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Drink alcohol, have GERD, pain in side and back. All test normal. Had gastric sleeve operation. Liver cirrhosis?

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For some time now, I have been worried that I may have cirrhosis of the liver. I drank heavily at night for about 7 years. I started feeling pain in my right side and back about three years ago. I also have gerd. Since then I have have had five normal ultrasounds, 2 normal ct's, 3 normal upper gi's, normal blood work (more time than I can count).

In January of 2010, I have a gastric sleeve operation. Because of that, I take vitamin B12. Today, I got my blood work back and my B12 levels were 1500. Everything else was normal- Liver enzyme, bilirubin, etc. Should I be concerned? I know high B12 is a sign of cirrhosis. I read that taking supplements would not make your B12 level high.
Posted Mon, 23 Sep 2013 in Liver and Gall Bladder
Answered by Dr. Amit Jain 2 hours later
Brief Answer:
No cirrhosis,may recheck your level of Vitamin B12

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).I appreciate your concern.

No doubt that vitamin B12 levels may be increased in cirrhosis but this is not so sensitive and specific marker for that and never used to diagnose or confirm cirrhosis. Rather most important marker for diagnosing cirrhosis are:
1. Derranged liver function tests especially decreased serum albumin and increased prothrombin time and decreased total leucocyte counts and platelet counts
2. Ultrasound abdomen showing shrunken liver, increased echotexture, splenomegaly and increased portal vein diameter
3. Endoscopy showing oesophageal or fundal varices with portal hypertensive gastropathy
4.Early cirrhosis or fibrosis can be diagnosed with fibroscan
5. And final test which is invasive and gold standard is liver biopsy which is usually not required if above tests are negative

So if all the above mentioned tests are normal I don't think it can be cirrhosis, so this is of no concern

You are right that serum vitamin B12 is not increased with supplementation as excess is secreted in urine. There are few condition like myeloproliferative disorders and some types of leukemia which can lead to increase in Vitamin B12 levels but again your blood work is normal which I hope also include complete haemogram

Also increase in Vitamin B12 also seen in acute hepatitis which is diagnosed with increase in transaminase levels (SGOT/SGPT) which is also normal

I hope I have made clear my point so there is nothing to worry. You may recheck your levels of Vitamin B12

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

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