Fatty liver- what to do?

[Hellokitty12345]

Hello, I am in remission from endometrial cancer (diagnoses 2018) and had a recent ultrasound via my regular oncology follow up which uncovered ‘mild to moderate fatty liver infiltration’. Liver was not being looked at in particular, it was just noticed. I had a letter from oncologist copied to gp asking him to monitor this. I’m wondering what that might look like? Ought I be worried? I’m not overweight, I drink socially, well I did but I’ve cut it out totally now for the month since being told I have a fatty liver. Should I see if gp thinks I need more tests or leave it for now? Feel I’ve had enough medical stuff with the cancer, but I admit I’m concerned. Thank you x

[nash2 Partner]

Well Kitty, congrats on being in remission. That's a big deal. It makes sense to pay attention to what the doc said but it isn't time to be afraid. Since you are not overweight, you do want to understand what is happening. A lot of things can affect the liver and your history has probably been complex so ultimately finding out your real status is a good idea. The first health question you should seek to answer is if your liver is being scarred by inflammation as a result of what you have been through. The easiest next step would be to have a FibroScan which will give you more information about both your fat content and liver stiffness or fibrosis. From there you can work with your doc to decide if you can be less concerned or might need additional testing. Don't be afraid right now but also don't just ignore the question. Good luck

Wayne

[Hellokitty12345 in reply to nash2]

Hi nash2 thank you for your kind reply. I’ve booked blood tests for Mon so we’ll see what they say. I won’t lie I’m quite anxious.

[nash2 Partner in reply to Hellokitty12345]

It can be scary so don't feel bad about the emotion. Probably not the first time you've been afraid. It may not be comforting but liver disease is usually a slow process you aren't helpless. One thing to be aware of, liver enzymes in blood tests can be normal even with a progressive problem. It is a proper place to start but may not tell you much about the fat in the liver. It is good if they are low but since you have a diagnosis what you want to know is if it is fatty liver (NAFLD) or steatohepatitis (NASH). Lots of information here if you want to dig into it.

fattyliverfoundation.org/ba...

Wayne

[Hellokitty12345 in reply to nash2]

Thank you, I’ve been reading the info and have cut out sugar as far as possible, still no alcohol and started coffee. Going to gp in the week to see if I should have a fibroscan- doctor I saw after ultrasound and bloods didn’t mention it but then again didn’t even ask if I drink nor suggest any dietary changes or any follow up at all, just said it’s only mild/moderate fatty liver so it’s not a problem... I felt uneasy about this attitude hence my own lifestyle changes and making an appointment for next week. No one least of all me thought I had cancer last year but I did so I’m going to push for at least a follow up lft test.

[7baes in reply to Hellokitty12345]

I hope the tests went well. Quitting drinking and sugar will help. I had cancer years ago too and think the meds may have damaged my liver. And then I gained weight and now years later, the fatty liver diagnosis. Try not to see this as what now but a warning before it got out of control. Recently, I had a lipoma (not cancer) with adhesions removed and feel better. I would not have known about the fatty liver if I did not have the lipoma so I am glad. My problem is the hidden sugar. Its in so many things. Peanut butter, pasta sauce, and high fructose corn syrup was in my sugar "free" coffee creamer. I gave up all grains and sugar and am down 8 lbs. Have been adding some grains back in, like oatmeal, oatnut bread (1 slice) and whole wheat pasta. But just sparingly for now.

[Hellokitty12345 in reply to 7baes]

Thank you 7baes- I had my blood test results pretty quickly -the AST ALT and ALP were raised but not massively at 48, 65 and 135, GGT albumin and bilirubin normal. As were the other general blood tests. However cholesterol also raised. I was panicked as I had been told i have a mild- moderately fatty liver prior to these tests. I saw gp who just said don’t worry yeah your liver is fatty and your numbers are raised- she was more concerned about the cholesterol- and to come back in 2 months and we’ll test the blood again. I’ve got myself a fit bit and am now walking a brisk hour to and from work plus more at weekends, also started taking Benecol drink things and eating oats and other assorted apparently cholesterol lowering things- cut out as much carb and saturated fat as I can although I was pretty healthy before really, and obv no alcohol... but I’m worried- I was told last year there was virtually zero chance I’d have the particular cancer I had because of my age, no risk factors etc and I did, so I’m anxious now. No mention of any other tests being needed. I’m so fed up and can’t face any more bad news.

[7baes in reply to Hellokitty12345]

I know how you feel. You can fix this, remember? The exercise is great! Good for you! I got a fitbit too but still have a hard time getting more than 6000 steps. I do 3 min of cardio every other day though. These are improvements for me though. Good luck.

[Hellokitty12345 in reply to 7baes]

Thank you- your cardio sounds good- have your numbers got better do you mind me asking?

[7baes in reply to Hellokitty12345]

I will let you know. I will have a followup appt soon.

[Hellokitty12345 in reply to 7baes]

Do let me know- wishing you all the best. I’m wondering if I need any more tests other than follow up bloods- Gp seemed so relaxed but I can’t believe a ‘mild to moderate’ fatty liver seen on ultrasound then raised bloods is perfectly ok. I had a total hysterectomy ages 46 as part of my cancer treatment last year and I’ve read that it increases risk of fatty liver- not sure why poss hormones? Gp said it was NAFLD and bizarrely asked nothing about alcohol intake nor said I should cut it out- which I did anyway when I had scan results over a month ago. I had been a social drinker - Poss a bit more than wise amounts but nothing dramatic. I’m wondering therefore if alcohol has played a part. Although GGT was normal so I’m

Confused

[Hellokitty12345 in reply to 7baes]

Hi 7baes how are you doing? Wonder if you have had your follow up yet? I went back to gp to see if I need any more tests and they said it’s fine and can be left- not quite clear as ultrasound showed mild-moderate fatty liver and my bloods were up but not dramatically. So no fibroscan or follow up bloods... wonder if that sounds right?

[7baes in reply to Hellokitty12345]

Hi Hellokitty! I don't need the follow up appointment until feb. So that's good. I think the holidays will be hard. I am modifying cookie recipes so I can enjoy them without gaining all the weight back! I am glad you are doing well and your blood tests are ok. I had a hysterectomy also but still have ovaries, did not know about the connection. I have to keep working on the weight and blood tests will be in feb. I have no idea what is right! It is crazy right!?

[Hellokitty12345 in reply to 7baes]

Hi! Yes it’s so confusing- I’m seeing gp this week to see if I need any follow up and when or if I need bloods again. Go who I saw about ultrasound and raised bloods before was not at all worried but I had the ultrasound because I’d been feeling so ill so I think I ought to at least have a blood test to see if the numbers have normalised. It’s so dull the diet I’m doing, no fun at all! Made a cake earlier and made do with inhaling the fudge sauce 😆

[7baes in reply to Hellokitty12345]

Hi Hellokitty how are you? I am doing great. I lost 10 lbs so far and my liver enzyme tests are normal. My triglicerides and cholesterol are still high though. I am on ezitimimbe or zetia now. The other cholesterol meds caused muscle pain. I am still trying to lose more weight and get the triglicerides under control.