ARLD or NARLD?

[jonboysez]

I have recently been diagnosed with a fatty liver. I am a type 2 diabetic and have been drinking far too much. I have been told to cut back drastically on my drinking and lose at least a stone in weight. But can they tell whether its ARLD or NARLD - or is it always ARLD if you are a heavy drinker? The reason I ask is that, after reading up on the subject, apparently any level of drinking could be very harmful for someone with NARLD (I know you can be teetotal and have NARLD) - I am having a dry January and was going to then drink no more than the UK advice limit of 14 units per week (if I feel that I might prefer moderation to complete abstention although so far I might achieve the latter) - but if its NARLD I have then I would definitely need to stop altogether if I want to live! My doctor did say that after giving my liver a month to recover that I should drink no more than the UK 14 units which would suggest it is ARLD - what I am asking is do the blood and ultrasound tests distinguish between alcohol-related and non-alcohol related if I hadn't told them I was a heavy drinker?

[Fibro2021]

Hello. In fact, it is correct to put in the diagnosis a combined liver lesion if both demage factors are present. Theoretically, there may be more of them in one patient, for example, hepatitis C + obesity + alcohol. It is categorically wrong to ignore one of the factors of liver damage if it presents. Of course, ideally, it is desirable to establish a leading factor, but in practice this is far from always feasible and possible.

[sophiaS1980]

Without a biopsy they can't be sure what caused your fatty liver, or it could be a combination of drinking and eating. In saying that, you shouldn't have dry Jan, but dry life, yes, that's right you need to let the alcohol go, this is a wake-up call, and I bet a lot of people on this site would love the wake-up call you are getting . I can't do anything about my liver issues due to it being autoimmune but people such as yourself can with diet and completely stop drinking.

[jonboysez in reply to sophiaS1980]

I completely understand your point of view and yes I should stop drinking altogether but it will be hard. It might actually be easier to stop completely than try to moderate it. In his book Adrien Chiles says "in order not to have a car accident you don't stop driving completely!"

[sophiaS1980 in reply to jonboysez]

Well, that's true if you are an alcoholic maybe you should slow down in moderation but if you are serious about stopping all together do it under medical supervision, We can all take passages out of books to carry on with the things we love doing, good luck!

[jonboysez in reply to sophiaS1980]

No - he wasn't talking about how its dangerous for an alcoholic to stop drinking all of a sudden - he was putting forward an argument for drinking in moderation as opposed to complete abstinence - like me he doesn't consider himself an alcoholic, he doesn't end up in the gutter, have blackouts, or fights, or drink on arising from bed but realised he has been drinking far too much but the thought of stopping altogether has big consequences for your social life etc and he was using the analogy of the car accident - you might reply "no you don't stop driving because you might have a car accident", but it has occurrd to me you might say "yes you do if you have faulty brakes!" I have 3 more weeks of January to ponder my dilemma

[AyrshireK in reply to jonboysez]

It's the fact you already have a liver which is showing signs of liver disease whether due to ARLD or NAFLD or indeed a combination of both. Your liver doesn't like being assaulted. Doing dry January will stop one of the things from attacking your liver and may help it heal a bit. Resuming any degree of drinking thereafter will be like throwing petrol onto a smouldering bonfire and can lead to even faster damage next time round.

You have risk factors for NAFLD too so why give your liver more work to do, why risk it?

As others have said you've had a lucky warning shot. Why risk damaging your liver when you have very good chance of avoiding it - there is no 'safe' amount of alcohol when your liver is screaming at you to stop.

Katie

[jonboysez in reply to AyrshireK]

I hear what you say and I can't say I don't agree with you. The only thing is the only enjoyment I get is from food and drink. No-one is put on this Earth just to survive, there's got to be more than that. I usually go to Benidorm to holiday - thats now out of the question so theres nothing to look forward to. I live alone and it feels like get up, go to work, come home, eat, watch telly, go to bed, get up, go to work etc etc now the little bit of enjoyment I had has to come to an end - I'm making do with drinking alcohol-free beer at the moment and its going well but I used to drink to relieve stress of work (always drink at home apart from when on holiday) - someone will tell me I need therefore to ditch whatever is causing me stress - 2 more years until I can retire though!

[mtk0925 in reply to jonboysez]

sounds like you have been drinking for quite some time if your near retirement. Is there anything that you can get into? Throw yourself into a new hobby, a new pet, fitness etc…. I stopped drinking almost teetotal I did have a few over the holidays …. I get the urge, stress relief, and joy it can bring it used to bring that to me. But now I only feel guilty and worried if I have them…. It sucks I see everyone letting loose but I order a lacroix or Diet Coke…. It’s hard but it’s my life I have to preserve it and live it.

[Ewife in reply to jonboysez]

Interesting thought from Adrian Chile's. I personally think there's far too much focus on 'whether someone is alcoholic or not' - everyone seems to have an opinion on what defines an alcoholic. Simple fact is, if the liver is struggling, for whatever reason, alcohol isn't for you. We don't have these discussions over sugar when the pancreas isn't working, or over nuts after an allergic reaction.I've watched Adrian Chile's documentary where he acknowledges his poor and indeed dangerous relationship with alcohol. If he is now saying this in a book, my guess is that he's still trying to find reasons why he can justify drinking. Since my husbands diagnosis, I've often had people discussing or asking me if the liver can repair and how much is safe to drink and blah blah blah, and they're all folks who deep down know that they drink too much, or their spouses do. I can tell they're trying to convince themselves. They want me to say my husband was drinking loads or was alcoholic or that he's better now etc (none of these are true) so that they can continue burying their heads in the sand.

Here's to Dry January (+)and a happy healthy life!

Take care

Ewife

[Rshc in reply to jonboysez]

there is a huge misconception that you need to be blacking out of waking up in the gutter covered in your own vomit to have a problem with alcohol and actually a red flag would be someone that feels the need to justify their drinking, most people without any level of dependency on drink would give up in a heart beat if they knew in the long term it could save their life. My partner was a dependent on drink but you wouldn’t know it, he rarely was ‘out of it’ but he is now on the liver transplant list because of drink. I have given up too in solidarity .

[Readlots in reply to jonboysez]

I saw Adrian Charles talking about his book on TV and it made me really cross, I thought what he was saying was really dangerous. If you listen to him you’ll end up on the transplant list and I’m fairly sure the transplant coordinator won’t accept the Adrian Charla argument as a good reason to give you a new liver. Sorry.

[Roy1955]

Whatever the cause of your liver disease ANY amount of alcohol will push it forward.

Compare it to rubbing salt into a knife wound!

The salt did not cut you but it bloody hurts😢