Alcoholic Liver Disease Online Support Group

Hello All, and THANK YOU so much to those of you that had the wisdom to start this group. I have posted a few times on the cirrhosis forum, looking for answers, but as I am not formally diagnosed with cirrhosis, I always felt a bit guilty asking those folks for reassurance.

Moonwatcher, your pinned articles are exemplary and I have actually finally gotten some answers to things I was never able to find in my own research.

Now, onto more questions. First, a little background: I am 43, about 50lbs overweight, and have been drinking heavily since the age of 18. Miraculously, I show all signs of being in robust health - strong appetite, excellent digestion, normal energy levels, good sleeper. If I get scratched or cut, I stop bleeding very quickly (fast clotting time). Lucky... perhaps, but one thing I do know is that liver disease is a silent killer and the fact that I feel great and have normal blood values,etc is not necessarily proof positive that I am well.

I do try to mitigate the damage - take lots of vitamins, milk thistle, eat well, drink a fair amount of water. And yes, I have and do try to stop drinking alcohol. However, if you are reading this forum you no doubt understand the extreme difficulty of stopping.

Most importantly - I know none of you are doctors, and even if you were, you cannot give official medical advice over the internet. I also know that the bottom line is that if I want to stay healthy, I must stop drinking. That being said...

Question #1: For many years, I have had the swollen, achy feeling around the liver area on and off. Not terribly painful, not always there, sometimes more pronounced (especially after a bout of heavier drinking than usual). Lately, although my drinking has not decreased, I don't "feel my liver" as much as before. That swollen, achy feeling has lessened dramatically and I am wondering if this could indicate that my liver is shrinking due to cirrhosis? Or, is this a more advanced manifestation of cirrhosis which would mean that I would have had other problems/symptoms by now?

Question #2: Also for many years, I have taken 1,000 mg of vitamin C daily. As vitamin C is a crucial component to collagen production, I have stopped taking it as I fear it may accelerate fibrosis in my liver. Does anyone know if this could be true? I really believe in vitamin C for many other health benefits and hate to stop taking it unless I have to.

Thank you to all who take the time to reply and share knowlege.

Hi ImogenWinter, & thanks for the kind words!

Regarding "that feeling" so many of us report under the right rib cage... I'm afraid I haven't seen a lot of info on what stage of liver disease this shrinkage starts to occur. I assume it is rather late in the process. I know my liver was still large and fatty when I began seeing signs of ALD (vascular lesions on skin) as it was uncomfortable for me to sleep on my right side. When I quit drinking, this resolved quite quickly (3 months?) and I now do fine sleeping on my right side for the first time in years. Don't know if my liver has shrunken down into a prune sized nugget or not!

An ultrasound would be invaluable in measuring where you stand regarding liver size and to a certain extent, fibrosis. They are cheap and easy to do, and your doctor shouldn't object to ordering one. If you don't want to fess-up and tell him you're worried about ALD, you might go in with "gall bladder symptoms" (episodic shooting/cramping pains and nausea after eating fatty meals). This should warrant an ultrasound and "full metabolic blood panel" which should give a good indication of where you stand. Always best to be honest with doctors, but some don't want a record of alcohol dependence, and these days, I understand why.

Vitamin-C is IMPORTANT for those still drinking, as it helps recycle glutathione (the liver's master anti-oxidant) back into a usable form again. Problem is... Vitamin-C GREATLY increases iron absorption from food, and if you've read many of my posts over on the cirrhosis forum, you know I believe alcoholic iron overload plays a big role in alcoholic liver disease.

The solution is to always take your vitamin-C on an EMPTY STOMACH (with a full glass of water). Vitamin-C only increases iron absorption when taken with iron rich food. Vitamin-C may contribute to production of collagen, but it also reduces/breaks down fibrinogen, and this is a good thing.

The fibrosis of alcoholic liver disease is caused mainly by oxidative stress created by acetaldehyde produced during alcohol metabolism. Glutithione helps remove acetaldehyde quickly, before it does too much damage, and vitamin-C (and cysteine) help prevent glutithione depletion. When oxidative stress runs amok, fibrosis will occur one way or another, so keeping this in check is more important than starving your body of nutrients it may also use to produce collagen.

No one loved their beer more than I, and I understand how one might attempt to have their cake and eat it too, but sooner or later heavy drinking will take it's toll. If you've still got good labs and a clean ultrasound, and can moderate your alcohol intake, you may be able to drink in moderation for many years to come. Something I wish I had given more careful consideration about 20 years ago.

Best of Luck to you, and nice to see you again!

Hello ImogenWinter,

Moonwatcher’s articles are great! He has so much knowledge and great advice. I’m responding to your post because you’re about my age, and I too was a heavy drinker until this year. I started drinking when I was 16, but really started to drink heavily in college. Everyone is different, and not all heavy drinkers progress to cirrhosis like I did, but I thought I’d post and tell you what happened to me, with the hope that it gives you the extra encouragement to take Moonwatcher’s suggestion of somehow getting an ultrasound and labs to check up on things.

In June of 2011 I had a back surgery, and the pre-surgical labs showed some abnormalities in some of my levels (bilirubin, INR). The surgeon suggested I “cut back” on my drinking, and made no big deal of it. I was sober for a month following the procedure, then started drinking again. I felt no symptoms.

Around Christmas 2011, I had a nosebleed, went to a doc-in-the-box, and was told that the dry winter air was drying out my nasal passages and causing irritation, and to use a humidifier when I slept. He also gave me an ointment to rub in my nostrils. That seemed to do the trick.

In January if felt what I thought was a lump right below my sternum. Made a doc appointment, and saw him in Feb. The doc palpated my abdomen, and said my liver felt hard. I quit drinking immediately.

He ordered a CT scan, which showed an enlarged spleen, and enlarged, possibly cirrhotic liver. He also ordered more labs, and this time in addition to the other out-of-normal range numbers I had before my surgery, my Albumin was declining to below normal levels as well.

He ordered a liver biopsy, which confirmed the diagnosis. I have since been seeing a Gastrointerologist, who performed an upper endoscopy and discovered I had ulcers and esophageal varices. I had no idea.

Now I’m looking at a shortened life expectancy, I’m being referred to a transplant center, and had I not felt that lump, which many folks with cirrhosis wouldn’t necessarily feel or notice, I’d still have no idea. My symptoms only arose after quitting, with the exception of the nosebleeds.

Now I’m on medication and a sodium-restricted diet to control edema and ascites. I’m tired all the time, and my ammonia levels are above normal.

My point in telling you all of this is that bloodwork and an ultrasound may reveal something you might not necessarily feel or notice. You may very well be one of the majority of heavy drinkers who don’t progress to cirrhosis, but if I had it to do over, I certainly wouldn’t chance it.

I hope all that wasn’t too preachy or boring, I just wouldn’t wish this on anyone. I hope it all turns out that your liver and body are fine, and that you live a long, happy, and healthy life. Best of luck to you,

Winston

Thank you to Moonwatcher and Winston.

Winston, I appreciate your honesty but yes - your post did scare the hell out of me However I know that keeping my head in the sand is pointless and I am better off knowing than not.

What also bothers me about your story, Winston, is that although you have been sober for a good little while now, you are still sick and symptomatic... from the sounds of things. I have always read and been told that if you remove the cause (alcohol) you will halt the cirrhosis. Are you getting better over time, do you feel as though you will make good recovery? Or is it simply the case that you will have the symptoms you do now but that you will not get worse?

Another interesting thing from one of Moonwatcher's posts is how he explains why alcoholics often experience their first symptoms of liver disease AFTER quitting - how the immune system ramps up and inflammation results. Almost makes me scared to stop! Unfortunately I know that I must stop.

Winston, would you mind if I ask how much you used to drink? I was on maybe 3 - 5 bottles of wine a week during my twenties, then once I hit thirty it went up to more or less a bottle of wine a day, give or take... occasionally I would have dry days, and on other occasions I would have 2-3 bottles in ONE day. Now, I seem to get through one bottle a night after work, a bottle on Saturday, and usually 2 bottles on Sunday. I rarely drink spirits.

Sorry this is so long... but I suppose that's what this message board is for - so we can vent our worries, problems, etc and help each other.

I have no health insurance at the moment, although am I working... so no plans to ask for an ultrasound anytime soon. Also too scared to know. Either way I know the only answer for me is to stop drinking.

Winston, I have a feeling your health may take an upswing if you continue in sobriety... In any event, you have my sincere best wishes for a strong recovery.

Hello ImogenWinter,

Looking at your alcohol consumption you are going to be in real trouble if you do not stop. I like you enjoyed a bottle of wine most evening and the occassional southern comfort at the weekends in addition to the wine. I am thought to have 'Early Cirrhosis'. I'm only 31. You may not have any sagnificant trouble with your liver but if you do then you need to stop NOW! Cirrhosis cannot be cured yet but it can be slowed down considerably if it is caught in time. Do not end up being one of the unfortunates who find out about the Cirrhosis when they throw 3 pints of blood up from thier esophogas. Itis also worth mentioning that I have experinced pain in the liver area, spider markings on the skin, itching and a whole load of other symptoms yet my liver and spleen are normal size. Dealing with the addiction is far easier than dealing with the prospect of a shortened lifespan as Winston has stated. Harsh words I know but if you don't want to end up where we are then STOP NOW AND FOREVER!

Thank you for your input, Guitar. I am sorry you are dealing with cirrhosis but thankful that you were able to catch it early.

It's true that I have no idea about the state of my liver, although my last bloods were excellent, but that was over a year go. In any case, I realize that the fact that I am asympomatic is encouraging as it could mean that if I stop now, I may escape serious complications.

I live alone (with my cats) so if I ever had a bleed in the middle of the night or anything like that, it's almost a certainty I would die because no one would be there to call 999 or to drive me to hospital.

If you don't mind my asking, how were you able to quit? I starting drinking in London, where I lived until I was 36... after 25+ years it is such an ingrained habit. I tried AA but felt very "managed" and my sponser was to the point of almost harassing me - calling and texting all hours of the day, etc etc. There must be a better way.

Living alone, and with little to no disposable income, I get bored and that contributes alot to the drinking, especially at the weekend. I think I must consciously fashion a new routine for myself including plenty of non-drinking activities that I enjoy... I suppose it would be a start, anyway. Unfortunately I live in an area of the US that I am very unhappy with, but due to a myriad of circumstances, I am stuck here for the next few years. It's hard being alone and living in boredom. None of these things are excuses, I fully realize that.

Please don't think I am not thankful that I am still strong and well (by the grace of God)and I am NOT going to throw that gift away.

Thank you again to all xx

Loss of an active addiction is very much like the loss of a loved one: you WILL experience fear, physical and mental pain and anguish and go thru the 5 stages of loss: denial, bargaining, anger, depression and acceptance. (Check out my post on stages at http://www.mdjunction.com/forums/cirrhosis-discussions/ general-support/2426262-stages. There is definitely both a mental and a physical side of ALD that you are beginning to see first-hand. Please see http://mysickliver.weebly.com/alcoholic-liver-disease- ald.html for more information.

You can check out our group's articles (via the tab towards the top of this page) where we have some articles about a couple of programs that can help you with your alcohol addiction. I'm sorry, but it is a huge topic that is beyond the scope of our group. Please get some help!

Hi ImogenWinter,

Like I say, you may very well not have liver damage, I just very much agree with MoonWatcher- it would probably be a good idea to get things checked if you can. The amount of alcohol you're talking about is significant. I also agree with Guitar, that heavy drinking can cause serious problems- even if it doesn't lead to cirrhosis, and with dmanflan- I hope you can find help with this. I've quit smoking as well as drinking, and it has been like losing a couple of "friends" in terms of the "grieving" process. Hope to hear how you do with all of this, and again my best wishes,

winston

I'm with you all on the 'grieving' process. It is just like a real relationship, great in the beginning honeymoon period then so much grief later on Seriously though ImogenWinter, quitting the last time for me was easy but the several times I tried before was not. You need to replace the alcohol with another obsession, preferably a healthy one. Something to fill the hole left when you no longer have alcohol to lean on. For me it was Martial Arts, playing guitar, watching movies etc etc. we all know how easy time passes when you consume Alcohol. You need to fill that time. For everyone it is different . Take one day at a time and never set time limits on abstainance. I tried that and spent the entire time counting down the weeks and days till I could drink again. It is easier by far to quit for good. That may be unimaginable just now but give it time and you will see there is life after the bottle!

Great advice, everyone.

Guitar, I especially like the idea of replacing alcohol with a healthy obsession, that sounds like an ideal solution.

Wishing everyone good luck and good health, and thanks again.