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Posted 7/22/2013 7:02 AM (GMT 0)

I found this forum through internet search during family time at the beach. I have to admit it wasn't easy reading upon some of the threads through my iPhone in middle of the beach for few hours... Many prayers and high hopes for all and everyone!

I've also happen to realize severity of liver disease being discussed in this forum seems little more severe than other forum where general concerns are with initial diagnosis of fatty liver disease.

I'm also one of the newly diagnosed with FLD but do not know the severity of the disease yet. here is my story: I've been diagnosed with diffuse fatty liver in march 2013 during my annual comprehensive physical exam and was told ultrasonography  technician I have inflammation and my ast36/alt67 were elevated. I'm 32 male in pretty active status, 5'11 inches tall and weigh about 95kg at the diagnosis but now down to 88kg.

I had my drinking days while in air force and bad eating habits here and there which probably led me to this point. Until recently, I thought fatty liver meant I had fat around my abdominal area and I probably had some fat around my liver and didn't bothered much until I started have dull discomfort around my RUQ. This is when I started to follow up the local doctor and did few more blood test but they came back around ast29/alt43. so.. I was relived and figured this fatty liver disease is reversing and maybe I can relax and had few beers to celebrate my positive result... and BAM! discomfort came back but more in mildness... so I quickly went to local hospital to do blood test to see if I had elevated enzyme level ast49/alt78 and was told it's not big deal, it'll go away if continue diet and exercise and avoid alcohol.

I'm going to see a gastroenterologist this Friday to perform full LFT and perhaps do another Ultrasound along with CT scan if need. by reading upon online documents, liver biopsy is the only way to detect but I'm not sure what to do... perhaps, I'll do what the doc recommends for me in the next steps. Hopefully doesn't tell me in such a vague dialog as others do "diet, absenting from alcohol, exercise and it'll go away". fingers crossed.

so.. in conclusion, I'm probably super tired of self diagnosing my self but could this be steatohepatitis? so called NASH? which is irreversible? cirrhosis? just worried.

Results from March physical examination:

T.Cholesterol 232

Triglyceride 475

HDL 43

LDL 133

AST 35

ALT67

ALP 102

T.Bilirubin 1.2

D.Bilirubin .2

T.Protein 7.5

Albumin 5.1

BUN 17

Creatinine 1.06

Uric Acid 7.9

Sodium 140

Potassium 3.7

Chloride 97

Calcium 9.5

Phosphorus 2.9

Amylase 53

Lipase 56

 

Posted 7/22/2013 7:24 AM (GMT 0)
Some of the others will come along who are better at interpreting the lab results. But I would say that you are correct to take this dx seriously as it can progress to NASH and irreversible damage. I think your doctors are indicating that it has not gotten to that point yet and you can reverse it. If needed you should be referred to a liver specialist and they will know if a biopsy is indicated. Most important is to avoid alcohol and fatty foods, research liver friendly diet and try to eat as healthy as possible. Coming to this site for answers is great, there are so many people with experience and knowledge who are willing to help. Best of luck!
Posted 7/22/2013 12:17 PM (GMT 0)
 Dole , Do be concerned but not enough to worry yourself sick . Back off the online search for answers . So often we look to self diagnosis and only compound our perceived problems . It's good to see that you are active in your health care , That goes along way in treating liver disease . Have your G.I look you over thoroughly and depending on his findings you may want to find a Hepatologist thereafter . G.I docs are knowledgeable in their field but when it comes specific to the liver a Hepatologist is the only way to go . A biopsy may need to be done before you truly get a solid answer as to what condition your liver is in . I'm sure others will be giving their input in as the day progresses . Again , Welcome aboard to HW .

 Ziff     

Posted 7/22/2013 1:36 PM (GMT 0)
Hepatologist, hepatologist, hepatologist, etc.... Get to one.
Posted 7/22/2013 2:34 PM (GMT 0)
Ditto all the above, especially the hepatologist. A biopsy will tell the story.
Posted 7/22/2013 5:36 PM (GMT 0)
Hi, Dole! Welcome to the forum! Are you in Hawaii?

Your liver enzymes look pretty good. ALT is normal, but AST is elevated. Normal is 8-43 and yours is 67.

I can't add much to what the others have said. Most of the members here have hep C or alcoholic hepatitis, though there are a few with fatty liver disease and NASH (Non-Alcoholic Liver Disease.) Since you were a drinker, we can't assume it's NASH. Probably "just" fatty liver (less serious.) There is no magic pill to cure this. It really IS about lifestyle changes. At your height, I think you could lose another 10 lbs. Eliminate fat from your diet. That might make all the difference. And NO ALCOHOL. It's a good idea to check your liver condition further with a GI doc or (even better) a hepatologist.

Please do keep us updated on your progress.

Hugs,
Connie
Posted 7/23/2013 1:13 AM (GMT 0)
Thank you for all the feedback above, I have to agree with your responses and get this guessing/self diagonsis out the way. As noted above, I'll have appointment with gastoenterologist this friday. According to the doctor (moms friend) LFT blood works and ultrasound works will be done for him to confirm the dianosis(i'm guessing he'll recommend way ahead). He has reviewed my past bloodworks but does not think anything further than simple fatty liver due to alcohol and bad eating habits.

Well, I probably had my worst phone conversation with my mom last night regarding my diagnosis with fatty liver and how I believe there is a need for further evaluation of current condition via biopsy. Firstable.. my mom is retired RN and she got very upset at the way I was approaching this whole situation and told me to follow what doctor is telling you and to follow the progressive steps that doctors refer you before you make self diagnosis. but my problem is... these doctors are not hepatologist!

My biggest concerns were the elevated liver enzymes since Nov last year from blood works and RUQ dull ache that comes and goes with periodic burping after meals. I guess i'll keep you guys posted on findings from this friday's check up.

I think I also need to loose little more weight.. i've been stuck at 88kg for while and I believe only way to get it down is to start jogging again. Ideally, I would like to be back to 78-80kg.

I'm not from Hawaii but have plenty of influence since being stationed in Japan/Korea for about 8 years. Lastly, I feel very welcomed and hope I can contribute much as possible for those that I can be help to.

One question regarding blood test.... before the lastt blood test (elevated liver enzyme ast49/alt78), I rode bicycle for 30 minutes before the test and had small lunch at 1130 and did blood test at 5pm. could this have affect on the result of the blood test?

Posted 7/23/2013 2:10 AM (GMT 0)
In answer to your question, no, the activity would have played no part in your ALT and AST results. It's always best to have labs on a 12-hour fast, but regarding you liver enzymes I doubt it would have made a difference.

Let us know what happens on Fri. The GI may hold off on a biopsy until after testing and lifestyle changes, to see if values improve. Fatty liver is something that is curable, unlike other liver diseases like cirrhosis.

Hugs,
Connie
Posted 7/23/2013 2:16 AM (GMT 0)
Agree with Connie that exercise would not affect your enzymes that quickly.

Your blood results are on the whole very encouraging. Your albumin is excellent (one of the main signs of synthetic function), and your bilirubin is good.

I would hazard a guess that the RUQ pain may not even be liver related - it could just as easily be related to diet (flatulence).

Certainly, you are looking for your enzymes to trend back to normal, but even as they are, the ratios are healthy enough not to be worrying about an inflammatory process. Providing you follow your own advice and steer clear of the booze and wrong foods I am sure that you will be fine.
Posted 7/30/2013 8:43 AM (GMT 0)
UPDATE from my visit to gastroenterologist.

I got up early to minimize the fasting period but didn't go my way as my flight was delayed by 1 hour and taxi ride to hospital was longer than I anticipated. but.. I made it to the hospital with over 12 hours of fasting. I first sat down with the head gastroenterologist (mom's friend) and discussed my current condition and etc etc. and went into withdraw some blood for LFT. I was than appointed to ultrasonography with different gastroenterologist (noob doc) which I thought it was  little odd but I was too tired and hungry to speak more than few words at the most.

so... the moment the doc (noob doc) starts to scan my abdominal all I hear is "woo... fat, fat, fat, white". I was informed right away that I had moderate fatty liver which I already kinda knew. he then started to explain each of his findings to include clear gall bladder and clean spleen but couldn't confirm the pancreas due to excessive fat and gas build up. The doc also went ahead and told me the didn't see any odd shape of liver in the edging... I didn't know when this meant and he told me it basically means there is no signs of cirrhosis bubble/shape. this concluded my ultrasonography which took about 20mins.

I had a brief conversation with the doc (noob doc) to go over my daily lifestyle and my eating habit along with my current height and weight etc... I was told to lose another 10kg from 88 -> 78 = 10kg/22lbs reduction. 

so.. my questions were asked after he told me the current status of moderate fatty liver:

Do I have NASH? he replied no, moderate FLD more likely but it can also progress to NASH if I don't lose the fat in short amount of period 6-12 month .5kg per week.

Should I do liver biopsy to determine what stage my liver is in? he replied no, with my previous blood works and findings from ultrasonography, he does not see the benefit of liver biopsy since there is no indication of cirrhosis.

I went home Friday afternoon and made a follow up consultation schedule with the head gastroenterologist(Mom's friend) on Monday to review the blood work I did Friday. Even though I was told nothing severe on Friday, I was very worried after the visit with the words like "moderate fatty liver" as I still don't know what that means?? and 6-12month to lose the weight etc.

I made it back to the hospital and sat down and the doc had this very serious looks as he had few pages of papers in front of him which I assumed it was my blood result. I started to get very nervous at this moment.... but the first word he said was "normal".... he also said I don't have to be on cholesterol medicine (vitorin 10/20) anymore as my cholesterol, LDL, Triglyceride, AST, ALT, ASP all are in normal window. Recommended to continue good diet and get the weight down and follow up in 6month.

Although I'm relieved to certain extend, My tiredness, mild RUQ discomfort and periodic burping still exist which I was told it's a symptom of fatty liver. I'll keep you guys up to date on my progression. Cheers.

 

Post Edited (doleplantation) : 7/30/2013 2:51:38 AM (GMT-6)

Posted 7/30/2013 9:30 AM (GMT 0)
Pleased for you doleplantation. Well done for taking it seriously - the liver isn't to be messed about with, as some of us have discovered to our detriment. Now, just to lose that little bit of weight, watch your diet and alcohol intake and your liver will be as happy as Larry!
Posted 8/1/2013 4:12 PM (GMT 0)
Nicechaplondon - how did you get your diagnosis? did you show significant symptoms that trigger the docs to go ahead with further diagnosis? did you have any symptoms prior to diagnosis?
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