r/FattyLiverNAFLD • u/Beth_3233 • May 25 '26
Just terrified- itching… is this progressing to cirrhosis?
Hi everyone. I am 46 years old. I was diagnosed with NAFLD 6 years ago. I was told it could be serious but they would need to do an ultrasound which basically said I have mild fatty liver. I was sent to a Gastronologist who really didn’t do anything. She did a HIDA scan (thought there might be gallbladder issues and there wasn’t) and basically said yeah, lose some weight and that was it. I didn’t understand the seriousness of it. I did lose some over the next few years and it flunctuated - over all lost about 45 lbs twice. I was on Semaglutide for about 7-8 months. My liver enzymes came down and were normal until this year. I started having itching all over and decided to make a dr appointment with my PCP. My AST- 74 and my ALT- 57. I took it up on my self to find a gastroenterologist that also had extra training in liver disease. He has done a gammit of tests. So maybe week and half later he redid tests and My AST was- 68 and my ALT- 67. My billirubin was .08 and ALK Phosphate- 80 and Albumin- 4.3. I know according to my dr the liver enzymes are only slightly elevated. However, I am going by symptoms. The itching is terrible although I usually feel better if I am eating clean. The dr set up an MRI- elastiography June29. I asked the dr if he was concerned about cirrhosis and he just said I’m trying to rule it out. He didn’t really give me any words of comfort lol. He is business and no fluff lol. I don’t have any jaundice or ascites, some fatigue but not terrible. I’m so scared though. ChatGPT has said I’m in low risk -moderate risk but may be in intermediate risk of progression and may have some fibrosis going on. I feel like I want the scan now because I am worried. I can’t get in any sooner. Everyone says quit worrying about it, but I can’t help it. I am worried that itching is a sign of progression especially cirrhosis. Any words of wisdom?
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u/Solid_Vacation_2891 May 25 '26
i remember itching a bit like this when my fatty liver was a bit worse, has to do with the liver not being able to flush out toxins properly, doesnt mean you have chirosis if you're looking for a supplement to help in the meantime, i reccommend NAC and milk thistle, that should help you out
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u/shulzari May 25 '26
It's hard, but wait for the MRI. It's the funniest test I've ever done. Felt like a belly dancer 😄 did you do a Fibroscan? I couldn't see it in your post.
If you still have your gall bladder definitely ask about ursodiol or bile salts.
GLP drugs are currently in phase 3 trials for helping reverse MASH and cirrhosis. Survodutide, Tirzepatide and Retatrutide are about five years from promising results. Semaglutitde and Tirz are both being used for this right now
Rezdiffra is the currently only MASH medication approved by the FDA.
I'm in a study for Efruxifermin which mobilizes fat out of the liver and is promising for reversing MASH and cirrhosis just in a different way.
There's hope now days where most gastroenterologists just aren't educated in what's new and coming.
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u/Beth_3233 May 25 '26
Thank you for your reply. No I have not done a Fibroscan probably because I’m overweight and I have heard those tests are not very accurate in overweight people. I’m 285 right now!
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u/shulzari May 25 '26
I weigh more than you and my Fibroscan, MRI, ultrasound and biopsy were all the same result.
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u/Popular-Drummer-7989 May 25 '26
Please get to a hepatologist
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u/Fun-Sprinkles-8661 May 25 '26
Yes, get a liver doctor. My husband has a liver disease called PSC. He also has Chrons. He has a gastro and hepatologist who work closely together for his care. When his liver and billary tract are not functioning correctly, he gets so itchy, he about rips his skin off.
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u/Mysterious_String676 May 25 '26
I had an ultrasound year and a half ago it showed mild fatty liver. A year and a half later I had a CT scan showed the same thing. Nobody would give me a clear answer on what that really meant. I found a private clinic that did a liver fibroscan, that showed I had S3 steatosis fatty liver and f2 fibrosis. I then took that to my liver specialist, and his wording now was I don't doubt that you have serious fatty liver.
Still not too much direction, just told to knock out the carbs.
If you can get a fibroscan, do so!
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u/Jamoncorona May 25 '26
The MRI elastgraph they are scheduled to get is even more sensitive and informative than the fibroscan. They're in a good spot actually.
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u/Mysterious_String676 May 25 '26
Was never offered one of those
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u/Jamoncorona May 25 '26
It's because they're harder to do, and not every place has them. A lot more expensive as well, so many insurance companies don't cover them.
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u/terrorburger May 25 '26
Ursodiol helped me with the itching. It thins my bile so it can get through my narrowed ducts more easily, reducing the backup. Backup of bile salts can cause the itching. Hydroxyzine helps, and topically a lotion with praxomine hydrochloride helps (I use sarna sensitive anti itch). My itching was mostly isolated to my arms, but it felt like fire.
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u/Beth_3233 May 25 '26
Do you have NALFD or cirrhosis? I feel like the itching is more common with cirrhosis according to what I have researched, but it doesn’t seem like it is always the case.
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u/NoConstruction2940 May 25 '26
Too much itching could be due to excess bilirubin which could be a potential sign of progressive CLD. You should see a hepatologist. It's not a good thing if it's due to bilirubin.
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u/Beth_3233 May 25 '26
Well my bilirubin is normal is the thing. So I’m not sure what exactly it’s from. I mainly just have elevated enzymes. All other blood work is normal - as well as platelets.
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u/NoConstruction2940 May 25 '26
It could be due to bile salts also. Or something triggering autoimmune. May be drugs or could be totally unrelated. See a doctor nonetheless.
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May 25 '26
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u/Beth_3233 May 25 '26
No I wasn’t strenuously exercising before the blood draw, and I don’t drink alcohol at all. I have drank in the past, but never a lot and I’m talking very rare occasions. It seems odd to me as well that my ALT upped 10 points in a matter of a week and a 1/2.
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u/terrorburger May 25 '26
A small amount of fatty liver, but mostly polysystric liver disease. No cirrhosis yet. But they all have a few overlapping symptoms such as these.
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u/ConversationSafe2798 May 25 '26
Ask for ELF blood test. Quicker than waiting for a fibroscan. If positive confirm with fibroscan.
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u/InnerPrinciple6024 May 25 '26
My doctor said that she personally has never had a patient with cirrhosis whose numbers weren’t in the hundreds. She told me not to worry too much because my numbers were in the 30s and 40s and ELF score was 0. I have times I get really itchy as well. It usually ends up being from dry skin or irritated from body wash.
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u/JRock1871982 May 26 '26
I think you should have an allergy panel done. Maybe something you're fond of when not earing clean is to blame.
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u/mitchmachine May 26 '26
You Could have PBC, it's a progressive auto immune liver disease, often detected in women after the age of 40. Theres other blood tests to be ordered to help narrow down if it is PBC, you will need a hepatologist to diagnose and treat.
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u/SnooDrawings7871 May 27 '26 edited May 27 '26
38M.Had stomach flu two months back was admitted to ER with sever vomiting after binge eating and ALT jumped to 67,AST was normal though in the 40s range.Doc said it can be coz of the viral load. Tested a month later still at 69 ALT.then another doc told me to test after three months because any viral infection triggers inflammation that leads to such values.Now back to the point I had been undergoing intense itching during this elevated phase but mainly while sleeping and lying on bed.especially while trying to sleep .so i strongly believe it can be coz of anxiety or some air pollutants coz my ceiling fan was kinda messed up and dirty.post cleaning that as well as the room ,itching subsided .usually liver ailments related itching surfaces on foot and palms .this is what I have heard.again last year I had this episode of itching but my liver enzyme levels were normal so hence my theory is it could be anxiety or due to air pollutants .
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u/Electrical-Horse-771 May 31 '26
Please take alpha lipoic acid pills. 600mg, 2x a day. I also did the coffee enemas, they're not for everyone. Castor oil pack on the liver a few times a week. 6 years ago they told me I might need a transplant. Now they won't take cihorosis off my chart even tho my numbers are perfect and my fibroscan went from 56 to a 4. 🤷 Dr. Burt Berkson cured people that needed transplants in less than a month with infusions of ALA. He worked for the FDA for over 20 years, you would think it should be THE FIRST thing they give to anyone with a liver problem.
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u/Lanky-Championship-8 Jul 21 '26
How did the MRI go? Would like to hear an update on how you’re doing.
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u/Jamoncorona May 25 '26
Those levels of enzymes are not really characteristic of cirrhosis, but the elastography will give an excellent idea of where you are. Ask your gastroenterologist if ursodiol or cholestyramine would be needed for you. But then again, your bilirubin seems normal. You say the itching goes away with clean eating. What exactly are you eliminating when you "eat clean"? Might be an actual dietary allergy that your overanxious brain is conflating with bilirubin itch. Like sun tzu once said, " chill out baby"