Cirrhosis Support Group

My apologies for the excessively long post upfront, but I have not had a chance to communicate with other in similar situations since I first received a diagnosis of alcoholic fatty liver. I'm new here as well, and many of the symptoms Arel said he has sound eerily similar to some of mine. I was diagnosed about two months ago with a fatty liver, caused by excessive alcohol consumption. I noticed a lot of wrinkles on the back of my hands a few weeks ago, but haven't noticed the same on my arms, yet. I also started to notice my nose getting quite red about three weeks ago, especially at the tip. It itches a lot too, though that's pretty much the only area where I feel really itchy. I also have Terry's nails, most pronounced on my big toes, and my toe nails, in particular, have become quite clubbed. My ALT enzyme, when tested a month and a half ago, was 75 and the high end of the normal range is 49; while my AST was 39, while the high end of the normal range is 37. My platelet count was just a litle low at 4.35 (normal is 4.5). I also get the red blotches on the palms of my hands, but it seems to come and go, meaning it's not constant. Like Arel, whenever I google most of my symptoms, the most frequent results always associate such symptoms (e.g. Terry's nails, soreness in upper right abdomen/lower right rib cage, clubbed nails, blotchy red palms, etc...) with really advanced stages of liver disease like cirhosis. But, my gastroenterologist, when I discussed the ultrasound report by which my fatty liver was detected dismissed the idea of me getting a liver biopsy because he said that I only had a fatty liver and that everything would return to normal if I could abstain from drinking. So, if I only have a fatty liver (not to trivialize it, I know it's serious, but not as threatening as cirhosis), then why do I have these symptoms that the Internet sites all say are associated with later stage liver diseases?

My concern, however, is that I was unable to completely stop drinking until about a week ago, even though my fatty liver diagnosis was two months ago. I knew I should have tried to quit right away, and I did at least go from drinking every day to drinking every second day (I know, not much of an improvement, but I was trying. I think I found it more difficult to break the mental dependency on alcohol than the physical once, since it's been about a week now without any booze and I haven't felt any withdrawal symptoms or anything. Believe it or not, I can't remember the last time I went an entire week without drinking at least once, but now that I know I can do so without a lot of difficulty, I fully intend to quit altogether. I've been trying to get my G.I. doc to do another liver function test and, if possible, another ultrasound because I'm really worried that the month and a half of drinking every second day may have worsened my condition from fatty liver to something a lot more serious, but he said he won't do another until 3 months after my last ones, which would be late July as the last ones were in late April. I'd also like to get a biopsy done, so that I could know exactly what shape my liver is now in, but he won't go for that either. I've called other heptologists and liver specialists, but none of them will see me without a referral from my family doctor, which he won't give me. Any suggestions?

Take care & talk soon,

Terry

Congratulations on being sober. Even a week counts. It's the biggest step you could have taken.

Don't be surprised by your Drs decision not to do another US yet. Even patients with known Cirrhosis usually wait 3 to 6 months between US. Biopsies are invasive and do carry some risk so drs normally will not do them unless some other test suggest more serious disease.

Your Dr is right that if you remain alcohol free you will improve. All of your symptoms and labs can be form the alcohol use alone and are typical for Fatty Liver. However it usually takes up to a couple of years to see major healing. remember you didn't get sick over night.

Alcoholic Fatty Liver & Alcoholic Hepatitis are both completely reversible. If you remain alcohol free (forever) Even Alcoholic Cirrhosis can be stopped in it's track.

The chance that you have progressed to a point where you should be worried in the short time between US is so slim that it's almost impossible.

The symptoms you mention (Terry's nails, soreness in upper right abdomen/lower right rib cage, clubbed nails, blotchy red palms) can all occur with any liver disease and also from non liver disorders. Advance liver disease complications are things like Ascites (which would have been seen on US, varices and Encephalopathy.

Continue to live a healthy life style and your body will heal in time. It normally takes decades for Fatty Liver to progress to Cirrhosis. And for most patients it never does.

Take a deep breath you're on the right track. And Please get help with staying sober. You should PM Dennis (Dmanflan) sometime he really has some good insights on ways to help yourself on that road.I know it's scary But we're here for you/

I've got the "terry's toes" (yes, mainly on the big toes!) too, and the nails on the big toes seem to be clubbing. I had palmer erythema, but found IP6, a supplement I was taking to chelate iron FIXED my PE with remarkable swiftness. Don't know if this has made my liver any happier, but it's wonderful not to see my hands all red anymore.

Your labs look WONDERFUL, and I'd be surprised if you were in serious trouble at this point, as long as you can keep away from the alcohol. I think the reason these symptoms are associated with cirrhosis is that they are common in many/all stages and types of liver distress. I know pregnant women get palmar erythema when they don't have cirrhosis. Perhaps they just haven't been well documented in cases of fatty liver, mild fibrosis, or mild alcoholic hepatitis.

Interesting thing about the red nose/face... As I posted on page one of this thread, I am quite interested in the role iron plays in alcoholic liver disease, and in researching palmar erythema, I came across "rosacea", the condition where people get unusually red skin on the face. It seems one of the major causes of rosacea is when ultraviolet light from the sun breaks down ferritin, an iron carrying protein in the blood, also present in the skin. The redness of rosacea is really often caused by IRON!

I mentioned to Arel that he didn't include iron studies in his labs, but in looking over his other numbers, I see his hematocrit is quite high, which is another indication of high iron.

I have been lowering my iron through blood donation, reduced red meat consumption, drinking coffee with breakfast and ice tea with lunch (coffee and tea prevent iron absorption from food), and taking IP6, and I really think this helped. I've posted some of my experiences with IP6, SAM-e, and De-Ironing my liver in the "medicine and treatments" thread under the main cirrhosis forums heading. Perhaps you might want to give them a look.

http://www.mdjunction.com/forums/cirrhosis-discussions/ medicine-treatments/3743678-how-alcoholic-iron-overload- turns-on-inflammation

http://www.mdjunction.com/forums/cirrhosis-discussions/ medicine-treatments/3607847-can-deironing-alcoholic-livers- improve-prognosis

http://www.mdjunction.com/forums/cirrhosis-discussions/ medicine-treatments/3553098-same-my-experience-and-a-couple- of-studies

http://www.mdjunction.com/forums/cirrhosis-discussions/ medicine-treatments/3454991-ip6-binds-iron-and-lowers- inflammatory-cytokines

I'm just over a year away from alcohol now, and feeling much better. My symptoms and labs were similar to both yours and Arel's (the low BUN with me too!), and I'm starting to think I'll be OK. At least things aren't getting any worse for me over the past year.

Best of Luck to you, and keep in touch!

Post edited by: MoonWatcher, at: 06/17/2012 10:04 PM

Hepatology: Textbook and Atlas : History, Morphology, Biochemistry ...

By Erwin Kuntz, Hans-Dieter Kuntz

Post edited by: mpmom, at: 06/18/2012 08:37 AM

Thanks very much for the helpful feedback. ruth8890 told me that her fatty liver progressed all the way to cirrhosis in only 6 months. Has anybody ever read or heard or been informed by a health care professional an everage (I know it varies a lot with individual) time it takes for alcoholic fatty liver to deteriorate to cirrhosis?

Thanks,

Terry

the definition you cited says parchment skin pertains to "chronic liver patient". I thought from what you said in your earlier reply to me that my siutation didn't sound that severe?