Blood results missing

[Liberty82]

I've just had a print out of my latest liver function tests and the Alt and PT tests seem to be missing. How important are these to diagnose liver disease? I feel like I'm going round in circles. They said my blood results were normal so they won't refer to a hepatoligist or even for an ultrasound even though I have many symptoms of liver disease, she said I'm too young for cirrhosis as I'm 36 but I of course know that's not true. My bloods are also missing some test results. My results were -

Albumin 47

T Protein 74

Billrubin 5

ALP 88

AST 15

GGT 19

I know you aren't doctors and cannot diagnose anything but I've lost complete faith in GPs. I recently moved surgeries hoping for a better service but if anything they are even worse! I recently had a private ultrasound done by a sonographer and she said the liver appeared normal and so a doctor didn't look at the results. I have a bmi of 35 so it's harder to get a clear picture because of my weight. I'm currently reducing my weight by eating clean and excersising. I feel like I've nowhere to turn. I've had to go private for other matters and I just can't afford to see a hepatoligist privately at the moment. This has been going on for 18 months and I'm getting nowhere. I know a lot of you have experience having to wait for certain results, it's a nightmare x

[CarpeDiem11]

Forum guidelines mean that we cannot comment on your results I'm afraid, so I'll just try to answer the question about ALT and PT. The PT is a measure of the clotting time for your blood and over the many years I've had LFT's done, it is rare to see it included, so not seeing them on your results is not unusual. As far as I know it is not used to diagnose liver disease.

ALT is looked at in AIH an autoimmune disease, and when raised it is an indicator of active inflammation of the liver. I'm afraid I don't know how it used for other types of liver disease.

I hope you get some answers soon. On a sidenote, if they thought there was any indication of liver disease, most people get referred to a gastro in the UK, since there seems to be more of them. Hopefully other people can add to what I've said and offer you some reassurance. All the best

[Ibrokemyliver]

Hi Liberty,

I think when I had my liver bloods done they only measured one of the two enzymes (ALT or AST). I'm not sure why. They don't usually use PT in liver blood tests, but it measures clotting time. If your liver isn't working too well your clotting time is longer and the clotting time can help establish how severe liver disease is (as part of the bigger picture). It's worth going through them with your doctor, it's good to understand the ins and outs. Have you thought about changing GPs if you don't get in with yours?

BLT's info is here which is very useful if you haven't seen. X

britishlivertrust.org.uk/li...

[Liberty82 in reply to Ibrokemyliver]

Thanks guys. Ive just realised forum rules about test results. Its good to know that PT isnt usually used for diagnosing liver disease. Ive just moved GPs and ive only been with this particular surgery for 4 weeks but this one which was recommended by a friend who attends there is actually in my experience in 4 weeks worse than the other. It may just be the GP i saw but she wouldnt refer me for further testing saying i dont meet the criteria. Even though i have a host of symptoms that strongly point to my liver. At least my old GP referred me on for an ultrasound but i wasnt able to make the appointment due to a family tragedy. I did go for a private ultrasound which only a sonographer did and she said my liver 'appeared' normal but im still having symptoms the sweating being the worst and i believe my liver issues are drug induced and one of the stories on the BLT website sounds very like mine, her symptoms were the same as mine, the sweating being the main one, she was fobbed off as i am being and then eventually she got ill and it turned out to be drug induced cirrihosis. Everyone knows their own body and as much as it would be wonderful for there to be nothing wrong that is pretty much impossible considering my symptoms. Thanks again for taking the time to reply x

[Ibrokemyliver in reply to Liberty82]

I hope you get answers soon! Just to clarify, PT is not part of the standard liver blood tests, but it can be ordered by doctors as part of assessing liver disease as prolonged PT can indicate liver disease. PT can be standardised into something called INR (which is essentially PT, but accounting for differences between different laboratories). INR is one of the things they use to work out the MELD score. When I said liver blood tests I meant what they used to call liver function test. Hopes that makes sense.

[CarpeDiem11 in reply to Liberty82]

When they say " appears," normal, that is the usual speak used. You mention on another post they didn't say " is normal " . This is because they commonly use the word " appears" for whatever they see. e.g appears enlarged, appears echogenic etc etc It is not something as a word to focus on if that helps

[AyrshireK]

ALT and AST are both liver inflammation markers and as you've had an AST test there isn't any need for ALT too. Your AST reading is well within limits indicating no ongoing liver inflammation. Bilirubin and albumin look good. Itching in liver disease is usually to do with bilirubin build up and yours is low so not the cause of any itching.

I am puzzled as to what symptoms you feel are liver related as most of those you list arn't obvious liver symptoms.

You have had a clear ultrasound and a fibroscan that indicated some fatty liver disease. Fatty liver disease is one of the quickest growing health conditions in the western world and by your own description you are currently carrying too much weight but have started tackling this which can only help.

The only way to rectify any fatty liver disease is to leave out all alcohol, eat more healthily, avoid too much sugar and salt.

Nothing you describe indicates any more advanced liver disease.

Hopefully if you can look after yourself and your liver better then you'll see a vast improvement if you do go for a further fibroscan in the future.

If you haven't read it already have a look at the British Liver Trust page on Non-Alcohol Related Fatty Liver Disease and see what further guidance you can glean. britishlivertrust.org.uk/li...

Your bloods above look good. Certainly nothing indicating that you have anything liver related going on.

Keep tackling the diet and fitness and you'll hopefully be grand.

Katie

[Allystar]

I live in Armagh so i go to daisy hill or craigavon. While ive been an inpatient ive had cat scans and mris done in a few days. Thats ridiculous asking you to wait that long. Id definitely be looking into it one way or another. X

[SteveM99]

I would definitely pay attention to what Katie has said in her post, as she always talks a lot of sense and is very knowledgeable.

CarpeDiem's posts are always thoughtful, accurate and informative as well and both these posters are well worth taking to heart.

If 2 GP surgeries have not found a reason to refer you to a Gastro specialist, then it makes sense to me that they do not feel it is necessary at this point. In this world of litigation, I am sure that if they had an inkling that there might be something there worth referring you for then they would do it rather than risk you complaining or taking it further.

As Katie and CarpeDiem have both said, the numbers and description do not seem to indicate an actual advanced liver problem at the moment.

Personally I would look on it as a positive that 2 GP surgeries don't see you have a liver problem, and people on this forum also don't see you have advanced liver problems

Great news!

A good time to tackle the diet and fitness side of things, as Katie said, to make sure it never happens and not to push the body into it.

Not everyone gets the chance to avoid advanced liver disease, so I hope this forum has helped and you can make some changes to make the most of life

[Allystar in reply to SteveM99]

Great information. These people know what they are talking about. Be thankful you haven't got any serious liver conditions. Good luck 🤗

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I had cirrhosis by 33. Your blood work however is not at all pointing to liver disease though