It is common for patients to fear liver issues when they are tested for conditions that have nothing to do with the liver at all. The fear of a liver problem can actually increase problems, even if there is no problem there. For example, a person who is fearful of having a liver disease tested because they think that a liver disease might make them feel worse might actually end up having that liver disease in spite of their fear. Researchers conducting an investigation into emotional stress have found that patients who were fearful of being tested had higher levels of cortisol, a stress hormone. The findings suggest that high levels of cortisol are tied in part to the development of liver disease, specifically fatty liver.
Many doctors are routinely ordering higher than normal liver tests, as new research reveals, that can cause unnecessary worry, costs and biopsies. Both studies recommend that doctors should immediately rule out other common liver issues such as benign liver disease before testing for the more unusual ones. Elevated liver enzymes can mean only one thing: disease. So doctors should start looking for elevated liver enzymes in patients who are experiencing, for example, abdominal pain or jaundice – a yellowing of the skin and whites of the eyes. If doctors find any symptoms at all, they should try to determine if those symptoms are related or caused by the other conditions that they are testing for.
Doctors also often order hepatitis and hepatitis B in blood tests, even though those tests do not indicate liver issues. When a doctor suspects that someone has liver problems, he will usually recommend liver testing. Doctors will look for elevated serum creatinine, an indicator of inflammation in the liver. They will also look for evidence of polydipsia, the condition in which a person cannot produce sufficient quantities of energy and must rely on food.
Researchers have shown that people with hepatitis B have higher than normal liver enzyme levels. People with hepatitis C have higher than normal serum creatinine levels. (A number of people with liver issues don’t have either of these symptoms, though.) But those tests are only possible after patients have been assessed and had their symptoms diagnosed.
So the best way to know whether you have liver issues is to have a blood test done. But the doctor may order more tests to be certain. If the doctor suspects that you do, for example, have high blood pressure and a protein test result is negative, there may be further testing to see if cholesterol levels are abnormal. The bottom line is that it takes doctors a lot of time and effort to establish if the patient actually does have liver problems.
But for some patients, a blood test gives them peace of mind and helps them make informed decisions. One recent patient’s doctor had ordered an ultrasound of her liver. After that test, the doctor told her that her liver issues were not related to drugs or alcohol, but to something more serious. The patient wasn’t relieved at the news, but was relieved that she was no longer having blood drawn as frequently as she sometimes did. And the patient had gone from having high cholesterol levels (as measured via a lipid profile) of about 200mg/dL to about less than half that at her last check-up. It’s important to remember that elevated liver enzymes occur in everyone; HDL cholesterol levels are usually normal, but triglyceride and cholesterol levels can vary wildly from high to low.
Ultrasound and liver function tests may be able to show what is going on. But sometimes, the liver issues are simply caused by something else going on in the abdomen. For example, many people with gallstones end up with abdominal swelling. The liver has a very simple way of dealing with that by producing more bile.
In short, some signs you may have fatty liver, or may be suffering from it, are a history of jaundice, abdominal swelling or redness, or even a jaundice-like rash. You should also see your doctor if you start getting abdominal pain or sharp pains. These symptoms could indicate gallstones or a serious complication of diabetes. If you have any of these symptoms after going to your doctor and getting an ultrasound, then it’s a good idea to get checked out for fatty liver.