Liver pain, fatigue, dizziness

[patrick62869]

Hi all,

32 year old Male, have been drinking regularly since college. For the past say 5 years anyway I would drink typically 5 days a week, sometimes more. I would drink heavily pretty much every friday & Saturday, and also drink 3/4 nights during the week (three double measures of rum on a weekday).

I'm sure there are people out there who drink more than that but I'm conscious I have been a chronic drinker for the guts of a decade, and have rarely ever gave my liver more than a couple of days to rest.

I have known that I drink too often but up until recently it hasn't caused me any outward problems (that were obvious to me). About a year ago i began to be aware of a 'stiff' feeling in my upper right abdomen. I had a binge period recently where I drank moderately heavy for 10 days straight (at least a few measures of rum or a bottle of wine e.g.) and I woke up with mild pain in my liver. This worried the hell out of obviously. I stayed off drink for a few days and felt it progressively better. On the fourth day I ventured a drink again and had a bottle of wine - again waking up with liver pain.

I'm panicking I have gave myself cirrhosis over the years without realising. I have read that you can develop it without showing symptoms and only realise too late? I have noticed a pretty loud gurgling/percolating type noise from my gut and bubbling sensation in the liver area too. I am reasonably healthy otherwise. Okay diet, exercise regularly, good BMI.

After the initial worry over my liver discomfort back in April i pretty much normalised it and went back to my usual drinking habits (maybe a day or two off it a week), all the while thinking "i really should cut down" but not actually doing it consistently.

For the past couple of months i've developed a really strong pulse / throb that I can feel throughout my body, it's very noticeable to touch and if i place my hand on my abdomen right below my ribcage you can feel the strong throbbing. A couple of week's ago, after having a few drinks (not a lot, 3 or 4 beers) i woke up at 3am with my heart absolutely racing, sweating, fingertips tingling... This has gave me a real shock

Happy to report that I haven't had a drink since (two weeks today). This is the longest period without a drink for me for years so i'm fairly pleased & determined to let my liver heal from whatever damage i've built up over the years.

Anyway, i still don't feel myself. The discomfort in my upper right abdomen remains, and I have bad fatigue & dizziness. The throbbing pulse sensation has gradually eased since my last drink two weeks back which is positive i guess. However, my circulation seems bad (it's never been great, i always would get numb fingers & toes from the cold when my friends are perfectly warm) but i really struggle to keep my hands warm now. I don't know if these circulation & fatigue issues are alcohol/liver related but it seems to be linked as it got worse following the development of throbbing in my abdomen etc.

I spoke to my doctor and explained i had been feeling unwell & admitted that i had been drinking too much. I got my blood taken for tests last week and very nearly passed out when the blood was taken (four vials). This has worried me in itself as I have no issues getting bloods in the past, and just confirms how i have been feeling lately - weak, lightheaded and spells where i feel like i could faint.

I called for the results this morning and was told that they returned normal. The lady on the phone told me that the liver test was labelled as "Gilbert's syndrome". This is a fairly benign liver condition that is hereditary and the doctor told me I have when i spoke to him before anyway. So the bloods haven't really really enlightened me about why i have been feeling so run down. I am a little concerned that the doctor has perhaps been dismissive of abnormal results in my liver function because he was expecting this due to Gilberts syndrome.. I hope this hasn't masked a more serious issue. Or am i just being paranoid?

I'm not sure what to do next. It seems that doctor is content to leave it at that. But i still have liver discomfort, and major fatigue, dizziness, circulation worries etc. Should i push to get scans done?

Is it possible to have bad liver damage that would not show up in blood tests? Or should i take this a positive development and just move forward?

Note: i tested positive for Covid-19 a month ago. I had flu like symtoms & loss of smell for a few days but these passed. I guess the residual fatigue etc. could be down to covid.

I am resolved not to touch a drink for the remainder of the year in any case. Pleased with myself for reaching the two week mark - but a little disappointed that i don't have boost in general feeling of wellbeing that I was looking forward too! Will continue to abstain, follow a healthy diet & get back to exercising when i feel i have my energy back.

[Hidden]

Hello and welcome to this forum.

Well done for staying off the alcohol , it is hard but very necessary - be good to your liver !

It is possible to have normal liver tests in the presence of liver damage so do not assume that all is well just because you have been told your tests are normal. It might be worth you having a conversation with your GP about your results and ask why they think you have Gilberts syndrome. There is information on it on our website

:britishlivertrust.org.uk/in...

I am sorry to hear that you have had COVID, you may well be right in saying that your symptoms of fatigue etc could be as a result of this however if it persists then your GP may want to investigate.

Is there any plan to review you, recheck bloods ?

We do have a free helpline if you want to talk to one of our liver specialist nurses:

0800 652 7330 Mon - Fri 10:00 - 15:00

regards

[JJgut]

Congratulations on your decision to stay off the alcohol for the time being. I know it can be scary to get these kinds of symptoms, and to not know what is wrong.

Sounds like you have been drinking for about 12-14 years, but heavily for only the past 5 years? Can you elaborate on how many drinks per week you've been drinking for the past 5 years vs. the 7-9 years prior to that?

As for your symptoms, it could be that you had a case of alcoholic fatty liver (hence the pain) that has resolved. This is a reversible condition. Your liver could also be inflamed due to COVID-19, which would be temporary.

What were your other blood test numbers? AST, ALT, ALP, and GGT are the liver enzymes to look at, but also bilirubin, prothrombin time or INR, albumin, MCV, and platelets. There are some online calculators that can predict whether or not major liver damage has occurred.

[Hidden]

Hi there.

I have recently learned that my normal liver blood tests do not mean my liver is healthy. The specific tests you need are an ultrasound to measure how fatty the liver is, and a fibroscan to measure it's stiffness. Turns out I have a stiff liver (fibrosis). I am now awaiting a further blood test (an ELF test) that will also indicate any fibrosis. A liver biopsy tells you the same thing, but I want to avoid this as it carries risks.

So as I smugly told the consultant I consume about 14-20 units a week he said drinking excessively in my partying days has probably been the cause (quite a few years ago but pretty excessive).

If you are able to discover this early enough, you can make the changes required to halt or hopefully reverse any damage.

I imagine it must be scary for you with your symptoms, but well done for laying off the booze while you diagnose, and researching into the causes of this.

Best of luck, and hope your symptoms disappear.

[patrick62869]

Hi guys, thanks for your comments.

JJgut - i typically would drink every Friday & Saturday, roughly a bottle of wine + a beer or two give or take. I would also drink regularly through the week, say 2/3/4 weeknights on any given week - drinking 3 double measure of rum. If i was meeting friends or whatever say a couple of times a month i would drink 8-10 beers in a sitting.

Trust5 - i spoke with my GP this morning; he is my family doctor and advised that Gilberts is hereditary and runs in my family. He believes it accounts for the slightly raised bilirubin levels in my blood results. The good news is that he told me that a wide range of blood tests were done and nothing was giving him cause for concern: liver function, bilirubin, iron, thyroid etc. I can't remember. I didn't press him for what exact liver test numbers these were e.g. AST, ALT, ALP etc. because i don't really know what i'm talking about!

I told him that i still have ongoing discomfort in the liver area but in his experience this is very unlikely to be caused by alcohol, given my age, drinking rate & good blood results. Again, i don't really know what this means, but he told me that my liver scores were in the 50's and he has seen people with numbers in the 1000's. I told him that i would find it very hard to believe that my symptoms aren't a direct result of my drinking over the years.

In any case, he has agreed to give me a referral for an ultrasound which i'm pleased with. I'm convinced that it will reveal a level of damage that the doctor is not anticipating but we will see. Needless to say, i am just hoping that whatever the level of damage, i have changed my ways in time for the liver to adeqauteIy heal. Dreading an advanced state of fibrosis. Will let you guys know the outcome for future reference!

He is also putting me on thiamine tablets to make sure i'm getting enough vit B1. Three weeks now without a drink - uncharted territory! I keep swinging between calm: "Doctor has seen x10 worse, he's unconcerned, just stay off booze and i'll be fine" and dread: "People can have good bloods but really bad liver disease, the fact that i have liver pain in the first place means there's something very wrong".

[patrick62869]

My doctor has said "it may be some time until I scan get an Ultrasound scan given current situation...". Has anyone had one recently and perhaps have an idea of current NHS waiting times for this? Also interested to hear if anyone has decided to go private to get a scan.