I hope not in the future?

[opyonin]

Hello fellas. It was 2017 when I was diagnosed with a fatty liver disease but thru the years it got even worse instead of being treated. At first its only like 10% above the normal for the SGPT and SGOT but then fast forward my last test was sometime in July 2019 my SGPT is triple than the normal and SGOT is doubled than suppose to be normal. My doctors have tried giving diff medicines but none worked out. It keeps on going high in the past years. Last year I came to know I have high cholesterol. Last year my doctor advised me to have a test for Hepa B which resulted to negative. I'm not an expert when it comes to hepa but I guess at this rate Im just afraid if its possible or afraid mine would go worst into cirrhosis stage if SGPT and SGOT dont stop increasing? Could anyone help or enlighten me here thanks

[Lynn K]

If you are overweight I strongly suggest you try to get down to a normal BMI. What have your doctors suggested as to a cause for your elevated liver enzymes? There are many causes for liver enzymes to be elevated.

Have you had a Fibroscan or fibrosure test to determine if you have any liver scarring or possibly a liver biopsy? That is the only way to know if you have any liver damage going on. Another helpful test is an abdominal ultrasound which can detect some changes associated with liver damage but not really the best way to initially diagnose liver fibrosis.


https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567

“NAFLD is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population.
Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.

Causes
Experts don't know exactly why some people accumulate fat in the liver while others do not. Similarly, there is limited understanding of why some fatty livers develop inflammation that progresses to cirrhosis.
NAFLD and NASH are both linked to the following:
Overweight or obesity
Insulin resistance, in which your cells don't take up sugar in response to the hormone insulin
High blood sugar (hyperglycemia), indicating prediabetes or type 2 diabetes
High levels of fats, particularly triglycerides, in the blood
These combined health problems appear to promote the deposit of fat in the liver. For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.
Risk factors
A wide range of diseases and conditions can increase your risk of NAFLD, including:
High cholesterol
High levels of triglycerides in the blood
Metabolic syndrome
Obesity, particularly when fat is concentrated in the abdomen
Polycystic ovary syndrome
Sleep apnea
Type 2 diabetes
Underactive thyroid (hypothyroidism)
Underactive pituitary gland (hypopituitarism)
NASH is more likely in these groups:
Older people
People with diabetes
People with body fat concentrated in the abdomen
It is difficult to distinguish NAFLD from NASH without further testing.
Complications
Normal liver and liver cirrhosis
Normal liver vs. liver cirrhosis
Esophageal varices
Esophageal varices
Liver cancer
Liver cancer
The main complication of NAFLD and NASH is cirrhosis, which is late-stage scarring in the liver. Cirrhosis occurs in response to liver injury, such as the inflammation in NASH. As the liver tries to halt inflammation, it produces areas of scarring (fibrosis). With continued inflammation, fibrosis spreads to take up more and more liver tissue.
If the process isn't interrupted, cirrhosis can lead to:
Fluid buildup in the abdomen (ascites)
Swelling of veins in your esophagus (esophageal varices), which can rupture and bleed
Confusion, drowsiness and slurred speech (hepatic encephalopathy)
Liver cancer
End-stage liver failure, which means the liver has stopped functioning
Between 5% and 12% of people with NASH will progress to cirrhosis.
Prevention
To reduce your risk of NAFLD:
Choose a healthy diet. Choose a healthy plant-based diet that's rich in fruits, vegetables, whole grains and healthy fats.
Maintain a healthy weight. If you are overweight or obese, reduce the number of calories you eat each day and get more exercise. If you have a healthy weight, work to maintain it by choosing a healthy diet and exercising.
Exercise. Exercise most days of the week. Get an OK from your doctor first if you haven't been exercising regularly.“

[Lynn K]

If you are not already I suggest you see a liver specialist or at least a gastroenterologist. General practitioners are not well versed in more advanced matters related to internal medicine.

[opyonin]

Yes I am overweight. They suggested diet and a supplement that doesn't really work for me. My last ultrasound shows no enlargement of liver and the doctor did not mention any scarring after reading the result? Is that suppose to mean I'm all good and nothing to worry about?

[Lynn K]

If you have fatty liver and elevated liver enzymes that is not a good situation. If you can’t lose weight through diet and exercise have you considered bariatric surgery or other similar methods. More importantly what has your doctor said.

As I mentioned ultrasound can not detect scarring only the gross changes that can indicate possible liver damage. Only a Fibroscan machine, Fibroscan blood test, or a needle liver biopsy can really determine if you have liver scarring (aka fibrosis)

As a lay person aka just another patient seems to me you need to try to get your weight under control for the health of your liver and all the other problems that can arise from being overweight.

Best of luck to you

[opyonin]

I'm having my check up with an Internal Medicine doctor. Gastroenterologist? Well my doctor did not advise anything except for some supplement diet and exercise. I don't think I'd like the surgery but I would if its the only solution. Continuously increasing of the SGPT and SGOT that is a symptom of a what possible disease? A fibrosis? I'll see if I can get somewhere a Fibroscan blood test. Yeah well I'm considering LCIF diet but the thing is I've had a stomach acidity lately which makes me unable to do fasting so I'm still checking if that's a diet I can consider implementing.

[Lynn K]

Fibrosis is a disease progression it means scarring that can happen if your liver is constantly under attack. Eventually if enough scarring develops that is when a person is diagnosed with cirrhosis. Elevated liver enzymes are caused when something is injuring your liver they are released when the liver is repairing itself. Having chronically elevated liver enzymes means your liver is under attack every day. Be it from excessive alcohol consumption, exposure to certain chemicals or drugs, a virus that attacks the liver like chronic hepatitis B or C. There are also certain autoimmune conditions that can cause liver damage. And simply being overweight resulting in fatty liver. Actually, there are some who aren’t very overweight but still for unknown reasons develop fat cells in the liver also resulting in NAFLD (non-alcohol Fatty Liver Disease)

The blood test is called a fibrosure it ISA composite of several blood test results as I understand it. A Fibroscan is a machine similar to an ultrasound which produces a sort of thump that can estimate liver stiffness.

https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/causes/sym-20050830

Causes
By Mayo Clinic Staff
Many diseases and conditions can contribute to elevated liver enzymes. Your doctor determines the specific cause of your elevated liver enzymes by reviewing your medications, your signs and symptoms and, in some cases, other tests and procedures.

More common causes of elevated liver enzymes include:

Over-the-counter pain medications, particularly acetaminophen (Tylenol, others)
Certain prescription medications, including statin drugs used to control cholesterol
Drinking alcohol
Heart failure
Hepatitis A
Hepatitis B
Hepatitis C
Nonalcoholic fatty liver disease
Obesity
Other causes of elevated liver enzymes may include:

Alcoholic hepatitis (severe liver inflammation caused by excessive alcohol consumption)
Autoimmune hepatitis (liver inflammation caused by an autoimmune disorder)
Celiac disease (small intestine damage caused by gluten)
Cytomegalovirus (CMV) infection
Epstein-Barr virus
Hemochromatosis (too much iron stored in your body)
Liver cancer
Mononucleosis
Polymyositis (inflammatory disease that causes muscle weakness)
Sepsis (an overwhelming bloodstream infection that uses up neutrophils faster than they can be produced)
Thyroid disorders
Toxic hepatitis (liver inflammation caused by drugs or toxins)
Wilson's disease (too much copper stored in your body)

[Lynn K]

A normal healthy diet is one you can follow for life not just for temporary weight reduction. One recommendation I’ve seen is a heart smart diet is also a liver healthy diet. And exercise doesn’t have to be training for running a marathon. Just getting more walking in every day will help your lose weight and get healthier in general