My liver enzyme journey — July 2024

Dr.ObesityLA said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 312 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible…

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 8 months on GLP-1 therapy:

FibroScan also improved — liver stiffness from 10.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

KetoKyle said:

ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"

My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.

LabKate said:

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Coming at LabKate’s question from a different direction. Start from the measurement rather than the conclusion. Almost every disagreement here turns out to be two people measuring different things and comparing the numbers anyway.

One thing that is still open after lisa_labSD’s answer:

How would you tell the difference between that and the alternative explanation?

Closing the loop on my own question.

Closing the loop. The answer turned out to depend on the detail I had left out of the opening post, which is a lesson about how to ask rather than about the subject.