Reversing Fatty Liver

[Hoppy4464]

I was recently found to have a fatty liver. It was picked up incidentally on an ultrasound I had for something else. My bloods also came back with slight elevated ALT at 43 and AST was in range at 28. The GP did a fib 4 score and said it was 0.48 they said this was ok and only become more concerned when it goes over 1.2. Before I found out I drank over the recommend units around 30-40a week, am obese and didn't particularly have the world's healthiest diet but do exercise 3 or 4 times a week. GP told me to lose weight, eat healthier and cut drinking to recommended levels. They said they would recheck bloods and fib 4 score in 3 years, this seems like a lifetime away. I abstained from alcohol for a month and since have drank around 6-8 units a week, I have lost weight about 10% of my body weight and am eating very healthily. I am still worried about the fatty liver how will I know if it is getting better, how often do people have check ups?. Is a fib 4 score test accurate? How do I know how bad my fatty liver is? I am really worried and just want to get rid of it as soon as I can. Can I reverse my fatty liver, how long will it realistically take? I tried to find answers on Google but this terrified me and am now worried it could be far worse that what the Dr found from my bloods.

Hello. Please do not stress....this is a very reversible condition. I am a Clinic Nurse and have been for a very long time.....Your liver function test enzymes are only very marginally raised and from what you are doing, I suspect they will return to range in next 3-6 months....Im no expert of course but I am pretty sure that the Fibroscan is at a good level and no where near the 'worry' point. Just keep going with weight loss, reduced animal fat intake and reduced alcohol....and do exercise....it all helps. Listen to your GP and do NOT look at Dr Google who is full of doom and absolutely doesn't know you, or, your personal medical and lifestyle history. If your GP was concerned you would be referred to Endo/Hepatologist pretty quickly so just try to relax......have the bloods done in 3-6 months and Im sure the Liver Function Tests will regularise.....the next Fibroscan can wait 3 years and IF its needed earlier, then your GP will tell you. I do know the worry but all you can do is what you are doing.....Fatty Liver is reversible and once you know you have it then thats the biggest positive you can have....just being aware helps but do not stress. ( assume Thyroid and lipid tests have been done also ? There is a big connection between these - your liver is a very effective purifying plant!!!) Take care and I am certain someone a lot more technical and qualified will come along soon!!! All the Best....

Thank you for your kind and reassuring reply. Is TSH level thyroid if so then I have had this back and was in normal range. I don't think I've had tests for lipids though what are these? Can I request bloods from GP in 3-6 months to have them redone, I think I would find this fairly reassuring (unless of course they've increased)!

I've also got a fatty liver as confirmed by ultrasound ("everyone seems to have one these days" according to the ultrasound tech!) - FIB4 score higher than yours but well under the concern point. I haven't been tested recently but am due to be checked (the GP said to get a checkup once a year). I wish I had been losing weight but I put it on over the past lockdown (variety of reasons - eugh) but am now actively upping the exercise and lowering the calories. I never drank loads - but am making sure I only drink a couple of days a week max and not too much. I've also been taking livercare tablets which have milk thistle in them amongst other things, obviously don't know whether they've helped (guess the next blood test will tell) but they seem to be highly thought of.

I'd be interested to know if anyone has any suggestions too.

Good to know your Thyroid is in range ( TSH is Thyroid Stimulating Hormone ) I would be surprised if Lipids were not done … these are Cholesterol measurements…. Again with Fatty Liver, your Cholesterol could be more than it should for all the reasons your Liver is fatty … But again you are taking all the right steps. Have a look on The Heart Foundation website for good diet and lifestyle advice - and if they are higher than they should be - again - they are reversible and can be brought back to good range with the adjustments you are already making. I would suggest that you be reassured by the Fibroscan results and yes - ask GP for repeat Bloods in 3 -6 months. If they are reluctant to do them then might be worth getting them done privately and then show results to the GP. We do have a number of patients with Fatty Liver and only a very very small minority progress to any more lasting issues. A good panel of Bloods - I suggest in your case is to have Cholesterol (lipids) done with HbA1c ( Diabetes screen) and re-run the Liver Function Tests. CRP to check inflammation would also be sensible. Aside from family history and inherited propensity to these conditions- you are very much in control of getting the results back to normal range and everything you are doing is very positive …… your abnormal findings so far are very marginal and it does take a good GP who will assess all components of the blood panel to find a way forward and decide what is significant and what isn’t …. Don’t forget - a blood test is a reflection of a moment in time and the results can entirely change from month to month. You will need to be ‘fasting’ for the next lot of bloods so make sure you do for at least 8 hours before blood drawing. Don’t stress! Knowledge is power and you have had a small warning to get your lifestyle back in balance and this will hopefully reassure when you get the next panel of Bloods back. Please don’t worry and stay off Googling - tempting though it is and usually at 3am!!! Don’t !! Good luck and we’ll done so far

Thanks so much @Claricethecat45 so much useful information. I had a check and definitely no lipid tests I did have the HbA1c one last year along with a thyroid one. I think I'll get some private bloods done in another month or two when hopefully I've lost a bit more weight and my liver might be in better shape

@inigomontoyahwillcox just looked at those livercare tablets, I'll be getting some of those the reviews are pretty fantastic! Thanks for the recommendation. Will they just redo your bloods for the check up or ultrasound aswell?

I think so, no more scan for the time being.