u/QueerCoffeeNerd

I was diagnosed with NAFLD in early June, elastography two weeks ago showed 6.2kPa.

If I know how to do one thing, it’s to stick to a diet. I’ve been following a Mediterranean diet since the diagnosis with no added sugar and only healthy fats like avocado. I’ve been tracking my calories and I’m coming in at 1200-1300 a day. Lots of veggies and fruits, leafy greens, healthy proteins, yogurt, overnight oats, baked sweet potatoes, etc. (and I love coffee, so coffee with unsweetened macadamia milk).

When I started my weight loss journey last September I was 215lbs (I’m 5’8”, 44F). I lost about 20 lbs on Zepbound, had to get my gallbladder out due to cholestasis, and stop Zepbound. After that, it wasn’t covered by my insurance anymore. I had lost an additional 20 lbs through diet and exercise between November and June. Since I started this diet at the beginning of June, I’ve lost about 10 lbs, and I have lost 4.6 lbs since June 19th. I’m down to 162.6, for the first time in the “normal” BMI range since before the pandemic. But I’m worried I’m losing weight too quickly.

Any tips on how to supplement my diet or liver friendly snacks I can eat to up my calories a bit? Everything that seems convenient (ie protein bars like rx bars) appears to be harsh on my liver due to the sugar content.

Hi all,

My elastography: Median shear wave speed is: 1.44 m/s.

From what I can tell, that indicates F2 fibrosis and should be taken extremely seriously.

I got this letter from my gastroenterologist today:

"These test results are normal. No evidence of liver inflammation or scarring. Keep up the good work on following a healthy lifestyle!"

How do I reconcile this? I've already reached out to my PCP about a referral to a hepatologist. But this seems like just blatant malpractice.

Context: I’m 44 F, normal range LFTs in most recent labs, I’ve lost 47lbs in the past 9 months and just 3lbs out of ideal BMI range, learned about fatty liver during imaging of gall bladder in November, doctors didn’t flag as important at the time. Advocated for further testing after acute RUQ pain in May.)

UPDATE: Note from by PCP is as follows, curious about thoughts on this as well!

thanks for reaching out and for being proactive about understanding your results. The confusion is completely understandable — interpreting liver elastography results is nuanced because the cutoff numbers vary depending on the specific type of machine and the specific liver condition being evaluated. The values you found online likely apply to a different type of elastography test or a different patient population than what was used for your exam.

Your shear wave speed of 1.4 m/s translates to a liver stiffness of approximately 5.9 kPa, which falls in the normal-to-mildly-elevated range and is well below the thresholds used to identify significant fibrosis (≥8 kPa) or advanced fibrosis (≥12 kPa). This is consistent with Dr. (Redacted)'s interpretation that the results are reassuring.

That said, your interest in understanding your liver health is understandable; I have placed a referral specifically to hepatology to help further clear things up.

Here’s what my results were. From what I can tell online, this would indicate low end of F2 fibrosis? Should I seek further testing like a biopsy to be sure? (Edit for more context: I’m 44 F, normal range LFTs in most recent labs, I’ve lost 47lbs in the past 9 months and just 3lbs out of ideal BMI range, learned about fatty liver during imaging of gall bladder, doctor didn’t flag as important at the time. Advocated for further testing after acute RUQ pain in May.)

ELASTOGRAPHY: Liver stiffness measurements were obtained in the right hepatic lobe on a GE ultrasound machine. 2D shear wave elastography technique was utilized following SRU guidelines.
10 valid measurements were obtained. Median shear wave speed is: 1.44 m/s. Interquartile range (IQR) to median ratio: 6.7%.

IMPRESSION:
No suspicious focal liver lesion.
The IQR to median ratio is less than 15% and the measure of liver stiffness is therefore acceptable.

The median shear wave speed is 1.4 m/s. This is less than 1.7 m/s, which in the absence of other known clinical signs, rules out compensated advanced chronic liver disease.

I have a Fibroscan scheduled for Wednesday, and I’ve been on azithromycin (Z pack) for strep throat since Friday.

I read that strong antibiotics can alter the elasticity of your liver and could make levels higher as a result. Should I reschedule the Fibroscan? I’m so anxious to know the results, but I also don’t want to freak out over skewed data.

I looked into because during a course of Augmentin in Feb (also for strep), I had a pretty horrible upper GI pain (burning, feeling of constant fullness) and my LFTs were super elevated in my blood work from right after that illness. That is the only time I’ve had elevated LFTs, including when I had very extensive lab work done before my gall bladder removal back in October. That was when the fatty liver first showed up, but my labs were fine.

I’m 44 F - I am a former athlete who was a healthy weight (5’9”, 175, muscular) up until my late 30s. I slowly gained weight between 2020-2025 until I was about 215 lbs. I also drank more alcohol during the pandemic, but never more than 2 glasses of wine at a time. No binge drinking.

I started Zepbound last September to lose weight and ended up losing about 25 lbs in the first 5-6 weeks. Due to gallbladder attacks, I got an ultrasound that showed gallstones. It also showed a fatty liver and my bloodwork showed elevated LFTs, but my doctor didn’t mention anything about it until I asked (and told me not to worry), neither did my Gastroenterologist. I figured it was because they chalked it up to rapid weight loss.

I had my gallbadder removed last November, and have continued to eat a very low fat diet, drinking in moderation (2-3 drinks per week). I am down to 170 lbs and bike, walk, and do Pilates to stay healthy and build back my muscle.

After a very rare heavy meal on Mother’s Day I had acute RUQ pain (much like gallbladder pain, just radiating less) so I flagged for my GI doc. She ordered an LFT panel, which was all normal, and an ultrasound, which just said “fatty liver” in the description. I’m waiting for my doc to follow up with me about the results and don’t know how freaked out to be. I’m certainly not drinking at all until I know more information. I already eat very well (basically a Mediterranean diet) so not much more I can do there!

Also - I consume very little processed sugar, as I’ve had hypoglycemic episodes in the past and have always been afraid of spiking and crashing. No sugary drinks, very very few sweet treats.

Would like to go tonight, but don’t want disappointed children if it’s not open!

I’m generally a success story after gallbladder surgery. I have pretty much been able to eat what I want with no diarrhea or other symptoms. I do eat relatively cleanly as I’m still on a weight loss journey (no meds after surgery, just eating well and working out). But I’ve had an occasional piece of pizza or fries and it’s been fine.

Today, I had a pretty heavy meal at lunch - short eggs Benedict, home fries.

I was feeling fine after, but when I got home a few hours later I popped a seltzer and literally one sip of it triggered a horrible upper GI attack. Honestly it was pretty similar to a gall bladder attack in terms of pain, but seemed more like really bad, concentrated gas, so I wasn’t worried it was a heart attack or anything. It was so bad I threw up just to try to relieve some of the pressure. I took Gas X and just tried to belch it all out. That helped for about 10 minutes, and then it came roaring back. I went through like 5 cycles of that. Now I just have some gnawing pain under my breastplate that isn’t really getting better.

I did have gastritis before having gallstones and take a PPI (Protonix) for that. But I’ve never felt anything like the really acute gas pain in my sternum that made it hard to even breathe.

I’m trying to figure out if this could potentially be bile reflux. The only thing that has slightly helped with the pain so far was Pepto Bismol, and I’m thinking it was because it briefly coated my esophagus/stomach.

Anyone else deal with something similar after getting your gallbladder out?