Liver health concern

[kmb152]

Hi doctor, I apologise for posting in this forum, the gastroenterology forum does not have a posting facility currently. I have a concern that is causing anxiety regarding cirrhosis symptoms and I hope you can help. I have on my big toenails an opaque area form the cuticle extending about 2/3 to the end. This looks like the phenomena of Terrys's nails to me. On my fingernails I have discoloured arcs behind every free end but the bed looks pink. I have read that Terry's nails are casued by a band of altered vascular tissue which results in the appearance of a band in that postion. Could you tell me if this resembles cirrhosis symptoms, as I have read, please? A few days ago I had LFT results back from my GP and all were completely normal. On that basis he doesn't believe any furhter tests are warranted (I have huge respect for him but its difficult to allay my fears given the huge amount of informaion  on the web). I have a risk factor of heavy drinking (I am deeply ashamed to report). On average two thirds of a bottle of wine per day for many years, reduced significantly over the last few years.At what stage do nails become affected, is it when
other symptoms would have manifested themselves already also? Best regards. KMB.

[Thomas D Schiano, MD]

these nail changes can be present in liver disease but can also be present in other c onditions or can be a normal variant.  i would recommend also checking a sonogram of the liver and repeat liver tests every 6 months for the time being.

[kmb152]

Thankyou for your reply doctor. Would a sonogram confirm there are no problems?

[Thomas D Schiano, MD]

yes

[kmb152]

I have made an appointment with a hepatologist where I will ask for an ultrasound as you suggest.  Thanks again.

[kmb152]

Dear Dr, thanks for your help. I have had a sonogram which was normal, liver and spleen size and texture, echogenicity, portal vein flow. Also accompanied by more blood tests including CBC all normal. I asked about the possibility of a biopsy but this was not considered viable. I was wondering what your opinion would be. Would it be worth pursuing to obtain definitive diagnosis?