I just received my results for liverfast and it showed that I had no liver damage despite my diagnosis of fatty liver and what feels like constant back pain at times . It feels great to see results like that on paper but I’m a bit cautious to take it as gospel as my pain feels like something a bit more sinister may be at work here . I have a fibroscan setup for the 24th through a new experimental study that is currently in its second phase. My question is , should I feel confident that the results I got from fibronostics is at least somewhat accurate if not completely correct ? Am I being negative in my outlook by not fully believing I have no liver damage at all as the results reflect ?
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In my eyes if all you have had our blood test. Then you should not be negative. Much better to stay positive during this and let the fibroscan be the complete piece of the puzzle. I got good results from my liverfast, and I'm gonna confirm with a fibroscan June 4th.
All medical tests have a margin of error and the human biology is vastly complex and that is part of the challenge we have as liver patients. In studies defined as "intention to diagnose" the liverfast test was slightly better overall than the other non-invasive tests but all tests do come with false positives and negatives. Just a lay opinion here, and I'd be interested in how things turn out for you, the very low score for inflammation would cause me to suspect an error with the fatty liver diagnosis. High levels of fat usually come with inflammation. Some other disease process could be going on of course but only more testing is going to answer your question.
Thanks for responding . Wow ur so right . It seems that these tests are leaving me with more questions than answers . I don’t see how my enlarged fatty liver that was causing me significant pain and was diagnosed through an ultrasound could be wrong but I will certainly bring these results to my Gastro . Hopefully we can make sense of how to move forward with a more solid diagnosis .
The problem with ultrasound is that it is good for looking for cancer but poor for looking at fat or moderate fibrosis. It is often used because it is available but doesn't usually help. Here is a link to information about a fairly new study that combines AST with Fibroscan for increased accuracy. pubmed.ncbi.nlm.nih.gov/320...
It can't see fibrosis at all. It may look rough and coarsened looking down at it and the shadow on the abdominal wall may show the nodules in profile for advanced fibrosis but for earlier stages it can detect high levels of liver fat but not fibrosis itself.
thanks for reply so with advanced fibrosis at the point of nodulars and coarsened architecture may be a tip off severe fibrosis crossing into cirrhosis so if it’s not at that point some may be able to reduce fibrosis to a degree
Some regression of fibrosis is possible at any stage, even compensated fibrosis, but catching it sooner is better of course and the amount of regression possible is very individual because of varying liver chemistry.
Inflammation causes swelling and deposition of new material in the liver during scar formation so if that can be controlled the liver will clear some, but not all, of that out and the liver will be a bit less stiff. How much and how fast is very individual which leads to confusion at times.
gotcha so as time goes on and you get inflammation and weight off as well as other blood issues in check and reducing steatosis than you should start to see KPA drop as well as cap in future fibroscans. I guess if you can’t get those things under control than the KPA and cap will go up.
Your case sounds so similar to mine that I had to post my first reply. I was diagnosed with NAFLD in 2014 after feeling a lot of RUQ and right flank pain that also moved around to the back. I also had changes in my bowel movements. My gastro diagnosed me with blood tests (ALT/AST in the 70-80 range) and told me to lose weight and stop drinking. I did both for a while and got my blood work looking good. Since then I haven't lived the healthiest life, but I've also never returned to my old drinking habits. I've gone through many stretches of weight loss and abstinence from alcohol, and no matter how good my blood work, the pain remained, mostly in my back from my spine to my right flank. I had a FibroScan in 2017 where I got a 4.7 and confirmation of mild fatty infiltration. I've had endless doctors tell me that this pain is musculoskeletal in origin and that my liver is more or less fine.
Since that FibroScan, I lightened up on myself too much. Moderate drinking every weekend and lots of sweets (I do dry January, but often replace all my alcohol with donuts, cake, and leftover Christmas candy). I thought as long as my blood looked good then I guess I'm alright. I thought this because it's essentially what my doctors told me. Then this year my symptoms started to worsen. Fatigue, nausea, and the back pain worse than ever. I went to the doctor for a case of tonsillitis and they ran blood tests which were normal except for LFTs with ALT 107 and AST 95. Since then I've been abstinent from alcohol, exercising, and dieting for a month and my pain has started to revert back to previous levels as have my LFTs. Nonetheless, my doctors just think it was the virus that caused the spike. I'm about to start the process of begging my gastro for a new FibroScan to assess the damage of the last 4 years.
I too deal with crippling health anxiety. When combined with chronic pain it becomes a behemoth. It becomes very difficult to trust doctors who tell you that you're wrong, but also can't seem to identify the actual culprit. As of right now, I don't know if I'm right or wrong. I could get another normal FibroScan with mild fatty infiltration as last time. The cause of my elevated LFTs could just have been a virus. Perhaps a spinal misalignment has been responsible for my pain all along. What I do know is that if I had lost the weight that I have lost now and kept it off, remained abstinent from alcohol, and continued to exercise I'd feel a whole lot better about my health right now.
I hope that you are able to find answers and perhaps even rid yourself of your pain naturally. It sounds like you're doing the right things in terms of lifestyle. Looking back over your posts, it seems like you've also gotten a lot of reinforcement that you're dealing with a mild fatty liver. I would feel quite good about the results that you've gotten thus far if they were mine. It can be difficult to strike a balance between diligence and obsession for people like us. I'm just trying to learn to trust my results and my doctors' interpretations, but also stay engaged with my health.
Keep us updated and stick with the healthy habits!
I appreciate you being open and honest . It makes me feel a little less alone in this fight for my health . My advice is be your own advocate . Put your healthiest foot forward even when it is hard (like holidays etc) because at the end of the day it’s YOUR life . These docs practice medicine not preventatives . That’s all in your control . We shouldn’t be looking for a reason to feel good about doing bad. I’m not accusing you , I’m speaking mostly about myself . Every part of me wants to eat what I want , smoke pot and never be active but that won’t keep me around . Be strong 💪
Thanks, I appreciate the support. I have indeed spent the last 7 years "looking for a reason to feel good about doing bad". Unfortunately, it's not too hard to find in the medical community. You're right though, it is on us, not doctors, to take care of our health.
My docs are extremely dismissive and due to my age they refuse to give me referrals for scans or any other advanced testing . This is a test I paid out of pocket for . It’s through a company called fibronostics. It costs $200
They’ll set u up with an appointment through one of their Hepatologist. Once that is done they send you an order form for quest diagnostics or labcorp or whichever lab you use .
That looks like a great report to me! Have you ever had kidney stones or kidney stone removal? I had a lot of back pain both before and after lithotripsy for a large stone.
Like all tests this one has both false positives and false negatives but it was trained on the same data used to qualify the FibroScan. Typical accuracy is around 80%. All tests must be viewed in the totality of your medical record but I've had good correlation between the two personally. Back pain can have a lot of mothers so isn't very useful for understanding liver disease.
I had the blood test done 6 months after fibroscan and it came back minimal fibrosis no activity, lower than the original fibroscan. But I did loose 45 pounds and sugar control in between. Do for a repeat fibroscan and I’ve dropped some more weight and all bloods are normal so I’m hoping the fibroscan is at least the same as the previous fibrosis blood test or better .also recent sonogram Normal size liver and what they call Homogenous perenchyma. So I think I’m headed in right direction.
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