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Concerned About Liver Disease. Heavy Drinker, Mottled Palms, Weight Loss, Abdominal Pain, Light Stools, Feet Tingling, Under Eye Circles.

Posted on Sun, 10 Jun 2012

Question: possible liver disease?

I am concerned that I have liver issues. I drank heavy for a solid 7 years, approx. 12 light beers every evening and more on the weekends. I always felt great, no hangovers. I cut back a year and a half ago and completley stopped drinking in March this year. I had a relapse in July and have quit since then. I have a small thread vein on my torso, a few light brokens vessels on my checks. I don't have any classic spider veins that I'm aware of. I have had motteled palms, some weight loss, a constant dull ache in my right side, some lighter stools, red bands on my nails past the luna, some tingling in my feet, circles under my eyes and I just look a bit rough latley. I have been really stressed out over this. The past year I had 4 labs done all normal. My doc had looked me over and thinks I'm ok and lost the weight from not drinking. He said my liver felt normal and smooth. My labs with platlets and enzymes come back normal each time. My platlets have been from 227 to 196 over the year. The last lab was done Oct 11.

PLATELETS 196
WBC 6.1
RBC 5.37
MCV 94
MCHC 32.6
RDW 12.9
GLUCOSE SERUM 93
BUN 12
BUN/CREATINE RATION 11
SODIUM 139
POTASSIUM SERUM 4.1
CHLORIDE SERUM 101
PROTEIN TOTAL 7.5
ALBUMIN 5.0
GLOBULIN TOTAL 2.5
A/G RATIO 2.0
BILIRUBIN TOTAL 0.6
ALKALINE PHOSPHATASE 74
AST 23
ALT 43
GGT 32
INR 1.0
PROTHROMBIN TIME 10.6
TSH 1.090
I don't feel awful but these symptoms concern me. I have a Ultrasound scheduled Oct 31st.
Is it possible to have end stage liver disease with 4 normal labs?

Answered by Dr. Poorna Chandra K.S (7 hours later)

Hello.

Thanks for the query.

Alcohol can affect liver in various ways and is grouped into three different stages -

1) Fatty liver - usually with normal enzymes & diagnosed on Ultrasonography.
2) Fatty liver with inflammation/ Steatohepatitis - elevated SGOT & SGPT are usually found.
3) Cirrhosis - Endstage liver disease where in there is evidence of liver dysfunction (low albumin, platelets and prolonged prothrombin time) with or without elevated SGOT & SGPT.

Hence by the description, you do not seem to have cirrhosis, but a fatty liver phase cannot be ruled out.

Dilated veins, mottled palms and weight loss point towards some liver dysfunction.

My advise is to abstain from alcohol completely, take a nutritious diet and get yourself checked for HBsAg, anti HCV and alfa foetoprotein.

I hope, this answers your query. I will be available for follow up queries if any.

Regards.
Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Poorna Chandra K.S (7 days later)

I fear it is worse than fatty liver based on the way I have felt over the past couple months. I look rough latley and just don't feel like my self. I no longer drink at all and I thought after several months off being sober this would have resolved. My platlets dropped 31 points since July. Is it normal for platlet counts to fluctuate that much? How long can it take for fatty liver disease to resolve? I am still waiting on the U/S. and the stress of the situation is taking it's toll on me.

Answered by Dr. Poorna Chandra K.S (26 hours later)

Hello again,

I understand your concern.

It is normal that the platelet count fluctuates. In fact, it fluctuates on a daily basis.

Fatty liver is a reversible condition and total alcohol abstinence is a must for it. It usually takes around 12 to 16 weeks to resolve, sometimes upto 6 months.

Do not worry, you should be fine soon and go ahead with the Ultrasound.

I appreciate your efforts in staying sober. keep going this way.

Get well soon.

Regards,

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Above answer was peer-reviewed by : Dr. Radhika