Cirrhosis of the Liver Community
abnormal liver functions tests
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abnormal liver functions tests

I have a friend that is in complete denial about her drinking.  She lives out of town now and came to visit me a couple of months ago.  She stayed with me for 4 days.  I didnt know until then she was in such terrible shape.  She has times that she can hardly have a conversation and one day she could not walk with out help. It seemed to me more of a neurological issue that day, because I don't think she was drunk.
She went to the doctor about 4 weeks ago to have her yearly labs drawn.  She hasn't been feeling well.  Here are her labs:

AST   239
ALT   68
ALKP 489
TBIL  2.4
RBC  3.32
MCV  113.3
MCH  38
HGB  13.2
PLT 57
TSH  17.71
BP 155/97


She has had problems trying to get her synthroid regulated.  The doctor keeps upping her dose but it doesn't seem to help. She has had very bad back pain for many years but it has gotten worse.  She had an ultrasound a week ago.  She called for the results and the nurse told her she has a fatty liver.  Thats all she knows.  She has not scheduled another doctors appointment and I'm afraid she may not.  Does this sound like a serious situation to you.  Her sister died from alcoholic Cirrhosis.
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1475202_tn?1388955435
Hello and welcome to MedHelp.
After reading your post I am very concerned for your friends health. Her liver is very irritated and undoubtedly inflamed. Her AST is unbelievably high and her bilirubin is of concern also. The AST is a strong indication of the amount of irritation. The bilirubin helps explain the function of her liver. If this irritation continues jaundice and cirrhosis are likely. Also your friends BP is high and she should be medicated to treat this.
Her platelet count is extremely low, this is a strong indication of an enlarged spleen due to portal hypertension, a direct result of limited blood flow through the liver due to cirrhosis.
I have a couple of questions for you since you mentioned synthroid. Synthroid is a medication used to treat an inactive thyroid. Nonalcoholic steatohepatitis (NASH) Fat build up in the liver that is not caused by alcohol use, is nonalcoholic steatohepatitis (NASH). NASH can cause the liver to swell and can lead to cirrhosis. People with NASH often have other health issues including diabetes, obesity, high cholesterol, coronary artery disease and poor eating habits.
Also you mentioned about her drinking, Chronic alcoholism is the leading cause of cirrhosis in the United States. Drinking too much alcohol can cause the liver to swell, which over time can lead to cirrhosis. The amount of alcohol that causes cirrhosis is different for each person. How much is she drinking?
Also I wonder if she is prescribed and taking any medication to help with her back pain? Most effective pain medications metabolize in the liver rapidly killing off healthy liver cells. This is why routine lab testing is needed to monitor the condition of the liver when taking certain pain medications.
See here is how it works, almost everything ingested in your body is metabolized by the liver, this process kills off healthy liver cells but that is okay since the liver has the remarkable ability to heal itself. This process takes time but is essential to survival since its primary functions are to assist with the abortion of nutrients and to filter harmful toxins. The problem occurs when healthy liver cells are being killed off faster than they can be reproduced, this causes scaring. It is this scaring that we refer to as cirrhosis. So it is critical to her survival to eliminate these things that are killing off massive amount of healthy liver cells (Irritation). This would holt or slow further progression of liver disease.
It is very important for her to see a doctor that specializes in the liver (Hepatologist) so that he/she may give her a complete and accurate evaluation. A Cat Scan is needed. Failure to pursue a further treatment will eventually lead to liver failure. Providing the Ultra sound was interpreted correctly she stands a very good chance to make an effective change in the condition of her liver, health and life!
Please keep in mind I am not a medical professional in any way but just a guy with cirrhosis that has done a lot of reading concerning my own survival. I hope this helps you out. Please feel welcome to post any further questions or comments and I will do my best to continue to help. I wish you both the best!
Randy
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Oh thank you for the information.  My friend is a very heavy drinker and has been for years.  She is 56 years old now and has been drinking daily since she was 20.  When she came to visit me she brought a large bottle of vodka (looked like a gal to me) and 4 large bottles of wine.  When she left 4 days later almost all of the vodka was gone and all of the wine.  I had one glass of wine.  She carries vodka with her in a water bottle in her purse.

As far as medications it's ironic because she doesn't really believe in taking anything for pain and hates to take any meds.  She eats very well.  Everything has to be organic.
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1475202_tn?1388955435
That's very good to hear she is so careful with medications and her diet but alcohol abuse is more than enough on its own to cause liver disease. Does she have any concerns about the results of her lab testing and ultra sound?

Unfortunately when it comes to our friends and loved ones that are abusing alcohol the best we can do is to express our concerns, but it is up to them to want to quit. Most people will hit "rock bottom" before they do but that is different for everybody.

Some things you should know about alcohol withdrawal:

Outlook (Prognosis)

How well a person does depends on the amount of organ damage and whether the person can stop drinking completely. Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.

Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver and heart disease.

Most people who go through alcohol withdrawal make a full recovery. However, death is possible, especially if delirium tremens occurs.

When to Contact a Medical Professional

Alcohol withdrawal is a serious condition that may rapidly become life threatening.

Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped. Call for an appointment with your health care provider if symptoms persist after treatment.

Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur.

Other symptoms of withdrawal are listed here: http://www.nlm.nih.gov/medlineplus/ency/article/000764.htm

I too drank for 20+ years and that’s how I ended up here. Sobriety is very possible to obtain and maintain. Judging from her test results she could certainly make a healthy recovery and begin a much more fulfilled and exciting life. It seems if she keeps on this path she is going to have to quit anyways so she might as way do it while she still has the option for a healthy recovery, as many here will tell you living with cirrhosis is a daily challenge never knowing what the next day will bring. You’re a good friend to make the effort needed to help. People like you will become a very important part of her sobriety and survival. I hope this helps. Take care,

Randy
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