LFT Results One

[whitedoor88]

I was quite a heavy drinker in periods over the last 15-20 years up until the end of January this year.
Sometimes it was 2-4 times per week,  some weeks nothing, sometimes periods of 6-8 weeks or longer without. Generally it was not daily though there were periods of several days in a row.
Essentially well above average, and I want to be clear on that
I have decided now at maximum to have alcohol no more than once per month if at all.
I ate well, kept myself in good shape, exercised a lot. I am just worried that I did not stop soon enough.
The only symptom I can really pin down is in the last 2 years sometimes when I have a small amount of alcohol my face goes very red or has red patches which vanish after around 30 mins.  I am aware of Asian Flush, ( I am not asian) but worry that this could be a sign of liver weakness
I post my blood work below ( In next question as of character count issues) over roughly a 2 year period.

  These were done in Ireland

My question -  although the standard LFTS are still within the normal ranges, is the increase over the two year period a concern? Also would be interested in your opinion on any other measures

I went for a Ultrasound last week as I was feeling a dull pain not very often on my right front side, Liver, Gall Bladder came back fine, - though I am aware that Ultrasound are not 100% accurate, based on your thoughts on the above blood work, could it be possible I have Alcoholic hepatitis or cirrhosis?

[Thomas D Schiano, MD]

MRI are as good as any imaging study to pick up early cirrhosis..  I think your labs are OK and you shouldnt be worried about these minor decreases

[whitedoor88]

Dear doctor
Thank you for your replies and your time
This will be my final post/question

I have been doing some research and it seems small liver cysts can be common.

Though I would prefer not to have any, and at least gives me the reason to be recommended for annual MRI to monitor

How good is an MRI with contrast to rule out cirrosiss?, with my labs, ok US and MRI, its high probability I should be ok, I hope

I have been looking at my labs over the last 2 years, one pattern I notice is my levels of creatine and urea. Over 6 labs tests over last two years they have dropped each time, they are both now close to lower reference band, cause for concern?

Creatine
2012   Value 78
2014.   Value 64
Ref range. (62-106)

Urea
2012.  Value 3.9
2014.   Value 2.7
Ref range (2.5 - 7.8)

I know low levels in these two can indicate liver damage, but with my other "good" results , I can sort of ignore this? Could this be normal change?

[Thomas D Schiano, MD]

looks good

[whitedoor88]

Was at doctors this morning and below is MRI report.

any advice appreciated!!!


MRI Liver with Contrast

"Standard protocol
The liver appeared normal apart from a 7mm cyst within the dome of the left lobe. Normal calibre intra-hepatic ducts and CBD
The pancreas, spleen and both adrenals along with the visualised portions of kidneys appeared normal. No enlarged lymph nodes or other abnormality identified through the upper abdomen"

[Thomas D Schiano, MD]

fantastic results--keep up the good work

[whitedoor88]

Good afternoon Doctor

I would like to thank you for your replies to date, for the record I post latest results below

I am still off alcohol and trying to eat well.
I
I have been taking Milk Thistle, Dandelion, Artichoke; lots of fish, no red meat and lots of water. Also lots of fruit juices

I am waiting for my MRI appointment, will keep updated. I also post below the full Summary text of my Ultrasound, this is all the information I have. I am pushing for the MRI for peace of mind.
On the note below, they do not mention size of liver, is it too much to assume its ok, or they could not measure it?

“Technically difficult examination due to extensive intra-abdominal bowel gas. Within this limitation to liver appeared of normal echotexture with no intra-hepatic bilary duct dilatation.
Gallbladder, spleen, both kidneys, aorta and IVC normal. The pancreas could not be assessed due to overlying bowel gas. Urinary bladder and prostate appeared normal. No Pelvic mass of free fluid.”

Albumin    49   (35-50)
Bilrublin Total   10   (1-21)
Alk Phosphate (ALP)    72   (40-129)
GTT       42      (10-71)
ALT      23     (0-41)
AST       18   (0-40)

Serum Iron  25  (11-34)
TIBC/C:TIBC (Calculated)    55  (50-85)
TSAT% Transferrin Satn         45% (<45%)   was 27% month before
Folate   18.8   (4.5-20)
Ferritin     225   (23-393)

Total Protein    75   (66-87)

White Blood Cells   3.3   (3.5-11) was 4.7 Previous month
Haemoglogin    15.7   (13-17)
Platlets        181 (150-400)   was 220 Previous month)
RBC         5.16   (4.5-5.5)
Haematocrit    0.465   (0.4-0.5)
MCV       90.1   (80-100)
MCH       30.4   (27-32)
RDW      13.2   (11-15)

PT   10.5 Seconds   (9.9-12.5)
APTT  32.2 Seconds    (24-35)


Sodium  144 (135-145)
Potassium 4.6   (3.5-5.0)


Urea    2.7  (2.5-7.8)
Creatine  64  (62-106)

Urea and Creatine have dropped values over last year

Best wishes!!!!!!

[Thomas D Schiano, MD]

i actually think that your liver is fine, as long as you continue taking good care of yourself

[whitedoor88]

Thanks so much for your reply


Still on my new healthy life

Went to another doctor today and got bloods done, will post results when through.

She examined were my dull pain is on right side- doctor was of view that it was localised and possibly muscular. She was also of the opinion that my red flushes were not liver related.

Dont know what to think as she is a general doctor not liver specalist.

I got a copy of the adominal ultrasound from other doctor, the one he told me was "ok"

I post below, the person who was doing the ultrasound at the time told me that the liver looked "fine", and I got the impression that the bowel gas was more a problem with other organs.



Anyway below the report. I should have the MRI scan in next days I hope, though hope it can go ahead with the titanium fasteners on my skull, i think i can.


"Technically difficult examination due to extensive intra- abdominal bowel gas. Within this limitation the liver appeared of normal echotexture with no intra- hepatic bilary duct dilatation. Then says all other normal..."

Im still a bit worried, i dont know if the ultasound any value, any thoughts?

[Thomas D Schiano, MD]

it is only the minority of heavy drinkers that develop liver disease--when people do develop it, it can be totally reversible with ongoing sobriety.  I am very glad that you realized that this could be an issue for you.  i think that its extremely unlikely that you would have any intrinsic liver disease in the absence of abnormal liver tests or an abnormal sonogram.  This however shouldnt be an excuse to return to drinking as you could most definitely still develop problems