I'm new here....Advice on ALD? - British Liver Trust

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I'm new here....Advice on ALD?

Thumberlina
Thumberlina

Having read other posts and the BLT documents I now understand the format. Newbie :-)

Looking to see if anyone can shed some light on symptoms if any with fatty liver, and the more advanced stage of ALD. I have been a heavy drinker, not excessive over the past few years in particular.

I had a recent LFT and other tests which showed a slightly raised ALP and Haematocrit reading (both marginal). Everything else was in the normal range clotting, white cells etc all fine (GP said they were within the tolerances and nothing to worry about).

I am sometimes sick with food, asian cuisine is the worse. If teamed with a glass of wine Indian food, I eat, pretty much immediately balloon and them throw up (no blood). Afterwards I feel fine.

I also have tender abdomen on the liver area, below my ribs in the centre and to the right as well as couple inches to the left I would describe as between my belly button and centre ribs (only if you press it). It has eased i think since not having any sweets/alcohol. I do suffer heartburn & indigestion regularly which eases when i don't have any alcohol but Rennie's seem to help. I have no other symptoms really, plenty energy etc.

I keep seeing GGT mentioned, i am not aware of them doing this GGT test (is it only done if checking alcohol related?) as they were checking for issues related to my thumb, joint swollen for no obvious reason (which has also eased).

Am I worrying for nothing or should I be asking for more tests? If so which ones? The info you find on google is a quagmire and conflicting. I have read that my symptoms (if that's what they are) are early stage and my liver if damaged will regenerate in time.

I do not need a diagnosis. I'm merely asking for other peoples experiences if any and advice.

20 Replies
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Hi Thumberlina, More or less in the same boat. If you are experiencing pain under the ribs, a sort of tender dull ache then it is likely that you have liver issues, especially coupled with a history of drinking. I have the same and have struggled with it for the last four years. First port of call in my opinion is to INSIST on a Fibroscan so they can measure the stiffness of your liver (Kpa) and a Cap score which will tell you if you have Steatosis or fatty liver. Most consultants won't intervene with liver disease until your at deaths door and getting a proper diagnosis can take years especially now we are at the mercy of Covid.

So... the best thing you can do is be proactive and eat a healthy diet, exercise regularly and totally quit the drinking, and no smoking as tobacco smoke is toxic and inflames the liver further, this is what I had to do in the end. I still get pain but not half as much as I would have if I continued with the sauce! I was a bottle of wine in the evening person to destress after work, which I religiously adhered to for about eight years. My mother was recently diagnosed with Cirrhosis so I am certain a weak liver runs in the family.

Hope this helps.

Thumberlina
Thumberlina in reply to arthole

Thanks Arthole, I have given myself a huge fright. I am now educating myself on healthy change and my liver in general.

As well as wine I ate a huge amount of crap, sweets and stuff.I have now stopped. The liver pain is only present when I press it and after 5 days of removing all the bad stuff it does seem to have eased off.

I've found an ultrasound clinic who do upper abdomen ultrasound so I've booked in privately. Hopefully if something is there they will see it and I can take that back to the docs. They currently insist on phone appointments so I'm left with little alternative than to investigate myself best I can. I wasn't sure at what stage my symptoms would occur, so I'm just hoping it is irreversible and I haven't done any permanent damage. It’s just the not knowing 😟

arthole
arthole in reply to Thumberlina

Can relate. I liked my rich foods and loved to cook them. I have found that by switching my diet to more Mediterranean fare my tastes for fatty, crispness has waned. An ultrasound is a good start as it will assess all organs such as liver, pancreas, gall bladder and kidneys etc.

Liver disease can be halted and sometimes reversed depending on the stage and type. Coffee seems to be one of the best medicine's to combat fibrosis which has had proven results in scientific tests. At least four cups a day they say. I am now a caffeine junky! Once an addict always an addict!!

Ultra can only detect fatty infiltration if it is 30% and above and cannot detect fibrosis, only the more extreme Cirrhosis, it can tell if the liver is swollen but still not a definitive tool for accurate diagnosis. If they do find liver issues then you must insist on a fibroscan as it is much more accurate.

Thumberlina
Thumberlina in reply to arthole

Ok, really appreciate the advice. The place I’ve booked doesn’t do fibroscans, only ultrasound but it would at least give me something to take to the docs and push for the fibroscan and put my mind at ease it is not a cirrhosis.

So is fibrosis reversible or permanent with lifestyle change? I get confused with all the terms and stages. Is fibrosis same as hepatitis?

arthole
arthole in reply to Thumberlina

Hepatitis just means liver inflammation. Prolonged or chronic hepatitis can lead to fibrosis which is scarring of the liver which is more or less permanent, however some research says it can be reversed to some degree potentially. Fibrosis can then lead to cirrhosis. Fatty liver can be reversed as I did, however I still have inflammation.

arthole
arthole in reply to arthole

Hepatitis is hard to halt as it’s basically your own immune system attacking your liver and it’s locked in a viscous cycle. The liver seems to just become over sensitive to all toxins.

arthole
arthole in reply to arthole

But yes it can be stopped if it’s being caused by booze, diet etc.

Lucky87
Lucky87 in reply to Thumberlina

Sound like me I used to drink wine and eat junk food. I went to have bloods for something else and my alt was 42 so only slightly raised but gamma gt was 216 the doctor told me they only do gamma gt if another liver enzyme is high. My case they told me it’s alcohol related but I don’t drink that much, upto my test I was taken ibuprofen 3 times a day as advised by doctor so I’ve come off that and changed diet and not drinking. I feel like sometimes I feel an achy in my right side where liver is but I didn’t feel it before my test so idk if it’s in my head. I am going for an ultrasound in December and then bloods again in January x

Thumberlina
Thumberlina in reply to Lucky87

Interesting. my Alt was only 15 but I can't see any AST reading, I am clueless with this and Dr Google sent me in to a wild panic. I called and asked them to talk me through for the receptionist to tell me I am fine, the docs have put a note on my file no further action. I had to demand an appointment, they are only doing them via phone and there's a bit of a wait. I will just have to hang on and see

Jm205
Jm205 in reply to Thumberlina

Fwiw, ALP and gallbladder problems go hand in hand, but mine was low (normal) the first time I got tested, and has gone down further with every test, so everybody's different, especially since some people have low functioning gallbladders without a stone issue. All my bloods have always been good though, and I've been on a pretty pristine diet for over a year. Maybe check your triglycerides to see if your good and bad cholesterol are flipped if you don't want a scan yet. That was the ah ha moment I had when I finally figured out my gallbladder was probably the main culprit. They're still normal, but very low normal, and I work out a ton with normal overall cholesterol. I've noticed many other things since that have confirmed it.

Thumberlina
Thumberlina in reply to Jm205

Ahh that's interesting, I can't see that word in the test resulst.The tests they done were

:Anti-CCP antibody level

Haemoglobin A1c levelUrea & electrolytes

Serum TSH level

Liver function test

Serum C reactive protein level

Bone profile

Erythocyte sedimentation rate

Clotting screening test

Differential white cell count

Full blood count

All came back fine other than ALP 105 and Haematrocit 0.473 which were marginally high and i'm told in the tolerance. Everything else was fine. I did mention to the GP last time i was in I had pain on the upper right so maybe it is a blockage of sort? My ultrasound scan is tomorrow so hopefully should shed a little light on it.

If nothing else this forum has educated me. It is a wealth of knowledge, advice and support

🥰

Jm205
Jm205 in reply to Thumberlina

I envy your health insurance. :) That's a lot of tests. That's the only thing I like about the medical industry in the states. I can just order cheap blood tests myself online to make sure I'm more or less safe without having doctors or nurses misinterpret what I need, or what I need to know. You're the only expert on what's happening with your body. I have the money even without insurance. Just don't have any patience left for them to keep wasting it. I was keyed in on my liver at first too. General medical professionals don't like it when you throw life-altering symptoms at them with really good blood work, or an occult groin hernia (very uncommon with men) they can't find on a first scan, and knowing my body I fully expect them not to be able to find issues with my failing gallbladder without extra work, because clear symptoms are all I have to go on for the most part. Only abdominal scan I've had so far is a CT scan only a month or two after abstinence, but it was without contrast. My last attempt failed to get an ultrasound, so on to the next doctor.

Anyway, what I mean is you're probably lucky that your blood showed something. Maybe yours will be cut and dry. Makes me want to eat fattening food again just so something will show ( I actually did this out of frustration with beer to see if it would give me a hint about my liver, but all was normal). If you're not a full-blown alcoholic (I somehow drifted into an every day major one for close to 3 years along with nightly cigar abuse) like you said, and everything else looks good, I'd for sure be looking at adjusting your diet for possible gallstone/gallbladder issues. Might be able to fix it, and you want to keep your gallbladder if you can. I just want mine to be cut out and thrown against the wall, but it's never a guarantee with gallbladder removal that it will fix everything. There's also no guarantees that my liver is fine, since there's a good chance compromising it was most likely what led to a gallbladder problem in the first place, so careful with the booze. I don't miss drinking. Life is much better with a clear head. Just miss being able to. Same with indulgent food, which I never abused though.

My first blood test was 4 months after abstinence, and my ALT was 16. ALP was 70 (60 as of the last test, which is less than the median). My full blood count tests were done months later, but hematocrit was perfectly normal. MCV can be another hint about your gallbladder, and that has been slightly on the higher end, with normal red bloods. Little clues is all I have to go on, or I'd never have thought to investigate it. Interesting to watch the work that your diet does. My HDL and LDL are flipped/low and high normal, but on the other hand I have perfect triglycerides, VLDL, and total cholesterol, so go figure. Might just be my arteries still adjusting from all the cigar smoke I was inhaling, but HDL and LDL can be good markers/cause for gallstones. Your biggest clue is your body jabbing you after eating. Has gallbladder/stones written all over it. Hope your ultrasound tells the whole story so you can get back to normal.

Thumberlina
Thumberlina in reply to Jm205

I've just checked back, you could be right last year I had similar slightly elevated ALP reading, but they also carried out serum lipid. My good was 1.5 but my bad was 3.7....theyve not done this test this time so il bring that up with them on Monday. Thanks so much 😊

Hi you need to ask for GGT as it’s no longer part of LFT ( I don’t know why). I’m sure you know what everyone is going to say..... If you stop alcohol you’re liver will recover, if you continue you could develop Cirrhosis! Basically you choice, there’s plenty of good 0% alcohol available so you won’t feel like you’re missing out. You should ask for lansoprazol for your heartburn and stop eating anything that makes it worse! Good luck

Thumberlina
Thumberlina in reply to Cat-B

I know, to be fair, even after 5 days everything has eased. I can't see the AST (i found also called SGOT) reading result either that people mention though, is this one only specific if checking for alcohol related disease?

I stopped the minute I started googling, I ate a lot of crap as well though, sweets in particular so i'm just anxious to know if i have damaged it in anyway, or if there is something else re gallstones etc. I'm pretty fortunate that I am not alcohol dependent, I am not craving in anyway and didn't drink every day. My job means I travel a lot (though not at the mo) but this won't be an issue. I have no problem enjoying a glass of water and not having to look at replacing it with 0% alcohol.

Lansoprazol is not recommended for long term use, I am however pretty confident this will ease if I cut out the bad stuff like you say.

I have booked for a private ultrasound on Saturday so I at least will be able to get some peace of mind or a recommendation to pursue with my GP. Appreciate the advice, thank you :-)

Downunda
Downunda in reply to Thumberlina

Hi Thumberlina. For what it’s worth GGT is an inflammation marker of the liver. It’s a marker that can point to liver disease such as cirrhosis. If your GGT level is high, then your doctor (preferably a Hepatologist) will schedule for an MRI and Fibroscan. Also, once you have complete bloodwork done, ask to have your Child-Pugh and MELD scores calculated. This will help as well.

Keep us posted. Cheers.

arthole
arthole in reply to Downunda

Your right about Lansoprazol. Can have a negative effect on the gut bacteria biome proving to be potentially harmful to the liver in the long run. I combatted Gerd with a healthy diet and no booze and it actually worked. I haven’t had indigestion for the past three years and previous to that I didn’t go anywhere without my friend Rennie.

Thumberlina
Thumberlina in reply to arthole

Yeah, only 5 days in I've noticed it has eased.

FlyingArrow
FlyingArrow in reply to Cat-B

Hi Cat-B Sorry to intervene with your conversation but can I ask, when did GGT blood test not become part of the standard LFT blood test results? I'm asking because I have LFT tests regularly and the GGT result have always been highlighted with the results! My last one was carried out in October!

Trish

No probs, maybe it was because they weren't necessarily looking for alcohol markers, I don't seem to have a result with AST either which I keep seeing mentioned (i'm in UK)?

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