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worrysome ELF score

mathkid profile image
16 Replies

Hi everyone

I’m new to this site. I just wanted to share my story. I was diagnosed last year with MASH ( formally known as NASH). I have just had a ELF test showing 9.81 ( 17/12/24) which has gone up from 9.23 in April 2024. Should I be worried as it is below the 10.5 level for cirrhosis. Have not been eating that well and back in candy and fast food. Guess that if I want to bring the ELF score down again to normal level of <7.7 ( is this possible to do?) is too cut out the junk and loose weight. Fallen off the bandwagon since the summer when I was exercising and trying to eat more healthier. Is it too late for me to turn things around? Not a heavy drinker only social drinker. I’m not sure of the extent of fat in the liver as recent fibroscan was inconclusive as did not get a reading but had ltrasound which showed liver was “ lumpy”😢. Again should I be scared? The consultant said there was a wide amount of varience in the results for some reason. My Triglycerides are in the bloods is 1 ( well in the normal range. I have not got diabetes. All my bloods are showing normal ranges LDL etc ok. Wonder why I have got fibrosis ( genetic? Due to fat in liver- lifestyle? Can anyone give me any reassurance. Perhaps should start the new year improving my excercise routine and eating properly.

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16 Replies
AyrshireK profile image
AyrshireK

Your liver needs some tender loving care - if you already had a diagnosis of MASH then you really should be giving your liver the care it needs and that does mean watching your diet, exercising more and really giving all alcohol a miss. The British Liver Trust has a downloadable leaflet on treating Non Alcohol Related Fatty Liver Disease which might be of use to you. Any amount of alcohol is like throwing petrol on a bonfire and that combined with a relapse into unhealthier ways is inevitably going to contribute to a worsening liver. As cirrhosis isn't yet indicated by the tests you've had then there is still time to try and turn this around which I urge you to do.

britishlivertrust.org.uk/in...

britishlivertrust.org.uk/do...

Best wishes with it,

Katie

mathkid profile image
mathkid in reply toAyrshireK

Thanks Katie so is reversal back to a normal liver quite possible with a) loosing more weight, b) stopping alcohol, c) eating more healthy and stopping eating sugar and candy? I feel quite well at the moment but have fallen off the bandwagon. Does drinking a lot of water also clean the liver out? I have passed the results to my liver consultant. Does fibrosis F3 level imply I have a fatty liver? It’s the fat together with inflammation that causes fibrosis in the first place. Could I get fibrosis score back to the normal level ie under 7.7? There is a drug in the USA that helps MASH which has just been passed in early 2023. What are the chances that this drug might be available to people in the U.K? A elf score < 10.5 is reassuring isn’t it? Best Paul

AyrshireK profile image
AyrshireK in reply tomathkid

F3 fibrosis is the step before cirrhosis (F4) so it is a little more than fatty liver in that your liver is showing signs of severe fibrosis. The good news is this is reversible - I can't guarantee it'll go back to absolutely normal but for sure if you don't tackle this soon it will get progressively worse.

Keeping hydrated is important - can't say it will necessary clean the liver out.

I don't know anything personally about MASH, ELF scores etc. Just have a lot of experience with cirrhosis and it is to be avoided at all costs.

Hopefully any medical research into potential medications to help is good news but I can't say when/if the one you've read about is available or due to be available.

Katie

mathkid profile image
mathkid in reply toAyrshireK

Interestingly FIB_4 measure was 1.1 which indicated that risk of severe fibrosis was minimal on the Ashok score 0-1 so not clear how my liver is with regards fibrosis! ELF might be more accurate as it is a blood test that will pick up liver enzymes but it is just over the standard range 7.7-9.8 for male. I have sent results to my liver consultant to give his expert opinion.

mathkid profile image
mathkid in reply tomathkid

Cirrhosis in the liver would be an ELF score of over 10.5 so as you say have to not get anywhere near this level diet, weight loss and hydration are required now.

mathkid profile image
mathkid in reply toAyrshireK

Hi I also wish to ask if anyone gets a strong musty/sweet smell in their nose- I don’t have it on my breath and have asked Porter if they can smell it? I don’t think it’s fector …the smell that people with end stage cirrhosis have? Is the bad smell in nose a symptom of NASH or liver struggling to do its job and not cleaning the blood properly hence the smell receptors are picking this up.

AyrshireK profile image
AyrshireK in reply tomathkid

I couldn't answer the question about a smell in your nose - I only experienced hubbies feator hepaticus when he was either dehydrated (when fasting for his many endoscopies) and when he was suffering badly with Hepatic Encephalopathy and in that case it was not only his breathe but through his skin - nurses at hospital thought he hadn't showered and the smell was still there even after I showered him myself.

Don't know about any smells with NASH.

Katie

Shloma profile image
Shloma

It's not a reason to be scared as it doesn't help. Most important to be on top of it. Do research apart of working with the doctors. If your scared might be worth contacting schycologist.

Important to check nutrition with a nutrition specialist to make sure that all are in good level & well balanced. They take a good toll on liver health & what causes liver issues. in some cases, if genetic or outside hand reach of environmental then can be harder to deal with. Be aware doctors will say what they are being taught is not always what reality is even if are following the guidelines. My experience, there is small list of causes. They used to blame alcohol which took many years till they started agreeing not every liver issue is alcohol. So they started claiming fats & sugar. Well, Thats not always the case. I have cut back on fats & sugar only to find cutting back to is also not good. Now I found new studies on the web of Bakers Heart & Diabetes (a well-known Australian medical research center) That 40% of Fatty Liver is DNA issue. DNA issue is usually not just DNA. From all health issues I have researched them my understanding is there a lot of information hidden. So, it's worth working with the doctors & the same other health alternative as nutritionist, Chiropractors & massages with deferent physio like gym exercise, Yoga & many more according to what you can afford

QuietButBold profile image
QuietButBold

Welcome.

Working towards changing healthy lifestyle habits and making healthier food choices is not really something I want to risk putting off until some future date. I am seizing the "here and now" (because breaking a harmful habit and fully establishing a better one, for me, is an iterative process of "do your best ...but just keep making it another step forwards better than your last effort" - which all takes some time to evolve, progress and get entrenched - as then my second-nature new habit of behaviour).

OK, my foot might slip off the most appropriate path every now and again - I am merely human. However, I try to notice that slip and then work out "of course, what you should have done was ...".

For my part, I am currently working with three self-imposed strategies:

1) Use a leak proof, lunch box and beverage bottle to always carry an appropriate snack and tap water with me - wherever I go (if someone is rude / nosey enough to quiz me or make a comment? - I just nod confidently and say "Allergy. It's boring, so, enough said!" - which I find usually swiftly moves people on from my business - and which is effectively true, as my liver has clearly been reacting badly to some ordinary food / drink items.

2) On my cell / mobile / smartphone, I keep a draft email to myself; with a list of food items or habits which I am trying to shift away from, then a prompt for their better alternatives and in brackets at the end of the line, a comment on why I succeeded or have more work to do. I can reference this list, to remind myself, e.g. in the supermarket / at a restaurant / at a friend's home / in my workplace. Here is an example of a line entry:

- Meeting a friend for lunch, often at a garden centre cafe; I used to order fried Fish and Chips / fries: now I should order a Chicken Caesar Salad (suggested to my friend we try changing our venue choice - to where they serve a range of salad options too = last time we met for lunch I got Chicken Caesar Salad = a tasty improvement).

3) At home on my laptop I maintain a spreadsheet meal plan / food consumed journal. On other tabs in the spreadsheet I augment when e.g. I have found a healthy Protein or low Carbohydrate item available from a particular supermarket. On other tabs I include prompt lists of: more suitable breakfast ideas, healthy portable snacks, hints to where I have a good recipe to share with my household or dishes to take to a relative's home, and a traffic light set of tabs "GREEN - lists of items to eat with little thought, AMBER - those about which be more mindful of ready-reckoner portion control / lower frequency, and RED - really should avoid and source a better ideas / or at least be extra-strict with the portion control PLUS balance out the detriment by being super-conscious of what else is ate that day".

I find these approaches can help boost my motivation - to do a better job of looking after my wellbeing- on a day of low mood (they happen, and do need this type of "autopilot" support).

If these three strategies ever sound way too arduous and nerdy ...I do try to remind myself:

...nobody else will likely ever love your liver as much as you do.

Good fortune; with your own personal: love-your-liver journey.

Bocellilover profile image
Bocellilover

Hello. You would benefit greatly from having no alcohol at all. Plus, a clean diet and exercise. Losing weight and refraining from alcohol should reverse your fatty liver.

You would need to begin this immediately as liver scarring can progressively get worse in a shorter amount of time than you think.

I am on no medications and don’t drink but yet I was diagnosed with liver disease. I have reversed some of the indications (liver enzymes) and I have lost 21 pounds. By no means am I heavy but I always was 95 to 115 pounds. Since a near fatal car accident, I gained weight from not being able to exercise.

My frame is small and the weight on me was too much for my liver to handle. I found out by losing 21 pounds (with more to go), that my liver enzymes returned to normal plus my cholesterol went down 22 points. I was amazed. My liver was not releasing the cholesterol it was making so my cholesterol went up for the last 2 years.

I am on the Mediterranean diet and I do measure all my foods. Since doing this, the weight has effortlessly come off. I have 30 more pounds to go but know I will reach that.

There is a new FDA drug that was introduced in March of 2024. I will go another 6 months on diet and exercise and see where I am at. If it is improved, I will continue without new meds. If it is the same or worse, I will go on the meds. With the meds you do have to eat a clean diet and exercise too. So I chose the 6 months without the meds to see how I do. I am positive as I already see changes.

My doctor said genetics also can play a role but now he feels that is probably not the case with me. But in 6 months we will surely know.

Once a person gets cirrhosis, they cannot go on this new drug. It will not help. So it is better to be proactive with your health and try to reverse prior to it getting worse.

Be very diligent with your eating and exercise. You can reverse it.

Good luck.

Sunnyskies33 profile image
Sunnyskies33 in reply toBocellilover

Hi! Are you referring to a weight loss drug or the fatty liver drug that has been successful in trials but not widely available?

mathkid profile image
mathkid in reply toSunnyskies33

yes

mathkid profile image
mathkid in reply toSunnyskies33

sorry yes the weight loss drug is called Mounjaro and the drug in the US is Rezdiffra ( not available in the U.K at the moment). In trials the Mounjaro drug has shown promise in Nash reduction. 😀

Sunnyskies33 profile image
Sunnyskies33 in reply tomathkid

Thank you.

Bocellilover profile image
Bocellilover in reply toSunnyskies33

Hi there. I am referring to the new drug that was successful in the trials. It was on the market in March 2024. The FDA fast-tracked it due to the successful results. This drug cannot be taken if your diagnosis is cirrhosis. But, I do know that there are many changes coming forth, per my doctor, and I am guessing that will change some too. I am waiting 6 months now to see if my diet and exercise will reverse my scarring. My doctor and my son (who is a doctor) feel this is best. Apparently, if you change your diet and exercise, it will have the same effect as the new drug (Rezdiffra). It will take a bit longer but it is feasible. I chose to wait 6 months. My doctor has stated that even if my Fibroscan shows a little bit of improvement, we know I am on the right track. Then I will not take the medication. If it is the same or worse, than I will go on the medication.

Sunnyskies33 profile image
Sunnyskies33 in reply toBocellilover

Thanks for the info. I had a kPa of 7.5 so a little scarring and early moderate fatty liver but doctor also hopeful that weight loss etc will reverse it. Blood tests good and have lost most extra weight. I am glad there are medications in the pipeline.

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