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Suggest Treatment For Elevated Liver Enzyme Levels While Having Fatty Liver
Question: Hello Doctor,
I have been suffering from fatty liver since last 2 years. I have been on medication at times for 3 months and then on hold. My liver profile has never been good in past 2 years. Last time I met my physician with the elevated reports he told me not to worry and gave me E-COD softgel capsules for a month and asked me to follow up with test again. I got my test done today and results are same with platelet count consistently decreasing( 72000) since last 2 tests. I have mild burning sensation and pain on right side just below my rib cage along with pain in my feet (Talus) when I wake in morning or after sitting for long time. I have attached my reports for your due consideration and opinion. My questions are as below
1. Am I suffering from cirrhosis? If not then what could be the reason of elevated enzymes even after complete abstinence from alcohol and cigarettes.
2. Do I need to consult a hepatologist rather than a general physician?
3. What else do I need to change to get this back in form. Currently I am not taking any medication expect for a supplement for NAC & Milk thistle( Should I stop it? Since my doctor did not prescribe this?)
Please guide and provide your opinion with respect to my ailment and further course of action.
Warm Regards, XXXXXXX XXXXXXX
I have been suffering from fatty liver since last 2 years. I have been on medication at times for 3 months and then on hold. My liver profile has never been good in past 2 years. Last time I met my physician with the elevated reports he told me not to worry and gave me E-COD softgel capsules for a month and asked me to follow up with test again. I got my test done today and results are same with platelet count consistently decreasing( 72000) since last 2 tests. I have mild burning sensation and pain on right side just below my rib cage along with pain in my feet (Talus) when I wake in morning or after sitting for long time. I have attached my reports for your due consideration and opinion. My questions are as below
1. Am I suffering from cirrhosis? If not then what could be the reason of elevated enzymes even after complete abstinence from alcohol and cigarettes.
2. Do I need to consult a hepatologist rather than a general physician?
3. What else do I need to change to get this back in form. Currently I am not taking any medication expect for a supplement for NAC & Milk thistle( Should I stop it? Since my doctor did not prescribe this?)
Please guide and provide your opinion with respect to my ailment and further course of action.
Warm Regards, XXXXXXX XXXXXXX
Brief Answer:
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
1. Am I suffering from cirrhosis? If not then what could be the reason of elevated enzymes even after complete abstinence from alcohol and cigarettes.
----- It is less likely you have cirhosis. This is because the ultrasound scan done in March 2016 is not showing any features of cirrhosis. Raised enzymes can occur due to many causes. In your case it is due to fatty liver. If it is due to alcohol intake, it may take at least 3-6 months for the enzymes to return to baseline in the absence of other causes. You need to get tested to rule out other causes . Tests for Hepatitis B, Hepatitis C and serum ceruloplasmin may be done.
2. Do I need to consult a hepatologist rather than a general physician?
---- Yes, you need to consult a Gastroenterologist/Hepatologist.
3. What else do I need to change to get this back in form. Currently I am not taking any medication expect for a supplement for NAC & Milk thistle( Should I stop it? Since my doctor did not prescribe this?)
----You can continue taking milk thistle. Discuss with your doctor about taking Trimeg.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.
1. Am I suffering from cirrhosis? If not then what could be the reason of elevated enzymes even after complete abstinence from alcohol and cigarettes.
----- It is less likely you have cirhosis. This is because the ultrasound scan done in March 2016 is not showing any features of cirrhosis. Raised enzymes can occur due to many causes. In your case it is due to fatty liver. If it is due to alcohol intake, it may take at least 3-6 months for the enzymes to return to baseline in the absence of other causes. You need to get tested to rule out other causes . Tests for Hepatitis B, Hepatitis C and serum ceruloplasmin may be done.
2. Do I need to consult a hepatologist rather than a general physician?
---- Yes, you need to consult a Gastroenterologist/Hepatologist.
3. What else do I need to change to get this back in form. Currently I am not taking any medication expect for a supplement for NAC & Milk thistle( Should I stop it? Since my doctor did not prescribe this?)
----You can continue taking milk thistle. Discuss with your doctor about taking Trimeg.
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Dr. R.K, this gives me some strength. I have some questions further.
1. I wanted to understand what could be the reason for my decreasing platelet count? Currently 72000/ cmm
2. Will my fatty liver disease progress to a more serious form?
3. What are my treatment options?
4. Will losing weight or changing my diet reduce the amount of fat in my liver?
5.What can I do to keep my liver healthy?
I have also attached new reports of CBC and LFT which I have received today. Please have a look at it as well and provide your opinion.
Warm Regards, XXXXXXX XXXXXXX
1. I wanted to understand what could be the reason for my decreasing platelet count? Currently 72000/ cmm
2. Will my fatty liver disease progress to a more serious form?
3. What are my treatment options?
4. Will losing weight or changing my diet reduce the amount of fat in my liver?
5.What can I do to keep my liver healthy?
I have also attached new reports of CBC and LFT which I have received today. Please have a look at it as well and provide your opinion.
Warm Regards, XXXXXXX XXXXXXX
Brief Answer:
Answer given below
Detailed Answer:
Hi,
1. I wanted to understand what could be the reason for my decreasing platelet count? Currently 72000/ cmm
---- There are many different causes for low platelet count. In your case it could be due to alcohol intake. You can consult a hematologist for complete evaluation
2. Will my fatty liver disease progress to a more serious form?
---- If the risk factors are eliminated, it will not progress to more serious form. In your case , the risk factor is alcohol intake. If you are obese, that also is a risk factor.
3. What are my treatment options?
---- Quit drinking alcohol. Weight reduction if obese. Control blood glucose abd cholesterol levels if they are high.
4. Will losing weight or changing my diet reduce the amount of fat in my liver?
---- Yes.
5.What can I do to keep my liver healthy?
---- Avoid alcohol. Eat healthy, balanced food. Maintain optimal weight. And good physical acitivity
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
1. I wanted to understand what could be the reason for my decreasing platelet count? Currently 72000/ cmm
---- There are many different causes for low platelet count. In your case it could be due to alcohol intake. You can consult a hematologist for complete evaluation
2. Will my fatty liver disease progress to a more serious form?
---- If the risk factors are eliminated, it will not progress to more serious form. In your case , the risk factor is alcohol intake. If you are obese, that also is a risk factor.
3. What are my treatment options?
---- Quit drinking alcohol. Weight reduction if obese. Control blood glucose abd cholesterol levels if they are high.
4. Will losing weight or changing my diet reduce the amount of fat in my liver?
---- Yes.
5.What can I do to keep my liver healthy?
---- Avoid alcohol. Eat healthy, balanced food. Maintain optimal weight. And good physical acitivity
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor, after discussion with you I have done test suggested by my doctor and attached are the results of all the tests along with my USG for abdomen and elastography report. The report says I have mild fibrosis of liver. FYI, my platelet count are low and liver enzymes are elevated attached are all the new reports please refer attached " New Doc 39.pdf" document for latest reports.
Please see through the attached reports and help me understand the following;
1. What does mild fibrosis of liver mean? Is this a reliable way of diagnosis for fibrosis?
2. How far I am with respect to my condition?
3. Can this be cured or reversed?
4. Can I go back to my normal healthy life and routine?
5. What could have caused this damage?
6. What are the further steps that are needed to be taken to reverse this?
7. What more tests are required to check if I have cirrhosis of liver or not?
8. What kind of medicines are prescribed for this?
9. What are dos and donts for this condition.
Requesting a reply at the earliest.
Warm Regards, XXXXXXX
Please see through the attached reports and help me understand the following;
1. What does mild fibrosis of liver mean? Is this a reliable way of diagnosis for fibrosis?
2. How far I am with respect to my condition?
3. Can this be cured or reversed?
4. Can I go back to my normal healthy life and routine?
5. What could have caused this damage?
6. What are the further steps that are needed to be taken to reverse this?
7. What more tests are required to check if I have cirrhosis of liver or not?
8. What kind of medicines are prescribed for this?
9. What are dos and donts for this condition.
Requesting a reply at the earliest.
Warm Regards, XXXXXXX
Brief Answer:
Answer given below
Detailed Answer:
Hi,
1. What does mild fibrosis of liver mean? Is this a reliable way of diagnosis for fibrosis?
---- Fibrosis means scarring. Yes, it is a reliable way
2. How far I am with respect to my condition?
-- You have early damage to liver. Avoiding alcohol might reverse this early damage.
3. Can this be cured or reversed?
----Avoiding alcohol might reverse this early damage.
4. Can I go back to my normal healthy life and routine?
---- Yes you can.
5. What could have caused this damage?
----- Alcohol. I presume you are negative for other risk factors like hepatitis B, C, autoimmune and metabolic liver diseases
6. What are the further steps that are needed to be taken to reverse this?
----- Discuss with your doctor about the tests for various causes. Quit drinking alcohol.
7. What more tests are required to check if I have cirrhosis of liver or not?
----- Elastography is enough
8. What kind of medicines are prescribed for this?
----- Treat the risk factor.
9. What are dos and donts for this condition.
----- Get vaccinated against Hepatitis A and B if not done already. Avoid alcohol.
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
1. What does mild fibrosis of liver mean? Is this a reliable way of diagnosis for fibrosis?
---- Fibrosis means scarring. Yes, it is a reliable way
2. How far I am with respect to my condition?
-- You have early damage to liver. Avoiding alcohol might reverse this early damage.
3. Can this be cured or reversed?
----Avoiding alcohol might reverse this early damage.
4. Can I go back to my normal healthy life and routine?
---- Yes you can.
5. What could have caused this damage?
----- Alcohol. I presume you are negative for other risk factors like hepatitis B, C, autoimmune and metabolic liver diseases
6. What are the further steps that are needed to be taken to reverse this?
----- Discuss with your doctor about the tests for various causes. Quit drinking alcohol.
7. What more tests are required to check if I have cirrhosis of liver or not?
----- Elastography is enough
8. What kind of medicines are prescribed for this?
----- Treat the risk factor.
9. What are dos and donts for this condition.
----- Get vaccinated against Hepatitis A and B if not done already. Avoid alcohol.
Regards,
Dr.R.K.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks you so much doctor, this gives me lot of hope. I was under constant stress after it was told to me that, I have fibrosis. I have a follow up question as well.
1. My Hepatitis B & A reports are as follows. But, I am not able to derive a conclusion out of it. Please let me know what does the below figure means?
a) Hepatitis B surface ABS (QUANT), Serum >1000 mIU/ml
b) Hepatitis A virus IGG Antibody( HAV IGG), Serum 12.6 S/CO
Does this mean I am immune to Hep A and B or I have infection?
2. Since I was suffering from fatty liver as per my earlier reports in last 2 years, has that lead to fibrosis? If the root cause not treated, how much time does it take to progress to cirrhosis?
3. My doctor had not asked me to do Hep C blood test? I understand Hep C is also a major reason for fibrosis. Should I get that test done?
Warm Regards, XXXXXXX
1. My Hepatitis B & A reports are as follows. But, I am not able to derive a conclusion out of it. Please let me know what does the below figure means?
a) Hepatitis B surface ABS (QUANT), Serum >1000 mIU/ml
b) Hepatitis A virus IGG Antibody( HAV IGG), Serum 12.6 S/CO
Does this mean I am immune to Hep A and B or I have infection?
2. Since I was suffering from fatty liver as per my earlier reports in last 2 years, has that lead to fibrosis? If the root cause not treated, how much time does it take to progress to cirrhosis?
3. My doctor had not asked me to do Hep C blood test? I understand Hep C is also a major reason for fibrosis. Should I get that test done?
Warm Regards, XXXXXXX
Brief Answer:
Answer given below
Detailed Answer:
Hi,
1. My Hepatitis B & A reports are as follows. But, I am not able to derive a conclusion out of it. Please let me know what does the below figure means?
a) Hepatitis B surface ABS (QUANT), Serum >1000 mIU/ml
b) Hepatitis A virus IGG Antibody( HAV IGG), Serum 12.6 S/CO
Does this mean I am immune to Hep A and B or I have infection?
----- You are protective against both.
2. Since I was suffering from fatty liver as per my earlier reports in last 2 years, has that lead to fibrosis? If the root cause not treated, how much time does it take to progress to cirrhosis?
---- It will take many years.
3. My doctor had not asked me to do Hep C blood test? I understand Hep C is also a major reason for fibrosis. Should I get that test done?
---- Yes, get tested for Hep C
Regards,
Dr.R.K.
Answer given below
Detailed Answer:
Hi,
1. My Hepatitis B & A reports are as follows. But, I am not able to derive a conclusion out of it. Please let me know what does the below figure means?
a) Hepatitis B surface ABS (QUANT), Serum >1000 mIU/ml
b) Hepatitis A virus IGG Antibody( HAV IGG), Serum 12.6 S/CO
Does this mean I am immune to Hep A and B or I have infection?
----- You are protective against both.
2. Since I was suffering from fatty liver as per my earlier reports in last 2 years, has that lead to fibrosis? If the root cause not treated, how much time does it take to progress to cirrhosis?
---- It will take many years.
3. My doctor had not asked me to do Hep C blood test? I understand Hep C is also a major reason for fibrosis. Should I get that test done?
---- Yes, get tested for Hep C
Regards,
Dr.R.K.
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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