Hi i havnt felt right for quite sometime now alot of

Patient

Q: Hi
i havnt felt right for quite sometime now alot of fatigue.. like i dont feel i have the energy to do anything.
so i had a health assesment done. They found my liver ast and alt were three times their normal level and my ldh was a tiny bit over too.

Iv been having really bad trouble sleeping as of late aswell. When im falling asleep i get all kind of weird sensations and feel like my insides are shaking. My hands arent shaking though and my heart isnt racing or pounding. What really is bothering me.. when i have these sleep problems i also feel like my vision is odd. Maybe blurry but not in the tired sense. In the middle of my eyes i feel theres something there making my eyes blurry. Its just from the middle to the bottom.

I know this may all seem quite odd but im miserable and have lost all motivation because im worrying about whats happening to me

Symptoms:  Fatigue, dizziness, spinning when close eyes
Doctor

A:   Hello. Welcome to Ask The Doctor. We are here for your help.

I am worried for your raised liver enzymes that is AST and ALT. This can cause the weakness that you are feeling. However your spinning heads sensations and other symptoms are anxiety related.
Now an evaluation is recommended for your deranged liver functions.
The most common causes being Alcohol, Viral hepatitis, Pain killer abuse. In cases where there are no such causes Non-Alcoholic Steatohepatitis (NASH) is a possibility.
I would recommend you following tests:
1. Ultrasound Abdomen.
2. Hepatitis B and C serology.
3. Vitamin D and calcium levels.
In case you consume alcohol you will have to quit it at any cost.
I would recommend you exercises and meditation for the anxiety issues that are causing you the spinning sensations.
Get the above-recommended tests done and write back to me with the reports so that we can discuss the treatment indicated.
I hope it helps you.
I wish you a speedy recovery.

If you have any further query, please ask me.
Stay Healthy.

Comments / Follow Ups

Patient: Hi thanks for the response.
yes you would be correct about the anxiety as i have a big history of the disorder.

On my health assesment i also had the vitamin D and calcium levels checked which came back normal. I also had cholesterol test which came back slightly high but thats assumed to run in the family.
im currently awaiting results for a full blood test aswell.

I have a question.. what can cause NASH?
I drink alot of fizzy drink and have a pretty bad diet which i plan to change immediately.
also i regulary have pain and aches on my right side (back area) around my lower ribs. Could that be a symptom
Doctor: Hi, Yes, right sided abdominal pain radiating to back can be a symptom of gall bladder issues as well as NASH.
NASH is a severe form of Non Alcoholic Fatty Liver Disease (NAFLD).
It mostly occur in people who are obese and have diabetes and dyslipidemia.
Take care of your anxiety.
Get the above discussed tests done and write back to us with the reports.

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