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General health

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Original poster

is it possible for an 'alcoholic' to have a normal liver blood test?

47 replies

imaginaryfriend · 24/07/2006 14:08

My aunt has been a heavy drinker for as long as I can remember but because she continually has liver blood tests that come back normal she believes she's kind of 'immune' to getting liver disease. The last few times we've seen her though I've found her looking very unwell, kind of sweaty and breathless and her feet have swollen considerably. Are there other ways a GP should be looking for signs of alcohol-related illness in her? I'm very worried.

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2plus2plus1 · 26/07/2006 21:51

Hi,
I can't be sure how much he drank as I wasn't there for the main. To the best of my knowledge it wasn't more than a 2 litre bottle of strong lager or cider a day. I wouldn't stake my life on it though, and there may have been a time when it was more than this whilst I was away at uni - probably a peak. But if you think about this EVERY single day for 15+ years...

Original poster

imaginaryfriend · 26/07/2006 22:57

Yes, 2 litres of strong lager or cider would add up to quite a lot of alcohol per day. I'd imagine (now I've done such a lot of research into it!) it would be about 10 units a day at least of alcohol, 70 a week, and the maximum for men is meant to be 4 units a day. My aunt has drunk a lot for as long as I remember. Like a true drinker she NEVER appears drunk, she knocks it back like it's lemonade ...

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Original poster

imaginaryfriend · 26/07/2006 22:57

Going back to the liver function tests ... if the liver was SERIOUSLY compromised, surely something would show on the blood test?

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Caligula · 26/07/2006 23:04

Yes i think it is because by the time you actually show symptoms of liver disease, you are very ill with it. You can abuse your liver totally for years and seem perfectly well and then suddenly without warning it will stop functioning. But also because it regenerates, it can recover from the battering an alcoholic gives it as long as it doesn't get to the point of no return.

Original poster

imaginaryfriend · 26/07/2006 23:22

Thanks caligula. So do you think that if it was really damaged something would show on a liver function test? Or only at the point of no return?

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kokeshi · 27/07/2006 04:51

Hi IF,
Thought I'd try and impart some of my "research" into drinking to see if it helps any. As a performing alcoholic, I saw my LFTs go dangerously off the scale. These tests are used by docs to give a rudimentary guage of how much distress your liver is in. Sometimes, quite arbitrarily, they would show up as fine which I seized upon as a justification that my drinking was fine. It is by no means definitive.

It's a common misconception that you have to drink a bottle of spirits a day, drink alone, or in the morning to be a true alcoholic. Indeed, I know people who regard themselves as chronic alcoholics even when they've had long periods of abstinence or just a couple of beers in the evening. Also this units business is misleading because everyone is affected differently according to genetic make-up and other health factors. Finally, the liver is just one of the organs affected by long term heavy drinking. There are many resources out there describing in detail global effects of alcohol abuse on the body.

At the end of my drinking I was hospitalised with acute pancreatitis, which could have easily killed me. It wasn't pleasant.

However, like another poster mentioned, your aunt has to decide for herself that her drinking is causing her problems but for you I would def recommend Al-Alon for friends and family of problems drinkers. They are a wonderful fellowship, which I have also (as well as AA) attended as my late husband died as a direct result of where drinking took him mentally, physically and spiritually.

I hope you and your aunt find some peace.

Much love

kxxx

Caligula · 27/07/2006 07:27

imaginaryfriend, I don't have the medical knowledge to be able to answer that - perhaps someone who knows will come along soon who can.

But I second the advice you've had to give al-anon a call. As well as being able to put you on to someone who might be able to answer your medical questions, they'll help you deal with your response to your aunt's alcoholism.

al-anon

Original poster

imaginaryfriend · 27/07/2006 18:29

Thanks again for the replies.

My aunt has had around 6 LFTs done so far and ALL have shown nothing. Does that count for anything?

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Original poster

imaginaryfriend · 28/07/2006 16:08

any more help with this? I see my aunt this weekend ...

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dinosaur · 28/07/2006 16:11

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.

Original poster

imaginaryfriend · 28/07/2006 16:34

No, I haven't. I could probably speak to them for advice only couldn't I, even if my aunt won't go there?

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dinosaur · 28/07/2006 16:35

This reply has been withdrawn

This has been withdrawn by MNHQ at the poster's request.

Original poster

imaginaryfriend · 28/07/2006 16:38

Thanks dinosaur. I've learnt such a lot about alcohol in such a short space of time!

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NotAnOtter · 28/07/2006 16:43

bloody alcohol feel its many millions of lives affected by it in this country alone....not a great fan of it in excess...

Original poster

imaginaryfriend · 28/07/2006 21:35

I agree notanotter, totally. What I've discovered in my many researches is also quite frightening - even drinking in what I thought was a fairly light way can be dangerous.

I see my aunt tomorrow and I want to be able to tell her that her reasssurance that she's basically doing herself no damage because her LFTs are ok is inaccurate. Although I haven't managed to find any solid evidence to back myself up. She always said to me that if she got unwell she'd quit and I think she's looking unwell although she says she's not and is constantly harping back to this 'clear' LFT. Apparently her GP is satisfied that if the LFT is ok she's not drinking excessively. It's a bloody difficult one.

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2plus2plus1 · 29/07/2006 11:08

Not sure what time you are off to see your aunt, this may be too late - it may also be of limited use but...

With the LFTs there is actually a 'range' of normal values. They still be normal now & will be until the cut-off threshold is reached. You may be able to see a trend in the results over time if she is doing damage but you are unlikely to have the imformation to tell that - but the GP would.

As others have said the liver has a massive repair & recovery capacity, so it may be that the liver is keeping 'on top' of the damage - for now. My father was told that if he gave up (12yrs ago) his liver would probably recover to give a normal function. If he didn't there would be a point in time at which the liver could not recover under any circumstances. He was also of the opinion that because the doctor said his results are suggestive of heavy jaudice (but without the jaundice) he felt there was nothing wrong & the "doctor must be wrong". Giving him the opinion it was safe to continue, he wasn't damaging his-self, doctors don't know anything etc. Ammunition really to deny the real probelm. Could your aunt be denying the probelm? could the results be borderline but nevertheless 'normal' therefore OK in her mind?

Going back to your original post - it is my opinion (with a small amount of medical knowledge) that nobody would be immune to liver disease. I was taught at uni that a person can only take a finite amount of paracetamol in a lifetime and I guess alcohol is the same. Irrespoective of the ?liver issues I think she should be encouraged to get the other symptoms checked out. They may or may not be alcohol related.

Finally I don't think the liver is the only point of damage for alcohol. There are certainly many other organs & systems which are influenced by alcohol. I think it is just the first target...

Hope it goes well with your aunt. Don't be too pushy though as you will ony cause her to get defensive & more cagy & then you may loose any ability to 'observe' her condition. I am sure you know that anyway.

Original poster

imaginaryfriend · 29/07/2006 13:44

I totally blew it. We were meant to be with her all day but here I am back home again. I left dd playing in the garden with dp and asked her if I could have a chat with her. I should add that when we arrived today she looked awful. She'd got her make-up and summer clothes on but she was very pale and more sweaty than we were despite being in a cool house where we'd been walking fast in the sun. And her hands were REALLY shaking when she made a coffee. Worst of all was that she smelled of vomit when I kissed her, vomit covered by toothpaste. And a definite whiff of alcohol too. Any doubts I'd had about saying something disappeared and dp caught my eye and agreed. All I said to her was that i was worried about her and would she like to talk about anything. She laughed it off at first and said she'd had a tummy bug (she may well have done for all I know so I gave her the benefit of the doubt) so I just said 'I guess that means you won't be able to have a drink if your tummy's bad?' and she totally irrationally suddenly flew off the handle. I've never seen her like that. She said she'd seen the GP in the week and told him exactly how much she drinks (one bottle of 12% alcohol a day she says) and he felt her liver, took her blood pressure (which is a little low), sent her for another liver test which she says came back normal (although I'm not sure how quickly you get results back?!). Then she 'politely' asked us to leave as she was unwell with this tummy bug. Dd was terribly disappointed to go as soon as we'd arrived. Looking back I can't think I said anything really provocative, just general and very friendly and gentle. She seemed ready to fight. I must have got a bad moment.

Now what do I do? I'd like to phone and apologise as I feel I can't do anything if we're not 'friends.' She's very important to me, like a 2nd mother as she brought me up a lot of the time.

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LaidbackinAsia · 29/07/2006 14:17

Hi IF, sorry that your afternoon didn't go as you wanted it to. Like I said before, people only change when they are ready to. There are different stages of change and your aunt sounds like she is pre-contemplative or at the early stages of contemplating change. These phases often involve denial and guilt.

How about writing her a letter ? Tell her how much you care about her. Say that you are worried about her drinking and the fact that she might get ill and not be around. Tell her that you love her whether she is drinking or not. Tell her that you will support her if she needs help. Tell her you will attend appointments with her or AA if she wants. Offer her your unconditional support. Letters are often better than direct confrontation - people can reflect on ther content without the emotional overload.

Get some support for yourself please. Supporting someone else can be very draining, whether they want your help or not. Good luck , your aunt is lucky to have someone who cares about her so much.

Original poster

imaginaryfriend · 29/07/2006 18:55

Thanks laidback. In fact I phoned her this afternoon and she apologised and insists she has a tummy bug. She did speak to me on the phone quite openly about her drinkings. She says she knows she drinks more than you're 'supposed' to but that until she has signs that it's damaging her health she's not going to do anything different. She thinks that for her age she's in good shape, happy, independent etc. So I'm back to square one. I wish I could speak to her GP although I know that's against the law. I'm just still so flummoxed about those liver tests.

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Original poster

imaginaryfriend · 31/07/2006 09:43

any last help on this?

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Caligula · 31/07/2006 09:53

IF, Laidbackinasia's advice on writing a letter is a good one.

The problem with your aunt's decision to carry on drinking until she gets ill, is that when (if) she gets liver disease, it will be too late to get well again. The liver is such a wonderful organ, that it can keep functioning until most of it is gone - and that's when it collapses and can no longer regenerate. She needs to understand that before she makes that choice. You don't get any notice of liver disease - you get ill and then you die, unless you get a transplant. So in effect, she's potentially choosing to drink rather than to live.

I agree with LBiA as well, that she may be in the first stages of understanding that she has a dependent relationship with alcohol and this is where the denial weapon comes in. Don't underestimate the power of it, it's the most effective one in an alcoholic's armoury. I suspect that the reason she over-reacted on Saturday, is because up to now, by not challenging her drinking behaviour, you have colluded (unintentionally) in her denial. This is the first time you've challenged her on it and it is incredibly frightening for her - as long as other people are still at the stage of not really thinking it's a problem, you can kid yourself it's not a problem. Once they start to challenge you, you have to make a decision about whether they're wrong or you are. And that's a toughie.

Please do call al anon, they will help you. You need support too.

Original poster

imaginaryfriend · 31/07/2006 10:00

I will, Caligula, thanks. I do get a sense that this is a crucial moment, a possible turning point for her. Which is why I'm harping on about it on here. I feel as though if I don't do something she will end up one of those people for whom there's no turning back. And she's such a wonderful person it would be a tragedy.

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