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Forum Name: Hematology Topics

Question: Fatty Liver Disease and Elevated ALT


 struff2000 - Mon Jun 07, 2010 11:46 pm

Hello Doctor,
I am new to this board so I will just give you some information about me and my problem. I am a 37 year old male and had 2-3 ultrasounds of my liver in the past year or two suggesting just fatty infiltration of the liver. I am also a type 2 diabetic, mildly high triglycerides and mildly high cholesterol and am on no meds for my diabetes. I have been seeing a GI doctor for about 2 years now and he keeps telling me to lose weight and I have neglected to do so. My ALT has been mildly elevated for the entire 2 years that I have seen him (between 65-95) but just recently I have had my LFT's checked quite often and the ALT was 119(dec 09) 153(Mar 10), 123(Apr 10), 108(Mid Apr 10), 119(Late Apr 10), 89(May 10) and then just recently 125(June 10). All other numbers are within normal limits. I was a pretty heavy drinker as a young man and as soon as I saw that my ALT went up to 153 I quit drinking IMMEDIATELY without any help just 6 weeks ago. The numbers have been slowly lowering but my GI suggests a liver biopsy and I am completely against it. What would you suggest that I do? I have also lost about 15-20 lbs in the last 6 weeks due to not drinking and eating better along with added exercise.
 Dr.M.jagesh kamath - Fri Jun 11, 2010 10:13 am

User avatar Hello,The problem with alcohol is that as we age our ability to handle alcohol by the liver becomes less.Consequently there is deposition of fat in the liver.This is known as steatosis and might be asymptomatic.Abstinence from alcohol for 2 to3 weeks is enough to clear the histologic picture.
But then long term high consumption could lead to an hepatitis and cirrhosis known by name alcoholic liver disease.Generally 40 to 80gms of alcohol for 10 to 12 years is associated with higher risk.Women have a higher chance so does obesity,and improper diet in both.
While liver function tests,ultrasound,triglyceride level do give some information the single test that is most sensitive in diagnosis would be liver biopsy.
Also it helps to rule out other liver conditions like hemochromatosis which could be found in diabetes also.
Also you would need to get your serum proteins and AG ratio since you seem to have lost weight in a short time which of course may be related to excercise,diet,and abstinence from alcohol.
The foundation of treatment of alcoholic liver disease is abstinence.
Best wishes.

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