Any help out there?

[Ruggerhead]

As you know this time of the year its a nightmare to get any help and to be honest have not been able to get a decent answer from anyone, so does anyone have a clue what has happened or who i can believe or not. So i am tested in hospital, CT scan, Abdominal MRI (with and without contrast) and ultrasound. Liver markers mildly elevated. Tests come back all clear, but liver functions remain again mildly elevated, sent for fibroscan and diagnosed with NAFLD, call back the hospital and they ( supposedly) check scans from a while back and say no all clear here, yet fibroscan puts me nearly at level 3 for fat deposits. How can this be? could it be a latency damage from a drug I was on 3 months previous, or even a result of drugs I was on when tested ie PPIs, SSRIs. Could medication bring on NAFLD as quickly?

[Hidden]

May I suggest you seek clarification from a hepatologist with regards to your own scans and progression. They should be able to review all previous scans and create a time line of any progression or development of condition.

For information I have attached links to Liver Disease Tests Explained and Non Alcohol Related Fatty Liver Disease

britishlivertrust.org.uk/in...

britishlivertrust.org.uk/in...

Trust9

[Ruggerhead in reply to Hidden]

The problem is they can't, thats the very issue. In hospital scans done, bloods done, etc all clear. Roll on to Fibrascan and it shows fatty liver, so was it a result of medications in between or was it there for years, again a blank. The thing being could the fibrascan be wrong? or could they have missed any fatty liver on normal ultrasound, MRI, CT. Not sure what the gold standard is here, ie fibrascan v the rest, who wins?

[CarpeDiem11 in reply to Ruggerhead]

I'm only going to comment on the fibroscan. They are not 100% reliable because of the way they work. They only take 10 readings, then they give you the average score. Alcohol damage tends to be even across the liver and so the score is seen as reliable for that. However, other cause of hepatitis can cause uneven damage and so it may depend on where the 10 readings were taken. The next time they repeat the fibroscan, there is nothing to guarantee that the readings came from the same place, so first time readings they scan are of lower fibrosis, next time they scan an area of higher fibrosis etc etc. The more even the damage, the more reliable the reading.

However, there are many things that can alter the picture, current inflammation being one of them. Can't comment on anything else, sorry.

[Ruggerhead in reply to CarpeDiem11]

Thanks Carpe, its not the fibrosis score as that seems pretty across the board, its the CAP score ie how they determine how much fatty liver ie 10-20% etc etc. I may be wrong but i thought MRI more or less makes up images of cross slices of an organ, so in my uneducated test then if fatty liver covered most of your liver wouldn't that show up, ie some colour difference or size. It just seems odd to me. But then I am not a radiologist.

[CarpeDiem11 in reply to Ruggerhead]

Yep MRI does take sliced images, but as to what that tells them, I can't say as I don't have fatty liver. Consequently I know nothing about CAP scores either. Nor do I know if fatty liver shows up across the whole liver or just some of it. All questions for the hep. Have you tried the search section. More than likely there will be some helpful posts there that will give you more info from those who have had the same problems. Best of searching.

If you type fatty liver into the search bar, then it comes up with posts not just from this forum but other forums too (but you probably already knew that) Sorry I can't be more use.

[raenata]

SSRIs are the cause of elevated LFTs for me. No long term damage except for mild fatty liver (no fibrosis). As soon as I stop the SSRIs my LFTs normalise. 1 month after starting them again they elevate. I have repeated this pattern 4x

[Ruggerhead in reply to raenata]

You know what thanks so much raenata, I believe exactly the same thing. Its funny because when you do your own research you find it hard to believe the so called experts. My LFT tests were all above my normal, what I mean by that is that most fall in the populations normal, bar ALT which is out of that range. But when i asked could it be the medications I was on, which at that stage was Zooloft, mirtzapine (antidepressant) and PPI's they said no. It just seemed a bit strange that when I came off those drugs, a few weeks later me function test lowered again, yet they told me that SSRI's could not do that, well here is proof that they can. Im exactly like you then, I think i was up from 50 mg to 100 on Zooloft, 15 mg Mirt, and PPI's why do they not think they might have been enough to raise my LFT's, and potentially fatty liver with no significant damage. Did the liver Dr give you any instruction on the Fatty Liver, ie diet, lifestyle etc?

[raenata in reply to Ruggerhead]

My Heptologist seems to agree with me after going on/off SSRIs 4x and seeing the same pattern with same approx timings. I have lost weight and drink no alcohol now. Seems to be a good approach. And I feel really healthy.

[Ruggerhead in reply to raenata]

Do you think that the NAFLD was/is due to the medication ie SSRI's or do you think its due to drink and weight over the years? i.e does your Dr think that the SSRI's are responsible for the liver damage albeit minor. Nearly half the pop seem to have NAFLD and don't know it. I need to get a re-scan in a few months just to see if by diet and off medications i have been able to reduce the numbers..