NAFLD with Liver Pain

Male, 30yo, 5'10", 165 lbs.

A few years ago, I was diagnosed with "most likely" NAFLD after blood tests showed a slightly higher than normal ALT level (~100) and some markers in a FibroSure test (no fibrosis but 0.44 necroinflammatory activity score, putting me in the middle of minimum and moderate activity) and ultrasound test showing fatty deposits concluded with "hepatic steatosis". All other tests (hepatitis, hemochromatosis, pancreas, gallbladder, kidneys, etc) were normal.

The doctor was hesitant to say for sure because I don't fit in any high risk categories (healthy weight, ok diet, barely drink alcohol, not terribly sedentary lifestyle, etc) but the doctor still wanted to monitor it with a gastroenterologist, along with getting more exercise and even better diet.

Throughout these few years, I did have vague dull pain in my upper right quadrant that would come and go randomly or after a seldom night out where I had a drink or two (never too much, though).

A few years and a few blood tests went by and my ALT did not rise or fall significantly. Then, my last blood test in mid 2020 suddenly showed everything within perfectly normal range. I did take up biking every day which may have helped.

Fast forward to a few months ago and I wanted to really focus on my health. I started having solely Mediterranean diet with lots of coffee and green tea, never alcohol and exercising heavily everyday, weights and cardio.

I am writing today because ever since I started the strict diet and working out heavily, my upper right quadrant dull, vague pain is much more constant, almost all the time. The pain definitely doesn’t feel muscular. I don’t have any other symptoms of liver problems (stool normal, no jaundice, I do have fatigue sometimes but never overbearing and I chalked it up to the workouts).

I am scheduling another blood test soon to check my levels and I will bring this up with the doctor. In the meantime, I wanted to hear from others. My questions are:

What can this pain be a sign of?

I've read and have been told conflicting info that NAFLD has no symptoms or pain is only felt if it's at a more advanced stage of liver damage. What is right?

Would NAFLD liver area pain come from working out i.e. from putting pressure on it from exercises like ab crunches?

Is this a sign of my liver being affected (good or bad)?

From anyone similar to me who has beaten NAFLD with diet and exercise, how long did it take for the liver to heal 100%?

Thanks for your time.

[confused71]

It took about 9 months for my pain to go ---recently i started bad habits with food again so in my case i knew my liver was probably inflamed so i have started back on my healthy diet and the pain has gone

[PhoenixRisin]

I am fairly similar - (except that I am 5'2" 170) - elevated enzymes - but little to no scarring. I have had a fairly significant amount of pain in my upper right quadrant. I was working out (lifting, rowing, and bodyweight exercises) every day. I eat a Mediterranean diet and don't drink. However, the pain was so bad that it was waking me up. I stopped lifting and doing crunches etc and it has subsided. I asked my doctor if those things could have been hurting my liver and he said it is VERY unlikely. His conjecture was that since I am worried about my liver, I must have been subconsciously compensating and in fact tweaking the muscles. It didn't feel muscular to me...but it is interesting that since I have stopped lifting/crunching it has gone away. The rowing machine never bothered it. Bottom line - I have no idea what it is. You may want to stop crunches and see what happens. 🤷‍♀️ Good luck!

[LindaC]

Might you have a gallstone? That is where my pain is and it has been confirmed.