Advice needed on further testing

[Nbgns86]

Hi, everyone. I hope someone might help with the advice.

I'm 38M and I have symptoms of liver disease since November that include RUQ pain (was more prominent in November and December), red palms, Terry's nails, spontaneous unexplained bruising, intermittent yellow stools and floating most of the time. I lost 6 kg since November from 67 to 61 kg but I tried to do intermittent fasting and get rid of sugar and sweets.

My main risk was MDMA abuse for few years which I stopped in early September.

I had one instance of elevated bilirubin in November at 21.78 just above normal but later in 3 or 4 subsequent bloodwork it varied between 13 and 18 the latest. ALT is normal varying between 16 and 25. GGT normal varying between 11 and 15. My iron is slightly elevated at 29.3 and cholesterol is elevated at 5.6. Ferritin was 265 on the upper side of normal.

Ultrasound was normal in November but Fibroscan in November showed 261 CAP and 3.9 kPa. My hepatologist said this is not fatty liver although CAP score shows it is.

I'm terribly anxious, SSRIs helped a bit but due to my symptoms and lack of help from the healthcare system, it's getting worse and worse.

Can anyone advise if I should request biopsy? What other options I have? If MDMA caused liver necrosis is there any other way apart from biopsy to detect it?

[BritishLiverTrust11 Moderator]

Hello

If you [are in the UK and] would find it useful to talk things over, our nurse-led helpline is open Monday 9am to 3pm and Tuesday to Friday 9am to 4pm on 0800 652 7330 excluding bank holidays.

Best wishes

British Liver Trust

[0range5520]

Hello,

From my experience it is very difficult to get a biopsy and consultants seem reluctant. I think you would find it near on impossible to have one just by a request but it wouldn’t do any harm mentioning. If they have made a diagnosis by others means they don’t seem to want to confirm with biopsy. Partly the risk and maybe partly with situation of the NHS. I don’t know what’s available privately.