Long-Term Liver Confusion

Hello, everyone. I apologize in advance for the long post. I have been dealing with liver problems for the past 2 years, and time has only served to give me more questions and fewer answers. I have seen numerous doctors and specialists, and each has given me contradictory information, or no information at all. I hope that by turning to other sufferers, I might shed a little light on my issues.

For years I was addicted to painkillers and alcohol. I am a 28-year-old male, and from years 18 to 26 I put my body through a hell of a beating. I am under no illusions that my problems are anything but self-created. I had a BMI of 32, ate junk food and energy drinks, got zero exercise, drank beer every day, smoked cigarettes and popped pills.

In 2014 I began having symptoms consistent with liver failure. I became extremely fatigued, had trouble getting up in the morning, trouble staying awake, and yet I couldn't sleep properly. An odd combination. The right side of my abdomen felt . . . strange. I began having pain, itchiness, and nausea while eating. Also some mental fogginess/lightheadedness and irritability.

I went to the emergency room because I didn't have health insurance, and was diagnosed with elevated liver enzymes after a blood test and gallstones after an ultrasound. The doctor seemed to think my elevated LFTs were a result of excessive acetaminophen consumption, and that my values would return to normal upon abstinence.

Fast-forward to now. I have a BMI of 23.7. I haven't touched alcohol or pills in 2 years. I eat a diet so healthy that I am routinely mocked  by friends and family (lighthearted mocking). I take daily vitamin and milk thistle supplements, and eat all the foods supposed to help the liver: garlic, lemon, avocado, grapefruit juice, spinach, broccoli, walnuts, etc. I exercise daily and sleep . . . as well as I'm able. Physically, I feel remarkably better.

But my last blood test showed higher elevations of liver enzymes than that day at the hospital. To my touch, my liver feels enlarged; significantly so. ANY prescription medication seems to cause my liver to enlarge further, and I am overly sensitive (again, so it seems) to large quantities of protein.

I have been told everything from: "Your liver is fine," to "One more sip of alcohol and you'll need a liver transplant, which is a death sentence because your insurance doesn't cover elective procedures." Most healthcare professionals I see are simply confused or dismissive. No one has told me, even in basic terms, what diet or exercise regime to follow. I have been told more times than I can count to quit alcohol--which I have done long since. I guess they don't believe me, but the fact that my results make them think I'm still drinking when I know I'm not terrifies me. 

The single bad habit I haven't yet kicked is smoking (that and too much coffee). The only explanation I'm left with--pure self-diagnosis here--is that my liver is irreversibly damaged. Of the signs and symptoms indicating cirrhosis, the only one I seem to possess is Terry's nails (my fingernails are white with the band at the edges). But one symptom is enough, I guess.

I went to the dermatologist recently (I have health insurance now, although it's crappy), for a prescription for finasteride, since I am losing my hair. THAT elevated my liver enzymes, and seemed to bring many of my symptoms back (hard to tell sometimes if it's anxiety or not). I know it's absurd, but the fact that I can't fight my hair loss depresses me more than the thought I might be dying. The dermatologist insists I should be fine taking the medication, that my LFTs aren't THAT high. But I'm paranoid.

Here is a summary of my bloodwork by date:

ALT(SGPT):

8/12/14 - 186 IU/L, Ref. 0-44

10/13/14 - 102

10/1/15 - 92

11/12/15 - 147, Ref. 9-46

AST(SGOT):

8/12/14 - 104 IU/L, Ref. 0-40

10/13/14 - 49

10/1/15 - 69

11/12/15 - 62, Ref. 10-40

Bilirubin, Total:

8/12/14 - 2.0 mg/dL, Ref. 0.0-1.2

10/13/14 - 1.6

10/1/15 - 1.8

11/12/15 - 1.4, Ref. 0.2-1.2

Alkaline Phosphatase:

8/12/14 - 104 IU/L, Ref. 39-117

10/13/14 - 113

10/1/15 - 119

11/12/15 - 145, Ref. 40-115

I have twice been given the hepatitis panel; negative both times. I was vitamin D deficient, but have since reached normal ranges due to supplements. The only other abnormality to note is:

TSH:

10/1/15 - <0.006, ref. 0.450-4.500

a shockingly low number, and the first time it was outside normal ranges; on my most recent test, it was normal again. t4, free(direct) has always been normal. i almost wonder if this was a mistake or fluke. and i have no idea how or if the thyroid is affected by the liver.

again, sorry for the long post, but i wanted to be thorough. any comments or advice would be much appreciated. my doctors are evasive and contradictory, and my low-class health insurance means i get shuffled between new doctors repeatedly, with large gaps between visits. i just don't know who else to talk to. ref.="" 0.450-4.500="" a="" shockingly="" low="" number,="" and="" the="" first="" time="" it="" was="" outside="" normal="" ranges;="" on="" my="" most="" recent="" test,="" it="" was="" normal="" again.="" t4,="" free(direct)="" has="" always="" been="" normal.="" i="" almost="" wonder="" if="" this="" was="" a="" mistake="" or="" fluke.="" and="" i="" have="" no="" idea="" how="" or="" if="" the="" thyroid="" is="" affected="" by="" the="" liver.="" again,="" sorry="" for="" the="" long="" post,="" but="" i="" wanted="" to="" be="" thorough.="" any="" comments="" or="" advice="" would="" be="" much="" appreciated.="" my="" doctors="" are="" evasive="" and="" contradictory,="" and="" my="" low-class="" health="" insurance="" means="" i="" get="" shuffled="" between="" new="" doctors="" repeatedly,="" with="" large="" gaps="" between="" visits.="" i="" just="" don't="" know="" who="" else="" to="" talk="">

a shockingly low number, and the first time it was outside normal ranges; on my most recent test, it was normal again. t4, free(direct) has always been normal. i almost wonder if this was a mistake or fluke. and i have no idea how or if the thyroid is affected by the liver.

again, sorry for the long post, but i wanted to be thorough. any comments or advice would be much appreciated. my doctors are evasive and contradictory, and my low-class health insurance means i get shuffled between new doctors repeatedly, with large gaps between visits. i just don't know who else to talk to.>

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