Update and questions

[J5527]

Update from hepatologist labs are perfect. Ultrasound in February and follow up as well with another set of fibrosure labs Fibroscan didn't work on me again today . She got no reading and used both size probes. Still says the elastography showing f3 is incorrect because she cant' even get a reading from fibroscan. She is still set on the Fibrosure blood test results showing no fibrosis and says her opinion is that I do not have advanced fibrosis.

my question is anyone have similar experience where dr says labs are showing no fibrosis but imagine test did and dr said they don't believe imagine test?

[nash2 Partner]

I have heard that story but it is far more common for them to not believe the blood tests. Some people have difficult anatomy for Fibroscan. Alternatives MRE, an MRI based elastography test, or ARFI, a test related to Fibroscan that is built into many of the newer ultrasound machines. I'd try to get one of those for confirmation. MRE will be the most accurate.

[J5527 in reply to nash2]

Thank you for the information. I'm scheduled for a regular ultrasound it seems in February. Thinking of calling her for MRE instead . I want to be happy that she feels I'm in a good place but I also still feel worried because of the other finding

[nash2 Partner in reply to J5527]

That is what I would consider as a next step. Ultrasound doesn't measure liver stiffness and that is the most important number that you want to understand. An ARFI equipped ultrasound is fine too but regular ultrasound won't satisfy you.

[J5527 in reply to nash2]

Thank you . I believe her reason for just ultrasound is to see if my fatty liver has been reversed not sure if just ultrasound would even show that either. At the visit she stated she didn't even think I had nash but I really would like to make sure of that and will be calling her to suggest I'd like to have the mre.

[nash2 Partner]

If she is really going to focus on fat content, ultrasound is a crude measure at best. To determine that the best test is PDFF, proton density fat fraction, which is done with an MRI. Most facilities that have MRE can also tell you the PDFF.

[J5527 in reply to nash2]

Ty for this information. I'd be lost without these groups

[MINTVCX]

I would say consider your hepatologist opinion and your specific blood tests (also basic LFT?), no reading from fibroscan that more probable is that indeed you do not advanced fibrosis. But also if even one test shows otherwise, it is a good idea to check this closer (even if it is less likely as in your case).One more thing did your ultrasound show S0, S1 or S3 regarding fat? What was the description?

[J5527 in reply to MINTVCX]

Ultrasound says likely fatty hepatomagaly and impression says likely fatty hepatomagaly suggests steatohepatitis or early cirrhosis. The shearwave elastography says liver echogenicities slightly increased. And the impression says moderate to severe fibrosis f3. The fibrosure bloodwork I took 2x's both said no fibrosis. And s1-s2.

[nash2 Partner in reply to J5527]

A lot of people have difficulty getting a diagnosis as it is complex. People, even docs, are casual about the words they use. Speak to your doc about what it all means but the shearwave elastography is likely your best info so far. The disease is NASH, nonalcoholic steatohepatitis, and it has 4 stages F1 to F4. Advanced fibrosis is F3-F4 and F4 is also called cirrhosis. Confirm with your doc but you probably have fatty liver disease, NAFLD, and NASH is the stage of NAFLD where scar tissue is formed. Your doc should stage it for you but I'd guess S2 F2/3 from what you have said. Concerning but manageable with lifestyle frequently.

[J5527 in reply to nash2]

The thing is doc says she's confident I have no scarring and that the imaging tests over estimated me because my labs say I have no fibrosis. I'm torn because she seems so confident about this and im stuck between getting a second opinion or keeping up with my exercise and diet and see in February where I'm at with imaging she ordered. I've lost 40lbs since March. Work out 4-5 days a week and eat mediterranean. When I first got the shearwave results I thought I was gonna die. My anxiety was so bad. Then I saw hepatologist and she orders fibrosure and results said no scarring so she said that she didn't think it's likely I have any. She did my fib 4 and apri and elf all coming in with low risk. I'm lost and still scared .

[nash2 Partner in reply to J5527]

The key thing for you is to take a breath. Your tests are fuzzy as to the exact diagnosis but there is no indication that you are approaching a really serious point. You are doing the right things, the condition can be managed, and more tests won't change the recommendations. Stay the course, continue to lose weight, recognize that the lifestyle change is life long but you chances to manage it successfully are good.

[J5527 in reply to nash2]

TY for encouraging words.

[Summtyme]

I had that problem. I showed a fibroscan of 17.5 and was diagnosed with cirhossis. During the fibroscan 2 technicians had difficulty even getting a reading. So they just sent off what they had. I had an ultrasound that showed very mild fatty liver. My bloodwork was fine.

My hepatologist completely believed the Fibroscan UNTIL the MRE results came in. My MRE finally showed very mild fatty liver within normal range!!! I even asked about how they had issues with the test and he said but your IQR median rate tells me it's correct regardless. He is now in agreement that I am fine. I do not have cirrhosis. What a blessing.

[J5527 in reply to Summtyme]

A blessing indeed! I'm glad that worked out fir you. What is the follow up care for you looking like any monitoring?

[Summtyme]

Hepatologist said to retest with another MRE in 2 years.