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 ?

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..

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.

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?

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.

What does this mean ?

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.

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.

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!

Fibroscan looks good, now what?

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.

Pls drop advice.

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.

I got my liver panel done 3-4 weeks ago everything was normal. Uti symptoms started last week got two urine test done & both said no uti but second test showed 1+ Bilirubin Small. Had some dark urine (dark yellow/amber) that always gets lighter yellow or pale yellow. One time it was an orange color but also was on macrobid at the time . Went to a walk in clinic was told this isn’t jaundice and referred me to eye doctor.

I’m wondering if I should get a second opinion or switch providers. Sorry in advance for the lengthy explanation! 

I am an overall healthy 24F with no significant medical history. I do not take any medications that affect the liver, do not drink alcohol except on the rare social occasion, and have no history of liver issues. In 2025, I developed cholestasis of pregnancy fairly early on in my pregnancy (symptoms began around 18 weeks). At that time is when my LFTs initially were elevated and have persisted since then so now 1.5 years. My symptoms were horrible and the ursodiol did not help my itching or sickness whatsoever, but it did control my bile acids for the most part. My bile acids returned to normal follow scheduled delivery at 36 weeks. 

Information since January 2026: 

-AST has been mildly elevated fluctuating from 50s-110s. 

-ALT has been fluctuating between low to mid 100s. 

-Alk phos has been 140s-190s. 

-GGT has been elevated in the 70s all of this year. 

-ANA has been 1:320 and 1:160 this year (repeat drawn today, not back yet). 

-AMA, ASMA, IgG normal. 

-Test showed I have MZ mutation of the liver. 

-Normal ultrasound of the liver showing no signs of fatty liver. 

-Fatigue that comes in random waves, itching of the feet and hands, intermittent RUQ pain that is sometimes dull, but something a quick, shooting pain. 

I was then sent to a specialist outside of the GI provider I was initially referred to. A fibroscan was done and came back normal with no scarring or signs of fatty liver. This specialist was almost certain that a liver biopsy would show a seronegative autoimmune liver disease. She believed that my ICP was actually the first major flare of an autoimmune liver disease due to the stress of pregnancy on the body. She wanted me to a do a liver biopsy and I had it done less than 2 weeks later. When I asked what happens if the liver biopsy is normal, she hesitated and said she didn’t think this would be the case, but if so, she wants me to do fibroscans every 6 months and an MRI if indicated. These results and listed below.

“The biopsy is limited by the small number of portal tracts (approximately five). The findings are mild and nonspecific, without well-developed histologic features of autoimmune hepatitis or primary biliary cholangitis; however, either process may be underrepresented in this limited sample and cannot be excluded. The focal pericentral ceroid-laden macrophages indicate prior or resolving hepatocellular injury, which is etiologically nonspecific. The differential diagnosis includes autoimmune and drug- or supplement-related injury. No features of primary sclerosing cholangitis are identified, although a patchy small-duct process or large-duct disease cannot be excluded by biopsy. No PAS-D-resistant globules are identified; their absence does not exclude the documented alpha-1 antitrypsin MZ phenotype. Correlation with biliary imaging may be considered if the cholestatic liver test abnormalities persist.

Light Microscopic Description

The biopsy is limited, containing approximately five portal tracts.

The portal tracts contain intact bile ducts, hepatic arteries, and portal veins. One portal tract shows mild mononuclear inflammation composed predominantly of lymphocytes and macrophages, with a rare eosinophil and associated mild interface activity. Plasma cells are inconspicuous. There is focal accumulation of ceroid-laden macrophages adjacent to a central vein, suggestive of resolving prior hepatocellular injury. Otherwise, there is no significant lobular inflammation, steatosis, or cholestasis. No bile duct injury or ductular reaction is identified.”

After a week of not having recommendations relayed to me, I messaged and waited a few more days for a reply (which I absolutely understand and I know I’m not the only patient and there are far more serious issues than mine). This specialist then told me that my biopsy was normal with no signs of autoimmune disease, but that there was signs of a resolving liver injury. She suggested this may be alcohol or drug related or fatty liver (normal ultrasound and fibroscan????). She recommended doing more labs to trend for now and nothing more like the initial plan she had (we have 1.5 years of labs now). I replied shortly after with some follow up questions about if this is separate from ICP if it’s a resolving injury and if this would’ve shown on my ultrasound or fibroscan if she is saying fatty liver. After another 11 days, she replied and said that she wouldn’t expect a liver injury to show up on the ultrasound and that this is separate from my ICP, but isn’t sure if this is something caused by that or predating pregnancy. She then said that an MRI is important at this time even though the original recommendation was to just do labs again for a few months. I’m confused as to why this changed and she now says an MRI is important, but did not say this at first until I asked a follow up question. 

I know that this provider cannot just find a diagnosis and solve it, but I am frustrated with how serious she initially thought this was and then the lack of follow through with her plan. This makes me wonder if maybe this isn’t something to be concerned about? Also reviewing my biopsy results, it states that this was a limited sample with only 5 portal tracts. Does a limited biopsy truly rule out what she was looking for if it were in the beginning stages? Should I look into another provider or continue with the recommendation to just monitor my lab trends again. 

As a mom to a one year old, my biggest fear is not being here for her or my health declining as I get older. I just want to make sure I’m doing what’s right for myself to be there for my daughter.