How are my levels back to normal?

[jebus22]

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?

[Kristian]

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.

[jebus22 in reply to Kristian]

thanks for you answer, i have gone a week now without drinking, mainly out of fear but i do feel better

[Whiteclouds in reply to jebus22]

well done for making it so far keep thinking alcohol is poison and is killing me to stop from drinking it as it truly is poison

[Roy1955]

Put it this way.

You don't need test to make a prediction that your likely to become very sick and die before you see your grandkids born!

Your drinking level is a slow and eventualy very painfull suicide.

Congrats on the weight loss if it was intentional but your sugar intake is still massive because of what your drinking.

[Onesmallstep1969]

Hi Jebus,

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?

[jebus22 in reply to Onesmallstep1969]

Just a regular ultrasound

[Onesmallstep1969 in reply to jebus22]

Get a fibroscan. An MRI/MRE is even better. Do it for your own knowledge of what's going on with your body.

[jebus22 in reply to Onesmallstep1969]

Dr will not order one, says it's not necessary

[Onesmallstep1969 in reply to jebus22]

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.

[devkermeg]

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.

[jebus22]

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?