Newly diagnosed don't understand Fib4 score.

[LilacPoppy]

Hi. I am very overweight so let's get that one out of the way first. I do not drink or smoke. I have Hashimoto's thyroiditis, Osteoarthritis, Fibromyalgia and now since my jabs and the virus twice, I have suddenly become diabetic.A scan on my liver came back as Steatosis, Hepatosplenomegaly and Cholelithiasis. Enlarged fatty liver, spleen and gallstones.

I was very ill with an ongoing bug for 4 months over the winter. Lots of coughing, and my partner had this, so did many people where he worked and many people in my village. So I don't think this is down to liver health or anything.

Just had a whole bunch or bloods the Dr wanted done to pin down my liver issues. Whilst a couple are very slightly over the top end of normal the one that stands out is Fib4 which is 3.79 which Dr said is high risk liver fibrosis. He has referred me to a specialist which seems to be quite urgent as if I don't hear by Thursday I have to ring to make and appointment.

I don't understand a Fib4 score. My AST which is raised on a year ago, is less than double my ALT which is down from a year ago.

I am very scared. I have been through a lot of stress as a carer for my Mum for 16 years, her death, 3 house moves, the last of which was just before Christmas.

The Dr's referral said "Suspected Liver Cirrhosis or Significant Fibrosis".

I am scared. I am 52 and not long started to live my life with my hubby, since losing Mum to dementia. My older brother now has early dementia and although I don't live close, the stress is often overwhelming.

[Fibro2021]

FIB-4 - an indicator that takes into account the age of the patient, the activity of ALT and AST and the number of platelets. FIB-4 <1.3 indicates little or no fibrosis, and >2.67 indicates advanced fibrosis. Fib-4 validated for Non-Alcoholic Fatty Liver Disease (NAFLD) and chronic hep C. Using the FIB 4 score, the diagnostic cutoffs represent a negative predictive value of 94.7% with a sensitivity of 73.4% and a positive predictive value of 82.1% with a specificity of 98.2%. Patients with FIB-4 > 1.5 are often given elastography/fibroscan to check for liver stiffness, which provides an indication of the extent of fibrosis.

[LilacPoppy in reply to Fibro2021]

Thank you for your reply, but does this mean definite fibrosis or a high risk?I am not stupid but I am not sure if it means I definitely have it or it's possible.

Sorry I am in a scared panic that I am going to die soon. Since finding out every bit of food I eat feels like I am exploding. I am sure it's all in my head but as I am sure we all do, I hate the wait.

[Fibro2021 in reply to LilacPoppy]

This indicates a high risk of fibrosis, but does not indicate whether this is actually the case. In other words, it's a "game" of probabilities - most likely "yes", but possibly "not", although it's less likely. I think your doctor will plan further research to confirm or refute this.

[LilacPoppy in reply to Fibro2021]

Yes I am being referred to Hepatology Triage Service and either they will contact me if they think I need to be seen or my Dr if they don't think they need to see me.

[LilacPoppy in reply to Fibro2021]

Oh also, Dr has done a whole heap of blood tests, 8 vials worth, and looking at my levels, very little indicates bad liver results. My lipids and cholesterol are spot on.

[Fibro2021 in reply to LilacPoppy]

To rule out fibrosis, special biochemical tests for fibrosis, fibroscan/elastography, or liver biopsy should be performed. Fib-4 makes it possible to suspect that there may be a problem. But it is not customary to make a diagnosis only on Fib-4.

[LilacPoppy in reply to Fibro2021]

Ok thank you for explaining that to me. I will stop panicking soon, I am sure 🙂

[BritishLiverTrust8 Moderator British Liver Trust]

Dear Lilacpoppy

If you 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)

Here is a link to some information on our website about preparing for appointments, including questions to ask your doctor and specialist, which you may find helpful when you meet the specialist:

britishlivertrust.org.uk/in...

Best wishes

British Liver Trust