Is there any way?

[kuda123]

I have NASH fibrosis which was dxd after blood test and fibroscan. Now my blood test are almost normal .My Hepa told to go for a biopsy but I don't want to go for the procedure .Is there any way other way to correctly dxd nash eccept biopsy.Does blood test improvement means am I cured off NASH ?

[Hidden]

If your blood tests normalise & stay normal then in theory you'll no longer have NASH (which by definition means inflammation of fatty tissue in the liver). As long as the inflammation doesn't return your liver shouldn't get any worse & may even repair itself over time with the fat deposits dissolving as a result of following a healthy lifestyle.

A biopsy should give you and your consultant an accurate measure of the degree of fibrosis. If it were me I'd want to know this & I'd get the biopsy despite the procedure sounding unpleasant. On the other hand if you can get and keep your blood test normal then in theory no further damage is being done and you could argue that there's no need for a biopsy.

Playing devil's advocate however if you know how much fibrosis there is you'll have an idea of how damaged your liver really is. You may even be pleasantly surprised to find that it's not as bad as the FibroScan indicated. I'd want to know that so I'd grit my teeth & get the biopsy! It's your choice!

[kuda123 in reply to Hidden]

I had a fibroscan with a score of 7.4 kpa suggesting moderate fibrosis .I had insulin resistance ,High cholestrol ,High Alt and ast .My blood tests are normal now ..Only concern is my fibrosis score.

[Hidden in reply to kuda123]

A score of 7.4 kPa being moderate fibrosis a biopsy is arguably unnecessary. The only advantage of one is that it should be more accurate than the FibroScan. If anything your FibroScan score is more likely to be inflated if your liver was inflamed when you had it.

Most consultants I'm guessing would not want a biopsy to be done when the fibrosis score is moderate like yours. If you feel pressured to have a biopsy then consider getting a second opinion or just flat out tell the consultant you want to wait & see what happens after following a healthy lifestyle for 6 months or a year & then having another FibroScan.

The important thing is that you follow a healthy lifestyle to give your liver a chance to repair itself.

[desballen]

Ive heard alot of people getting biopsies and 3 months later it changes.....my doctor wanted to do a biopsy on me and like you i dont want it...its been 3 years sense i 1st was diagnosed with fatty liver and she told me i reversed it so i dont know why she would want 1...my bloods have been normal for 2yrs now so i feel like you why get it...

[kuda123 in reply to desballen]

I think fibroscan is better than getting biopsies

[Hidden]

Hi

In my case the biopsy was more accurate than the fibroscan.

I have heard that sometimes your alt can be normal but your liver isn't. I know this probably doesn't happen very often. Take care Lynne

[kuda123 in reply to Hidden]

What was your fibroscan score ....?

[Hidden in reply to kuda123]

From what I remember it was 4.3 xxxx

[Ellewoods1]

Your liver blood tests can be normal but you can still have a fatty liver or a damaged liver. The biopsy is the only accurate test.

[Gag233]

What is your Fibroscan score.

[kuda123 in reply to Gag233]

7.4kpa

[Hidden]

Good morning kuda123,

I have attached a link to liver blood tests explained and non alcohol related fatty liver disease (NAFLD) which may help to guide your decision making and future conversation with your hepatologist.

britishlivertrust.org.uk/in...

britishlivertrust.org.uk/in...

I hope this helps.

Best wishes,

Trust9

[kuda123 in reply to Hidden]

Thanks

[Bluesky5]

Just to add to the conversation.

My ALT/AST where elevated in 2014 and the 2015. I was age 37 BMI 28 at the time and that’s about it.

Through 2016-2019 my ALT/AST where normal kPa 3.7 CAP 187 I thought that means your fatty liver is gone. NOT a chance. When I had kidney stones and other such tests around the abdomen during this time period - my reports always said at the bottom diffused fatty liver infiltration. It never went away - I thought if your levels return to normal it’s gone.

At the middle of 2019- BOOM my ALT/AST are elevated with kPa 6.2 and CAP 350. Just to explain better my weight, lifestyle, cholesterol, has always been the same since the elevation in 2014. So, I have no idea how they go up and then go down.

My point is..I don’t know but every doctor I have seen GP/Hep/Gas doesn’t know either.

Regards,

BS

[Woodystar]

Have you had the ELF blood test?

[kuda123 in reply to Woodystar]

I had elf test which suggested moderate fibrosis .I had been tested negative for viral hepatitis. I am lean so no chance of obesity related fatty liver but due changes in lipid profile and pre diabetes my doc suggested that I might be having NASH

[Woodystar in reply to kuda123]

You sound very similar to myself. I just took part in a trial for a liver multiscan. The MRI multiscan shows the inflammation and fibrosis alongside fat and iron content with colour coded pictures and hopefully will replace a lot of the need for biopsy. It's not yet been adopted by the NHS but there is some NICE info about them.

I feel the same about a biopsy as the ELF score was borderline moderate to high. I just feel it would damage my liver further for no good reason.