Elevated tests

[Asherleymoco]

Hi all.

Hope you’re all okay and staying safe.

I’ve had 5 blood tests in 5 months which have all show elevated serum ALT. I have previously been diagnosed in June with NAFLD.

I had an ultrasound scan yesterday and it’s come back completely normal with no fatty liver.

Has anyone else had this happen and is there ever any other explanation for serum ALT increasing?

Thank you all

[nash2 Partner]

Hi Ashleyultrasound is not a reliable test for NAFLD. It depends on how bright the operator thinks the image is. Elevated ALT means something is causing distress in your liver and that can be a variety of things so I suggest that you get a second opinion and you need something more sophisticated like a FibroScan or LIVERFASt test to get a more specific understanding of what is going on. Fibroscan requires an office visit but if you want to get a blood test yourself you can. Here is some info about that.

fattyliverfoundation.org/li...

Wayne

[Asherleymoco in reply to nash2]

Hi nash2 thank you very much. How would I go about getting these tests - is it something a doctor can refer?

[nash2 Partner in reply to Asherleymoco]

A doctor has to order them in either case. You can do a google search for a doc who has a FibroScan in your area and seek a referral or you can do the blood test through a telemedicine call. If you fill out the request form online a doctor will get back to you to discuss the tests and next steps.

[Asherleymoco in reply to nash2]

Thanks Wayne. The link keeps coming up bad gateway. I will look online at the fibroscan

[nash2 Partner in reply to Asherleymoco]

I think they are changing browser flow again. If you go to our site and look under noninvasive tests you can get it there.

[Asherleymoco in reply to nash2]

It comes up the page you were looking for was not found

[nash2 Partner in reply to Asherleymoco]

can you go to our website in a different browser fattyliverfoundation.org

[nash2 Partner in reply to nash2]

I'll have to discuss this with the software people. What they are doing is linking to http rather than the secure version which is https and the browser thinks it is not secure.

Don't know if that makes sense but you should be able to get to our site directly.

[Asherleymoco in reply to nash2]

Yes I have got it now! But the web I’ve won’t load

[nash2 Partner in reply to Asherleymoco]

Well, my system is broken too. Something is going on with the system. I'll send in a trouble ticket and I imagine it will get resolved before too long. Sorry about the confusion, I have no clue about what they are doing.

[Asherleymoco in reply to nash2]

That’s okay. I’m just a little worried now because I did have fatty liver - haven’t drank for a year and cut out a lot of fat. And now it’s not showing but still have elevated ALT. Had around 50-60 types of blood test done and nothing has come back abnormal except Alt at 130

[nash2 Partner in reply to Asherleymoco]

well, mostly good news but getting to the bottom of the ALT is the right thing to do. It can be elevated by a number of things so not a simple question. The LIVERFASt test is one of the more sophisticated blood tests looking at liver chemistries so it may be helpful. I use it to monitor my condition for changes.

[Asherleymoco in reply to nash2]

Is this something that I can be referred for or do I have to pay for it?

[Asherleymoco in reply to Asherleymoco]

Also I did have a couple of CRP tests and they came back as 2 and normal shows 1-10

[nash2 Partner in reply to Asherleymoco]

medicare and most major insurance covers it but it does depend on your policy since it is not routine. It costs $199 private pay.

[Asherleymoco in reply to nash2]

I’m in England

[nash2 Partner in reply to Asherleymoco]

I don't know much about that coverage

[Asherleymoco in reply to nash2]

Ah it’s not something I have heard of over here. I believe ultrasound is used more so to discover the problems

[nash2 Partner in reply to Asherleymoco]

Fibroscan is your best bet then. See it there is a Tawazun Health in your area. They are doing them for screening though I don't know the financial details.

[gillianTS in reply to Asherleymoco]

You will have to push to be referred to a consultant through your GP or whoever you are seeing. I am afraid many walk around with raised enzymes and little is done to investigate issues until things become major. My husband used private hospitals here in the UK for further testing since this did not appear to be forthcoming via our GP who had to refer once we established who my husband wanted to see.

[Asherleymoco in reply to gillianTS]

I am under a gastroenterologist already. Would you say I should push to see a hepatologist or would it be better to just stick to the gastroenterologist?

If I wait for a hepa then I’ll be waiting around 18 weeks. I have a gastro appointment next month

[gillianTS in reply to Asherleymoco]

A Gastroenterologist is obviously not a liver specialist and I would most definitely would be asking to be referred to a hepatologist, if this is refused then please ask why, make sure you read up before you go to discuss why you want a referral based on your diagnosis last year etc, the gastroenterologist might think because your ALT has reduced, you have no signs of fatty liver from a ultrasound scan that this is satisfactory, I know this is crazy but they just think they are specialists in all fields... you need an answer why your ALT is still raised and he/she obviously thinks by ordering an ultrasound this is going to provide you with an answer and comfort. Research the hospital you go to and find out the names of the hepatologists, sometimes it helps when you name drop, sounds like you are familiar with the persons expertise.

Good luck with your appointment.

[Asherleymoco in reply to gillianTS]

Hi Gillian. Thank you for your response. I’ve been informed that the gastro im seeing deals with the whole abdomen so he will be able to help me regarding that. I’ve looked online and it’s currently only at mild levels. I feel quietly confident as the levels aren’t massive at the moment. However I do want it sorting and my GP is off sick today. Typical. I have an appointment in May so not too long to wait. I spoke with my cardiologist yesterday who reassured me that he was facing the same issues and we both had Covid the start of January!

[gillianTS in reply to Asherleymoco]

Yes it is usual for a Gastroenterologist to deal with the abdominal area, this does not make them a hepatologist, a hepatologist diagnose, treat, and manage problems associated with your liver, gallbladder, bile ducts, and pancreas. Yes there is a cross over but a hepatologist is a specialist in his or her own right and naturally has far far more training, knowledge etc etc than a gastroenterologist regarding the liver.

[Monicka in reply to gillianTS]

Hi! I probably have the same situation as you do. I have slightly elevated liver enzymes ALT and AST for almost 6 months now. I already underwent 3 ultrasounds and 2 fibroscans. All came out clean. I had other bloodtests done too to exclude any liver diseases but nothing has been found. All my other bloodtests are within the brackets. I mean I’m like wandering from one doctor to another trying to find out the cause with no avail so far. I have three more doctor’s appointments scheduled next month and another very detailed bloodtest. If all of it comes out ok I’ll probably just forget about it. I mean I’ll still eat healthy but won’t bother about it any more. Every person is different and sometimes we just don’t fit within the standarts even we are completely healthy.

[gillianTS in reply to Monicka]

If you have had covid 19 it might be worth mentioning to every one of the specialist you see that much has been written on raised ALT even for people who were not hospitalised and other's that did not realise they had it.