Fatty liver 19 year old

[Coriuk]

My 19 year

Old son has been diagnosed with fatty liver disease, he has a BMI of 31

Doesn’t drink alcohol

What could be causing it?

We haven’t been offered any treatments so far

What should we expect or be asking for ?

[Luca17]

What’s is diet like

[Coriuk in reply to Luca17]

Mostly ok , doesn’t eat too much junk but probably mot enough fruit and veg .

[Hidden in reply to Coriuk]

Get rid of ALL the junk, concentrate on removing all added fat, sugars and salt from his diet. He needs to adopt a long termhealthy eating plan, drink 8 glasses of water per day and get regular daily exercise. If you want help with this, speak to your GP about an appointment with a dietician. There is no magic cure any doctor can give him. His only cure is himself and his lifestyle.

[AyrshireK]

If his BMI is 31 I presume he's carrying a little too much weight.

The fastest rising cause of liver disease in the Western World is a condition called Non Alcohol Related Fatty Liver Disease (NAFLD) - largely attributed to us generally having poor diet, too much processed food and an increasing sedentary lifestyle.

Other contributory factors to NAFLD can be prescription medication, diabetes, sugary drinks (the high caffiene energy type drinks are really dangerous to the liver) and vaping.

The good news with fatty liver disease is you can make MAJOR improvements by making lifestyle changes - better diet (a Mediterranean style diet has been identified as a great one for reversing NAFLD) and more exercise.

The British Liver Trust has an excellent page detailing NAFLD at:- britishlivertrust.org.uk/in...

Study about the Mediterranean Diet at:- britishlivertrust.org.uk/ea...

Coffee has been shown to have beneficial effects in fatty liver/liver disease and obviously just eating better and exercising more.

You might want to ask if a Fibroscan machine is available in your health board area - this is a very simple scan which measures both the quantity of fatty build up in the liver (CAP score) and density of the liver (kPa) which will let you know if the fatty change has started to cause issues with the liver actually becoming damaged (fibrosity).

How are his blood tests? Is he currently suffering inflammation of the liver - raised ALT, AST?

There is no treatment for fatty liver but it does need to be taken seriously or it can potentially advance and create more serious issues it also requires monitoring going forward.

Has your son been referred to a gastroenterologist or better still a hepatologist (liver specialist)? I wouldn't want him fobbed off with a NAFLD diagnosis based solely on the fact he doesnt' drink - there are other liver issues that are totally none alcohol related and i'd want to be absolutely sure it is 'just' NAFLD.

Katie

[Coriuk in reply to AyrshireK]

Yes though the weight gain has only been in the last 6 months - he is looking into it though He doesn’t drink any fizzy drinks so not a major sugar intake . He mostly just drinks water and tea. ( two cups of tea a day)

I’m not sure what his blood results are but the GP did say inflammation of the liver

He hasn’t been referred to anyone yet , they are doing some more blood tests and a stool test

[AyrshireK in reply to Coriuk]

What have they based the NAFLD diagnosis on at present?

If it's just the fact he doesn't drink and he's a little overweight I think I would definitely want further examination. There are numerous other causes of liver issues from auto immune, viral, genetic and more.

Fibroscan might not be the best tool (just now) if he has ongoing inflammation as it can't differentiate between actual fibrous tissue and inflammed tissue.

Once these next tests are done definitely push for referral to a hospital specialist who can do a full workup and see what's what.

If you don't mind me asking what took him to the doctors in the first place to have this discovered?

Katie

[Coriuk in reply to AyrshireK]

They did an ultrasound which GP said confirmed fatty liver- for about 6 months or so every now and then he would start to feel bloated or get a pain/ cramp in his stomach area occasionally after eating - no particular pattern

At times he felt lacking energy and generally lethargic

I understand the viral issues causing liver in problems

What are the auto immune and genetic factors that could be causing this ?

[AyrshireK in reply to Coriuk]

There are three main auto immune illnesses of the liver - Autoimmune Hepatitis (my t-total husband has cirrhosis due to this), Primary Biliary Cholangitis and Primary Sclerosing Cholangitis. Hereditory/genetic issues include things like Haemochromatosis, Wilson's Disease, Gilbert's Syndrome etc.

Some of these there are specific genetic or markers for that can be tested for in blood tests others (like AIH) consist of a jigsaw of tests to come up with a diagnosis.

Has your son has an endoscopy? A camera down into his tummy etc. to see if there is anything untoward going on there. The pains/cramp in tummy could be related to something else - I take it gall bladder issues have also been ruled out.

Diagnosing a liver issue can be quite a long path, a case of ruling things out a lot of the time before you reach a true diagnosis and it's why I suggest you push for a referral to specialists if you arn't totally happy with the NAFLD diagnosis.

Best wishes, Katie

[Coriuk in reply to AyrshireK]

Do you think it’s worth trying to get him to loose the excess weight first before pushing for the refferal to a specialist ?

[AyrshireK in reply to Coriuk]

He should definitely try to work on his lifestyle changes and these may be sufficient to turn around what is going on if it is NAFLD. But if he still has symptoms - particularly the pain after eating and stuff which doesn't sound particularly liver related then maybe get the ball moving with the referral. You don't want something being missed especially as he is so young.

Katie

[Hidden in reply to Coriuk]

I think it is worth it any really??

[AyrshireK]

The British Liver Trust website is a goldmine of information - the page about the Patient Charter may be useful in that it outlines what you should expect from your care plus good questions for you to ask.

britishlivertrust.org.uk/li...

Katie

[JimmyJackson]

I am 83 & was diagnosed with NAFLD 6 yrs ago only after a successful bowel cancer op.I have always been well above average fitness, eaten a good diet, not overweight, blood test show no enzymes,so do not fit pattern for cause. My suspect is amiltryptaline which I took for many years for mild depression /insomnia but this si only a guess

[Ruggerhead in reply to JimmyJackson]

Jimmy you might be onto something, I am the same as you, healthy eating, no alcohol fit but yet diagnosed with NAFLD at 60, I think due to either an antidepressant or other medications. My bloods all normal, so cant get an answer from anyone.

[JennerLayne in reply to JimmyJackson]

I was mis-diagnosed with indolent lymphoma following a chest/abdominal CT scan showing multiple swollen lymph nodes (lymphadenopathy). The young doctor placed me on Amiltryptaline during a three-year 'watch and wait' regimen with an oncologist because I was stressed, depressed, and didn't sleep well. Further testing began to point away from lymphoma toward autoimmune illnesses which have now been Dxd as PBC/AIH overlap and Sine Scleroderma (Systemic Sclerosis).

Due to the timing, I believe the enlarged nodes were likely already fighting the inflammation in my body and that taking Amiltryptaline did not set off the process.

[Hidden]

Hi,

If you are in the UK, you are very welcome to call our nurse led helpline on 0800 652 7330 10am to 3pm Mon to Fri

Best wishes.

[Kristian]

Hi Cori,

Yeah, a BMI of 31 for a 19 year old is a wee bit on the high side. I think technically, even though he may not look it, a BMI of 30 or above is classed as obese. I am of course assuming here he isn't an Annie Schwarzzenigger look-a-like.

You've already got good advice from others here about following up with other potential causes, but it would do no harm to look at starting to lose the extra weight too. The NHS website has some really good advice on this and its advice that really does work.

There's no need to follow the latest trends and fads when it comes to dieting either. Most of those don't work in the long run as they are nigh on impossible to continue long term. Its a simple rule really, eat less calories than you use each day and you will start losing weight. The important thing is, that gap doesn't have to mean drastic lifestyle or diet changes. However, some sensible changes and a bit of perseverance is required, lol. It won't go away on its own unfortunately.

Good luck with it and hopefully he'll start to see some noticeable improvements relatively quickly. Trust me, people will notice the difference.