Symptom or Cause ?

[Oztrax]

Hi, 58 year old male from Australia,

up to 2 years ago had a great life, couldn’t wait to wake up each day to work on my mechanical projects and enjoy life near the beach.

Then fatigue started, didn’t do much anymore except rest, then developed inner ear issues with vertigo, migraines and vomiting 9 months later, the ear stuff almost resolved over the next 9 months.

Fatigue increased again end of last year with bowel issues (diarrhea, cramps, nausea) developing followed by upper abdominal pain.

Jan enzymes levels AST 64 ALT 78,

Feb AST 23 ALT 27

Had cutout all alcohol by then, didn’t think 2-3 drinks a day was too much…….

Ultrasound says: “hepatic steatosis , modular hepatic contour suggests cirrhosis”

“Liver is heterogeneous with a nodular capsule”

“Numerous subcapsular cysts are demonstrated, largest 6mm”

CT scan a few weeks earlier showed nothing except the 6 mm liver cyst.

Previous CT and US from 2019 just said “diffuse fatty infiltration of liver with focal

fatty sparing in the region of the gallbladder fossa with 7x9 mm cyst”

over the last 4 weeks have got worse with bilateral bad shoulder, elbow, neck pain.

Feel bloated, with pain when I push n upper center and right abdomen.

Sometimes feel a slight bulge on rh upper abdomen.

Also over last week now have a constant headache.

Fibroscan scheduled 18th April.

I am too sick now to go back to work , I have struggled working full time again for the last 6 months.

I can accept my liver is sick ATM, but what’s with all the other crippling symptoms?

Seems atypical from what I have read

regards

OZ

[pushthrough]

Hey there. Obviously Im no doctor. Some of your symptoms resemble liver issues but many of those issues could also be something entirely different. The cramping and or pressure is something many with liver disease have including myself sometimes. However you could have some other digestive issue going on. The good news is you quit drinking so if you have damaged your liver it will stop the progression. The ultra sound is a great first test but it’s far from a fibroscan or an mri.

Being fatigued is a common symptom with liver disease. It was one of the first ones I had but just thought I had been sleeping like crap. Your enzyme levels don’t seem terrible. Bilirubin would be something to watch out for. If I were in your shoes I would keep up the great work of not drinking, cut back on salt, and eat as clean as possible. Btw I found out I had compensated cirrhosis at 38 and I’m 40 now. I felt like crap for a few months but after following the specialists advice I was back up in about 4-6 months.

Check your stool for dark tarry waste.

Keep an eye on urine color

Keep us posted after your fibroscan. Others will chime in soon. Take care and talk to you soon!

G.

[Oztrax in reply to pushthrough]

Thanks G,

I am pretty positive as my family doctor, who specializes in pathology and diagnosis, had nearly given up after 2 years. So it’s been interesting to find a possible cause for fatigue and some of the other symptoms.

I have lost about 1 kg/month over the last 6 months without trying, but this may also help my liver.

Getting tested for hemochromatosis and Wilson’s/copper overload presently.

Should know something over the next few weeks.

Just too tired and sore to work ATM.

Joint pain really only should be present with iron overload or autoimmune hepatitis, so this might point somewhere.

Also am type 2 diabetic since 2018, but it’s well under control.

Hopefully over the next few months I might get my life back 😊

Regards

OZ

[Oztrax in reply to Oztrax]

Other blood tests results to add:

URATE low 0.188 mmol/l

ALT has been elevated a bit in the past couple of years eg 43 u/l

R-U-ALBUMIN is high 21 mg/l

URINE tests always com back SG 1.039 which is highish

ANCA Negative

HSP-70 Positive

Regards

OZ

[Oztrax in reply to Oztrax]

Forgot too add lowish blood pressure 103/82

Have been on Candersartan and Amlodopine for a few years.

Stopped the Amlodopine beginning February, made no difference to my BP.

Also Rosuvartin 10mg for cholesterol, stopped that for a few weeks and cholesterol went right up .

Regards

OZ

[Fibro2021 in reply to Oztrax]

Hello, Perhaps you wrote URAT but meant UREA? May I also ask you if you feel a ringing or beeping in your head or ears?

[Oztrax in reply to Fibro2021]

both actually…….

Very loud tinnitus in my left ear, every now and then in right ear.

And a popping sound sometimes.

I am very interested why you asked this

OZ

[Oztrax in reply to Oztrax]

Fibro2021,

Read your bio, you mean NRH,

I also have the red spots, have appeared over the last few months.

Portal vein US appears normal.

Where can I find good info on NRH ?

Are you taking steroid medication for your NRH ?

OZ

[Fibro2021 in reply to Oztrax]

No, I do not take any steroids to treat NRH. I am taking lactulose, rifaximin and LoLa for my persistent hepatic encephalopathy (HE) . The likely cause of my NRH is regular drinking in "social" doses. Maybe something else was involved in this process, such as some kind of genetic predisposition.

[Louby- in reply to Oztrax]

Hello Have you had your ears sectioned? You put a softener in 3 days before you have it done. Just sit holding a cup under your clear then a gentle suction using warm water. You will be shocked how much wax comes out & the colour. I was gee wonder how I was not deaf

The crackling before was annoying 🙄 after bo more crackling. I had a private ladybin my area. Specsavers does it. £50 was. They do it twice for that 4 weeks apart. I put earex in once a week & no crackling & no build up of wax. My hearing is so much better. Try itb8f you think that will help. It's painless & quick

Take care

[Hidden in reply to Louby-]

ladybin?

[Fibro2021 in reply to Oztrax]

Thanks for your reply, Oztrax. The level of urea in the blood decreases due to the inability of damaged liver cells to synthesize urea, which in turn leads to an increase in the concentration of ammonia in the blood and can lead to the development of hepatic encephalopathy. Perhaps you should check the level of ammonia in the blood.

[Oztrax]

thanks to all for your comments.

my fibroscan results will be interesting , if no fibrosis shows

will have to get a liver biopsy or 2.

am definitely asking they also check biopsy for NRH

in the meantime going to stop taking Arava/leflunomide.

Leflunomide half life is 3 weeks, so should feel better in a month if it’s affecting my liver

thats all i can do ATM

regards

OZ

[Oztrax]

thanks fibro

was actually thinking along the same lines as you

my wife commented my thinking is off lately........

ammonia buildup is definitely toxic

were you thinking HE ?

probably systematic toxicity as welll

I see my doctor on the 11th april

for latest blood tests which had complete liver studies including iron, copper etc

will also ask for new test for ammonia

any other uncommon blood tests you can suggest ?

regards

OZ

[Oztrax]

thanks Fibro,

what are your thoughts on my low blood pressure?

resting is 103/82 consistently

i have been on medication for hypertension afte an “irikandji” jelly fish sting in 2017

BP was more like high 130s with medication for years till a few months ago.

OZ

[kensimmons]

I am not a doctor, but your numbers do not indicate - at all - liver disease.

I hate to say it, bit sound like - old age!

Living a more healthy life, foods, no alcohol, exercise does remarkable health turnarounds for many and probably will for you. Worry less, exercise more and eat better!

I am not a doctor, so talk to one, don't listen to a fool on a message board like me. But you don't have liver disease, you just have old age in my opinion and you have oh my god health anxiety.