Am I crazy??

[chelley69]

In June I went for a physical and was called a few days later letting me know that my ALT and AST were high and they wanted to do an ultrasound. My AST is four points over the upper limit of normal and my ALT wouldn't even be considered high had the lab not lowered their parameters by more than half. I suggested checking the bloodwork again at my appointment in December and proceeding with the ultrasound if they're still elevated, as I have no other symptoms of a liver issue. I'm 51, on a statin and diagnosed four years ago with NAFLD, after an ultrasound on my gallbladder showed it. Their office has called me two more times, since the call in June, wanting to schedule the ultrasound. Now I'm wondering if there's something seriously wrong with me. Am I crazy for wanting to recheck the bloodwork before moving forward with more testing??

[nash2 Partner]

The ALT AST tests are marginal tools for diagnosing early stage liver disease so they are a flag the suggests additional tests may be appropriate. You might take a look at the FIB-4 calculator which can be useful for deciding next steps

fattyliverfoundation.org/no...

[chelley69 in reply to nash2]

Thank you so much for your response. I’ll check out the calculator. I just wish I could get some sort of peace before my appointment on the 17th. I’ve scared myself and self diagnosed myself with everything because I can’t stop googling it.

[chelley69 in reply to chelley69]

So, my FIB-4 score is 1.18. I’m guessing that’s good?

[nash2 Partner in reply to chelley69]

Yes, not a diagnosis but a low probability of scarring. For most people liver fat is completely reversible

[LillyLiver1]

Hello Chelley69

I’m a bit confused! You’ve been offered a health check?! For free, is it? If so, why hesitate? It seems that your doctor is very proactive, which is great. So if you’ve been offered an ultrasound then go and have it! I’m left wondering if you are a bit worried about the outcome and would rather not know? Is there something concerning you perhaps? Knowledge is power so if you go for the ultrasound and all is well, then fantastic! If you go and you still have NAFLD then you will be empowered to take action to resolve/manage the condition to the best of your ability.

Good luck!

Lily

[Ednoral in reply to LillyLiver1]

Go for a fibro scan. I'm getting one done as soon as the covid hysteria is under control.

[chelley69 in reply to LillyLiver1]

Thanks for your response, Lily. No, it isn't free. I'm in the US, where healthcare is quite expensive ( my husband and I pay close to $800 monthly for health insurance, and we have to pay $3000 out of pocket up front before anything is covered.) If something is wrong, I definitely want to know, but at the same time I don't want to do an unnecessary test. When I went last September my ALT was 63 and was considered normal. At the June visit it was 65, which is now considered high because "normal" dropped from 78 down to 32. My big issue is that if the parameters hadn't changed I don't think I would've ever gotten the first phone call. I'm also concerned that it may be about the money, since everyone is hurting from the pandemic. I actually got an email the day after the last phone call from the group my doctor works for, asking if I would like to make a monetary donation to my physician during these "trying times". I have my next appointment the 17th of this month, and if things are still high, I will most definitely be moving forward with the ultrasound.

[LillyLiver1 in reply to chelley69]

Wow, valuable context there, thank you. Yes, it’s so difficult to know what is the best thing to do when the rules change. I can see your dilemma. I doubt if 2 weeks will make a huge difference so your plan sounds sensible and balanced in my amateurish opinion. And I’m sure you’re doing all in your power to be kind to your liver in the meantime. Take good care and stay safe. Lily

[chelley69 in reply to LillyLiver1]

Thank you so much! I’m trying my best to do what I need to in order to make sure those enzymes are down. Take care.🙂

[BonArr in reply to chelley69]

A DONATION? Wow! I do know some medical personnel have lost jobs, gotten back, got hours cut, etc due to COVID-19 if they are not in the actual care of it. That's pretty ballsy on the Dr.s part as much as we in the US already pay out of pocket. But if you see your Dr.s staff begging on Street corners with a cardboard sign maybe you could drop some change in the bucket. Lol.

[chelley69 in reply to BonArr]

There’s actually a billboard on the side of the interstate where Covenant Health is thanking people for their donations. I saw it this past Saturday.

[Alterity]

Forget the blood work and take the ultra sound or even a MRI to be safe. My blood work says I'm fine and I'm in stage 4. I'd rather be safe then sorry. Why not do the Ultra sound. It doesn't hurt. Biopsies hurt and hopefully you never have to have one. Listen to your Dr. 1in4 people have developed Nash.

[chelley69 in reply to Alterity]

Thanks for your response. I have to have bloodwork every six months anyway, due to the statin I take. If you don't mind me asking, were you having any other symptoms? If not, how did they diagnose you?

[Alterity in reply to chelley69]

I had no symptoms in 2001. I was going in for gastric by pass surgery. They took test after test. All my blood work was normal. I didn't realize in 1985 when they took out my gallbladder that I had fatty liver, no one told me until years later I read the reports. Fatty liver didn't mean anything in 1985. When they opened me up for Gastric By Pass they aborted the surgery, said it was the worst liver they had ever seen. This Dr sees many fat people as all he does is gastric by pass. They said I would of died on the table if they continued. I had no idea, no symptoms. I weighed 283 pounds. Now I know the signs and know what to watch for after 20 years of living with Nash. In 2018 I was told I was going into stage 4, they talked to me about the living liver. I weighed 250 then. My blood work shows slight elevation sometimes, not always, it's like a yo yo. I know can tell when my liver is not working properly and yes Stress has a big part of it. Exhaustion, flu like systems, sometimes stabling pain, swelling in the stomach, or legs. My liver can't handle statins, so be careful the Statins could be causing the liver problem. Your liver runs your total body. I have decided there must be sections of it that rule different parts because it doesn't affect every part of my body all the time, but I tell the drs. when it hits what I call a dead cell, like a car battery. My liver is why I have heart problems. My heart dr. now calls me his NASH patient. Please listen to your dr. and get the ultra sound. NASH is a silent killer. It now affects 1 out of every 4 people. If you don't know you have it, you don't know how to protect your liver and it will kill you. I listen to my liver, I sleep and rest when it has digestive problems because you will be exhausted. I don't eat red meat unless I'm under no stress and then only once a month if that. It might not be NASH I'd rather be safe than sorry. Good Luck

[chelley69 in reply to Alterity]

How scary! I'm so glad you've learned to recognize when it isn't functioning properly, and I hope you're doing well now. I have so many questions I'm jotting down for my discussion with my doctor on the 17th. Thank you so much for your response to my question and sharing your story with me.

[Imagistics300]

No wouldn't hurt