Cirrhosis but no change in bloodwork

[FlippinOut]

Diagnosed with fatty liver 10 years ago. Recently had a CT done for kidney stones and it showed Nodular liver. I was shocked. The weird part is my blood tests over the last 10 years always came back normal or just slightly elevated AST/ALT so doctors never thought there was a problem. Even now my standard bloodwork is normal and almost exactly the same as it was 10 years ago.

AST 24, ALT 31, ALP 48, BILI 0.8, INR 1.0, Platelets 219, Albumin 4.7, Ammonia 22

It’s only when they did more specific tests that abnormalities showed up:

GGT 80, AFP 7.9, Uric Acid 7.3, A2M 356, Creatine kinase 27

The other strange thing is I have plenty of symptoms. Upper abdominal pain, extreme fatigue, hair loss, easy bruising, spider veins, no appetite and trouble sleeping. I would think some of those would be reflected in blood tests?

Also recent changes in blood pressure and thyroid function that indicate my meds are not working well anymore. Don’t know what to make of it all. Doctors are not helpful and just telling me to lose weight. Is that the standard answer because there’s nothing else they can do for me?

Thanks for the advice and help everyone has been giving me! I’ve learned so much here.

Anita

[Realy]

I know you said you had a Ct done as well

As Fibrosure test. Has the Dr looked at both and come up with a decision or offer more tests?

[FlippinOut in reply to Realy]

His answer is that the only way to know for sure is a biopsy which he’d like to avoid. He says it wouldn’t change anything or change their approach. Only other tests he wants to do are endoscopy and colonoscopy (to check for varices but he also said there was no signs of portal hypertension on the scan, whatever that means). Nothing makes sense to me regarding my symptoms vs the test results. I’m so confused 🫤

[Realy in reply to FlippinOut]

you may need a second opinion, He has to have a idea or needs to get a 100 pct answer to this. Push for another test as people have suggested or call your insurance company I don’t think he can deny further testing .

[FlippinOut in reply to Realy]

I definitely need a second opinion from a really good hepatic specialist.

[WayCas]

Bloodwork often doesn't indicate liver disease if the liver is functioning well. I went from fatty liver to NAFLD to NASH to HCC and never had a bad liver blood panel. Even though, I had all the symptoms you described. My liver is still giving good number even after radiation, chemo and immunotherapy. The liver is a tough organ. Do everything to keep it healthy. Good luck. Wayne

[FlippinOut in reply to WayCas]

Thanks Wayne. It’s good to hear you’re still going strong after all you’ve been through. It gives me hope.

[Onesmallstep1969]

The blood tests almost all measure inflammation. You don't appear to have an inflamed liver. But that doesn't mean your liver is not damaged. The liver can be scarred but have no inflammation at all.

Since the surface of your liver appears to be nodular, there is something going on. The best way to check to see if the "nodular surface" is cirrhosis is either a biopsy or a Magnetic Resonance Elastography (MRE). A less accurate but still useful test for stiffness of the liver is the Fibroscan.

I took interest in what you wrote about changes in your blood pressure. Cirrhosis does in face often cause these changes. Keep digging for the truth.

[Realy in reply to Onesmallstep1969]

keeping those liver functions in normal range should help, I believe that’s a good measure keeping inflammation or activity under control and prevent further damage. Over time like myself I had metabolic syndrome and my enzymes were always in range had 2 times slight elevation. The type 2 and cholesterol was my problem with the weight.

[FlippinOut in reply to Realy]

I can’t get my cholesterol or weight down no matter what I eat or don’t eat. Been on very low fat and low carb diet but my fasting glucose is still 120 and my triglycerides went up 😆

[FlippinOut in reply to Onesmallstep1969]

You’re right, there’s very little inflammation going on now. I’m trying to find a hospital or radiology office that has the MRE scan. I think that will tell me a lot more than the fibroscan.

[Realy in reply to FlippinOut]

I have had fibroscan and am due for another soon, I would like the MRI as well.

[pushthrough in reply to Realy]

I second the MRE scan. They are replacing biopsies with that in the states. It’s NOT just an mri, it’s an mri with elastography. So there is a paddle that’s strapped to you and it vibrates as you are getting the scan done. It’s how they made my official diagnosis. It’s quite uncomfortable but certainly beats a biopsy. Being stuck in limbo and not knowing is terrible. I experienced the same thing. I wish you the best.

[VeeWat]

I saw a video by Dr Robert Gish who said— for women, if the ALT and AST are over 20 then there should be investigation.

[FlippinOut in reply to VeeWat]

Sheesh! Mine has always been over 20!

[VeeWat]

youtu.be/vmnQBtsM7cY(Not working as expected?)

Workup for liver disease—Gish

[FlippinOut in reply to VeeWat]

This was enlightening. Thank you for sharing. Every GI doctor and PCP should have this info. I cried when he said “everyone with metabolic syndrome should be tested for liver disease “. If my doctors had known that, I wouldn’t have cirrhosis today.

[VeeWat in reply to FlippinOut]

He’s the best in the US. Give to your doc.

[Liver3 in reply to FlippinOut]

Absolutely 💯 I have for 10 years slightly elevated ast & although no one thought anything was wrong with me I was a running picture of health! 20 yrs later Hep c shows up! 2 treatments later I have cirrhosis it's sad doctors are not more in tune ti investagate

[VeeWat in reply to Liver3]

did you already have cirrhosis when you treated?

[Alibaba80]

Anita you need a biopsy if possible try to push for one, like me, blood's are not always informative. You have heart and blood pressure symptoms right and many other symptoms like me...you may have Nodular Regenerative Hyperplasia like me but without biopsy you will never know.Unfortunately the doctor's are useless and know next to nothing about this disorder

[Moux1]

your platelets are really good which normally don’t coincide with cirrhosis, do you drink at all , not judging at all , just wondering if this can be part of your symptoms. The liver would not give any pain but if the organs around it are enlarged you may feel a tenderness and pain , take care and follow a clean diet

[FlippinOut in reply to Moux1]

I was never a drinker just a glass of wine on special occasions. Last one was 3 months ago on Mother’s Day. I have metabolic syndrome which is what caused my liver disease. It’s recognized now as a common condition and is actually called MFLD (metabolic fatty liver disease).

I’m praying I can keep my liver from getting worse.