Fatty liver, raised liver function tests

[Laterthanyouthink]

I have just had repeat blood tests for liver function tests as the levels were raised. GP was going to send me for ultrasound and a liver screen but I remembered having been told I had a fatty
liver a while ago - she checked and turned out was 2012 when previous ultrasound and tests were done. They found I had a fatty liver but could give no reason for it and no advice on what to do.

I have low to normal blood pressure, a good diet (coeliac) but ongoing fatigue, sallow skin, pale stool.

Anyone any idea what is going on or what I should be doing to feel better? GP was reluctant to do any more tests as seems they already been done, albeit 7 years ago!

a coeliac diet on its own doesn't mean good or bad diet, as it is not so much what you cut out, gluten in your case, but are what you put in your mouth. Do you eat a lot of eggs, dairy, meat? How is your cholesterol ?

A Chinese herbalist once told me I had a fatty liver when I was around 30 and lived on the Med. I thought I had a good diet. In hindsight, I probably drank 2 bottles of wine a week and 1-2 diet cokes per day.
I drink less alcohol now, gave up anything with aspartame years ago and drink lots of mint tea, green tea and water these days. Nothing flagged for my liver at a recent Gp test.
Are you in a good bmi range?

Well if you had a fatty liver 7 years ago and still have raised levels does that not mean that you've had it all this time and it may have progressed to something more serious and so warrants further testing? I can't believe the gp thinks that tests from that long ago are still sufficient!

Also, given that you already have an autoimmune disease, then you are more likely to have another, several of which can affect the liver. I think you should insist on more tests.

Thanks for replies!

I was meaning gluten free diet meant I eat a lot of unprocessed food so a fair mix of chicken, fish, some meat, veg, salad, fruit and some gf bread, crackers. I drink maybe a couple of glasses of wine per week but not really fussed about having it. Don't drink fizzy drinks.

I'm also on levothyroxine for underactive thyroid (hashimotos).

I think my notes probably say I want lots of tests but I've been sick for about ten years, first diagnosed coeliac, then hypothyroid and early menopause on the way so yes I'd like to know why I still feel crap.

Any ideas what further tests would be worth asking for?

Oh forgot I don't know what my cholesterol is!

And BMI is fine (23.8) though worth saying I've put on a stone in weight, mainly round the middle, in the last year.

Liver disease has three stages. Fatty liver, fibrosis/hepatitis, cirrhosis. Not everyone with fatty liver goes on to develop the latter two stages, but there is obviously an increased chance if you have a fatty liver.

Fatty liver is either alcoholic or non-alcoholic. The latter is also known as NASH. It is also much increased if you have autoimmune disorders.

You need an ultrasound to look at the extent of the fatty liver, then you need an ELF blood test which will show the likelihood that the fatty liver has, or will, develop into fibrosis. You can have a very advanced scan called a fibroscan but they are not widely available. Fatty liver is reversible, fibrosis is but it’s harder work and the chances of doing so are slightly less. Cirrhosis is not reversible.

The British Liver trust website has some great advice.

I should point out too that LFTs are NOT a reliable resource for fatty liver or damage. Your liver function can ironically remain ‘normal’ on tests right through to having quite extensive damage. ELF is the better blood test for this.

You can be slim and have fatty liver disease and your last post, having gained a stone around your waistline is maybe the reason.
liverline.com/can-thin-people-get-fatty-liver-disease-7e91e3ae3dde

Try to eat more plant based or at least Mediterranean following the Harvard Medical school blog www.health.harvard.edu/diseases-and-conditions/the-skinny-on-fatty-liver-disease

I am shocked that your Dr wont do more tests, what kind of a Dr thinks like this,you do need more tests, my sons have a fatty liver ,the Dr put it down to eating too much meat.but they are also drinkers, and alcohol can cause it, or a combination, but if you have a sallow skin too, i think that is connected with liver or gallstone problems,
There could be other reasons of course
My twin sons have Haemochromatosis, which i have actually talked about in another thread
My ex,also has a fatty liver,he is a heavy drinker,[or was] might still be
If i were you i would ask the Dr to check for HH [herditary haemochromatosis] just in case, if you do have this,then other members of your family will have it too, usually your parents have it or carry the gene
HH can cause joint problems, stomach problems , heart and kidney etc,,also extreme tiredness
You mention pale stools, another sign of liver disease
Do you have any of these problems?
Please go back and insist that you have more tests,
In my opinion your Dr is being negligent

Sorry just read your op again, and see you are having more blood tests,
Please update us,i would be very interested to know what the outcome is, cant believe your Dr doesnt think it neccessary

Thanks princess

I do have lower kidney function too (stage 3a I think) and fatigue is the biggest issue for me.

Alabaster
Thanks for advice on tests, NASH was mentioned before though with no explanations.

How do you reverse fatty liver?

Does lots of aerobic exercise help? Or a zero/low fat diet?

Lots of good information here but you need to know what stage the fatty liver is at now, not years ago. Push for the tests and review before deciding with your GP (or consultant if he then refers you) a way forward.

www.britishlivertrust.org.uk/liver-information/liver-conditions/non-alcohol-related-fatty-liver-disease/

So I had a message today to say hospital are asking for more blood tests (after a chest x Ray I had about a month ago). I don't know what other tests they want to do yet but will try to get booked in this week, thinking it maybe ELF test?

Actually that was wrong. I had a letter today from consultant which was asking me to see GP to do more in depth blood tests, looking for antibodies of some kind?

I have no idea how he is monitoring the previous blood tests - I only see him once a year for a checkup and last time was 4/5 months ago. Maybe system flags up odd results to him?

Cut the sugar.

www.ncbi.nlm.nih.gov/pubmed/29408694

Blood tests were done yesterday, quite a few different ones. Testing for autoantibodies, hepatitis and various other things so may know more by the end of the week/early next week.

If you are overweight or drink a lot of alcohol this can give you a fatty liver. Or diabetic

So test results are normal/stable so no further forward. I will go back to GP to find out exactly what was tested and what can happen next. A rather scary development is that I'm starting to feel some mental confusion, just not able to think clearly and struggling with simple things eg. Writing the date wrong, getting slightly lost when driving, mixing up tea/coffee for someone.

WRT your symptoms (weight gain, confusion etc) could your thyroid medication need re-jigged?

Thank you for the suggestion but it doesn't feel like thyroid is out of whack. Last tests for that were fine, TSH around 1.0.

I am having quite a bit of abdominal discomfort now as well as a pins and needles feeling in feet/legs. That comes and goes but is pretty constant now. I just can't make sense of any of this!

My understanding is it's a known complication of coeliac disease. My almost t-total coeliac family member is constantly questioned if he's an alcoholic by the GP when he goes for blood tests because his LFTs are raised.

I suspect his is exacerbated by not being very good at sticking to his diet and using quite a lot of paracetamol (never exceeding daily amounts but frequent enough use that it may be a factor)

That's interesting, it was the gastroenterologist I see for coeliac that suggested further testing! I do stick to gluten free and that is confirmed in annual antibodies test. I don't drink much and have abstained since the raised liver enzymes came up. How do I get GP to review where I am and investigate further? I feel like they just repeat the same tests and nothing definite shows...