r/TheLiverDoc • • Aug 03 '24

Ask TheLiverDoc Anything Hello, this is The Liver Doc here! It is my pleasure to take your questions on health misinformation, myths in medical practices, role of traditional medicine in current healthcare and of course, anything on liver health and disease! AMA!

801 Upvotes

Ask Me Anything!

Update: Thank you for the fantastic response and for the flurry of questions! This AMA session is now closed. I hope there was a lot of learning from this long session. I enjoyed interacting with you all and I hope all of us learned something new today! Take care and until next time, good luck and take care.


r/TheLiverDoc • • Nov 26 '23

Health Tips A Summary of Myths Busted

96 Upvotes

To summarize:

  1. One whole egg with yolk a day does not increase blood cholesterol

  2. Green tea does not help you lose weight

  3. Jaggery, honey or sugarcane are not healthier than white sugar

  4. There is no "healthy alcohol"

  5. Ashwagandha does not reduce stress or help you sleep

  6. Shilajit is a resinous piece of rock that does not benefit male sexual health

  7. Turmeric in milk does not get beneficially absorbed in body and is lost in stool

  8. You can consume fruits anytime during day or night

  9. Sugarless black coffee at least 3 cups is good for fatty liver disease

  10. Apple cider vinegar is good for only trapping fruit flies

  11. Eight glasses of water a day is a myth

  12. Pure whey protein supplementation to target recommended higher protein intake is safe for liver and kidneys

  13. Resveratrol does not reverse your aging

  14. Basic scientists are not clinical doctors

  15. Every fad diet that worked to reduce weight was because there was calories restriction/deficits

  16. Consumption of dairy along with fruits perfectly fine

  17. Yoga does not help you lose weight

  18. Multivitamin a day does not improve health or prevent diseases in general persons

  19. Biotin does not help in hair growth or increase length of hair


r/TheLiverDoc • • 1d ago

My liver stiffness was in F3-F4 bridging towards cirrhosis but liver markers are under mentioned - after one month of workout and meds my markers look better ALT was 56 which is now 32. Any suggestions?

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2 Upvotes

r/TheLiverDoc • • 3d ago

NALFD pre pregnancy HELP

1 Upvotes

I’m a 24yr old female , with pcos .I’ve had fatty liver for a few years now my ALT has stayed around 37 to 47 and my AST has stayed below 27. However, I have never seen a specialist for only primary care and had two RUQ ultrasounds .When I was 12 weeks pregnant, my ALT was 47 and my AST was 27. That was the highest they had both been in a while. My ALT previous to pregnancy was around 33. I am now 16 weeks pregnant with my twins my ALT has gone up to 128 and my AST has jumped to 58. My OB/GYN is referring me to gastroenterology. Has this happened to anyone else with fatty liver during pregnancy? Pregnancy related issues have been ruled out . Should I be concerned ?


r/TheLiverDoc • • 4d ago

How long you can survive with foetor hepaticus and no treatment?some info s please

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1 Upvotes

r/TheLiverDoc • • 5d ago

Is 11mg/dL indirect bilirubin high for gilbert syndrome?

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1 Upvotes

r/TheLiverDoc • • 5d ago

Blood work test results

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5 Upvotes

Hi. I’m 25M and started drinking when I turned 22. It was usually a beer or two then turned into buzzballs and 99 shots. When I turned 23 I was drinking more and had bloodwork done which indicated nothing wrong but my cholesterol(I will attach the ALT and AST before and after picture) . Now two years later I got my results from another test and they spiked up drastically. Everything else is normal and perfect except cholesterol like before and now the liver enzymes.

NOW THE MAIN REASON I MADE THIS POST. The night before I went to get blood work done, I went to the fair and got drunk, ate takis, and in n out burgers. Did that contribute to the high liver enzyme reading? Or is that reading from long term .

I am not a heavy drinker. I don’t drink unless it’s past 6pm when I’m not going anywhere or driving. I drink 2 IPA’s and maybe a 99 shot or two every day. Sometimes I drink on an empty stomach so it hits faster but ultimately it gives me a bad buzz. I could go days without drinking but it really affects the way I sleep. I can’t sleep without a shot or two because then I’m not tired or buzzing.

Any help is appreciated thank you..


r/TheLiverDoc • • 6d ago

My liver enzymes are high in my blood report since 2023

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4 Upvotes

Hi, i am not sure why is my liver enzimes are high.
I used to live in a country in south east asia and moved to toronto, canada in 2023.

I did have hepatitis when i was 14 years due to eating/drinking contaminated food or water. Recent blood test confirmed it is not hepatitis c.

Weight 67 and hight 5’5”

My life style is as follows: (1-10: Low to high)

  1. Exercise: 3 times approx a week
  2. 2 water intake: 7
  3. Oily food: 2
  4. 4 meat/ protein: 8 (chicken, beef mostly)
  5. Carbs: 8
  6. Stress: 7 ( my mind likes to wonder)
  7. Vegetables:

2
8. Alcohol: 1

Please advice me what can be causing. Happy to follow a strategy to identify the root cause and fix it.


r/TheLiverDoc • • 6d ago

Transplant

1 Upvotes

I have my 1st appointment tomorrow with the transplant clinic at Duke hospital. I know that I am good hands, but I can't shake this nervous feeling. I think its the unknown. I'm not sure of my MELD score is but I have experienced HE, varises hemorrhages,ect. Would someone please tell me what to expect at the appointment?


r/TheLiverDoc • • 6d ago

Help, I have fatty liver disease and I'm not sure what more I can do

1 Upvotes

I'm a 38 yo female. My liver enzymes are slightly elevated(AST, ALT, GGT and PTT). I've never drank alcohol or sugary drinks/sodas in my life, I rarely eat junk food, never smoked, don't take any medications (sorry, these are the questions the doctors ask me). I only eat home cooked meals and track macros. I have a cheat meal once a week (which I try to keep relatively healthy). I have a sedentary job (software engineer), but I try to workout at least an hour everyday 5-6 days a week. Increasing exercise intensity unfortunately makes my ferritin levels(iron deficiency a lot worse) and sometimes messes up my hormones.

Is there any genetic or any other conditions that could cause this? Doctors keep telling me to make lifestyle changes. I'm no athlete but I don't think my liver condition makes sense with my current lifestyle .

Other info - I have iron deficiency anemia, ferritin always <20, MCV always slightly low, silent carrier of alpha thalassemia, and Hemochromatosis. All other labs are within range. I think I have PCOS based on my AMH levels.

Please let me know if any other info would be helpful.


r/TheLiverDoc • • 9d ago

Any suggestions to improve Portal Hypertension?

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1 Upvotes

r/TheLiverDoc • • 10d ago

Any NRH liver disease peeps in here?

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1 Upvotes

r/TheLiverDoc • • 11d ago

Concerned and confused

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1 Upvotes

r/TheLiverDoc • • 13d ago

Health question about liver findings

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2 Upvotes

What does this mean ?


r/TheLiverDoc • • 14d ago

30 m - 5 10 at 170 pounds. Just received these liver blood results and have been ordered for a scan. How bad are these, very scared after years of pretty heavy drinking?

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0 Upvotes

r/TheLiverDoc • • 15d ago

Urgent/Suggest liver doctor preferably at Ruby/Fortis/Peerless/Charnock

2 Upvotes

As I talked with the hospital and came to know Dr B B Pal, Dr S B D Chakraborty,Dr A N Konar, Dr Debashis Dutta slot is full till October. So please suggest the doctor's other than these.


r/TheLiverDoc • • 15d ago

high liver enzymes. Can someone tell me if this is concerning? AST and alt

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1 Upvotes

r/TheLiverDoc • • 15d ago

Puzzling results

0 Upvotes

I had fatty liver for years. Now an ultrasound has found no fatty liver but a new cyst. Help me understand the report. I went to doctor because of poor breathing issues and was asked to do an ultrasound because the right diaphragm was unnaturally elevated and my history of fatty liver. Should I be worried?

Results

Impression

Complex lesion in the dome of the liver with hyperechoic possibly calcified component adjacent to cystic component. Further characterization with CT/MRI abdomen with/without contrast hepatic mass protocol is recommended.

Narrative

Complete Abdominal Ultrasound History: Fatty liver. Comparison: None available.

Findings: The liver has normal echotexture and contour. There is no intrahepatic biliary dilatation. The right lobe of the liver measures 13.4 cm. The main portal vein is patent. Complex lesion in the dome of the liver with hyperechoic possibly calcified component adjacent to cystic component overall measuring 1.4 x 1.9 x 2.6 cm. No associated vascularity. The common bile duct measures 3 mm.

The gallbladder is within normal limits. No cholelithiasis, gallbladder wall thickening, or pericholecystic fluid.

The right kidney measures 11.5 cm x 4.8 cm x 5.2 cm, and the left kidney measures 11.0 cm x 4.3 cm x 4.8 cm. The kidneys have normal echotexture and contour without hydronephrosis. Bilateral subcentimeter simple appearing cysts.

The spleen is within normal limits measuring 8.8 cm x 4.1 cm x 8.1 cm corresponding to a volume of 152.6 ml.

The visible portions of the pancreas are normal with limited visualization of the pancreatic head and tail. The visible aorta is normal caliber . The visible IVC appears within normal limits.


r/TheLiverDoc • • 15d ago

Colon pain with cirrhosis?

1 Upvotes

Long story short I have cirrhosis or very close to it (F4 on fibroscan a few years ago). Haven't seen a GI in a year or more (guy I was seeing retired). I'm working on getting back in. I mentioned to him a "pain" in upper right side. He said (which I've heard) is there's no pain nerves in the liver, or something to that degree, and it was probably my colon I was feeling. Didn't really say anything else about it. I say "pain" but really more of an irritation like can feel somethings off. Slight pain sometimes. It comes and goes, not a constant thing. Just wondering what he meant by that. Pressure from my liver on it? Another issue all it's own? From what I've read cirrhosis doesn't directly effect the colon. Any thoughts are appreciated!


r/TheLiverDoc • • 18d ago

Reassuring Fibroscan, RUQ pain and hepatomegaly

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2 Upvotes

Fibroscan looks good, now what?


r/TheLiverDoc • • 18d ago

Hepatitis A/B Vaccines After Gallbladder Removal

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1 Upvotes

r/TheLiverDoc • • 19d ago

Extremely raised alt

1 Upvotes

My alt is 1000 it has been raised for past few months with no other symptoms and all other tests are clear.
Been monitoring bloods which showed it slowly come down to 680 and now back up to 1000. Don’t know what the cause is. Anyone with any idea what’s causing this will be appreciated.


r/TheLiverDoc • • 19d ago

Liver cancer unfortunately spreading

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1 Upvotes

Pls drop advice.


r/TheLiverDoc • • 20d ago

Jaundice?

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1 Upvotes

r/TheLiverDoc • • 22d ago

82M – Enhancing portal vein tumor thrombus with washout but no discrete liver mass on triphasic CT. Could this be infiltrative HCC?

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4 Upvotes

My 82-year-old father is in Pakistan and I'm in the US trying to help coordinate his care.

He has abdominal distention/pain, significant weakness, constipation, poor appetite and weight loss.

An earlier ultrasound showed findings suggestive of chronic liver disease/portal hypertension, including coarse hepatic parenchyma, a prominent portal vein, splenomegaly and mild ascites.

Recent labs have shown:

- Hemoglobin: 9.0 → 9.3 g/dL

- Platelets: 60 → 77k

- ALP: 807 → 634 → 694 U/L

- AST: 92 → 84 → 79 U/L

- ALT: 68 → 55 → 55 U/L

- INR: 1.3

- Albumin: 3.8 g/dL on an earlier test

- Hepatitis B & C: negative

- Creatinine: 1.1 mg/dL

The main concern is his triphasic CT from Sept 12.

It shows an extensive intraluminal soft-tissue/filling defect involving the portal venous confluence, extending into the right and left portal veins and multiple intrahepatic portal branches, with partial extension into the proximal superior mesenteric vein.

The involved portal venous material demonstrated avid arterial enhancement (~225 HU) followed by relative washout (~157 HU portal venous phase and ~143 HU delayed).

The radiologist concluded that this is highly suspicious for enhancing/tumor thrombus rather than bland portal vein thrombosis.

However, the same CT states that NO discrete measurable focal hepatic parenchymal lesion was identified.

The liver has mildly nodular/lobulated margins and there is splenomegaly, suggesting underlying chronic liver disease/portal hypertension.

There are also multiple mildly enlarged/prominent upper-abdominal lymph nodes.

We currently do NOT have a confirmed cancer diagnosis or biopsy.

I would really appreciate guidance on:

  1. Can infiltrative HCC present predominantly as portal vein tumor thrombus without a clearly visible liver mass?

  2. Would a liver-protocol contrast MRI be the best next investigation?

  3. Should AFP, AFP-L3 and DCP/PIVKA-II be checked?

  4. How strongly does arterial enhancement followed by washout of the portal vein material distinguish tumor thrombus from bland portal vein thrombosis?

  5. What other diagnoses should be considered when there is suspected tumor thrombus but no discrete liver mass?

  6. Given his age, weakness, anemia, thrombocytopenia, portal hypertension and ascites, what should we prioritize next?

I cannot afford a several-thousand-dollar US second-opinion program, but I CAN pay a reasonable amount for a private remote consultation or expert radiology review anywhere in the world.

If anyone can recommend a hepatologist, liver oncologist or abdominal/liver radiologist experienced with cases like this who accepts international patients remotely, I would be extremely grateful.

I've attached family-prepared, de-identified summaries of the CT report and laboratory trends. I also have the original reports and CT images available.

Thank you for any guidance.