Intro

[Mszy]

Hello everyone! I’m from Indy Indiana. I was diagnosed with fatty liver via an ultrasound after a ct blood work came back normal but I was still experiencing nausea and upper right side discomfort. I see a specialist but not until June - question are there other tests I should request from my family doctor that wants to see me on Monday? Thanks I’m advance for any additional info! Appreciate it.

[LeiL]

I recommend asking for an MRE (Elastorgraphy). I recommend this over a Fibroscan.

[Mszy in reply to LeiL]

Thanks so much I will do that Monday! Appreciate you!

[Maxy6 in reply to LeiL]

Would you mind sharing why you make this recommendation?

[MINTVCX]

I would wait for your specialist recommandation regarding futher tests. Please keep in mind any even most accurate test alone is not 100% conclusive.

Meanwhile if fatty liver you can calculate your FIB-4.

[Mszy in reply to MINTVCX]

Thanks so much !

[Mszy in reply to Mszy]

What is Fib-4

[MINTVCX in reply to Mszy]

Check here but remember it is only some estimation.

mdcalc.com/fibrosis-4-fib-4...

[nash2 Partner]

Generally primary care docs aren't going to do much beyond the routine blood panels but in them look for high ALT, AST, bilirubin, glucose and low albumin and platelets. There are a bunch of other things that your specialist is likely to look at but if you have a liver issue these are among the things that are affected. Unless your primary is quite uncommon you won't get much help there for liver concerns as they just don't have the training.

[MINTVCX in reply to nash2]

Maybe primary care docs can just learn on their own? For example using google (although they should have access to many medical science articles :)). Of course Fib-4 is an example here I am not saying is perfect (you can still have solid F2 with low score and wake up couples years later with F3 so not the perfect one but knownig its limitation can help).

"FIB-4 First in the Diagnostic Algorithm of Metabolic-Dysfunction-Associated Fatty Liver Disease in the Era of the Global Metabodemic"

(...)

"Approximately 25% (!!!!!) of the adult general population is suffering from nonalcoholic fatty liver disease (NAFLD), which has become a serious health problem"

(...)

"Accumulating evidence has suggested that vibration-controlled transient elastography (VCTE) and the enhanced liver fibrosis (ELF) test may become useful as the second step after triaging by the FIB-4 index."

"Although several problems of FIB-4 index remain to be solved, FIB-4 index is believed to be enough as the first triaging tool to exclude hepatic fibrosis, especially for general physicians or endocrinologists. However, limitations of FIB-4 index were kept in mind. As mentioned above, the MAFLD population with obesity or T2D might be inferior to that without obesity or T2D. It is plausible that heterogeneity of MAFLD has some impact on the performance of NIT."

ncbi.nlm.nih.gov/pmc/articl...

[nash2 Partner]

Indeed, we've written about various aspects of the problem in our blog but it won't change until the standard of care guidance recommends screening for early stage disease. The standard today doesn't consider diagnosis absent symptoms.

fattyliverfoundation.org/fo...

Wayne

[sophiaS1980 in reply to nash2]

I saw the fibrosis calculator hanging up in my doc's office. I asked, him about it, and he stated it is a good tool, however, he has found labs change month by month.

[nash2 Partner]

That is true but when you track it over time you will see the trend develop. It works best as an annual snapshot that can tell you if there are changes over time and warn you if you advance into levels of concern.