Hi made a post earlier in the week about high ALT. It was 253, then 289 on next blood test and doctor was concerned and booked me for ultrasound. My other liver function results were normal, only ALT was high. Had an ultrasound and the doctor contacted me today and confirmed to me that I have a "severe fatty liver", which is the probable cause of the blood test results, and some bile duct dilatation but they don't think that the dilatation means anything but that my liver is heavily infiltrated with fat . I'm getting referred to liver clinic.
I don't drink any alcohol and have never really drank. I'm overweight but not obese. I'm not diabetic either.
Sounds like NASH to me then... As far as I know NASH means fatty liver with ongoing inflammation, but correct me if I'm wrong there. Have another blood test next week to see if any change in enzymes.
I suppose with referral, I'll find out fibrosis and such, then know the full extent of things.
I was expecting this honestly as it seemed like the most obvious outcome given I was told I had fat on my liver years ago. I don't think we know how bad it is until they do more investigation but doesn't seem particularly good if my enzymes are that high all the time.
I find the liver a bit confusing. If they said I have kidney disease I'd think right I have a lifelong condition I have to manage now, I think there is some problem around the common narrative that the liver is such a hardy organ and very forgiving, and in my mind I still think yeah it's the liver, I don't drink, so it will probably be fine right? Having learnt more I realise no it's not that simple.
On the other side at least I don't drink. Perhaps if I did drink it could be even worse at this point, maybe at this point it's fully reversible and had I drank through my 20s it wouldn't be.
I think at minimum it must mean that my lifestyle is going to destroy my liver, or in reality that it already is doing that. That it's not a can I can kick down the road as far as I'd like to. A part of me feels "they are telling you you have a fairly serious disease", then another part says "yeah but it's the liver so it's probably reversible and 1 in 4 adults have fatty liver".
Then I'm thinking my doctor's words, specifically that it's severe, which probably put me in a different category to the 1 in 4 already, still in my 20s, and not a category I'd particularly want to be a part of. One that hopefully, I can remove myself from with some major lifestyle changes and hard work. It shouldn't really be something you have to think about at this age but here we are!
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Yosaron
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In a nutshell you have fatty liver caused by poor diet, hence you are also overweight. Yes the liver is 'forgiving' but only if you make good permenant life style changes by eating healthily and getting regular daily exercise. You will then lose weight and reduce the amount of fat in your liver. Carry on as you are and believing you liver will forgive you for it, will lead you to greater problems later on. It's not just alcohol that can cause fatty liver, poor diet is also a huge culprit. So make those essential changes today and give your liver the chance to recover and your body the respect it deserves.
You're right I did exercise 2 months, saw improvements, then lost motivation stopped doing it. Lost lots of weight then gained it all back several times. Hardest bits making it sustainable and part of routine, having a serious think about what I can do. Example live near supermarket instead of ordering shopping weekly can walk there and buy fresh food, vegetables more regularly now that pandemics dying down. I'm not a fussy eater... but I am a lazy one and I'll be first to admit that.
I don't believe my liver is that forgiving it's obviously struggling. The doctors was shocked it was that bad they originally believed it must be something else. If I can engage with them to monitor it regularly then maybe we will start to see improvement. It could prove to be a blessing in disguise for overall health as I don't think I can ignore this one.
The British Liver Trust has excellent guidance on NAFLD and the recent study that has examined the benefits of a Mediterranean style diet for reversing the condition.
Thank you I actually like this food. I never got out of uni eating patterns. Stick an oven pizza in, have a meal 20 mins later. I'm trying to think of ways to incorporate cooking into my routine. I find it a bit daunting and time consuming but I've never given it a proper go, otherwise you're going to end up eating processed food which is probably the reason this happening.
See, you do know what you need to do to reverse this. Yes it does need to be sustained though. Only you can do that. You are the only one who can control your lifestyle by getting into the right mindset. I wish you luck .... you CAN do this
Started walking to the shops every day for the days ingredients, which kills 2 birds with 1 stone in terms of exercise and cooking fresh food with lots of vegetables. I was eating takeaways or oven pizzas pretty much every night.
I don't know if it's a placebo but I have a lot more energy already after a few days of eating vegetables and fresh cooked food. I think getting out of the house helps too, having been working from home for over a year and not going out much.
I found cooking has put me in a "flow" state and when the meal came out tasting good, with healthy ingredients it gave my self esteem a boost and I felt pretty happy for the rest of the day that I'd achieved something.
Thanks for the advice. Surprised how easy it is to make food that tastes far better than any takeaway!
That's a fantastic turn around ! Keep those thoughts of how great you feel foremost in your mind and you will continue to improve your physical and mental health and well being. Well done x
Hi, you should also enquire more about the bile duct dilation.
If you are in the UK, NICE (The National Institute for Health and Care Excellence) have devised guidelines with the British Society of Gastroenterology (BSG) that state people diagnosed with NAFLD should have further testing to assess for their risk of fibrosis- stiffening or scarring in the liver.
The specific blood tests are Fib-4 score blood test or an Enhanced Liver Fibrosis (ELF) blood test. A specific scan called a FibroScan also estimates fibrosis.
You may want to discuss this with your own GP who will be able to look up the NICE guidance.
If you do have some weight to lose, then you could also ask your GP for a referral to a hospital registered dietitian for more support and guidance.
Hi Yosaron, as Laura said, it sounds like you know what needs to do, you just need to do it. From personal experience, it takes me about 20 extra minutes per day to eat healthy. And then 2hrs of prep on the weekend to set up for the week. There are 1440 minutes in a day, so that is such a small part of the day, why not do it?
And the 2nd thing which helps motivate me is about the long term risks vs short term rewards. If you havent done so, I recommend you read some of the stories from the users on this forum about decompensated liver with varicies. It sounds awful, and some of the stories are truly heart wrenching.
I dont say this lightly or as a scare tactic, just what personally keeps me going. Im not a doctor, but I've read that not everyone who gets nafld will develop nash, and not everyone who has nash will decompensate. But why risk it?
An ounce of prevention is worth a pound of cure. Or in my case, 20 minutes a day to help avoid something terrible in 20 or 30 years. Why not? Hope that helps.
ALT came down from 289 to 208 in about a week by cutting the dose of medication I was on, we are reducing further and keeping an eye on it. It's going in the right direction at least.
I actually feel better at the lower dose of the medication now. It was making me feel fatigued all the time.
They are going to refer me to the liver clinic for that and I've already changed my diet. Started walking to the shops every day for the days ingredients, which kills 2 birds with 1 stone in terms of exercise and cooking fresh food with lots of vegetables. I was eating takeaways or oven pizzas pretty much every night.
I don't know if it's a placebo but I have a lot more energy already after a few days of eating vegetables and fresh cooked food. I think getting out of the house helps too, having been working from home for over a year and not going out much.
I found cooking has put me in a "flow" state and when the meal came out tasting good, with healthy ingredients it gave my self esteem a boost and I felt pretty happy for the rest of the day that I'd achieved something.
My ALT level was the same as yours 289 on my last test (well, first and last test because I had never done a liver test before). I got my ultrasound scan back and it stated mild inflammation and moderate fatty infiltration. The doctor called my ALT level mildly elevated (I thought it was very high??) The doctor told me to continue my diet (I have weight to lose) and not drink (I don't) and my liver should heal itself in time. I have follow up bloods next month and ultrasound in 6 months. Maybe it's where I live, but I was NOT sent to see a specialist at all. Anyone else find that weird? Do I need one for moderate fatty liver?
No, you don’t need a specialist at this point. You have received excellent advice from your doctor, GP I presume?
If you lose the weight and stay away from alcohol etc, hopefully the ultrasound in 6 months will give you a clean bill of health. Hopefully the blood results next month will put your mind at ease.
Are you on any medication? Mine came down from 289 to 208 in about a week from lowering the dose of one of mine, instructed by doctor. I would talk to your doctor about it though. They are going to refer me to the liver clinic and I've already changed my diet. Presumably because they said mine is "severe" that's why I got a referral. I'm still hoping to reverse it though.
Started walking to the shops every day for the days ingredients, which kills 2 birds with 1 stone in terms of exercise and cooking fresh food with lots of vegetables. I was eating takeaways or oven pizzas pretty much every night.
I don't know if it's a placebo but I have a lot more energy already after a few days of eating vegetables and fresh cooked food. I think getting out of the house helps too, having been working from home for over a year and not going out much.
I found cooking has put me in a "flow" state and when the meal came out tasting good, with healthy ingredients it gave my self esteem a boost and I felt pretty happy for the rest of the day that I'd achieved something.
I wasn't taking any meds but did have rapid weight loss (16lbs in 2 weeks - intentionally) from what I've googled, rapid weight loss can transiently boost up your ALT bloods. I don't go for repeat bloods for another month. I've lost another 10lbs (26 total in 7 weeks) so I'm hoping my rapid weight loss doesn't keep effecting my numbers. We will see!
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