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Q. I have weird symptoms, and my liver enzymes are elevated. Is it due to liver cirrhosis?

Answered by
Dr. Ajeet Kumar
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Aug 27, 2020 and last reviewed on: May 12, 2021

Hi doctor,

I am a 26-year-old male with a weight of 184 kilograms and a height of five feet seven inches. I am experiencing some weird symptoms for the past three months. I am a recovering binge eating addict. I use to eat fast food two to three times a day usually with meal size after work. Lately, I was eating healthier but I started experiencing weird symptoms. I experienced weird breath that tasted almost like musty or moldy, brain fog, dry skin, weird urine color, stomach tightness, and constant dry mouth. I had fatigue with weird odor farts. I had an SGOT of 42 U/L, SGPT of 86 U/L, bilirubin of 1.2 mg/dL, alkaline phosphatase of 82 IU/L, albumin of 4.9 g/dL, globulin of 2.9 g/dL, protein of 7.8 g/dL, cholesterol of 254 mg/dL, LDL of 192 mg/dL, WBC of 6.5 billion white cells/liter pf blood, RBC of 5.29 million red blood cells/mcL, and platelets of 344,000 platelets/mL. I am worried. I have elevated levels of liver enzymes for seven years. My urinalysis is clear. Is it possible for me to have cirrhosis? I lost ten pounds last year. I do not drink. I do not have jaundice and ascites.

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Hi,

Welcome to icliniq.com.

Your weight is slightly higher. Your body mass index is 27.2. Ideally, it should be less than 25. BMI is proportionate of your weight according to your height. So, you have a possibility of having fatty liver disease due to deranged liver function tests. Your FIB-4 (fibrosis score) score is 0.34 and it is normal. It means that you have an unlikely chance to have cirrhosis at this stage. Aging with a similar elevation of liver enzymes can definitely cause liver cirrhosis. A fatty liver takes around 10 to 15 years to develop into liver cirrhosis.

There are few other tools for calculating the risk of liver cirrhosis. You need to do AST (aspartate transaminase) to calculate APRI (aspartate transaminase to platelet ratio index) with another fibrosis score. I suggest you do some investigations given below. Coming to your symptoms, they cannot be defined with fatty liver disease alone.

You can have thyroid dysfunction or any other disease-causing fatigue, lethargy, dry mouth, and dry skin. You can have diabetes, autoimmune disease, metabolic diseases such as Wilson's disease, or hemochromatosis. These diseases can cause deranged levels of liver function tests. Do the mentioned investigations given below to guide you further with a further course of management.

Please mention whether you have used any herbal or homeopathy medicines. Please mention some details about your personal information. Please mention whether you have a risk of having viral hepatitis due to tattooing over the skin, high sexual behavior or unprotected sex, or travel history.


The Probable causes:

You seem to have fatty liver disease.

Investigations to be done:

You need to do CBC (complete blood count), complete ANA (anti-nuclear antibody) profile including ANA, ASMA (anti-smooth muscle antibody), AMA (anti-mitochondrial antibody), fasting blood sugar, HBa1c (hemoglobin a1c), anti-LKM 1 antibody, serum ceruloplasmin, serum ferritin, serum iron, transferrin saturation, TSH (thyroid-stimulating hormone), FT4 (free thyroxine), vitamin B12, RBC (red blood cells), folate, HbsAg (hepatitis B surface antigen), Anti HCV (anti-hepatitis C virus), Hb (hemoglobin), vitamin D levels, serum calcium, phosphorus, magnesium, BUN (blood urea nitrogen), creatinine, electrolytes. Kindly send your previous LFT (liver function test) reports.

Treatment plan:

Based on your investigations, I can guide you further.

Regarding follow up:

Have a follow-up with your investigation results.


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