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!

You need to see a different dr and ask for repeat bloods. I don't want to scare you in any way but don't let it drop.

I'm sick of some dr's thinking thy know best when they clearly don't.

Good luck and keep us posted.

www.bmj.com/rapid-response/2011/11/02/abnormal-liver-function-tests-don’t-forget-coeliac-disease

Here - it's not an answer but there definitely is a link between CD an liver stuff.

Mental confusion can be Hepatic Encephalopathy (HE) which is related to toxins not filtering from the liver.

I said up thread that I didn't want to scare you but I had a liver transplant a few years ago due to damaged liver which came from nowhere and I only found out why after.

Even if you have to ask your coeliac consultant to sort tests out.

Have you thought about secondary hypothyroidism? It can cause raised liver enzymes but your TSH remains low.

Thank you - I have Hashimoto's though so think that means they tested for antibodies, I take thyroxin for that already.

Rang GP this morning but no appointments or callbacks so I tried out the online consultation which took very detailed information and said I would get a callback by end of Monday. GP did actually call back this afternoon but annoyingly I couldn't take the call. They followed up with email saying GP is now on holiday for two weeks and that I should call to speak to a GP on Monday... I have no chance of getting through on phone/getting appointment on Monday morning! Aaaarrrggghh

Just to second a previous post re haemochromatosis. It can cause liver issues and 'brain fog' is a common symptom. Check if Doc has done an iron studies test as this will show whether iron levels are high which could be a sign of haemochromatosis. I have just recently been diagnosed, is more common than people think and can managed when caught early. All my other bloods were completely normal.

Just noticed you mentioned early menopause, another haemochromatosis symptom as is fatigue (main symptom). Sure if you had that many tests they will have done iron studies, you specifically need to know ferritin and transferrin saturation percentage, if these are high suggests further genetic tests. Doctors don't seem to know much about it. Can you not see your test results online? A lot of GPs do that now. Good luck, sounds like you having a thorough MOT, always good!

Fatty liver can be caused by excess carbs and sugars, GF foods often have excess sugar in to make them palatable.....

I cured mine by following a LCHF diet.

Fat does not cause fatty liver!

Thanks for everyone's thoughts! Had phone consultation this morning and GP does not seem concerned about any of the test results but also didn't offer any info on fatty liver, I will get appointment in two weeks when my own GP is back from hols (hopefully!)

However I do have copy of test results:

Bilirubin 19 ( range 3-21 and was 22 in Dec, 23 in March)

ALT 113 (range 10-50 was 82 in Dec, 96 in Feb)

Alk phos. 44 (range 40-125, was 36 in Dec, 34 in Feb)

Cholesterol 6.2

Ferritin 273 (range 15-200)

Full blood count tests all in range except
Mean cell Hb 32.2 (range 27-32)

And haemoglobin 160 is at top of range

GP says results not high enough to indicate iron overload /haemochromatosis

Anyone see anything different there to think about?

I would disagree with your GP on the iron overload. I would push for an iron studies blood test as that is the only test that can show iron levels accurately. Ferritin can be increased with any infection or inflammation, even a cold. Higher LFTs and higher haemoglobin are also found in Haemochromatosis. I have just been diagnosed with this so been doing my research. I will say though I'm sure it could be something else as well and don't worry! I spent weeks googling my test results worrying, only a Dr can read the multiple results and interpret. Although Drs pretty clueless on Haemochromatosis I have to say! There is a good website run by Haemochromatosis UK that explains more.

Cholesterol seems high at 6.2.

Following bloods and an ultrasound, my GP diagnosed non-alcoholic fatty liver for me a couple of months ago , my cholesterol was 5.6. I've got a high BMI (that's such a polite way of saying I'm beyond fat!!) He's given me six months to see if I can improve matters by exercise (as in, actually doing some) and diet, before we have a more serious conversation. Funnily enough, I'm on Levo too. I wonder if there's a correlation?

Yes I thought cholesterol was high too but she didn't mention that. There do seem to be links between hypothyroidism and haemoochromatosis too and fatty liver. My bmi is normal, I'm just under nine stone, though that is nearly a stone up on a year ago (and I'm quite short!).

Another thing I notice is being very very irritable this week, losing temper on minor things far too quickly.

@Lilythepink3 what was your ferritin level at diagnosis and what symptoms did you have?

Thanks

And did you get referred to a consultant?

Symptoms wise I feel lacking in energy, generally grotty, twingey pains in abdomen and elbow, hand, knee (it gets to your joints), generally unwell. This is all very recent but I have read on the Haemochromatosis Uk Facebook group that people can suffer for many years and the Doc just palms them off. That is why I just wanted to flag it with you, just in case, worth getting it checked as can cause some real damage and lots of stories on there about late diagnosis. If however you did have it then you have caught it well early which is great, that ferritin level is ok. Mine was 537 which Doc said was still low, they start to worry at 1000. Doc says I shouldn't have symptoms with those levels but Facebook group is full of people with low levels and symptoms. Is a funny condition that presents with lots of different symptoms. With that slightly high ferritin they should at least do an iron studies blood test just to rule it out. I am also 9st, with a cholesterol level of 5.3 which surprised me. The Docs will get to the bottom of it but as I found is a process of elimination, I had so many tests all coming back fine, just one young doc decided to query my slightly high but normal MCHC level in FBC. You will get there but I think being pro active will get you there faster. Can't tell you how many docs I saw in last few months, telling me I had anxiety.

Sorry, yes my lovely young doc went out of her way to find me the next available consultant appointment, gastroenterologist. This was after the iron studies test strongly suggested haemochromatosis but before I had confirmed genetic blood test result. Iron studies test looks at ferritin and transferrin saturation, both will be out of range with haemochromatosis. Consultant wasn't bothered with me, I pestered him for ultrasound, liver was fine and now I start the treatment - giving a pint of blood weekly till levels return to normal. Honestly if you do have it, which you may not but good to rule out, then you caught it very, very early so all good!

If you are getting tingling in your feet could be b12/pernicious Anaemia? Have you had b12 tested recently?

Sounds like peri menopause symptoms to me! I was 37 when all my symptoms started

Thanks for all the info! I have reread consultant's letter as I was thinking of contacting him to get his input and he actually said he would be back in touch after these tests were done so I will wait for that/GP to get back from hols. He is a gastroenterologist anyway so likely I would just keep seeing him (originally referred for coeliac). I spent quite a while being told I was depressed before coeliac diagnosis and same before hypothyroid so not really going to listen to that again!

I am way beyond perimenopause though, last period about a decade ago! I do get B12 injections too as that does not seem to have recovered from coeliac damage.

I feel horrible though, fatigue, joint pain, tinnitus, pins and needles, abdominal pains, brain fog/memory problems, irritable and I do think my skin is a bit yellow...

Glad you got follow up and brilliant you already with a gastroenterologist. Push for the iron studies blood test and an utrasound. It could be haemochromatosis, they used to call it the bronze diabetes as skin colour change is a symptom, your other symptoms also common. If it is brill as you have caught it. Get the ultrasound though to check your liver for reassurance. It might just be the fatty liver causing you problems or something as simple as a virus giving you hell! Let us know how you go on. Best of luck x

Thanks Lilythepink3 I appreciate the info and advice very much x

Later i am surprised that you have been told your ferritin level is ok,
I have been told it shouldnt be over 100, i build iron very slowly but after having blood taken it drops quickly
I get very annoyed when i am told i need a venesection when my ferritin might be just over 100, and have refused to have one,as then it might drop to something like 38, and even dropped once to 12,and makes me feel ill
I hope you get it sorted out soon

Lily i cant believe your ferritn is classed as low at over 500, shouldn;t and 1000, classed as worrying. are you in the UK?

My LFT's were raised after surgery for colon cancer, and it appears that was due to the paracetamol drip I'd been on.

How are you feeling now Laterthanyouthink?

Have you seen your gp yet.

I went to the doctor a few weeks ago and he happened to mention that I was diagnosed with a fatty liver in 2010! In the last 9 years not one gp has mentioned that to me at all, and I have been in to see them a lot over the last year or so due to peri menopause. No idea when it was diagnosed as he couldn’t tell me that and he couldn’t explain why nobody had mentioned it to me before now. He has arranged for an ultrasound and I had blood test that day. Bloods are all absolutely in normal range.

He advised me to follow Diet Doctor which he said is good for reversing fatty liver.