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Diagnosed With Fatty Liver. Take Alcohol And Smoking. Hypertensive. Started On Vitamin B12 Injections. Suggestions?

Posted on Thu, 12 Sep 2013

Question: I am a 27 year old Indian male (height: 5 feet 8 inches, weight 72kgs). I was diagnosed with fatty liver in XXXXXXX this year. I have been an alcohol user (180ml whisky alternate days from about an year). i have cut down on alcohol (once a week now). I smoke 4-5 cigs a day too,. I am hypertensive and am on medication for it. My BP is under good control. My current blood work reports are as follows:

VITAMIN B12 174.0

LIVER FUNCTION TEST

BILIRUBIN, TOTAL 0.97
ALANINE AMINOTRANSFERASE (SGPT) 218
ASPARTATE AMINOTRANSFERASE(SGOT) 101
GAMMA GLUTAMYL TRANSFERASE (GGT) 92
HEPATITIS B SURFACE ANTIGEN NON REACTIVE

LIPID PROFILE and Blood Sugar

FASTING BLOOD GLUCOSE, PLASMA 111
GLUCOSE, POST-PRANDIAL, PLASMA 122
POST-PRANDIAL URINE SUGAR NOT DETECTED
GLYCOSYLATED HEMOGLOBIN (HBA1C) 5.8
MEAN PLASMA GLUCOSE 120

CHOLESTEROL 233
TRIGLYCERIDES 296
CHOLESTEROL HDL 17
DIRECT LDL CHOLESTEROL 144
CHOL/HDL RATIO 13.7
LDL/HDL RATIO 8.5
VERY LOW DENSITY LIPOPROTEIN 59.2

KIDNEY PROFILE, SERUM

BLOOD UREA NITROGEN 8
CREATININE 0.9
URIC ACID 7.0

URINALYSIS

COLOR PALE YELLOW
APPEARANCE CLEAR
PH 6.5
SPECIFIC GRAVITY 1.020
GLUCOSE NOT DETECTED
PROTEIN NOT DETECTED
KETONES NOT DETECTED
BLOOD NOT DETECTED
BILIRUBIN NOT DETECTED
UROBILINOGEN NORMAL
NITRITE NOT DETECTED
WBC 1-2
EPITHELIAL CELLS 1-2
RED BLOOD CELLS NOT DETECTED
CASTS NOT DETECTED
CRYSTALS NOT DETECTED
BACTERIA NOT DETECTED

I had a TMT in XXXXXXX this year with was normal. Heart 2D echo was also good. I have just started on Vitamin B12 injections (Once every day for a week. Then once every week for 4 weeks). I have just started Liv 52 (some herbal medicine for liver). I have also this started fenolip to reduce triglycerides and increase HDL. My question is that can I drink alcohol socially? How bad is my liver?

Answered by Dr. Dr.P.Ratnakar Kini (15 minutes later)

Brief Answer:
You have to stop drinking alcohol

Detailed Answer:
Hi,
Thanks for posting your query,
I am Dr.Ratnakar Kini and I am pleased to assist you.

I went through post.
You are having fatty liver disease. Fatty liver can occur due to many conditions like alcohol intake, diabetes, high cholesterol , obesity etc.

In your case, the risk factors are alcohol intake and high cholesterol and high triglycerides.

The liver function test report says that liver is significantly damaged ( hepatitis).
You need to quit drinking alcohol completely and bring cholesterol level under control.

Other causes of liver damage should also ruled out which includes testing for hepatitis B and Hepatitis B virus has already been tested and is found to be negative.

I hope that answers your question.
Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr.P.Ratnakar Kini (1 hour later)

Do you mean that I have alcoholic hepatitis? Is my condition reversible? What is the prognosis if I quit alcohol completely. I do not have any abnormal external symptoms now.

Answered by Dr. Dr.P.Ratnakar Kini (48 minutes later)

Brief Answer:
You have features of non alcoholic steatohepatitis

Detailed Answer:
Hi,
Though you consume alcohol, your liver function test reports is more suggestive of a non alcoholic steatohepatitis.

Yes, it is reversible.

Control of triglycerides and cholesterol levels and stopping alcohol intake would be helpful.

Let me know if I can assist you further.
Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Mohammed Kappan