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What Causes Weight Loss And Hair Loss When Suffering From Liver Disease?
Question: I believe I my have ESLD even though my blood work is not bad. My albumin is 3.4, A/G ratio 2.0, I have 1/100 Nuculated red blood cells. I have lost most of my hair in 6 months. I have lost some weight but mostly I do not look like the same person in a matter of months. My family is alarmed. I have hollowed in my face and neck and am losing muscles in my arms. I am having a hard time digesting protein and meds I have taken for years now make me feel bad. I had a cat scan last week that said my liver and spleen looked normal and no asceties . but I have a 1.2 cm lesion ajacent to the superior vena cava and hepataic veins. it is a low attention lesion and the radiologist said I need a mri to further diagnose it. I am tired but can't sleep well .I also have POTS on many days. Any ides as to what is going on.
Brief Answer:
You need proper clinical exam & investigations.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
I gone through your problems in detail.
I think ESLD is over estimation.It is because serum albumin and A/G ratio is alright.Besides this your CT Scan findings are also normal.So,you don't worry at all.
It is important to rule out myopathy(muscle degenerative diseases)in your case.
You need proper clinical examination and investigations.
Investigations include routine hemogram,RBS(Random blood sugar),LFT(complete liver function test),Renal function test(RFT),Lipid profile,Thyroid profile,serum calcium and vitamin D level.Further investigation can be done if needed.
As you have small lesion adjacent to the superior vena cava and hepatic veins,you should go for MRI abdomen with contrast.MRI can give clue regarding diagnosis.
Treatment depend upon clinical findings and investigation reports.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
You need proper clinical exam & investigations.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
I gone through your problems in detail.
I think ESLD is over estimation.It is because serum albumin and A/G ratio is alright.Besides this your CT Scan findings are also normal.So,you don't worry at all.
It is important to rule out myopathy(muscle degenerative diseases)in your case.
You need proper clinical examination and investigations.
Investigations include routine hemogram,RBS(Random blood sugar),LFT(complete liver function test),Renal function test(RFT),Lipid profile,Thyroid profile,serum calcium and vitamin D level.Further investigation can be done if needed.
As you have small lesion adjacent to the superior vena cava and hepatic veins,you should go for MRI abdomen with contrast.MRI can give clue regarding diagnosis.
Treatment depend upon clinical findings and investigation reports.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
What about the severe,fat muscle loss in face and neck. I also have lost most of my hair. My liver is not breaking down hormones and my cholesterol is 398. I get sick when I eat protein and have had stomach problems for years. I was a drinker but am not now. My thyroid is fine . I take vitamin D buy my osteoporosis is getting much worse. My immune system is also down . Recent pneumonia and bronchitis .
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
It is important to rule out myopathy/muscular dystrophy if you have severe fat and muscle loss in face and neck.
Loss of hair may be due to acute infection(that you have already mentioned),acute stress etc.You don't worry about this.It will regrow if it is due to these reasons.
I don't think you have any liver problem because some of the liver function parameters(like serum albumin,A/G ratio) are fine.However,you need full liver function test(LFT). If LFT is fine then nothing is required.
You need tablet Atorvatatin10 mg for increased cholesterol level.
For severe osteoporosis,in addition to vitamin D and calcium supplementation,you may need medicines that suppress osteoclasts.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
It is important to rule out myopathy/muscular dystrophy if you have severe fat and muscle loss in face and neck.
Loss of hair may be due to acute infection(that you have already mentioned),acute stress etc.You don't worry about this.It will regrow if it is due to these reasons.
I don't think you have any liver problem because some of the liver function parameters(like serum albumin,A/G ratio) are fine.However,you need full liver function test(LFT). If LFT is fine then nothing is required.
You need tablet Atorvatatin10 mg for increased cholesterol level.
For severe osteoporosis,in addition to vitamin D and calcium supplementation,you may need medicines that suppress osteoclasts.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have to have a contrast MRI next because of the small mass. Will a MRI show more that a CT ? Does a contrast CT always show cirrhosis ? Would a contrat mri show it more so ? My liver panel was good. My albumin was low end of normal. Platets are fine.My urea was good. No asceties . No varcies are seen on ct scan. I am most concerned about having trouble breaking down the same meds I have taken for years ? Can that mean Cirrhoiss or could it be reverible at this point. I have not drank a some time, but I do take pain and sleep meds. Could the hairloss be more likely low protein or low hormones. I have both.
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
Yes,Contrast MRI is the investigation of choice for small mass lesions in abdomen.MRI is more helpful in better characterization of lesions and diagnosis will be more close.
Don't worry about liver pathology.CT scan of abdomen would definitely had been picked cirrhosis of liver.Your liver status is fine.
It is important to exclude loss of protein through the urine.Loss of protein from urine may lead to borderline albumin.Urine( routine RE/ME and microscopic examination) should be done initially.Further tests can be done if needed.
Hair loss need detail evaluation by a dermatologist.It is due to many reasons like stress,hypothyroidism,hormonal alteration etc.You can consult a dermatologist.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
Yes,Contrast MRI is the investigation of choice for small mass lesions in abdomen.MRI is more helpful in better characterization of lesions and diagnosis will be more close.
Don't worry about liver pathology.CT scan of abdomen would definitely had been picked cirrhosis of liver.Your liver status is fine.
It is important to exclude loss of protein through the urine.Loss of protein from urine may lead to borderline albumin.Urine( routine RE/ME and microscopic examination) should be done initially.Further tests can be done if needed.
Hair loss need detail evaluation by a dermatologist.It is due to many reasons like stress,hypothyroidism,hormonal alteration etc.You can consult a dermatologist.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Does a MRI show cirrhosis nodules or would an ultrasound show them better ? I am stressing because I have drank in the past ,but I do not now. Are you sure a CT would show even early cirrhosis ? I am so confused as to why I am having problems breaking down my sleep meds and I never did before. I also have neurophic pain.I have read that a liver can be normal size with cirrhosis, but mine was normal size and attenuation. Spleen was normal, no varcies, etc. I did have plaque in my main arorta .Sorry for so many questions, but I would rather know the truth than fool myself into believing all is well .
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
Cirrhotic changes of liver are well detected by ultrasound and CT scan.
In early stage,liver size is normal with coarse echotexture. Gradually liver shrinks in size with formation of nodules which can be easily detected by imaging.
Your liver size is normal with normal echotexture,so it doesn't support cirrhosis.
Spleen enlarges in size and varices are formed in advanced cirrhosis due to portal hypertension.
There is no need to be so worried.I suggest to few step wise investigations which can clear your doubt.
Firstly,Complete liver function test should be done followed by Ultrasound of abdomen.Elastography can be done to assess elasticity of your liver.If these findings normal,then you don't need further investigations.
It is good that you have quit alcohol.
Aortic plaques are age related findings.For neuropathic pain,you can consult neurologist.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
Cirrhotic changes of liver are well detected by ultrasound and CT scan.
In early stage,liver size is normal with coarse echotexture. Gradually liver shrinks in size with formation of nodules which can be easily detected by imaging.
Your liver size is normal with normal echotexture,so it doesn't support cirrhosis.
Spleen enlarges in size and varices are formed in advanced cirrhosis due to portal hypertension.
There is no need to be so worried.I suggest to few step wise investigations which can clear your doubt.
Firstly,Complete liver function test should be done followed by Ultrasound of abdomen.Elastography can be done to assess elasticity of your liver.If these findings normal,then you don't need further investigations.
It is good that you have quit alcohol.
Aortic plaques are age related findings.For neuropathic pain,you can consult neurologist.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
on e last question. My ct scan said normal atteuantion . Does that mean texture ?
Brief Answer:
Normal attenuation means liver if fine.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
CT findings are mentioned in terms of attenuation.Normal attenuation means liver if fine.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Normal attenuation means liver if fine.
Detailed Answer:
Hello XXXXXXX
Thanks for writing back
CT findings are mentioned in terms of attenuation.Normal attenuation means liver if fine.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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