Can you have cirrhosis but good blood work

[Shantton]

My ALT is 70 and all other liver blood work is good. Is it possible to have cirrhosis with only ALT being slightly elevated

[RosaRugosa]

Yes, it's possible to have liver damage even with good Liver Function Tests (LFTs). The enzymes detected on a LFT are signs of the liver trying to repair itself. But, if severe liver disease develops, the liver will lose some of it ability to repair itself, and the LFT may drop towards or even into the normal range.

I had this problem. I had developed life-threatening cirrhosis, but it went undetected because my LFTs were fairly normal. I didn't have enough liver left for it to produce all the LFT enzymes it should had.

Of course, most people with Fatty Liver or Nash are nowhere near that sick.

One technique to see if the LFTs are accurate are to compare them to the platelet count. If the platelet count is normal, then the LFTs are likely to be an accurate measure of liver functioning. (LFT values can still be unreliable due to rare bone problems and other rare diseases.)

An ultrasound or fibroscan would tell you more about your liver. But, if your other blood measures are normal and your spleen is not enlarged, the LFTs are probably accurate. Still, it's worth asking your physician.

[RosaRugosa in reply to RosaRugosa]

I'm worried my post came out a bit alarmist. If your liver problems are mild, they might have just gotten better on their own or in response to better control of your glucose. I felt a need to point out what happened to me, because my doctors really dropped the ball in my case. But, hopefully your liver has gotten better! I'd suggest having your platelets checked and maybe an ultrascan or fibroscan. Also, do you feel good? If you've been experiencing more nausea, tiredness, itching all over, those are signs that should be checked out.