Hello! I was diagnosed with fatty liver over a year ago after an ultrasound following abnormally high LFTs.
Since then, I’ve lost 3 stone in weight, however my LFTs continue to rise which has been disheartening to say the least! A recent blood test also showed that my cholesterol is high and I think the GP is going to suggest statin treatment (I haven’t spoken to her to discuss these latest bloods - I’m under an endocrinologist and she appears to have written to him with her thoughts to get his opinion too). On reading up on the NHS website, it says that statins aren’t advised with liver disease or blood tests that show your liver isn’t functioning properly… my LFTs are 2/3 x normal - my Gamma GT is 5 x normal!
I will obviously discuss this with the GP when she contacts me, and take her advice, but I just wondered if there was anyone else who has NAFLD and been offered statins?
Hi, I was told I needed staying but also was worried. My doctor put me in ezemtime. It did bring my cholesterol down, along with trying to lose weight and walk more. Apart from my alt still being high all others were ok. Until April last year where quite a lot of my liver results were high. I was referred to gastro , saw the consultant in October. I had stopped the ezemtime in sept and it was making me nauseous. He also asked if the doc would change my BP medication. I have since stopped the BP medication and now waiting to see the consultant again in April to see if results have come down . If you do go on the. , make sure your doctors do blood test every 3 months. That's what mine did
Thank you for sharing your story, it’s so great to hear others stories and experiences.
I keep trying to get a referral but I keep being told I don’t meet the threshold for a fibroscan or referral and just to check my bloods again in 12 months… I’m not happy with this so I’m hoping when I speak to the GP re my statins I can get a better plan of action - it’s been 2 years since my LFTs were first abnormal, although they settled on repeating them, but for the last 12 months they’ve been high and increasing.
Good luck with your consultant in April and hoping you get some good news and improvement in the blood results.
I was just 38 when my nafld and high cholesterol was found. I’ve been taking atorvastatin ever since (56 now). My ALT is still double what it should be and my Gamma GTA is currently around 5 but it has been has high as 40 something. I’m also on ramipril. Heart and High cholesterol issues runs in my family, so I was always monitored. I also have bile acid malabsorption which causes me bowel issues.
Thank you for sharing your story. I’m 33 and with no family history of liver or high cholesterol problems but I have a chronic condition which makes me more prone - hence why I’m under an endocrinologist- but he hasn’t been much help just recheck bloods in 12 months which isn’t really reassuring when my LFTs were first abnormal 2 years ago and continuing to rise! My Gamma is 190 and should be under 40, and my others are 2/3 times at least the highest normal range. My Bilirubin is 35 and should be under 21.
Thank you again for sharing. I’ve just discovered this forum and found so much useful information and it’s great to know I’m not alone with this.
Hi Nicki-Lou33, this type of to-start-statin / not-to-start-statin consideration is something I discussed with my Hepatology Dr just recently (as, depending upon which GP I see in my Practice about unrelated matters - I receive confusingly polar opposites of mixed messages re: should I / not start statins).
Hep. Dr explained two things which might be the source of that combined GPs' mixed messages:
1) very much a case by case matter - taking into account family history, the patient's other conditions and what the Hep. Dr assessment might infer, and
2) whereas the "10%" NICE rule before statins were recommended by GPs had been the cutoff for years (a patient's score for risk profile calculation for potentially developing cardiovascular disease or stroke); within the last couple of years the NICE guidance had been updated to give GPs further flexibility to suggest statins to some of their patients who fell below the 10% risk probability score - but for whom family history / other patient conditions might give a GP pause for additional consideration about the potential benefit for starting statins a bit earlier instead of awaiting the patient meeting that 10% threshold. I found a NICE article which matched the scenario my Hep. Dr was warning me about (some GPs might become more enthusiastic than others):
My Hep. Dr summarised, in my particular case, what on balance they felt about yes / no to statins - were a GP to pressure the point with me.
Personally (and it needs to be each to their own I feel) I am inclined to keep that Hep. Dr conversation in mind, my understanding of my Fibroscan results, my other underlying health conditions and my family history - rather than just accept a GP's interpretation.
In my case, in my personal risk profile, I was most grateful to have discussed it with a Hep. Dr in addition to a GP. As I have only had one recent Fibroscan; I feel that I want to apply the guidance on diet and lifestyle from the Hep. Dr and attend my follow up monitoring appointment with the Hep. Clinic to learn what improvement / plateau of liver health occurs - before I am keen to add statins into the mix (as I have a track record of adverse response to a range of medications - often involving both an over active immune system and gastrointestinal objections!). But that is just my body and risk profile being considered.
I have noticed, around the different Health Trusts of the UK you can sometimes see the local Trust's decision tree diagram / guidance to GPs re: implementation of NICE Hepatology pathway guidance for referral for their patients can be slightly nuanced / differently worded. This might be the clue as to why some of us get referred to Hepatology Clinics by our GPs while others hear the "you don't meet the criteria" in apparently very similar circumstances.
I have been genuinely surprised, when it comes to liver disease in particular, how restricted the GP Practice grasp on the topic and process of testing and what happens at Hepatology Clinic - when compared with other areas of medicine.
Maybe a chat with the British Liver Trust Helpline might help you judge how hard / or not / on which parameter-based lobbying with your GP you might choose to re-open the dialogue with your GP about potential referral to Hepatology?
I know I was also glad to read through the British Liver Trust Patient Charter (to help me gain an improved understanding of what I might reasonably expect would be "usual"):
Thank you so much for your detailed reply. It makes a lot of sense. I will obviously discuss with my GP but my thoughts are leaning to holding off statin treatment mainly due to the fact that I’ve only had one ultrasound a year ago which shows fatty infiltration, and my LFTs are continuing to rise but I keep being told no further action/no referral, so I’d be reluctant to add any further stress to my liver if I don’t have to… however saying that I am also a little reluctant to just sit back and carry on doing nothing - I’ve lost 3 stone steadily and consistently over the last year and it’s made no difference yet I just get told keep losing weight it will help! I’m not due further bloods for another 12 months but I’m going to ask when I speak to the GP re cholesterol and push for a better plan of action.
My understanding is that statins are considered relatively safe for people with cirrhosis. I had a discussion with my GP a couple of months ago when he wanted me to start taking them.
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Statins and the Liver
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NAFLD & cirrhosis
