn’t worry about it either.So if I quit drinking and still get Cirrhosis that would really suck. So my next question is, What is worse, a beer or a Twinkie? Lol. I give up. I guess I will do the best I can with dieting and just live while I can. I hope everyone in here gets the help they need.😀

[Hidden in reply to Casinobo]

Keep in mind when alot of us say we have normal LFTs in cirrhosis it certainly does not mean we have always had them be normal. They only become normal when the cirrhosis either becomes inactive or dormant by not having active inflamation. Or when the liver is so damaged that the parts that are completely destroyed no longer leak enzymes at all making the enzyme levels in the blood appear lower.

Heres an example of the latter as it was explained to me. I'll use ALT as an example. So let's say the normal cut off value for ALT is 50 U/L. Now Imagine if you cut the liver into 5 proverbial sections and each of the sections is inflammed and leaking 20 U/L of ALT into your blood stream. Your test result would appear high at at 100U/L. Now if 3 of those sections become destroyed to where they do not function anymore at all they will no longer leak ALT into the blood stream leaving only the 2 sections that are leaking the enzyme. Your test would now have a result of 40U/L making your test seem in normal range. When in fact your worse off because now 60% of your liver is not functioning at all.

However a liver in either of those scenarios would certainly show up on an ultrasound in some format. Also keep in mind that fat in the liver can make it hard to see some morphological changes in early stages and the liver can hide behind it where a doctor doesn't see the whole picture behind it.

[Hidden in reply to Hidden]

This is a perfect way to explain how ALT can appear normal, but actually another story is going on in the liver.

[Hidden in reply to Casinobo]

Fatty liver can be caused by so many things. So in short is one literal twinkie worse than one literal beer? Most would say the alcohol is always worse. But depending on your aeitology it could be the twinkie. It's so hard to ever quantify that even medically. Which is why the suggestion to not drink is there as a fail safe. Eating crappy food is just as bad though. Even alcoholic fatty liver and alcoholic hepatitis have so much to do with poor nutrition that it's almost equally the cause of it. My liver enzymes never seem to change no matter what I eat. But my cause of liver disease is alcohol. But I know some members whose enzymes rise if they start eating junk food again which makes sense since their disease is cause by problems stemming from that very thing.

I currently am in agreeance with Trust 1 on not drinking with fatty liver until it can resolve. Again it's the fail safe. Since noone knows if one beer will actually cause a person to progress or not is alwas unclear it always safe to stay on the side of caution.

There are studies being done that argue that moderate alcohol intake in some types of non alcoholic fatty liver disease are showing protective qualities against the evolution toward NASH in their test subjects. It's interesting enough to ask a doctor about, but I personally wouldnt suggest it to anyone or take it as a proven science until when and if it ever became a actual proven science.

I'm all about free will brother. I think people should live they way they choose. As long as someone is informed in those decisions than their life is their path to lead and it should never be any other way in my opinion.

This stuff can all be very confusing and frustrating. But take care of yourself as best as you possibly can.

[Casinobo in reply to Hidden]

Wow Phoenix! You are surely a fountain of knowledge. That at least gives me some perspective. I have had slightly elevated AST and ALT but nothing crazy. I have also taken fat people medicines High dose of Crestor, Blood pressure meds and a min dosage of Metformin. I am working hard on the diet since, I think that being overweight going into the Golden years is as bad if not worse than boozing. The eating right is tougher than the alcohol part for me. Cause I sure love a good pizza and whatever else your not supposed to eat. I do check my LFTs and other stuff every 6 mos. just to keep an eye on stuff. I need to drop another 30 lbs then maybe I will lose some of these damn pills. Thanks😍

[Hidden in reply to Casinobo]

Oh its very true concerning diet. Unless a person is extremly addicted to alcohol it would be easier to stop than it is to keep diet clean. Alcohol is one thing to keep out of the shopping basket and it's easily recognisible. But with diet it's so many things to take out and things to add in that it can sometimes be overwhelming to remember whats good for you and what's bad. I try to keep it simple myself by trying to only eat whole foods. Lean meat lots of vegetables and fruits are a good way to go and exchange white pasta and white bread with whole grain bread and whole wheat pasta. Basically a mediteranean diet. I'll be honest at first eating all that stuff tastes boring and bland. But after a couple weeks you can bite a mcdonalds burger and all of a sudden the salt content alone becomes overwhelming to the taste buds to the point that it almost tastes bad now. Once you get the weight where you wanna be you can cheat a little or reward yourself whatever term works for you lol. For me I love beef tenderloin.. it's my Achilles heal. I eat it maybe twice a month with scotch bonnets and bluecheese melted on it cooked blue rare. That I will never give up. If I have to I'll eat the cow while hes still alive to get it from him 😅

[Casinobo in reply to Hidden]

I hear ya on the Steaks! Hope you are well! See ya around. 😎

[Hidden in reply to Hidden]

McDonald's almost tastes bad? It does taste bad surely lol

[Hidden in reply to Hidden]

No comment 😋

[alfredthegreat in reply to Hidden]

Reminds me of years ago when I had an hotel. I asked a customer how he liked his steak? He replied "Knock it's horns off and wipe it's bum". It doesn't come much rarer than that! lol

[Hidden in reply to alfredthegreat]

Yup that's the only way I'll eat it! It has to be to the point where you need a coroner to tell if its truly dead or not. Lmao

[alfredthegreat in reply to Hidden]

Your ancestors probably hale from Transilvania !

[Hidden in reply to alfredthegreat]

I have often wondered that very thing Alfred. I truly have. 😅

[GrandmaDylan in reply to Marydel63]

I lost 35lb last year doing a low carb diet. I had blood tests for my diabetes which all came back virtually normal. My gp complimented me on my weight loss and my liver function tests being normal. The only abnormallity was anaemia so I was referred to a haematologist. She did a thorough examination and informed me that my liver was enlarged and the spots I was covered in (I had been asking doctors if they were liver related for the last 3 years and no one knew what they were) were spider naevie which WERE liver related suggested liver disease and sent me for a liver scan. It turned out that I have cirrhosis, an enlarged spleen with varices, portal hypertension and early esophageal varices. My lft's are still virtually normal, so yes you can have normal blood tests but still have advanced liver disease. It turns out that I have autoimmune hepatitis and have probably had it slowly damaging my liver for at least 10 years.

[Hidden]

😉