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

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

I am a 26 year old male weighing 184 5'7. I have been experiencing weird symptoms over past 3 months. I should mention I am a recovering binge eating addict. I used to eat fast food 2-3 times a day usually meal size after work. Lately I have been eating healthier but have been experiencing weird symptoms. I have been experiencing following: -Weird breath that tastes almost like musty or moldy -Brain fog -Dry skin -Weird urine odor -Stomach tightness and constant dry mouth. -Fatigue -Weird odor farts Here are some of my blood test results:

SGOT(AST): 42 SGPT(ALT): 86 Bilirubin:1.2 Alkaline Phospate: 82 Albumin:4.9 Globulin:2.9 Protein:7.8 A.G. Ratio 1.7 Choloestorel:254 LDL:192 WBC:6.5 RBC:5.29 Platelets:344

I am worried. I have had elevated liver enzymes since seven years but never these symptoms. Urinalysis is all clear. Is it possible to have cirhossis with these numbers. And should I be worried? I have also lost ten pounds since last year. Also I do not drink alcohol. I also have no jaundice and no ascites(I think as physician did physical exam)

#

Hello. I welcome you to icliniq.

Your concerns are quite reasonable but let me tell you some of the facts about this.

Your weight is slightly to the higher side. Your BODY Mass Index BMI is 27.2. Ideally it should be less than 25. The BMI is the proportionate of your weight given to your height.

So fatty liver disease is a possibility here given your deranged liver function tests and with no use of alcohol. Your Fib 4 score ( a tool to tell significant fibrosis of the liver) is 0.34 which is normal. This means it is unlikely that you have cirrhosis at this stage of the life. Yes since as age goes on with the similar elevation of the liver enzymes can definitely cause liver cirrhosis. A general rule is it take 10 to 15 years of fatty liver disease to result in liver cirrhosis.

There are few other tools to calculte the risk of liver cirrhosis - I would need the the reference range of the AST to calculate APRI and one other fibrosis score. You should upload the lfts report online as I can see that. Plus I am going to ask you some more tests to be sure of that it is fatty liver disease and not anything else, as a cause of deranged liver function tests.

Now coming to your symptoms, they can not be defined by fatty liver disease alone. There may be thyroid dysfunction or any other disease process causing fatigue, lathargy, dry mouth ane dry skin namely diabetes, automimmune disease, and metabolic disease such as wilson disease or hemochromatosis, annd this might be the underlying cause of.deranged lfts as well.

So the optimal step is that you get the tests and let me know the results to guide further course of management. Also let me know have you used or using any herbal or homeopathic medications? And kindly let me know some personal information like are you married? do you have risk for viral hepatitis like tattooing over skin, high sexual behavior Like unprotected sex ? travel history?


The Probable causes:

Fatty liver disease

Investigations to be done:

CBC
complete ANA profile including ANA, ASMA, AMA
Fasting blood sugar HBa1c
Anti LKM 1 antibody
Serum ceruloplasmin
Serum ferritin
Serum iron, transferrin saturation
Tsh, FT4
Vit B12 and RBC folate
HbsAg
Anti HCV
Hbcore total
Vit. D levels
Serum Ca , Phosphorus, mg
Bun Cr electrolytes
upload previous lfts report

Treatment plan:

Will guide based one investigation findings

Regarding follow up:

follow up with the investigations.


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