sorry to bother you Any advice would be appreciated.

[Paula1710]

As some of you are aware I was told I had a fatty liver after a US scan last February.Since then I have had 2 ct scans,1 MRI and 1 fibroscan.Found a cyst on liver

Had COVID Nov 22

This year my stools have been pale,tired,itchy skin,hairloss,spider veins.headaches and a tad forgetful diarrohea,low BP no idea why

My ESR suddenly dropped to 2 under range which can indicate liver disease

My ALT at its highest was 94 then 39,50 and recently 68 it always seems to return to normal.GGT and AST normal Blood clotting ,sugar,cholesterol etc normal

Liver autoimmune negative,heb b c. negative.

Stomach issues got worse.pain gurgling,acid etc

Did have a weakly positive ANA but after stopping PPI now negative ANA.

Hpylori negative after biopsy and stool sample

Vitamin deficiencies in iron,vit D,folate and Zinc identified.B12 deficiency discovered in 2016 now on injections.

Burning in forearms bone and muscle pain.

4 high cortisol results.

I'm stumped to what this is but I am wondering if its my liver worsening?

Lost 10 stone in weight was a size 24 now a 10. No alcohol for 18 months.

Any insights????

Thank you

[Fibro2021]

Hello, Let me ask you, did you determine the acidity in the stomach during fibrogastroscopy (pH meter) and did you prescribe folic acid at the same time as vitamin B12? ESR is closely related to fibrinogen and other acute phase proteins. With a decrease in the level of fibrinogen, which is synthesized in the liver, the ESR slows down. With an increase in the level of fibrinogen and other proteins of the acute phase, ESR accelerates.

[Paula1710 in reply to Fibro2021]

Not had any stomach acid tests as yet.No just B12 injections no idea what my folate level was when diagnosed.Sorry what does my ESR of 2 mean?

[Fibro2021 in reply to Paula1710]

It's just that in your opening post of this thread, you indicated that folic acid deficiency was also determined. Low ESR may be due to fibrinogen deficiency. Since fibrinogen is synthesized in the liver, this indicates that the synthesis of fibrinogen in the liver is reduced (not directly) for some reason which should be established.

[Paula1710 in reply to Fibro2021]

Just written that down to ask hepatologist.Thanks for the info appreciate it.Folate has been low for years had to supplement a few times

[Paula1710 in reply to Fibro2021]

Hi my fibrinogen is slightly over range and my ESR is still 2 any idea what that means ?

[kensimmons]

You ask - any insights?

Yes, google fatty liver diet and follow it and you will be fine.

[Paula1710 in reply to kensimmons]

So you don't think the raised ALT pale stools spider veins are of concern?

[Hidden in reply to Paula1710]

I've had pale stools and have spider veins and an ultrasound said fatty liver I have stomach cramps, muscle cramps, memory problems but my bloods are normal I feel generally ill all the time but my GP won't do anything thing about it.

[Paula1710 in reply to Hidden]

I'm lucky there my GP has referred me to gastro and hepatology mind you my ALT keeps going up and down.Keep at them

[Hidden]

mine has done nothing apart from ultrasound and blood test, I know I should be seen by a gastroenterologist and a hepatologist

[Paula1710 in reply to Hidden]

Hepatology refused to accept my referral at first last year but as my liver tests are going up and down plus worsening of symptoms I got referred and accepted recently.Going to see them in June

[Hidden]

Hope you get things sorted

[Paula1710 in reply to Hidden]

You too

[Hidden in reply to Paula1710]

Thanks 👍

[BritishLiverTrust3 Administrator British Liver Trust]

Dear Paula1710,

If you [are in the UK and] would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Best wishes

British Liver Trust

[Oztrax]

surely your fibroscan result would have been elevated with FLD ?

[Paula1710 in reply to Oztrax]

This is where I'm confused.Got 1 letter stating no fatty liver then after a ct scan Jan gastro guy looked at my scan and pointed out the fat.When they did they fibroscan last Aug nurse said I didn't have much space between my ribs.Shd got 10 readings.cap 164 kpa 4 8 .Don't know where I'm up to

[Oztrax]

they are good numbers, fatty liver doesn’t mean fatty liver disease.

You are below the 5 kpa cutoff

Interesting chart above shows different stiffness for different liver conditions, but at 4.8 kpa you will make a lot of people here jealous……

Liver stiffness

[Paula1710 in reply to Oztrax]

Thing is that scan was done last Aug.I stopped drinking 18 months ago lost 10 stone but fat still on scan.Had COVID and lost weight quick

I have pale stools,abdo pain,spider veins,red palms,tired etc so don't know if it's gotten worse.My ALT has gone up in Oct Nov and Feb highest 94 don't know why

[Paula1710 in reply to Paula1710]

Letter states F0-F1 keep getting letters with different opinions on.1 letter states FLD. If I could get a definitive diagnosis thunk my mind would be more settled

[Oztrax]

Paula, just looked at your symptoms and time frame , seems exactly like mine, even your ALT levels. Have you considered a second opinion ?

Eg AIH or NRH and not fatty liver.

[Paula1710 in reply to Oztrax]

Had the blood tests for AIH negativeThey won't do a liver biopsy

[Paula1710 in reply to Oztrax]

Fat has been seen on my liver on US and ct scan

[Oztrax]

I didn’t see a reference to alcohol consumption, in my case cutting out all alcohol dropped my LFTs to middle of normal

[Paula1710 in reply to Oztrax]

I drank heavily for 12 years and was morbidly obese.18 months ago i stopped drinking completely and lost 10 stone.Still 1 stone over weight which I'm working on

[Oztrax]

CAP of 164, is representative of low fat content.

150 is considered normal. You are more like F0, but NAFLD diagnosis and levels seems to vary with health professionals.

Another fibroscan may show you have progressed better than you think.

Fibroscan should be done every 12 months.

[Paula1710 in reply to Oztrax]

They won't do another scan until August next year.im going to see Gastro again in June

[Oztrax]

youtu.be/tG2gejQRLDI(Not working as expected?)

Watch this YouTube webinar, it’s called “Baffled My NAFLD”

I found this very informative

[Paula1710 in reply to Oztrax]

Interesting thanksIt states fatty liver on ct and us can only pick fat up at 33% My fibroscan doesn't correlate with ct .Had ct Jan this year and he could see fat

[Oztrax]

my understanding is CT will not show fat infiltration or fibrosis.

But MRI can show both these conditions

[Paula1710]

Mri last year said unremarkable liverGastro guy Jan 23 said he could see fat but no mention on report just a cyst

[Onesmallstep1969]

The ALT is above normal. It means something is inflaming your liver. No matter whatever else may look good, as long as the ALT is elevated, your liver is not normal. Now the doctors have to figure out why your liver is inflamed. Keep looking for answers. Good for you that you've lost weight and are taking better care of yourself. Have a good day!