Asymptomatic hepatitis, waiting for exact diagnosis

[EssexGirl13]

I’m 54 and was diagnosed with non-viral hepatitis in March 2023. No symptoms. I have a GGT of 512 and ALP of 375. Stopped drinking alcohol (was moderate drinker - 10-15 units a week) since high GGT discovered in Dec 2022, level went down for first few months, now back up again.

BMI 23 (was 25 when had initial high GGT, so lost 5kg), exercise regularly, healthy balanced diet, no meat, lots of fresh fish, fruit and veg, though weakness for cheese and chocolate!

Had an ultrasound (liver normal, spleen slightly enlarged), and waiting for a fibroscan (I live in Spain) so I can (hopefully) get an exact diagnosis and medication, if appropriate. Consultant ruled out auto-immune hepatitis.

Any advice or suggestions for lowering my GGT gratefully received 😀

[AyrshireK]

Having a fibroscan whilst you have liver inflammation is likely to give you a false high result and may just cause further confusion and not much to help a possible diagnosis.

[EssexGirl13 in reply to AyrshireK]

Thanks for,your reply. Fibroscan is the scan that is offered here - they don’t do biopsies at this stage, since seen as too invasive. From what I understand, the fibroscan is to evaluate the texture and softness/hardness of the liver. I am not sure if/when my liver will *not* be inflamed, as my GGT is going up despite my careful diet, exercise etc.

[AyrshireK in reply to EssexGirl13]

Unfortunately, Fibroscan isn't going to reveal WHAT is causing your high liver numbers.

It may indeed reveal tissue density (kPa score) but this could be falsly high due to ongoing inflammation.

It may also provide a CAP score revealing how much fat there is in your liver.

But, it won't offer anything in the way of diagnostics to tell you why you are having these issues.

Interested to know how they ruled out auto immune things because there is such a thing as sero-negative AIH where you don't necessarily have wayward auto immune markers.

High GGT and ALP combined often points to a more biliary system problem. A fibroscan won't help finding out that.

Katie

[EssexGirl13 in reply to AyrshireK]

Many thanks for your reply, Katie. I will bear all these points in mind for my fibroscan, if and when I ever have it, and for my next consultant appointment. Really appreciate your feedback.

[EssexGirl13]

I finally had my Fibroscan, 8 months after my consultant ordered it. 180 CAP and 6.8 KPA. Still waiting for latest blood test results, then will see my consultant. Not eating quite as healthily as before, but still taking reasonable amount of exercise. No booze at all for 14 months now. Feel fine mostly.