I think I have liver disease and need some advice

Digestive health
1

Hi everyone I am new here. I went to the doctor last week and they did some blood tests. So my doctor thinks that I have fatty liver disease. Here are my results from the liver tests

SGOT (AST) 44 U/L 

SGPT (ALT) 71 U/L 

What stage of liver disesae does this put me in? would it be stage 1 or 2? I am going to go back to the doctor again in 2 weeks because they want to do more blood tests on me. And they also said i may need an ultrasound.

Are these numbers really bad? Also with these numbers would I be able to heal my liver with diet and exercise?

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Hi.....I posted this but it's waiting to be moderated because I included a website in the original post. This is the post without the page reference.

Hey Megan! Firstly, as with everyone on here I have to stress, I am not a medical professional. I have had liver disease (cirrhosis) which resulted in a full transplant.

You might want to check out the link at the end of this post.

Raised enzyme levels can only indicate wether or not there may be a problem with the liver. Unless they are massively off the scale, it doesn't say how bad the problem is, so you can't really say you're "stage 1" or "stage 2".

Your AST is 44 and the suggested is 5-40 u/l so slightly raised. ALT is 1-56 u/l so again slightly raised.

The problem with looking at just the enzymes only is that it doesn't clarify how well the liver is functioning. It is very possible to have raised enzymes and the liver is functioning OK. The tests that will tell you if the liver is functioning are Albumin, bilirubin and a coagulation panel (I think that's called INR but can't remember off the top of my head).

Post those if you have them. The scan is also going to be important as the doc should be able to see if there's any damage / enlargement (maybe scarring (cirrhosis) or enlargement)

Have a look here, might give you an insight, but until you have the albumin, bilirubin and INR, all you can say is the enzymes are slightly elevated......oh, and the scan!

NAFL (non alcoholic fatty liver) can be reversed if you're in the early stages, but the problem is it's often undetected because there's not really any specific symptoms that point directly to is. Sorry if these questions are blunt, but are you obese, or carrying excess belly? Are you diabetic? If you're not diabetic, how much refined sugar is in your diet (candy, soda, processed food, puddings)?? These can be factors to consider.

The best thing to try and reduce fat in the liver is to try and reduce carb intake, especially the refined carbs (again, candy, soda and processed foods are culprits). You obviously need some carbs to keep alive, but you need the right carbs. I'm diabetic as well so....!! Watch the fat levels in food....Monounsaturated fats are the nicest of the fats, and try to avoid saturated fats. You'll usually find them in most foods, but try to have less than the usual 70g a day (70g is the recommended max for a 2000 cal per day).

Hope this helps. Any questions just ask.

P.S. Exercise is also a good way to help reduce fatty cell build-up. Won't solve any probs on its own, but will help.

3

Hi i talked to you the other day in the kidney failure forum. You replied to my comment about my blood test results on my kidney function. I was the one that originally thought that i had a low kidney function because i have been having light brown urine, increased skin pigmentation, easy bleeding and bruising and muscle twitches. So then i went to the doctor last week and they said my EGFR is 88 so they aren't worried about that at all. The doctor just said she is worried about my liver and she thinks that i have fatty liver disease.  I did also get the results for my Albumin and bilirubin. ALBUMIN 4.1 g/dL 3.4 - 5.0 g/dL. So my albumin is 4.1 and it says that the normal range is 3.4 to 5.0. BILIRUBIN, TOTAL 0.6 mg/dL 0.3 - 1.2 mg/dL. So the bilirubin is 0.6 and it says the normal range is 0.3-1.2. Hmm. so why would my albumin and blirubin be normal, but my liver enzymes be elevated? does that mean that i just have the beginning stages of liver disease? Or does it mean i have some other problem? And yes I am obese, but no i don't have diabetes. The doctor just said I am pre diabetes, so i'm pretty close to having it. I wonder why my doctor thinks i have fatty liver disease then if my bilrubin and allbumin is normal. I'm confused. Maybe she is just worried that I might have it and wants to do an ultrasound to see if I do or not.  She didn't do any INR test I don't think. But she said when i go back in 2 weeks they are going to do more blood tests. The ones they are goign to do are COMPREHENSIVE METABOLIC PANEL, IRON, TIBC, AND FERRITIN PANEL, FSH AND LH PANEL, HEPATITIS CHRONIC PANEL (A,B,C), HCG QUALITATIVE, SERUM. Are any of those the INR? i have no clue what those mean. She just said i will get blood tests for those things in 2 weeks. Oh and also yes i do eat too much candy and cookies and junk food. But i am going to stop doing that now and i am going to eat healthy. Thanks for your help so far. If you can please answer my question about why i have normal albiumin and bilrubin and not normal enzymes then that would be great. 

 

4

Hey there,

The problem with ALT and AST are that they are found in other parts on the body too, although the highest concentration of them is found in the liver. They can become raised from muscle damage, for example, amongst other things. The results, if elevated, need to be used alongside other liver blood tests (looking at the ones you have shown for your next visit), to establish the bigger picture.

The reason the albumin and bilirubin are normal is a possible indication that the fatty liver has not yet been damaged. You can have nafl and not damage the liver when reversing the effect, but the longer it goes on, the more susceptible to damage (like scarring) it is.

The scan is very important to see the size of the liver and the extent of the fattiness. The doc may even order a fibroscan.

So, the alt and ast are kinda saying "there might be a problem over here", but the liver, even if damaged, is still functioning correctly. Bit like still running full pelt when you have a sprained ankle.

Did you get a result on the bloods called GGT?

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So all of those blood tests that i am about to get done are going to show if there are any liver problems? And i sure hope that there isn't any major damage to my liver yet. I guess i will have to wait and see how the ultrasound turns out. I have also been having a few symptoms. I get easy bruising and i had 3 nose bleeds in January and then one in April too. Then i also have muscle twitches and sometimes i get light brown urine. And i have this increased skin pigmentation too. Does that mean that my liver disease could be in the late stages already? Or can some people get symptoms in the earlier stages too ? I just hope that i caught the fatty liver disease early enough. I am not sure yet though. And i'm pretty sure i do have liver disease since i am getting those symptoms. And my doctor thinks i have it too. I guess she must be doing those tests to see if i do have it like she thinks or to see if the elevated liver enzymes are being caused by something else. Also no i don't think they did a GGT test yet. What is the GGT for? 

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Hi Megan. Firstly, urine. I tend to stay away from urine colour discussions as people put too much emphasis on this as an indicator. If it's always a different colour for an extended period of time, I'd be concerned, but the occasional change for 1 per here or there can be a multitude of things, even down to what we've eaten or drunk. Not saying it couldn't be a problem, but some people have one slightly off colour per and go into meltdown. You know hour bloods are off slightly so concentrate on what they are telling you.

When you say you have "some" pigmentation, what exactly is some? It it yellow, darker skinned or??? And how much is some, a small area or whole sections of your body? If you're worried about jaundice, a common place it is evident is in the whites of the eyes particularly near the nose where the little lump is. Jaundice comes about because there is too much bilirubin and the bodily process can't bind it to other bodily chemicals to get it ready for excretion. It gets reabsorbed and that's why people can turn a bit yellow.

GGT is another enzyme that is raised significantly when the liver (particularly the bile ducy) is damaged or blocked.

Again, going off what results you have so far, one can't say what stage of the disease you have, if any. It's not enough to look at these 2 and say cirrhosis...you need to have those other tests done and the scan. The scan will show any scarring or enlargement and the doc will make a more informed diagnosis then.

Hope it's going to be good, reversible news.

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Oh most of the time my urine is a normal yellow color. It only gets light brown like maybe once a week. Maybe i'm just alittle dehydrated though because i usually don't drink enough water. I'm trying to drink more water now though. And the pigmentation is just on my feet. It's like these small brown patches of skin. It's not everywhere on my body though.And no i don't have any yellow skin anywhere. The rest of my skin is still how it normally looks. So i don't think that i have jaundice at all. And i checked my test results but the doctor didn't do the GGT test last week. Maybe she will do it when i go back in 2 weeks though. Also would the doctor be able to tell what stage i am in just by doing the ultrasound scan? Oh and do i need to go to a liver doctor if i do have fatty liver disease? Because i know like with heart disease people go to heart doctors. and with kidney disease people go to kidney doctors. So would i probably have to go to a liver doctor if they do find liver disease? Oh and like if i do have fatty liver disease is there a way for the fat to come off of my liver? or would the fat stay there forever but just not get worse if i go on a strict diet?

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Also i have one more question. I noticed on my blood tests that i have high triglycerides. It was saying my triglycerides are 172 and the normal range is 0-149. Does the high triglycerides mean i have liver disease? 

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Hi. From a scan, IF it were liver disease they can probably see how much (if any) damage has been done.

If they find something, yes, it'll most likely be dealt with by an expert. Either a gastroenterologist or a hepatologist.

Yes it can be reversed if it's not done any lasting damage, just google "reverse fatty liver" there's tonnes of stuff on it, mainly regarding sensible diet.

Raised triglycerides can be an indicator, but I wouldn't ever say "mine are high so I must have NAFLD"

HTH.

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Thanks so much for all of your help so far. So the ultra sound will be able to see if there is any damage? or would they need to do an MRI or a CT scan in order to find any damage?? I just was wondering if i need to ask the doctor if she can do a CT scan and an MRI on my liver as well? Or would just doing the ultra sound scan be good enough??

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That's something the Doctor will have to assess. It's best to ask them that question.

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Ok i will ask the doctor if she thinks i need a ct scan and mri too. and thanks so much for answering my questions. that's all the questions i have for now. hopefully you could help me next week if i have any questions on my blood tests that im going to get.