Please Evaluate my Labs... opinions please
First my history. On and off drinking since I was in my 20s. Im 45 now.
In the early 90s I drank what I considered heavy (2 or 3 nights a week drunk) for maybe 7 years. But I know PLENTY of daily drunks. I NEVER drank to that extreme on a daily basis. Anyway, that was for maybe a 7 year run when I was young and crazy. Afterwords I was just a social drinker, a few cocktails before dinner, very rarely 4 or 5 drinks but only on occasion.
I am a severe hypochondriac with anxiety and panic disorder. So I am at the doctors ALOT! I have had 5 ultrasounds over the last 20 years, maybe 3 times they show fatty liver. My liver enzymes were only really elevated once in my 20s.
2 years ago I go in for a check up, I have mild pain URQ which he thinks is sluggish gallbladder. I get mild pain after a fatty mean or indigestion. He does blood work and AST/ALT elevated by 2 points, so he says its nothing to worry about. I request an ultrasound. The results were:
Moderate to SEVERE fatty Liver! with mild hepatomegely
Well that scared the bejesus out of me! I never seen severe before in my fatty liver diagnosis and the mild enlargement was not too comforting!
I stop all alcohol completely. And I go on a diet. Im 50 pounds overweight,
Last year I go to recheck with another ultrasound, this time a new doctor because I moved. The results came in NORMAL! I was very happy naturally.
When we read the top part where they detail all the organs etc it did say "Something something conisitent with MILD fatty infiltration of the liver"
My doctor quickly pointed out the the doctor who read the scan didn't even think the fatty liver was significant enough to include it in the conclusion and just wrote "Normal Limits abdominal sonogram"
Being a hypochondriac I still worry about Cirrhosis. I have what I perceive as "signs" for example
1-Pale Finger Nails (but I have had pale fingernails since childhood, and my dad has it too and his liver is fine)
2-Red Palms -they burn sometimes. Have had for a few years. Never worried about it until I started googling.
3- A few spider veins here and there. Not tremendous, but if I look hard I will find them.
Now before I post my most recent blood test results, let me give you one more caveat to ponder. I have been diagnosed with Low Testosterone. Its very common for middle aged men with fat to have this. As a result, my estrogen is a little high. I know high estrogen can be a sign of liver disease, but in my defense, I must say I have had high estrogen all my life. when I was a kid I developed male gynomastia (male breasts) from too much estrogen. So I am hoping that my red palms and spiders are a result of the estrogen imbalance and not a faulty liver. I am currently on Testopel (Testosterone pellets).
I also read online about distended abdominal veins, and if I look carefully at my chest and belly, especially after I work out at the gym I can see a few veins. But I would think the ultrasound done only one year ago would show portal hypertension.
The good news is that since going on Testosterone therapy I have been having blood work almost monthly! Its not a major panel, they do that once a year, but its a basic. As a result of the testosterone therapy, my RBC runs high, which is common for men on T therapy. So I give blood at the Red Cross every 8 weeks. I asked my doctor to do another ultrasound and said no I don't need one. He said "don't look for trouble" -When I pushed him on it he said that "too many of these tests lead to more and more tests then the next thing you know your doing biopsys because of a cyst here and a cyst there. You feel good, you don't need it, your labs are normal"
This is my lab results from 2 weeks ago:
Total Testosterone 905
Free Testosterone 108
Estadiol (Estrogen) 62 -should be under 55
My bilirubin does seem to stay in the high range of normal bouncing between .08 and 1.3 over the last year. He said he is not concerned.
I read somewhere that people with Cirrhosis usually will have AST elevated 2 or 3 times the ALT, where as in every other form of liver disease its ALWAYS the ALT that rises. that gives me some hope as my AST is very low compared to my ALT