Hepatomegaly with increased parenchymal echogenicity, suggesting a
diffuse infiltrative process such as steatosis. No discrete
abnormality.
(liver size is 18.9cm) I am a 245lbs 6' male so i dont know how enlarged this is?
Dr. says that this NAFLD, he is aware of my histroy of pretty heavy drinking... but he insist it is more likely due to me being overweight and having bad Cholesterol
My quest is do you think this merits further workup or should i take my Drs word and consider it NAFLD?
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jebus22
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Morning jebus22. If you are unhappy with your diagnosis and know you are/have been a heavy drinker, then ask for a hepatology referral. It doesn't sound as though you're happy with what your GP has said, so you will always have that hanging over you. Good luck 😊
I think what your doctor is saying is that as you are over weight and have high cholesterol, it's your diet which needs to change. You can reduce the fat in your liver by eliminating the fats you eat which include fast foods which are high in sugar and salt, fried foods and alcohol. I think rather than insisting on test after test , a referral to a liver dietician would be more beneficial to you. Your body is crying out for a healthy alternative. Everybody knows what a healthy diet is, how to lose weight, exercise and get fit, it's just getting into the correct mindset to make that lifelong change to avoid a life of illness, disease and pain. We owe it to ourselves don't we?
I have since cut out most carbs, and sugar completely (most of my sugar was coming from drinks so i switched to zero sugar drinks) still working on the alcohol, down to 2-3 nights a week instead of every night. My 2nd blood work improved my ALT has stayed the same 82, but my AST dropped from 79 to 47 from what i read this is a good sign
If it's fatty liver either through alcohol or non-alcohol related or even both then the lifestyle changes required to improve are the same so if doctor is happy with a diagnosis of fatty liver then go with it.
Best wishes,
Katie
Hi,
We do ask members not to post test results in our forum guidelines. This is due to the fact that reference ranges for blood tests vary between laboratories, and also no one on the forum is medically qualified to safely advise you.
If you have concerns regarding your clinical management, can you request a referral to see a hepatologist ( liver specialist)?
If it were me, I wouldn't ask for more tests. All the results (high cholesterol and liver enzymes) point to fatty liver, and your ultrasound corroborated that. You could ask for tests to rule out viral hepatitis, but other than that, I'm not aware of any tests that can tell whether it's alcohol-induced or not.
Your AST/ALT ratio is lower than 1, which tells me that it's less likely to be alcohol induced, though alcohol could be a contributing factor. Not sure how much merit the AST/ALT ratio has though.
What you didn't mention are the following:
- How much you drink, and for how long you've been doing it
- Your age
- If you're on any other medications that could be contributing
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