No one on this forum can diagnose you. Here is the link to information on our website explaining liver disease tests, diagnosis, and screening, which you may find useful
The current national guidelines from NICE and the British Society of Gastroenterology (BSG) highlight the need for an assessment for advanced liver fibrosis in people with non-alcoholic fatty liver disease (NAFLD). The recommendation is a blood test called either Fib-4 or ELF (Enhanced Liver Fibrosis). If these results are high, then further investigation and/or referral to a specialist is required.
If you are still concerned and 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)
Hi, you've had a great response from the BLT moderator, but no, a liver function test does not diagnose liver damage. It is one of a number of diagnostic tests that would likely be done, including a number of scans.
My husbands diagnosis took several blood tests, an ultrasound, an MRI scan, a CT scan with contrast, a gastroscopy, an echocardiogram and a fibroscan. By the time the results of all of those came back, he had stopped drinking and his liver function tests were broadly normal with the exception of slightly elevated bilirubin which was also far lower than it was previously.
Basically yes. Your LFT readings can be ok but you can still have scarring. I didn’t realise that until I had my latest fibroscan. I did have an ELF and fib-4 test which indicated fibrosis so had the scan to check. I’m 56 and my fatty liver was found when I was 38. I’ve had regular bloods and ultrasounds over the years and was surprised it had changed. Nothing to do with alcohol as I’ve never drank but I have lots of other conditions and medications.
Well fingers crossed there isn't any scarring, and reading your reply to another member, an ultrasound doesn't necessarily pick up any scarring, you need a fibroscan for that. With liver issues I was told you should have an ultrasound every few years and a fibroscan every 5 years. I had a fibroscan one right at the start of finding issues, and then there was about a 14 year gap. So don't know how long I've had fibrosis for, but it's F3. After your Fib-4 (and hopefully ELF) test, you'll have a fibroscan and see where you go from there. Good luck
A large majority of the members on this forum have drank too much. You have the ability now to prevent further damage. Try not to focus on blood test numbers, the clinicians are the experts; not us or Doctor Google. When I was first diagnosed I wanted to know and understand everything but soon realised that my blood tests vary wildly. We don't have the expertise to understand the bigger picture. Liver Trust and NHS website are more than adequate for information and support.
One reason liver damage is often not picked up until it is quite advanced is because it can build up without having much (or any) effect on the blood results. As I understand it, you would typically need an ultrasound to pick up fatty liver and a fibroscan (special type of ultrasound) to pick up fibrosis. Fibrosis can be calculated using various formulae which refer to blood results but which include things like platelet count and other readings you would not necessarily associate with the liver. And in any case the calculations are only an estimate and the scans would confirm.
I was under the impression that an ultrasound would also pick up scarring. I specifically remember back in 2018 the radiologist saying “you’ve no scarring, you have a fatty liver”
Surely using an element of 2+2, you’d naturally think that if you have scarring, by default your liver would suffer to work so would show on an LFT?
Your ALT and GGT are inflammation markers and form only part of a full set of liver function tests.
Liver bloods reveal various things.
(1) is the liver inflamed at present and suffering ongoing damage? If so it gives off markers to reveal that it is under attack. Inflammation markers like ALT, AST, GGT.
(2) is the liver working ok and doing it's various jobs? - things like the markers for bilirubin, creatine, sodium, albumin would reveal whether the liver is performing it's 500 tasks including:- Filtering out dangerous chemicals, Breaking down the food you eat, Building proteins that keep your body in good repair, Creating immune system factors that can fight against infection, Creating proteins responsible for blood clotting, Breaking down old and damaged red blood cells, Storing extra blood sugar as glycogen, Producing bile, a fluid that helps the body digest food, Metabolizing proteins, carbohydrates and fats so your body can use them, Producing substances to help blood clot.
(3) You can have full on cirrhosis with no ongoing inflammation therefore the inflammation markers can be normal even in fibrosis/cirrhosis.
A compensated liver may be functioning not too badly so the other markers may also be in a decent range. The liver may be doing the most important of it's 500 jobs so bloods may still be ok here.
When it comes to the liver actually struggling then you'd might expect to see those other things like bilirubin, albumin etc. going out of range (becoming deranged) because the liver just isn't working properly to regulate hormones, proteins etc. etc. & you might then expect to see symptoms occuring and often the ones at the more serious end of the scale.
Inflammation markers alone don't reveal what is actually happening in the liver other than revealing presence of inflammation which is why any liver diagnosis requires a jigsaw puzzle of tests to get the full picture.
Crikey that is one comprehensive response and I thank you for that. It just goes to show the complexities of the liver and what is expected of it when under diagnosis.
I’ve gone through the past 6yrs keeping a constant tab on my LFT’s and making sure they haven’t got too high. They’re going in the right direction and have improved further since last years. Not where they need to be but have improved.
I’m not I’ll but since 2018 have had a niggle on the right side. Not pain. Just a sensation of something under the skin is going off.
I’ve spoken with the doctors and have seen a hepatologist. Had 3 ultrasounds an MRI and a CT as recent as December 23. Nobody until this week has mentioned fibrosis if which has now opened up yet more uncertainty. To know something in side of you is not well yet you can’t see it nor does it tell you with acute symptoms is pretty scary.
To be honest, I’m getting truly worn out with it all. The energy this is sapping from me is totally bruising.
The 10th of June is DDay for me then when I have my FIB bloods done. Just hope my ignorance to the whole subject hasn’t gone too far.
hope this helps. May 23 I had a fibroscan it tests liver stiffness/scarring of my liver. I am in no way a medical professional! The scale runs from 2-14kpa(some scales are a little different) 75 being the highest possible score possible. Mine was 75… so basically as scarred as possible I imagine. Now I need a mri and liver biopsy. I’m just telling you the fibroscan was completely painless and took not even 5 minutes so perhaps ask your dr about this. I wish you well and best wishes.
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