anyone use the fibro score calculators online and are they accurate

[mtk0925]

they usually ask for ALT AST albumin blood count and BMI to measure so far all the ones I’ve tried say slight risk, or no risk

[nash2 Partner]

They basically give you a probability. They can't be diagnostic so if the readings say no risk docs will want to watch you for changes. As the probability goes up they will want to do more detailed testing. They can be a guide but have to be understood in the context of all the other measures of your health.

[mtk0925 in reply to nash2]

thanks for your help that makes sense. Right now my plan of care is one ultrasound a year, to every other year, my dr said it’s hard making the insurance approve them yearly, blood work done every 6 months. Should I be getting more? Does this seem proper? Currently my ultrasound has not shown fatty liver but high cholesterol and my liver enzymes range a few points above normal my LDL is normal it’s my HDL that is high

[nash2 Partner in reply to mtk0925]

With a low indicated risk that makes sense. Be aware that ultrasound isn't very good at measuring liver fat. If you can slip in a Fibroscan sometime it will give you a better measure. Those of us with advanced disease typically have blood work quarterly so every 6 months is more than most low risk patients get. Typically the docs get more concerned if your enzymes are more that twice normal. I think that is too conservative but watch the trends. If they are climbing steadily you need a better workup. If not watch your diet and exercise and you will probably do fine.

[mtk0925 in reply to nash2]

thanks for your reply. If there is fat would the ultrasound see it or no? I may just ask for the fibroscan my alt has been 36 29 being the normal and ast has been one point from normal 41

[nash2 Partner]

Ultrasound determines fat by an estimate the radiologist makes of whether the liver looks "brighter" in the image. Fat is a bit more reflective of the sound wave so it shows as less grey. A crude test that depends on the skill of the operator. A fibroscan isn't perfect but is a much better tool for understanding the liver.

[mtk0925 in reply to nash2]

thanks I’m going to push my dr for a fibroscan this year instead of US

[mtk0925]

albumin seems important in determining extent of liver functioning

[nash2 Partner]

That scoring system is confusing since they go to negative numbers but the general interpretation is less than -1.5 means a low probability of NASH fibrosis so -2.06 suggests a low probability of NASH. These tests aren't perfect but can be helpful guides.