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Suggest Treatment For Elevated ALT Levels With History Of Fatty Liver
Question: Hello,
I have a question regarding my liver, when I was around 18 I found out I had a fatty liver, I am 26 now, and I have serial monitoring of my liver enzymes, my ALT is usually around 60 the highest it's ever been is 90 and my AST is always normal, the last ultrasound showed an echodense heterogenous liver parenchyma, suggesting hepatocellular disease, fatty infiltration, or a combination thereof, my ultrasound before that was about a year prior and it shows echogenic liver heterogenous, consistent with underlying hepatocellular disease, likely fatty infiltration, I had a CT 2 years ago that showed a normal liver this was a week before my ultrasound showing heterogeneous liver, my question is, do I have cirrhosis? I am 26 now, I haven't had a drop of alcohol for over a year, when I look down at my belly it looks like my right side sticks out farther than my left, but my doctor thinks it looks the same, I have been to 4 different doctors now, and I've never had a biopsy, they all just say, since the ALT is the only elevation, and the ultrasound just shows fatty liver, the only thing you can do is lose weight, a biopsy wouldn't change the course of treatment, my question is do I have cirrhosis, and should I insist on a biopsy? Thanks and sorry for the lenght of my message.
I have a question regarding my liver, when I was around 18 I found out I had a fatty liver, I am 26 now, and I have serial monitoring of my liver enzymes, my ALT is usually around 60 the highest it's ever been is 90 and my AST is always normal, the last ultrasound showed an echodense heterogenous liver parenchyma, suggesting hepatocellular disease, fatty infiltration, or a combination thereof, my ultrasound before that was about a year prior and it shows echogenic liver heterogenous, consistent with underlying hepatocellular disease, likely fatty infiltration, I had a CT 2 years ago that showed a normal liver this was a week before my ultrasound showing heterogeneous liver, my question is, do I have cirrhosis? I am 26 now, I haven't had a drop of alcohol for over a year, when I look down at my belly it looks like my right side sticks out farther than my left, but my doctor thinks it looks the same, I have been to 4 different doctors now, and I've never had a biopsy, they all just say, since the ALT is the only elevation, and the ultrasound just shows fatty liver, the only thing you can do is lose weight, a biopsy wouldn't change the course of treatment, my question is do I have cirrhosis, and should I insist on a biopsy? Thanks and sorry for the lenght of my message.
Brief Answer:
No data for cirrhosis.
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and understood your concerns.
From what you are reporting, there is no indication for liver cirrhosis. Perhaps, hepatosteatosis (fatty liver). However, I ask to have the tests reports to get them analyzed by myself:
- complete blood count to check for thrombocyte and protrombin level
- abdominal ultrasound
or any other test you have done.
With regards to biopsy, it is true that is the last examination to determine liver cirrhosis. Other test include elastography which can also determine the level of fibrosis. However, they are advised when other tests are inconclusive regarding cirrhosis. Let me have a look at your tests results first, before determining if you need to go for these other tests.
For the moment, I highly advise to:
- lose weight
- take liver-antioxidants (e.g. vit.E, etc.)
Hope it helped!
Dr.Klerida
No data for cirrhosis.
Detailed Answer:
Hi XXXX,
I have gone through your medical history carefully and understood your concerns.
From what you are reporting, there is no indication for liver cirrhosis. Perhaps, hepatosteatosis (fatty liver). However, I ask to have the tests reports to get them analyzed by myself:
- complete blood count to check for thrombocyte and protrombin level
- abdominal ultrasound
or any other test you have done.
With regards to biopsy, it is true that is the last examination to determine liver cirrhosis. Other test include elastography which can also determine the level of fibrosis. However, they are advised when other tests are inconclusive regarding cirrhosis. Let me have a look at your tests results first, before determining if you need to go for these other tests.
For the moment, I highly advise to:
- lose weight
- take liver-antioxidants (e.g. vit.E, etc.)
Hope it helped!
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Here's my most recent blood work, I don't have a copy of ultrasound on hand, but it says, the only thing found was a heterogenous, echodense liver, no visible nodules or lesions, gallbladder normal, hepatocellular disease, fatty liver, or a combination thereof.
Brief Answer:
No sign for cirrhosis...get hepatitis testing done
Detailed Answer:
Hi back,
I have gone through the lab reports you sent in, and I have noticed that all parameters are within normal range. There is only a high level of ALT which is indicative for possible liver damage from drinking alcohol. No sign for cirrhosis, but possibly fatty liver.
Most probably the fat is dispersed heterogeneously through the liver, that's why it is reported heterogeneous in the ultrasound examination.
I did not find any clue regarding hepatitis testing. If you have not done any test yet, I advise to ask your doctor to get hepatitis screening (hep.B and C) to exclude it.
Otherwise, every change in your liver is due to fatty depositions dispersed heterogeneously in the liver. It is crucial to follow healthy lifestyle and diet regimen as mentioned earlier. Antioxidants, vitamins and sillymarin are also recommended.
Hope it helped!
Dr.Klerida
No sign for cirrhosis...get hepatitis testing done
Detailed Answer:
Hi back,
I have gone through the lab reports you sent in, and I have noticed that all parameters are within normal range. There is only a high level of ALT which is indicative for possible liver damage from drinking alcohol. No sign for cirrhosis, but possibly fatty liver.
Most probably the fat is dispersed heterogeneously through the liver, that's why it is reported heterogeneous in the ultrasound examination.
I did not find any clue regarding hepatitis testing. If you have not done any test yet, I advise to ask your doctor to get hepatitis screening (hep.B and C) to exclude it.
Otherwise, every change in your liver is due to fatty depositions dispersed heterogeneously in the liver. It is crucial to follow healthy lifestyle and diet regimen as mentioned earlier. Antioxidants, vitamins and sillymarin are also recommended.
Hope it helped!
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, I did have the full hepatitis panel done, which was negative.
Brief Answer:
No sign for cirrhosis,follow the earlier advice
Detailed Answer:
Hi back,
If it was negative, then, everything is related to alcohol-drinking and no sign of cirrhosis.
Continue with the advice as given earlier.
All the best!
If no more query, please do not forget to close this discussion!
Dr.Klerida
No sign for cirrhosis,follow the earlier advice
Detailed Answer:
Hi back,
If it was negative, then, everything is related to alcohol-drinking and no sign of cirrhosis.
Continue with the advice as given earlier.
All the best!
If no more query, please do not forget to close this discussion!
Dr.Klerida
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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