Is it possible to have a liver problem with normal LFTs?

[mandyT24]

Hello

I am new here to the boards...
First a little introduction: I am a 24-year old female, 110 lbs, 5.6 feet, I drink very rarely and has never been a person who drank much, was a former smoker (for about 5 years and 10 to 15 cigarettes a day, non-smoker now for about five months), hep a,b,c tested negative, my nutriton is more healthy than too unhealthy and I do not exercise so much.

Don`t wanna sound hypocondriac but I have these symptoms, some of them quite long in my life, others of them about some years or coming and going.

-nails look strange for a very long time, like in liver disease (saw this on coincidence at an image on the web)
-difficulties concentrating and clumsiness since child age, later also mood problems (irritability, easily angry, withdrawal) ,concentration got a bit worse instead of better
-forgetfullness
-flatulence (especially in the evening/night) and often constipation
-sometimes I have this dull ache/pressure under my right ribcage for a while, often accompanied by pale and soft stools (constipation or frequent stools) ,this thing only sometimes comes and goes
-itching, ( reddish)  points which come and go
-some mild itches and easily being drunken in my head also when drinking very little of high percent alcohol
-sometimes feelings of weakness
-periods of being easily fatigued, especially in the afternoon, very fast changing energy levels
-mental fatigue (lethargy)
-sometimes waking up between 1 and 3 a.m.
-easily feeling cold or sometimes hot (especially in face)
-my menstruation has never been normal, started out a bit irregular and got rarer ,weaker and shorter-durating by the years, ct of sexual organs normal but it was made some longer time ago
-my recent thyroid levels showed up that I am borderline to pituitary hypo-thyroidism,  but CT of head and thyroid are normal
-feeling of being hungry very easily and feeling weak, but blood sugar is normal
-some few occasions with mild impaired fasting glycemia (105-115) in the past two years, but normal OGTTs and after meal readings

At the moment I have this problem with the dull pressure under my right ribcage and annerving digestion problems again, but I had this checked out one and a half year ago when I also had it for some weeks.
And they found normal blood results including normal liver enzymes and so I wanted to ask if it is possible to have a  liver problem although?
I once wrote on another board about my problems a bit longer ago and some user referred me to the topic Wilson`s disease.
By now I only know that it is a disease where you build up too much copper and that it occurs rarely but mostly in young people my age or younger and it damages liver and other organs.
Oddly my skin turns a bit coppery (or orangish?) in summer and some greyish-yellow in winter and my hair is also of copper-brown color, which has changed over the years (from blond, dark-blondish)

Now I don`t know if I should be concerned or not because there are always periods when I have these "suspicious" symptoms, then feel better again or some vague chronic complaints.
My last ultrasound which included the liver was some 5 or 6 years ago, my last ultrasounds were in the last year (head and thyroid gland) and on the back (because of backache) and they made the kidneys, said they look normal, but they didn`t make liver and other organs.

I don`t like going to the dr because he always treats me strangely  when I have a suspicion about an issue of my body (for example if I would  say liver, he would ask me why and if I read too much in the internet)
Yes I sometimes read in the internet but I already knew what liver symptoms look like-from biology lesson in school.

So should I be worried and trust normal blood LFTs or should I ask my dr about a ct?

By the way recently one doctor also raised a suspicion that I may be having a mild problem with my heart muscle (because of sometimes mild dizziness and shortness of breath while lying flat for longer time), but this would be investigated at another appointment if it doesn`t stem from a common cold and gets by without any treatment by itself again...

[mandyT24]

Oh sounds very complicating but I am glad for you that you had that luck with the transplantation and got rid of the virus. ;)

Liver failure is something quite serious and dangerous and I would do further testing also if my sx wouldn`t disappear by themselves soon.

Good luck

Mandy  ;)

[mikesimon]

Sure you can ask me.

Hepatitis C.
I was transplanted in June 2000 and cleared the virus in June 2004.

Mike

[mandyT24]

Hello mike

May I ask you which disease you have had?

Sorry I for being quite curious...

[mandyT24]

Hello you

Thx for reply ;)

Yeah thats the problem with doctors, on the one hand you like your doc and on the other hand he treats you strangely sometimes.

I definitely do not have Hep c (was excluded one and a half year ago) and I think I am also not at the risk groups for this disorder.

There are many opinions and researches about having liver disease without elevated LFTs, some say it occurs very rarely, others mean that too many people could have fatty liver or even have fibrosis with normal liver enzyme readings, especially in people who live/are otherwise (very) healthy, it could show up lately.
So what and whom should anyone believe or not??

I don`t think, that if I`d really have liver disease, that it would be advanced and my liver could be that damaged, because then I think my enzymes would have gone up one and a half year ago when I had them tested.
But also have migraines  and as I said too slow or too fast digestion and strange stools from time to time.
Also didn`t have a normal menstruation for  months now, only some with rather brownish thing or very little blood and lasting only about a day.
But I don`t pay so much attention to that thing most of the time, because it does not make any pain or discomfort.

Unfortunately I maybe have many liver symptoms (also other readers on forums said some longer time ago), but I do not have jaundice, I do have a good appetite most of the time (sometimes too good because then I would feel sick), but I don`t gain or loose many weight and I am rather slim.Have no vomiting but frequent nausea.
The only thing of which I think is possible with a good appetite and liver disease would be fatty liver.
I know an overweight person with this condition, also with prediabetes...
but I am not overweight or someone who likes alcohol or too many fatty meals...
I have some skin changes but not too dramatical and I really do not look pale or sickly.

I think that I will  wait if RUQ and digestive symptoms persist for longer then some weeks or up to two months and if they do, I would ask my doc for a CT or change my doc if he speaks to me strangely again.
But I don`t think that I will talk to him about Wilsons disease because then he may think that I am quite crazy.

[mikesimon]

You said:
"I don`t like going to the dr because he always treats me strangely  when I have a suspicion about an issue of my body (for example if I would  say liver, he would ask me why and if I read too much in the internet) "

I find myself frequently saying this to people who talk with me about their medical issues - "get another doctor". And almost everyone responds that they like their doctor. I found out the hard way that everyone likes their doctor until they get really sick. Then they find out just how important a good PCP is.

Wilson's Disease is complex and I don't know much about it. I believe the diagnosis can be difficult because Wilson's looks like so many other disorders. And it's not a very common disease. I think that generally with Wilson's Disease the liver enzymes will be elevated. I also know that with Hepatitis C people can have normal liver enzymes and yet have significant liver damage so perhaps that is true with Wilson's too. I tend to think if you did have significant liver damage you'd see some blood results out of range but I do not know that for certain.

My best advice is either find a new doctor who will listen to you and do something to find out what's going on with you or see your present doctor and get tough with him/her. Sometimes you have to push pretty hard to get the kind of attention you deserve. I suspect that a concerned PCP would refer you to a gastroenterologist or hepatologist for further work-up.

BTW, I am not a doctor or in the medical field in any capacity. I'm just a patient who has had liver disease and am now OK.

Good luck,
Mike