A little bit more about me
-MRI shows fatty liver
-Fibroscans show no significant liver damage
-Eat healthy, go to gym, taking egg protein since july (all advised by doctors)
-Do not drink heavily or often
-Do not smoke, do drugs, take any medication (paracetamol etc.)
The specialists have refused a biopsy and just 'want to see what happens'. My GP
has not been particularly helpful or caring. I just feel a little bit down :(
Hello have you gone to a GI/Hepatologist? That would be the type of doctor to go see. I apologize if you have done that.
When you say they want to see what happens, does that mean they have asked you to change your diet?
My friend has NASH a non alcoholic liver disorder and she has been told that she needs to better control her diabetes and lose weight as she is nearing cirrhosis.
If you are not happy with your doctor you can always get a second opinion.
Please let us know how you are doing.
Thank you for your reply. I have seen 3 gastroenterologists but no hepatologists. We don't really have heptatologists here in NZ.
I am not overweight, I was considered underweight. Since starting bodybuilding a couple months ago I have got my BMI up to about 24. However I have had abnormal LFT for the past 2 years.
I have not been on any medications. My doctors are pretty stumped too, they don't know what's going on. I just don't want it to turn into cirrhosis so I am trying to eat clean, exercise etc. but I just can't seem to get my ALT levels down.
"...Liver function tests: Alkaline phosphatase and GGT
Another of the liver's key functions is the production of bile, which helps digest fat. Bile flows through the liver in a system of small tubes (ducts), and is eventually stored in the gall bladder, under the liver.
When bile flow is slow or blocked, blood levels of certain liver enzymes may rise:
Liver function tests may check for any or both of these enzymes in the blood.
If alkaline phosphatase and GGT are elevated, a problem with bile flow is most likely present. Bile flow problems can be due to a problem in the liver, the gall bladder or the tubes connecting them..."
First I want to make it clear that I am not a doctor or in the medical profession in any capacity. What little I know I came by as a patient who had hepatitis c which necessitated a liver transplant in 2000.
I really have no idea what is wrong with your liver but I do know for sure that something is wrong and I strongly advise against the "watch and see" approach your specialist has recommended. In my opinion that approach is much too cavalier. It has been my experience that these types of situations do not usually resolve on their own. Perhaps it is possible that all of your blood levels are the result of Fatty Liver Disease but I would not be comfortable assuming that is the case. Your ALT has gotten progressively worse since April 2012 and I see no reason to expect that will change without some type of intervention. The excerpt I posted from webmd.com raises the possibility of a bile duct problem and I would want to have that ruled out. You haven't posted your bilirubin which, if elevated, might further suggest a biliary problem. If you cannot prevail upon your current specialist to conduct further tests then I would advise finding another doctor who will. As stated above by Dee, a hepatologist would be my first choice but if one is unavailable then I would find another gastroenterologist who will pursue your situation more aggressively. I certainly don't intend on alarming you unnecessarily and I do not feel there is reason to panic. But, I do believe you need to find a doctor who will embark on an aggressive plan to diagnose the cause of your enzyme elevations.
I agree with Mike! I would ask the doctors to carefully evaluate the ducts associated with the liver, gallbladder and pancreas. Do you have copies of the reports generated from the MRI and fibroscan? (Its always a good idea to ask for and retain copies of such reports for your own files.) Have they also done ultrasound studies? Do any of these studies note any enlarged or otherwise abnormal ducts? Don't let them wait too long without more effort at discovering the cause of these elevated enzymes - if they wait until you are really sick then it can be more difficult to treat some problems. Good luck on getting to the bottom of this, and keep us posted.
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