First question from a newbie, about fatty liver diagnosis and results.

[Jack5557]

Hi everyone.

This is my first post here and hopefully it will be my last – no offense. I’ve been ghosting here for quite a while, and I’m very grateful to you all for what I’ve learned.

Brief bio:

I’m a 47-year old male. I’ve been an excessive binge drinker all my adult life, with drugs thrown in quite often (I stopped that a few years ago). My mother (non-bio) died from alcohol-related liver disease. That wasn’t pleasant to watch. She was a very extreme drinker – morning whisky, no food.

My father (bio) also died from alcohol-related liver disease. I don’t know much about him as I only found his relatives shortly after he’d died. Still, these two factors worry me. Boozing addiction has been pervasive, and I also don’t know if liver weakness (father) to alcohol is genetic (hard to find info, research is all over the place)

I have binged, as I said, with alacrity. But I have also held down good jobs and worked out very strenuously (4 or 5 days weak, quite hard) pretty much all my life. This might have helped me. But, during lockdown, I started drinking on the weekdays, stopped exercising completely, so two or three days a week turned into 5 boozing days (not as excessive as binges, but close). I also put on weight and am now 13 kgs overweight (doc said my belly close to being too big for scan, but said it was ok). Basically, in terms of what is deemed safe, I have been in the very dangerous club.

In short, I got worried. I have bad health anxiety and worse general anxiety (hence the sad boozing) and seeing what happened to my mum in the past pretty much sent me here. I had an awakening.

So, about four months ago, I had some blood tests. LFTs came back all normal. They always have. I was glad, but still had loads of anxiety. Not caused by you guys, you actually educated me and lessened that anxiety.

Today I bit the bullet and got a Fibroscan. I live in a foreign country, but am quite fluent in the language and could communicate my lifestyle with the doc. He gave me a physical exam around the liver area, and we did the scan.

He seemed surprised that the result was 3.8, which seems low. He said it was good. I’ve done a lot of reading about this, too. BUT, and it is a huge but, my liver showed severe fat levels. 330. I am trying to understand what this means, and so have come to you.

The doctor said just work out more, lose that excess weight, reduce, or better, quit drinking. But he didn’t ask for a follow up. His diagnosis was “fatty liver.” I know this is a big warning sign, but not sure how dire that warning is.

What kind of fatty liver is it? Simple? I guess I can’t know if it is inflamed? Do you think I should have more tests? If so, what?

I have been cleaning up my act already for some time (just stopped all booze for 5 weeks and rode many kms on bike) and will follow doctor’s orders, but just want to know what the term is for what I have. When I google it, I can’t seem to find a fitting term.

I would also like to ask if anyone else here has been in my position? That looks like some severe fattiness. Could it progress really quickly to scarring? With it being that severe, could it make me really ill even if I do all the right things and it doesn’t progress to fibrosis? With my new lifestyle, do you think I could reduce it? Is it all down to booze, or a mix of booze and weight gain? I actually eat really healthily.

Any information would be much appreciated. I might be fluent, but medical language is pretty hard. As I said, the doc just said I should live a healthier life. We didn't talk much more than that.

After this, I’ll stop visiting the site and get on with things. Thanks very much for all the information you’ve collectively put out there. You are the reason I got the scan, which is the reason I know I need to change. Kudos. I wish you all the best.

[Positive001]

Hi Jack. Your doc is correct in saying live a healthier lifestyle. Its the only way to lose weight and reduce the levels of fat in your liver. You HAVE to stay off the booze. You have seen yourself what it did to your parents so don't allow the same to happen to you.

You should be eating low fat fresh meats and fish, plenty of fresh fruit and vegetables, slow release energy foods such as porridge and measured amounts of rice and pulses, pasta etc. Drink plenty of water.

Avoid salty and sugary foods.

You must also get back to regular daily excercise.

Do not be tempted to take any suppliments which claim to cleanse your liver, they dont in fact many can cause further damage. There are no miracle cures it's all down to your own determination to cure yourself.

Good luck.

[Jack5557 in reply to Positive001]

Thank you. Yes, you are right. I have to quit booze. I think I eat well, but I tend to fast and then eat. I am not sure this is very good for me. I am going to try and eat regularly but with better foods. I also have a big problem with water. I hardly drink any That once led to bladder stones.

I'm already getting back into the exercise. I don't take any supplements, but I admit I have drunk kratom to help with anxiety and stay off booze. I don't suggest anyone else do that. I've read the literature about kratom and the liver. If I could take that or alcohol, I'd take that, but I know I should take neither. I actually have quite a good diet. Never, ever, snack or eat junk. I have lived in Asia for 22 years and the food is very good here, but during lockdown, I just lost the plot. My anxiety went through the roof. I did everything that is bad. I even took benzodiazepines 'cos I was in such a state and couldn't even sleep. My god, coming off those was hard. I drank more then. But as I said, I cleaned up my act. I shall now endeavor to follow your advice and try and do something about all this fat on my liver.

BTW, do you know the term for what I have?

Cheers.

[Positive001 in reply to Jack5557]

You MUST drink 8 glasses of water each day to avoid dehydration.. like you say you have experienced the consequences of not drinking enough water. Alcohol itself causes dehydration and anxiety, it is poison afterall.You should not be having periods of starving, eat properly.... 3 meals each day, starvation diet fads don't work as your metabolism slows down making your body have to work harder to burn off excess calories. Just stick to a healthy eating regime.

Your doctor has told you you have fatty liver and by making these positive lifelong changes in your lifestyle you can reverse it and enjoy a long and healthy life.

[AyrshireK in reply to Jack5557]

You'll be at the stage of alcohol related fatty liver/steatosis Jack.

Liver damage caused by alcohol tends to follow a pattern as shown in diagram. If your liver bloods are good then hopefully you've not progressed onto the steatohepatic stage where your liver is inflamed as well as fatty because at that point you'd be starting to sustain fibrotic change and liver damage (your fibroscan rules that out at present).

You are at the fortunate stage of identifying this early enough to make big changes and do something about it so continued abstinence, healthy living, good diet and exercise and fingers crossed you can turn this around within a good few months hopefully.

britishlivertrust.org.uk/in...

All the best,

Kathryn

Progression of alcohol related liver disease.

[Jack5557 in reply to AyrshireK]

Hi,

Thank you so much for that. Every time I google fatty liver with no scarring the only results I got was NAFLD. That confused me, because my diet has always been good and until my lockdown nightmare, I have never been overweight. I have drunk a lot, though, as I said. Way, way, too much.

Now I know. I am very close to creating irreversible damage. I'm glad I came here. It is time for big changes. It is good I checked at this point, and I am grateful my liver has kind of held out.

Cheers again for clearing that up for me. I didn't really know how to get this across to my doc. The downside of being an expat.

[Hidden in reply to Jack5557]

I was diagnosed with the non-alcoholic version and was surprised - I was a binge drinker for many years (15 pints a night and I am a 5" 2' woman) but could go a few days without so wasn't actually an alcoholic.I also have a bad relationship with food though.

[kensimmons]

Good questions Jack! My guess is you actually know all the answers to them and are simply looking for reassurance. Here it is. You are okay. For now. And if you start behaving better (better eating, NO drinking) you will live a nice long life (barring something else happening like getting hit by a car or something of course). If you continue to drink your liver will become worse and in time you very well may have serious problems and you will bemoan the fact that you didn't cut back sooner, because then it will be too late.

You can be fine, it's all up to you now. (And congratulations - I would consider that GOOD news).

Good luck!

[Richard-Allen]

Hello Jack.

There are two points I’d like to talk about here please.

Firstly, it has been debated and argued for some years now about the existence of the elusive “Alcohol Gene”. Some theorists believe that the alcohol gene is developed within the genetic coding of a person and is passed down from adult to newborn. While research into this is still ongoing, this may be a reason as to why some people are more susceptible to wanting to experiment with drugs and alcohol than others.

But to be able to turn round and simply say that a person’s alcohol problem is generic, maybe a falsehood. “It’s not my fault, it’s in my DNA”, is a lame excuse to justify a person’s problem. (In my opinion). The ultimate decision as to whether to have a drink or not is still going to be their decision, they will be doing it because they want to, not because they have to.

This video is now some 7-years old, it would be interesting to find the conclusion of this study. I’ll be doing some more digging: youtu.be/eLz8l7dsuRE(Not working as expected?)

Because you have a history of alcohol abuse I’d be a little more concerned over the state of your liver at present. I don’t want to cause any alarm here, but I intend to merely highlight a possibility.

The liver is a pretty remarkable organ, carries out the normal 500 plus functions it performs all without us knowing about it. It’s also a very hardy and forgiving organ. It can take an awful lot of abuse and even when it’s been severely damaged, it can still recover enough to function.

The analogy I often use is taken from a hepatologist friend of mine who explains alcohol liver disease a bit like this.

Say you prick your hand, and it bleeds, after a few weeks it will repair itself and carry on as if nothing had happened. Now if you were to prick that hand say 30 times, it will still heel but scar tissue will form. Now, if you were to prick that hand 100 times, then there’s a good chance it’s not going to make it. The liver is a bit like this.

The basic “liver function test” (LFT) is merely a brief snapshot of how the liver is performing at that moment in time. A person can have damaged their liver to an extent that it may have become cirrhotic but it has been able to recover enough to carry out most of its functions. It is, therefore, possible for a GP to say, “Oh, your liver test are all normal” but your liver could still be heavily scarred. Some GP’s can give too much faith in the LFT, and the next thing the patient knows is when they look in the mirror one morning and notice that the white’s of their eyes have turned yellow.

I would ask your GP for an ELF test, (Enhanced liver fibrosis test) this will show up any possible fibrosis on the liver. Better still a scan to show up any possible scarring on the liver. Even if nothing is found, this will at least give you peace of mind.

Finally, knowing all this and of your alcohol history, try and treat this as a wake-up call. An alcohol-free world is such a lovely place.

Good Luck and I hope this is of some help.

Richard

[Jack5557 in reply to Richard-Allen]

Thanks Richard. Good answer. I had the scan yesterday, though, which is why I posted. The LFTs were the first thing. I just didn't really understand what was going on, but you guys have made it pretty clear.

[Ruggerhead]

Ok jack I know a lot about this topic having had numerous fibro-scans and am actually training to be a technician, as its something everyone should have. Heres the reality, 3.8 is how fibrous your liver is, a healthy liver is malleable, soft, sponge like one that starts to become scarred becomes tight, the science is that the scan sends out waves that bounce off the liver and the time taken to bounce back dicates the fibrous content. It can change even between scans and like everything can be operator based. So 3.8 is quite good espevcially given you are overweight, scores can be around the 2's but usually these low scores are reserved for skinner, fitness types ( I wish) So good news for you there, bad news is that your fat content that is building across your liver and is very high. I suggest it is drink related given your lifestyle, so simple thing is cut out the boose, and lose weight, then have another scan in say 3-6 months and your numbers will be significantly reduced. This as a warning shot, you can do something about this before it becomes a problem, in another few months it may be something like 3.5 and 250 on the fat score, i see that happening so often.

[Jack5557 in reply to Ruggerhead]

Cheers. I am going to do exactly what you said, which is quit the booze, work out a lot more, and eat better. Maybe that fattiness will diminish.

[nerd1 in reply to Ruggerhead]

Hi Ruggerhead, wow that's interesting that you're training to be a fibroscan technician - do you already work in the medical field? I fully agree that they should be used routinely, as waiting for problems to show up in LFTs doesn't seem ideal.

[Ruggerhead in reply to nerd1]

hI nerd, sort of, I actually started business with one of the first MRI private scanners in the country, so I learnt a lot about imaging, X Rays etc. Because of my own health journey, I wanted to know more about Fibro-scan, so have set about doing the hours required to use the machine. It is very interesting. I am also an advocate of trying to get pre diabetic patients or obese/ heavy drinkers or at risk people to get a scan every year. I even had several of my friends do it and realised just how many people had NAFLD from bad diets etc. As a rule of thumb for men especially, if they can see there toes when they look down they have fatty liver. I know it costs of couple of hundred euro but it is an investment in your own health..

[Dd4560]

I was told I had a mildly enlarged mildly fatty liver last October through an Ultrasound. I was a heavy weekend drinker, and took it overboard during the first 3 weeks of the lockdown in March-April last year where I drank heavy daily. I stopped drinking, and only drank 4 days in the last 15 months. I just had another Ultrasound and my liver is still mildly enlarged and mildly fatty at 17cm. Even though I stopped drinking, I didn't lose weight, as I am only 5ish pounds lighter than I was last October. I thought since I have AFLD that I could just stop drinking and my liver will go back to normal, but most likely I have a mix of AFL/NAFL as I am also BMI of 30. Your cap score of 330 should definitely give you something to think about. You definitely shouldn't drink more than recommended guidelines with a fatty liver, and don't expect to improve by just cutting out the alcohol like I thought I would. Start exercising, change your eating habits, lost some weight if you are overweight. A kpa of 3.8 is wonderful news meaning you have minimal fibrosis or none at all. However fatty liver over time can cause fibrosis, as many people who don't drink get cirrhosis by being overweight. Be happy you still have a fairly healthy liver despite the alcoholic damage over the years, but definitely work on that fatty liver.

[Ruggerhead in reply to Dd4560]

Dd Did you have a fibroscan to check if your numbers had dropped, ?

[Dd4560 in reply to Ruggerhead]

I never had a fibroscan, my blood tests never showed elevated liver numbers, I had 2 Ultrasounds in the last 13 months which showed only mildly enlarged, mildly fatty liver. I'll talk to my hepa about getting a fibroscan next time I see him sometime in November, and will update if/when I get a fibroscan.

[Jack5557 in reply to Ruggerhead]

Hi. No, it was my first one. I did it out of general concern.

[Smegmer]

You did the right thing! The Liver fat limit is 5%. I had a Fibroscan about 4years ago after I had stopped drinking for 6 months, it showed I still had a little but it amounted to 6%, but still technically it was "fatty liver". Inflammation causes scarring, not the fat itself and you aren't showing any. When I told the guy doing the Fibroscan I drank around 40 units a week, he just went "pffft, you've been on google haven't you"

Your fat is likely the increased binging over lock downs. Maybe give it 6 months of clean living and have another test if you are worried.

[Jack5557 in reply to Smegmer]

Thank you. I am doing just that right now. I actually did cut down a lot, from ridiculous units to close to safe. Now I am going clean and trying to eat well. I don't expect the fat to shift fast, but anything would be good. Thanks

[Smegmer in reply to Jack5557]

How much were you drinking on lock down? I got back up to 40 units, maybe a bit more. I have now reeled it in and have had 20 units in the last 2 weeks I will bring this down to zero now but have a good Xmas with family and start the new year with the aim of nothing for the 1st 6 months at least.

I might get another Fibroscan late next year

[Jack5557 in reply to Smegmer]

Good on you. Hope you can keep it up.

I don't really know how much I have drunk in general. For the past 30 years, two very heavy days a week (often with drugs) which could go from night until the sun comes up in the morning. Then often a bottle of wine at the sides, Thurs and Sun. It woukd add up to many units. Not sure how many because the weekends were a bug blur.

Then during lockdown I added more days, so a big weekend with at least two bottles of wine at the sides with another day on top of that. Some weeks I drank all week, at least two bottles of wine on weekdays and much more on weekend nights.

I don't know how many units that adds up to, but I know it is wrong and dangerous, and seeing my mum die that way, I should have known better. I think stopping benzos damaged my brain a bit. In the past, I hit booze hard after quitting other drugs.

Like you, I don't want to live this life anymore. As strange as it sounds, even with all that booze (not lockdown) I exercised a lot. I felt I had to do both to stay sane. Now I feel a bit bored of myself. I'm ready to change. I'm just thankful I don't think I caused myself too much damage yet.

Good luck with your abstinance. If it is any help, I am feeling very good for mine. Went hiking on Sunday, when usually that day would be a write off. From Happy Mondays 48 hour party people to Happy hiking Sundays. The peace is better, bit it took some time to realise that. I think we have to work out why we drink to stop drinking, which can be a life's work. I'm getting there.

[Smegmer in reply to Jack5557]

I need to start a fresh, I'm a bit annoyed the lock down caused my bored brain to pick up the bottle again. But to start with I wasn't too bothered since nobody knew if the dam virus was going to kill a load of us anyway. Should have knocked it on the head last summer I think, can't do anything about that now.

Yeh, I did a couple of all weekenders in my 20s, one thing I am grateful for is that I never earned much money in my 20s, I most certainly would have drunk everyday if I could have. I could get a small amount of weed and was pretty happy to smoke and play video games in the week. Also, I have always had pretty bad hang overs, if I did a 15-20 units session I would need a fry up the next day and not touch booze again for 3 or 4 days. Some of my friends could just carry on after, I now see the hang overs as a good thing, since it stopped me carrying on.

You and I need to be always conscious of our family genes. My uncle is 62 and has drunk 2 bottles of wine a day for the last 10 years, that's 140 units a week, this is when he slowed down 10 years ago, so god knows what he was drinking before ! His last blood results were normal, he did arrange a Fibroscan, but I don't know the results of that. My dad has also drunk alot, but kept it under wraps with just a couple of pints of bitter a day since he hit his 40s. Truth be told the entire village I grew up in were alcoholics, I just didn't know it at the time. Pubs full of regulars supping beer all day everyday

I think I'm just too old at 46 for this now, a session can knock me down a for a week now.

[Jack5557 in reply to Smegmer]

Yes, we are not alone. I have many friends still going hard at it. My father (non bio) has drunk every day all of his life, but a four pack of beer. He is now 82. But some people will get sick fast, as this site has shown me. My town, too, is full of heavy drinkers. I left the UK over 20 years ago due to addiction issues and watching friends die way too young. It is a shame. Something isn't working when so many people seem like they have to get out of it all the time.

I have always destroyed myself and then built back again ,for 30 years, week in week out. I'm done with it now. I think I thought because I want doing as my mother did and drink whisky from morning til she passed out angry and incoherent, I was ok. I wasnt. I was shocked when I came to this site and read how little booze can cause huge problems. I thought q bottle of wine a night wàs being healthy!

I know we can't beat ourselves up about what has happened, but that doesn't help. Just got to look forward and be positive. Nothing good comes from sitting alone swigging on a bottle. It seems you know that very well, so hopefully it won't happen too often from now. We are almost the same age. A good time to change some things.

[Ruggerhead]

both of you may just be lucky genes wise, we all know of people that hell raise for years and have nothing wrong, we also know of the people that train everday, only drink a little and bang, cancers and liver problems. A friend of mine who never drank, smoked, ate badly. Was fit and had no family history was told he had end stage liver and pancreatic cancer and never made it out of hospital. The lesson is to say that you have dodged a bullet and change your life. You can still enjoy the odd night out but don't let your lives become a drunken blur, i beg of you, I have lost too many friends who would take it back if they could..

[Jack5557]

Thank you. I am being a better person as we speak.