Good morning to you all, I am speaking with my Dr in two weeks time and would like to ask advice on what blood tests to request , as you probably remember I had a bad ultra sound and a bad ct scan followed by a really bad fibro scan, I was not followed up or referred and because of this I worry what is going on inside, I feel like I am in the dark.,.. as routine bloods they always do the ALT….BILLIRUBIN…..ALBUMIN …. ALP…. I would really like more liver blood tests but not sure what to ask for. I was going to ask for the following but not sure if I need them and not sure if I’m leaving off important ones, I would be so grateful of advice as to what else I could request or what needs removing from this list , thank you in advance, my platelets are 255 by the way xx
GGT
AFP
AST
INR
PT
also do I need to check for any of the hepatitis bloods or immunoglobulins,? which ones are usually raised IGG IGA or IGM these bloods were done a year ago and one was almost double and one was barely on the low range, these bloods were for a different reason and not one Dr knew what the readings meant so I have always worried about them , now I wonder was it liver related and is it worth requesting to see if they have altered, thank you again for any help you could offer as in bloods I can request just to see a picture of my liver health as it’s the only way I can see anything due to no referral xx
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Sophia1968
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Do get in touch with the folks at the British Liver Trust as suggested in their response. They will be able to go through things with you far better than any of us can.
I note from your earlier posts that you have a high fubroscan, high cap score and a high BMI. So, clearly there's quite a risk there for Non Alchoholic Fatty Liver Disease or Steatosis. NICE produce guidelines for the medical professionals in the UK and they do have one for NAFLD. Along with that they have a section on info for the public where they set out, albeit briefly, what things you should expect to see in your diagnosis and treatment. Hopefully the link below will take you to this info.
I'd probably not focus too much on the extra blood tests. The ones you indicate they do as standard should give them enough info to gauge how it's currently functioning. Instead, I'd probably ask more direct questions about the following:
1) what is my actual diagnosis? (If they haven't told you this already)
2) What stage of the disease am I at? Do I have any fibrosis? Or do i have advanced fibrosis or not?
3) What is the management plan for me? What is the usual protocol for my disease?
These questions should at least put you more in the know about where you stand and what you should expect. At some point there will need to be an assessment of whether any fibrosis is present and if so how advanced. Its that which will determine whether a referral to a specialist is appropriate or not (according to the NICE guidelines). To determine that they suggest an ELF test should be carried out, so may be raise that if your gp doesn't have a picture of disease progression in you.
From your earlier posts your gp has indicated that not much will differ between their advice and that from the specialist. To be honest, they're probably right, if there isn't too many signs of advanced fibrosis, then that would be the general rule anyway.
Hope thats helpful. I'm sure the trust can give you even more and better pointers, so do take them up on that phone call if you can.
Liver disease diagnosis can quite often be a process of elimination. It's a case of looking at the obvious first before moving on to other potential causes. So finding out if it is NAFLD in your case would also be a good start. I know I've made that leap here, but I'm no expert so it is worth trying to get that confirmed or not too.
Oh Kristian, thank you ever so much, everything you say makes perfect sense, I will call the nurses but you have helped heaps, I assumed my dr just didn’t care or understand when in fact it prob is that they have nothing to go on regarding bloods and I honestly think they believe weight loss will improve my scans and fibro score, I do feel better for reading your reply and I thank you so much, I won’t ask for the extra bloods but I will ask the questions that you have suggested xx
No problem. Just remember also that in early stages of liver disease, it is usual practice to manage in primary care anyway. So your gp isn't necessarilly on the wrong path. They just may not have communicated this very well to you.
Aww ok, I did not realise that either, I just assumed bad scan , fibro score of 21.5 meant I should be checked for varicose and cancer etc, my dr thinks losing weight will help and I have lost 4 stone since, she even said to me once try not to worry too much about your liver, this then made me feel that she absolutely had no idea of the seriousness, but your comments habe really helped me see it differently , and from their side x
You can ask for the FibroTest (FibroSure) blood test. It will give you another clue about fibrosis level (F2, F3, etc). I think you were worried about muscle mass recently too. A creatine kinase blood test will show that. Good luck, I hope all goes well for you.
Hi Sophia, Kristian and Flippin are spot on. Do call the nurses, they are lovely.
I get my blood results on the NHS Ap and there is a link to a third party website that explains your results: labtestsonline.org.uk/tests....
I would say use with caution though because there is a lot of information, some of which may not apply and you can scare yourself unnecessarily. But I know you’re like me and you’d rather have the info and be prepared.
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