I heard this can happen with advancing liver disease mainly cirrhosis for a short period of time liver enzymes return to normal do to the liver being unable to simply make the enzymes as much.
A little background info im 33 I have been a daily drinker since 2017 of about 6-15 beers a night with very few breaks. In 2020 i wasdiagnose via ultrasound and labs with NAFLD, yes NAFLD my dr belived it to be more of a combination of alcohol and obeseity (295lbs) . anyways here are my intial labs, the AST dropped from the initial lab work to normal but ALT remained elevated.
Now fast forward to 2023, the only things I have changed is I avoid added sugars at all cost, and have been on atorvistatin for 3 years, and i have been taking milk thistle, nac, b12 daily (my cholesterol seemed to drop allot, especialy triglycerides i read this can also be a sign of advancing liver disease). I now weight 219lbs compared to the previous 295lbs.
Things to note my creatine has always been low even before i started drinking to begin with
My Dr. said with this new labwork he sees no reason to reimage but said if they lookd at my liver again it would probably look in better shape then before despite still having the same drinking habits
So my question is should i request more test, and is it possible i could have cirrhosis? Should i ask for a 2nd opinion?
Written by
jebus22
To view profiles and participate in discussions please or .
In the situation you quote, I.e. normal labs due to a fully cirrhosed and shrunken liver, you would by that stage know something was severely wrong. Symptoms would most likely be particularly debilitating. It would also be highly unlikely that all lab work would be normal. Whilst enzymes like ALT, AST, ALP etc may well be impacted, other stuff like bilirubin, INR, heamaglobin, platelets, sodium, albumin would all likely still be deranged, some quite significantly. You'd also feel extremely unwell. Additionally it would be highly likely that other organ functions would be affected too, kidney function for example, so electrolytes would likely be off. In the interim too, as the liver started to fail, you'd certainly notice it, if you didn't have a significant yellow palour to your skin, you would definitely see some colour change to your palour. Liver grey I call it, lol. By all means seek a second opinion, but to me you've probably just ducked out of the way of one of Clint Eastwood's bullets. Just remember though he has a .44 magnum that has multiple rounds. So whilst losing the weight is great, and keep up the good work on that, if you don't significantly moderate your drinking, it may well be only a matter of time before one of his others gets you. Trust me, you don't want to get to the stage where the symptoms I describe above hit you. At that point, you might be quite thankful of one of Clint's projectiles hitting their target.
Good luck with your continued progress. Hopefully, that will continue and you can stave off any further liver damage.
Please do get an imaging or ultrasound test for fibrosis. A Fibroscan at least. Then, get the scan regularly, especially since you've been diagnosed with NAFLD and you want to make sure that you know if you're progressing toward cirrhosis. Have you ever been given a Fibroscan or some other imaging/ultrasound test?
The Fibroscan costs about $150 to $200 in most areas. Get a second opinion. Maybe a different doctor will order one. If all else fails, consider paying for it yourself.
You have made improvements and that’s great but if you continue to drink, especially at that level, the things you fear will become your reality. My brother passed from cirrhosis and exploded varicose. He bled to death internally. Daily drinker and totally functional alcoholic. Barely 50 years old. Count your blessings and stop now.
something to point out, when i had covid, i didnt drink at all for about 3 weeks because of being to sick, i read that fatty liver from alcohol improves rather fast (when you stop drinking); is it possible that my fatty liver went away at this time; explaing the normal labs?
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
ALD with normal labs.
Can LFTs come back normal and still have cirrhosis
My encouraging experience lowering my liver enzyme levels in 20 days.
I have to make a decision between my mental health and my liver 
If a liver function test comes back normal, how would you know if you still had liver issues?
