Elevated LFTs and Fatty liver

[shiv26]

Hi,

Exactly a year ago, I was hospitalized for another reason when a liver test was done side by side .. My SGPT and SGOT values were in excess of 100 (I used to be a heavy drinker till that point in time). For the next 6 months i cut down on alcohol (from everyday in the past to just once a week ). My SGPT dropped to 80. In the last 6 months, i have been more stringent with avoaiding alcohol (when i drink i dont drink more than 2 pints / 60 ml of whisky say 1-2 days a week)

Recently underwent an ultra sound - The doctor said i have fatty liver and my latest SGPT readings are at 67... It doesnt seem to go down below 67 despite exercising and cutting down on fatty food (Pizzas, KFC, etc.)...

My questions?

- Does an ultrasound help identify cirrhosis ? I mean if i had cirrhosis would it show up on the ultrasound ?
- Do recovering enzyme levels necessarily mean i dont have cirrhosis currently ?
- I have started working out every day (been 14 days now) to lose fat , however, am not having enough stamina to complete a full workout (I get super anxious and weak post every work out - basically a 2 km jog, plus 50 jump claps, plus exercises for flatttening my tummy). Does this mean i have fatigue (which i understand is again related to cirrhosis)
- I have been suffering from severe anxiety in the last 12 months (so intense that sometimes i just need to clutch someone and break down into tears ). Is this hepatic encephelothapy?

Your guidance will help a lot.

Thanks

[shiv26]

Thank you so much for taking time out to reply; it helps a lot to connect with people. I checked my latest LFTs The readings are as follows:
GGTP: 49 (normal <55)
Billurbin total:0.97
Total protein: 7.51
Albumin:4.5
A:G ratio: 1.5

Regaridng HE, I am able to perform at work, and eat and sleep well. but whenever i get anxious (for no reasons)( my hands start trembling a lot) , Even under normal circumstances my hands have been trembling more than usual in the last year...

As suggested will go to to a hepatologist to reconfirm, however, given the quality of doctors i ve visited so far; I doubt they really give clear answers....

[Sevetts]

Hi Shiv26.  I'm sorry to hear that you are having all of these problems.  I really can't add anything to what Mike has told you other than to say if you are having liver issues alcohol in any amount is not good at all.  

Good for you for doing your workouts.  Hopefully with time your stamina will build.  Exercise and diet are very important.  A few of the biggies for diet are NO alcohol, no salt, low fat, protein (the less red meat the better) protein is good for muscles...I forget what else at the moment, but those are the big ones.

I agree with mike that you should see a specialist to find out exactly what is going on.  He/She will be able to answer your questions and give you the best treatment.  

Shelley

[mikesimon]

- Does an ultrasound help identify cirrhosis ? I mean if i had cirrhosis would it show up on the ultrasound ?

Yes, cirrhosis and advanced fibrosis will show up on an ultrasound.

- Do recovering enzyme levels necessarily mean i dont have cirrhosis currently ?

No, not necessarily. Liver enzymes reflect that amount of ongoing cell death/damage. Personally I like to see low enzymes but they do not reflect the overall function of the liver. Tests that can more accurately reflect liver function are prothrombin time (clotting time), platelet count, albumin, bilirubin and some others that I am forgetting right now.


- I have started working out every day (been 14 days now) to lose fat , however, am not having enough stamina to complete a full workout (I get super anxious and weak post every work out - basically a 2 km jog, plus 50 jump claps, plus exercises for flatttening my tummy). Does this mean i have fatigue (which i understand is again related to cirrhosis)

Your lack of stamina could be related to cirrhosis but there are other possibilities. You could simply be out of shape.


- I have been suffering from severe anxiety in the last 12 months (so intense that sometimes i just need to clutch someone and break down into tears ). Is this hepatic encephelothapy?

I suppose it could be a sign of hepatic encephalopathy but I doubt it. If you were suffering from hepatic encephalopathy I think you would have experienced other symptoms before now such as sleep problems, forgetfulness, confusion etc. Does this sound like something you've experienced?

Here is the criteria for assessing Hepatic Encephalopathy:


"Diagnostic criteria
West Haven criteria [23]

These criteria are based on severity

    Grade 0. Normal

    Grade I. Mild impairment: sleep alterations, subtly impaired intellectual function, heightened irritability, metabolic tremor, and impaired muscular coordination

    Grade II. Moderate impairment: lethargy, grossly impaired intellectual function, disorientation to time, inappropriate or bizarre behaviour, slurred speech, hypoactive reflexes, ataxia

    Grade III. Severe impairment: somnolence, confusion, disorientation, paranoia or anger, hyperactive reflexes, nystagmus, Babinski's reflex, clonus

    Grade IV. Coma: unconsciousness, dilated pupils."

If your anxiety is due to a fear about your liver health I strongly urge you to see a specialist - either a hepatologist(liver disease specialist) or a gastroenterologist(digestive disease specialist). I think knowing what is going on and dealing with it is far better than worrying about what might be going on.

Good luck,
Mike