I have high liver enzymes. AST 91. Alt 134. Ggt 235. Fibroscan cap 366 and kpa 5.6. What does this mean .
Cirosis : I have high liver enzymes. AST... - British Liver Trust
Cirosis
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Curryblue
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The CAP score indicates the amount of fatty change in your liver and kPa is liver density.Your CAP is very high indicating fatty liver disease but good news is your kPa doesn't indicate that you have any serious degree of fibrosis so this should be reversible.
Bloods indicate ongoing liver inflammation.
They need to investigate why your liver is inflamed and get whatever is at fault treated either by lifestyle changes and/or treatment.
Do you know if you have any risk factors for liver disease - do you drink alcohol is always a first question? Are you overweight, do you eat healthily and exercise? Do you have diabetes or other health condition or take medications?
Non Alcohol related Fatty Liver Disease (NAFLD) or MASLD (Metabolic dysfunction Associated Steatoic Liver Disease) is one of the rising causes of liver illness in the western world but it can be reversed in most cases with healthy living. britishlivertrust.org.uk/in...
Katie
I was very depressed and drank vodka all day for five months. I now think I have cirosis and cannot function anymore. I have four adorable boys and grandchildren and I have let them down and cannot forgive myself. Do you think I have cirrhosis’ with those results? My family say it s my mental health and do not believe I drank so much but I absolutely did.
A kPa score of only 5.6 doesn't indicate cirrhosis at all indeed it is bang on normal. Cirrhosis in alcohol related liver disease doesn't appear till about 22 kPa.You need to get sober and get the inflammation under control and the blood scores and fatty liver should reverse.
Who ordered your fibroscan and what feedback have you received?
Katie
My gp as had fib 4 score 1.54. The fibro scan was then ordered. The nurses had only been doing it for a week and tbh were pretty clueless and had to repeat it. Can they get it wrong ? I gave such bad health anxiety. Would it def show cirrhosis on fibro scan? I am honestly going crazy. I was such a happy person and now I can’t leave my bedroom as so depressed .
Ask if you can get an ultrasound, fibroscan can return faulty scores if there is operator error but surely no one so inept should be carrying out such an important diagnostic scan.
I have had one. Showed diffuse fatty infiltration. . I know what you’re saying but they honestly were learning were their words. Waited for results and called me back to repeat test 🤷♀️. Whatever it’s my own fault for hitting the bottle in desperation. I just wish docs could give you a def diagnosis. X
Can you have bad fatty liver without cirrhosis ?
Yes. There is a progression pathway to liver disease as per diagram. Right up to full blown cirrhosis you have the opportunity to reverse liver damage. If your 5.6 kPa is accurate you don't have cirrhosis but do currently have the Steatosis (fatty liver)and bloods probably reveal a degree of hepatitis (liver inflammation). Abstinence should cure both issues and prevent fibrosis and progression to cirrhosis.
Katie
Liver disease progression image.
Thank you. Is iqr/med same as kpa as they said it was ?
The iqr is the spread of the 10 results you'll have had taken the median or mid point of this range gives you the overall kPa score. The important scores are the CAP and kPa results.
Sorry you are going through this right now, the cap score as others have stated is the fatty-ness of your liver basically and that was what my cap score was a year back, it’s now 144. I wasn’t overweight or obese, I just had an extremely poor diet and was an alcoholic.
My liver stiffness score was 22.2kpa as well, which as Katie rightly says is cirrhosis levels for alcohol liver disease. Thankfully since going sober, I’ve managed to not only reduce my cap score, but also my liver stiffness score which now reads 9kpa and my doctors say means likely moderate fibrosis which is still scarring, but not cirrhosis.
If you drank vodka every day for a few months, that will damage your liver and your high LFTs could, again as Katie alluded to, be some form of (alcohol) hepatitis of the liver which with abstinence can be reversed.
The good thing is it appears your liver stiffness levels are in the normal range and although none of us are doctors here, you stand a very very good chance of reversing whatever damage exists.
I was a raging alcoholic towards the end, from the moment I woke up to the moment I went to sleep. Every day for over a year pretty much. Prior to that I was a heavy drinker for a decade and was hospitalised with jaundice, ascites, alcoholic hepatitis and likely decompensated cirrhosis as per my initial fibro scan result.
Through abstinence, a healthy diet and regular exercise everything now is pretty much back to normal in terms of my bloods, LFTs and whatever damaged I’ve caused to my liver, it’s remodelled and healed so it’s more than well compensating now.
Health anxiety is real and a big issue for many people as is mental health which for me pretty much can and do go hand in hand which can lead people into drinking to excess or self medicating with drugs or even things like painkillers.
It seems you’ve had a scare and need to work on getting better in terms of your liver, and any health anxiety or other health issues which I prey and hope you do and I’m sure you will. You will likely need more tests and and just follow whatever your doctors say. I can’t tell you not to drink again, but while your liver fatty-ness is so high and LFTs are off, reducing or stopping altogether even if temporary would be wise.
Good luck and take care.
Thank you all so much x
Did you just quit or did it take a while to come off it ? X
I was detoxed in hospital March 2023 and haven’t touched a drop of alcohol since and nor can I ever touch a drop ever again, otherwise my already fibrotic liver will quickly turn into cirrhosis. It’s taken me a full whole year just to get my bloods and LFTs within the normal range. However, I still suffer some alcohol related damage like neuropathy in my feet and muscle wastage, although I’m now back to my ideal weight, most of my muscle mass has gone in my legs and arms and that will take a long long time to return.
Hi I have recently been diagnosed with Cirrhosis and my scores were CAP 337 and kpa 47.5 While it’s not great and mine can’t be reversed if I eat healthy and exercise if I can keep it like this I should be able to live as long as I would have without this.
You must get your alcohol under control, I don’t drink much but have been told to totally abstain.
I wish you all the best
Sarah
Thank you. You too x
You still drink with cirrhosis or have I read your post wrong? Again I can’t tell anyone not to drink and it’s easy for me to say don’t do this or that if you have this or that, but it’s universally accepted by liver experts that anyone with advanced liver disease such as cirrhosis cannot ever drink again, at all, even if you get a transplanted liver, it’s the biggest no no and the biggest cause of an early and ugly horrible death with cirrhosis.
Probably my wording… I didn’t drink much when diagnosed however I was still advised to totally abstain from alcohol going forward
Ah right, sorry, sadly people get liver disease through no fault of their own, I say fault, no person deserves to be inflicted by any disease. Well, certain people don’t deserve be any sympathy, but the vast majority of people on this planet are good honest people.
I think you have been answered really well re the liver condition. The thing that leapt out in as sad was from your post is your mental health. I am so sorry you felt so low and felt unable to reach out which led to your drinking. Please try to address this. I know the NHS is in crisis, but they still will respond if they understand the gravity. Go to your GP or a local alcohol service in your area and address the mental health issues. You were self medicating your mental pain. You have had a health scare now, which may make you stop drinking for a while. However, there is still a danger of returning to booze or just getting worse mentally when the shock of this subsides.Please reach out for help. I believe your GP can, nowadays, even prescribe drugs to help you be less likely to return to drink( like nicotine inhibitors). There can be a lot of shame around alcohol problems. This is ironic in the world that actively promotes this dangerous drug. However your GP will have heard it all before. You also need guidance on diet and taking care of yourself again, especially mentally. You need to try love yourself enough to take some steps. It sounds like you have loving people around you which is great , so please seek help for the underlying issues that got you to this point. That can be done. I know this for a fact x
Do think if I have all those bad results I can recover. I am soooo not good xxx
Yes. Absolutely. Just click around this site and read all the stories of people who have survived and living a good life despite worse results. Keep hope x
Of course you can, I was drinking myself to death and while in hospital my bloods and LFT function results would have made me eligible for a liver transplant in some states of America. Now apart from some physical issues, I’m all good health wise, and especially mentally since I quit drinking. Even with cirrhosis, which you DO NOT have if your liver stiffness levels are returning normal results indicate, you can reverse everything fully. You have an extreme fatty liver and that’s what you need to work on with a healthy diet, abstaining or reducing alcohol levels and regular excercise. You don’t have to be a gym freak or lose x amount of weight to shift a fatty liver, it’s a common misconception that if you have a fatty liver you must be obese, a lot of people who have a fatty liver aren’t overweight and are not heavy drinkers. It’s mostly diet related. I cut out sugars and salts and foods that contain ingredients the body just doesn’t need. Hydration is very important too in terms of water. Also auto immune issues and genetics can play a part in getting a fatty liver and it’s even thought that stress can be a risk factor, again good luck and take care.
I m skinny as and stopped going gym re my mental health. I can’t leave the house. Wish I was as strong as you. Do you mind me asking how much you drank ? I need to get a grip for the boys. My drinking is obviously cause of fatty liver and surprised my kpa is only 5.6. Which I hope is correct. I m so glad you are ok now xxx
I’m not strong, I just had to choose between dying or living and when I have a wife and two young children and a whole life to still yet live, it’s an easy choice really and the only choice. Don’t get me wrong it’s hard and has been and will continue to be, but I just have to look at my wife and kids every time I feel like I want to have a drink and whatever that feeling is it subsides quite easily and quickly, you can do it, you just have to work on your mental health which seems to be the cause of your problems, mentally and now physically.
You can overturn the fatty liver 100% and are starting from a very positive position regarding any damage done to your liver, but you can’t keep drinking as much as you have been doing for much longer before the damage worsens which it will, it can take a year or years. It took 10 years or more of me drinking heavily.
And that was mostly 90% me drinking whiskey only, towards the end I was on 3 bottles of 70cl whiskey a week easily, I’d wake up and drink until I passed out and would repeat the same thing day and night for at least a year hiding my drinking in between and trying to still function until I was bedridden dying with jaundice, ascites and likely compensated cirrhosis, which turned out to be alcohol hepatitis, which is more deadly in the short term as if I’d have carried on drinking my liver and kidneys would have failed and there would have been no option of a transplant.
I was another fortnight away from likely dying and for some reason I must have known I’d be dead soon before I picked up the phone and dialled 111 and they said to come in straight away, I was in hospital for 11 days and it’s taken me a year to recover physically and emotionally to be fully functioning, but I still have some physical issues and a few alcohol/liver damage related symptoms. But I’m on the mend and my prognosis is excellent according to my hep doctor, so long as I stay off the booze! Good luck and take care.
Thank you for all your help and advice. I def need a kick up the ass as just feeling sorry for myself which is not fair on the kids and family. My head is soo gone right now. You sound a strong person to me . Just don’t get it as was the happiest person with the best life and now it’s gone. Alcohol is such a bad thing . Xxxx
Thanks for your kind words and it really is a bad thing, I used to be so strong, but allowed alcohol to almost kill me, but never again and it happens to people of all walks of life, mental health is real, my own drinking wasn’t really down to that, but more me liking whiskey, liking it a lot, having an addictive personality and once it got its wicked way with me, I become dependant on it and that’s what I’ve learned is the hardest thing about drinking it is when you physically and emotionally become dependent on it either for both or just one, but in the end it will get you both ways. If you have a family to think of that’s all the motivation you need, you need to be there for them and they need you, you mean something to someone and that’s important, be kinder to you self and allow yourself to have bad days and not everyone is 100%, not even the seemingly most happiest, wealthiest and healthiest of people. We are humans not robots, you can do this.
Thank you. I so hope so. My family are so lovely and I can’t believe that all I want to do is kill my self. Tbh every minute right now is pure torture. I pray I will get some strength and pull through from all this. Your word s help xxxx
Is there an underlying cause your mental health issues and reason for you drinking? You don't need to answer that here but you do need to address why you have been on this journey of alcohol use. It sounds like you need to get some help with detox and to learn how to love yourself again.
Your liver issue isn't a cause to be hitting self destruct, it sounds to have been caught early enough for you to reverse it. The fatty liver stage is reversible as are the high inflammation numbers BUT you need to give your liver the time it needs to heal and that means getting off the very thing which is attacking it. Alcohol is a depressant drug too so you are not going to start feeling positive until it is gone from your life.
You've got a family you love but you need to love yourself too.
It sounds like you need to reach out to talk with some professionals in the alcohol treatment sector. Ask your GP for help in accessing appropriate local services. As regards you talking about self harm please seek some help - the Samaritans are a free call away and they can help get you started on talking about your issues. samaritans.org/ (Free Phone 116 123)
You've reached out to us, reach out to those who can give you actual practical support too.
Best wishes, Katie
Thank you Katie. Yes I reached out to the alcohol through health anxiety and when nothing was actually wrong I now feel I have damaged myself . I have massive health anxiety. I am awaiting mental health help at the moment. I still can’t believe though that my liver is ok and I never believe the doctors. Can you have all those high liver enzymes and get back to normal? Sorry for repeating myself but I m not well in the head xxxx
Yes, you can. Those liver numbers show that your liver is inflamed just now and it is because of the assault it's been getting through the booze. If the booze and the assault is stopped the liver will become happier again and the risk of further damage prevented. As I showed you on the diagram there are stages to liver disease and you currently have liver inflammation and fatty liver which is reversible through abstinence. If the assault continues though the liver will gradually become more and more fibrotic until it all becomes cirrhotic. Everything up to full on cirrhosis is reversible. Health anxiety is dreadful but its a vicious circle - booze fuels anxiety and provides more cause for worry & I know that mental health services arn't really set up to support folks who are still drinking.
You can recover this, you have people who you love and no doubt they love you too, please believe test results and doctors and get yourself on the road to recovery - physically and mentally.
There are loads of folks on here who wish their condition was caught as early as yours has been and when there is still time to change it around. Loads of us are living with the consequences of too late a diagnosis.
Ask for specific alcohol detox support, cold turkey may not be appropriate or safe with the quantities you've been consuming up to now. Be totally honest with your medical team and get yourself on the road to recovery ........... loads of us are rooting for you.
Katie x
Thank you so much . I have so many people rooting for me. I am just so lost and don’t know where I have gone. I appreciate your response and you are so lovely to do so. Thank you . I was always the party animal but will have to not be anymore ❤️Xxxx
How quickly can fibrosis and cirrhosis occur ? X
Sorry I think that's impossible to say - in some folks it might be fairly quick or on others many years. It sounds like you've 'dodged the bullet' at the moment and you want to keep in that way.
Thank you. So fatty liver is not fibrosis or cirrhosis even with that high score ? I guess with those figures mine is grade 3 ? X
S3 - Steatosis Grade 3 yes but not fibrosis/cirrhosis. According to your fibroscan result you don't yet have any significant fibrosis.
But fatty liver combined with on going inflammation is what can/will eventually start damaging the liver leading to fibrosis so it's essential you get the inflammation and fatty liver under control and that means getting off the drink and living more healthily.
Katie
Sorry to be a pain but what does iqr 15 percent mean ? X
The IQR is just part of the calculation process and as a non maths boffin it goes way over my head. "We can find the interquartile range or IQR in four simple steps:Order the data from least to greatest.
Find the median.
Calculate the median of both the lower and upper half of the data.
The IQR is the difference between the upper and lower medians."
In fibroscan the % IQR speaks to the accuracy of the scan (kPa) result.
"IQR (interquartile range) quoted as an absolute number or as a percentage of the median. This number should be less than 1/3 or 30% of the median for a valid, high quality reading."
The only scores relevant to you as the patient are the kPa and CAP.
Katie
I know I m going insane katie. So cap 366. Iqr/med 5.6 iqr 15 % is just bad fatty liver ? So sorry to keep bothering you but I m so worried. X
Yes from that result your IQR being below 30% infers that your scan has provided a "valid, high quality reading" - 5.5 kPa (little to no fibrosis) and a CAP of 366 (S3 - Steatosis grade 3) - fatty liver at the most severe end of the scale but NOT irreversible.
Stop worrying but really do concert all your efforts on turning this around.
Katie
Is a fib 4 score normally accurate ?
It's certainly one of the tests advised for assessment/diagnosis of NAFLD and in their documents it says :- "Fibrosis (FIB)-4 Score (FIB-4) — a score of greater than 2.67 suggests advanced liver fibrosis.
If the person is at high risk of advanced liver fibrosis, refer to a hepatology specialist for further assessment and management.
If the person is at low risk of advanced liver fibrosis, explain they are unlikely to have advanced liver fibrosis, and follow up the person in primary care."
Full assessment/diagnosis protocol is detailed at :- cks.nice.org.uk/topics/non-....
The fatty liver foundation states talks about accuracy of Fib-4 saying:- "In clinical trials for NAFLD/NASH diagnosis, patients with a FIB-4 score 2.67 were classified as having advanced fibrosis. Those with FIB-4 scores 1.3-2.6 were indeterminate, requiring further testing. As a test to rule out advanced fibrosis (FIB-4 2.6), FIB-4 has a positive predictive value of 80%. This means that 80% of those identified as having advanced fibrosis truly have advanced fibrosis, while the remaining 20% are false positives requiring further validation."
Your 1.54 would have been in that indeterminate bracket requiring further testing which it would appear has been done and your other tests say not advanced fibrosis.
Katie
Sorry. Me again. Did you find it easy to just quit ? I ve heard so many withdrawal stories. I just want my life back. Xx
At first it was really tough as I wanted a drink every day and felt like I needed a drink for the first month, but it gets easier and while that want may never go, that need certainly has. I may feel like I want a drink sometimes, but I never need a drink. I know I cannot ever drink again because it will kill me and that’s a mighty incentive. I just look at the screensaver of my wife and kids on my phone whenever I feel like I want a drink and it disappears instantly.
I’ve been lucky as whiskey was my drink of choice and not alcohol per se so I can give or take other drinks easily, even when I was an alcoholic. I’ve learned with myself, my drinking wasn't because I was masking any inner issues or using it to self medicate, not initially anyway, I just have an addictive personality, loved the taste of whiskey and how it made me feel, got hooked on it and then eventually become dependant on it.
That dependency has been removed, but if I started drinking it again, because of my addictive personality and the fact I like the taste of it, I’d soon be hooked again. Today, I’m hooked on my home-made herbal teas ha ha which I swear are one of the major factors behind my liver remodelling itself and healing to the point my doctors now state moderate fibrosis, down from 22.2kpa to 9 and an extreme fatty liver of over 360 cap score to 144. I’m hoping that’s went down further when I next have tests in July as those results are from December.
You too can reverse whatever damage you have done and fully because you’re not at the fibrosis stage yet based on your kpa score, but if you keep drinking and to excess you soon will be, so take care and good luck.
Thank you again. Everything you say is so true. I have my boys on screensaver and cry every time I look. Cannot believe I have got myself in this mess when nothing was ever wrong in my life bar one of my boys moving to Australia. He s done the best thing. Keep safe and happy. I pray I will be like that soon xxxx
Honestly, you can see this now as a positive, I was crying out for help with my drinking and thought about how great it would be to finally be sober, but I’d always kid myself that although I have a problem, I can control it and even when I started turning yellow and my health deteriorated massively I thought to myself, ah I’ll be OK eventually, and then something clicked in me and said no this isn’t right or good and that if you don’t seek help ASAP you will die, my mind and body was telling me.
I’m kind of grateful I started to turn yellow and ended up bed ridden and in hospital because it forced me to take my health and my drinking seriously for once and as a result I’m now pretty clued up about liver disease, alcoholism and my own health and what it now takes to live a healthy life and to take good care of my health which is the most precious resource available to all of us.
I’ve had money, flash cars, nice watches, great holidays, own my own business and home, but despite all that I was poor without my health and now I’m the richest person alive without needing any material objects or all that bull shit which no-one needs really and it’s all because I now have my health and I get to hopefully enjoy my life with my wife and kids a relatively healthy person. That’s priceless, you can’t buy that!
And the beauty of being healthy is the happiness it brings to not just yourself, but everyone around you. I’m the happiest I’ve ever been in my life and mentally the strongest I’ve ever been, nothing bothers me now, I could be made homeless tomorrow and I’d still feel like I’m winning at life because I have everything I ever need in life, my health, my happiness and my amazing wife and kids, honestly I’m rich rich rich because of that and because I’ve come back from the brink of death and losing everything I’m so much more resilient now.
It gives you a whole new perspective on life and especially yourself. I also appreciate massively how fortunate I am and how had I carried on drinking even though I was spewing it all back up towards the end, I still put bottle to mouth, I’d be 6 feet under right now with my wife and boys having to visit my graveside. There is also the shame which don’t let anyone tell you to ignore or think isn’t important, because it’s good to feel shame, it’s good to be embarrassed and it’s good to feel angry and upset with yourself, because you’ll need that to pull through, it’s an inner human trait, but you can’t let it sink you further or allow others to guilt trip you.
I used it as a motivation tool, I was embarrassed at how skinny I’d become, how deathly I looked, I was ashamed of hiding bottles of half empty whiskey from my wife, I was ashamed I likely took my kids to school and went to work still pissed. I have vowed to myself and those important to me they will never ever ever see that me again because that person is now dead, and that’s just many many tools I use to stay sober and to stay healthy, physically and mentally.
Think of your own health scare as a wake up call, your life starts now and think of how you’d like to live your new life and what matters most in your life. Strip it all down and happiness and good health is the key and you can’t have one without the other IMO, but you can most definitely have both and that should be your aim from this day on!
Thank you. Your words help a lot. Fingers crossed I will feel the same as you. Glad you are so happy now. You deserve it for sure xxx
I think more than 67 percent of your liver is affected by fatty change
So can this recover ? I am so worried and still can’t believe I drank so much . I keep asking I know and have had responses but my mental head is driving me crazy x
BritishLiverTrust12ModeratorBritish Liver Trust
Hi Curryblue,
We are very sorry you are finding things difficult at the moment.
If you are in the UK and would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays).
You may also find it useful to look at the information on our website. Here is the link to our page on mental health: britishlivertrust.org.uk/in...
Here is the link to our page on alcohol related liver disease: britishlivertrust.org.uk/in...
All the best,
British Liver Trust
i think you are panicking get some help with'your nerves and stress
