Confused about results and would like some clarification

Hey all, I am new to the forum. I was diagnosed with 'fatty liver' but I am noticing some rather conflicting results. Wondering if this is why I am feeling so icky lately! I'm currently pretty confused as to where I stand. 28/M/ex-drinker (4 months sober now!) - I quit when I got alarming labs back. I have a history of elevated ferritin most of my life which my GP told me could cause liver problems, but I assumed blood donation would help and kept drinking anyway.

My initial labs showed high bilirubin (total of 45 u/mol and direct of 19 u/mol) and AST/ALT of 19 and 17. Doing some reading, I saw that high bilirubin is a sign of worse than fatty liver - cirrhosis or hepatitis - and that the AST/ALT ratio can usually show whether or not someone has serious liver disease.

So I pursued this to no end - first getting three ultrasounds, and the third one showing my liver being 'mildly coarse in a nonspecific subtle finding, no enlargement or focal lesion'.

This freaked me out so I ordered a contrast CT scan of the abdomen - which found nothing wrong. Then I got three Fibroscans - all came back at 4.5 - 5.3 KpA or 'no fibrosis'

An internist then did a very thorough blood workup - bout two weeks later since the first initial lab - and bilirubin had gone from 45 to 5. 5!! The only thing high was IgA (by about one point) and MCH (which has been high for years)

So notably I am rather confused :( I have lab results and the AST/ALT ratio (which I read is reliable) suggesting liver disease/cirrhosis, and an ultrasound that found a mildly coarse liver, but fibroscans saying no fibrosis and a contrast CT that found absolutely nothing wrong, either.

Anyone experienced confusion like this or could perhaps enlighten me as to what the heck is going on with my body? My GP and my Internist both assure me I am fine but I don't believe them. What results do I trust?!

Thanks and glad to be here.

You need to go see a hepatologist. A GI or GP is not going to be knowledgeable enough for your needs.

I haven't even been able to get a referral to a hep - several declined the consult. My GI states that two Fibroscans and a contrast CT rules out liver damage (I got the third one on my own after freaking out more about labs)

In his defense I have looked up studies and it appears to be 90-95% accurate in detecting cirrhosis - two of those plus such a low score and completely normal contrast CT makes all this seem rather confusing and strange.

My other labs were:
INR: .9
Albumin: 48
Total Protein: 70


I've gone through two PCPs so far. The first one took me to two internists - both ruled out stuff. My second PCP got me to a GI who did a very thorough workup, but I just can't stop googling and researching and seeing all of these tests come back making not a lot of sense.

What do you guys think of my concerns? Are they valid? Could by some error that so many imaging studies and fibroscan missed cirrhosis?

Trying to find another PCP to refer me to a hepatologist is going to be exhaustive, but I can't stop thinking about all of my results and which ones might be right or wrong...

Post Edited (JakeMajor) : 9/21/2014 6:28:11 PM (GMT-6)

My AST was 19, ALT was 17. Platelets were 380 last I checked. They were 289 at one point though.

This is what confuses me - some tests saying liver is fine, others saying not so much.

Just a little confusing. I'll keep pushing to see a hepatologist. I'm sure a contrast ct would pick up *something* wouldn't it?

I'm just wondering if any of you have had similar conflicting results from tests or experiences like mine. I spoke to someone from the Toronto Liver Clinic, and they said that Fibroscan pretty much superior to a biopsy as it measures the whole liver not just a tiny piece, but the reason biopsies are still done is to determine cause of liver damage and inflammation, etc.

I'm at the point where I'm literally ready to snap. I HATE being in the dark about what is going on with my body...

Should prove interesti

As ML already mentioned/asked, have you been tested for Hemochromatosis? If not, that is a simple blood test that should be done based on your history of high ferritin.