Should I Seek Earlier Assessment for Incidental Liver Findings?
Greetings! I’m a 40-year-old female, standing at 5 feet 4 inches and weighing 215 pounds. Recently, I underwent a calcium CT scan as part of a coronary artery disease screening, prompted by mildly elevated LDL levels and a family history of cardiovascular issues. Fortunately, my calcium score turned out to be zero. However, the scan did reveal incidental hepatic steatosis and an elevation in my right hemidiaphragm. It’s clear that my weight and lifestyle could play a role in these findings. I do not smoke or use recreational drugs, and my alcohol consumption is quite minimal—fewer than six glasses per year. I am managing several medical conditions and medications: - Hashimoto’s hypothyroidism, treated with Levothyroxine - Depression and anxiety, for which I take Prozac and Gabapentin - ADHD and idiopathic hypersomnia, managed with Vyvanse - Polycystic Ovary Syndrome (PCOS), treated with Metformin In addition to my prescribed medications, I also take some supplements and occasional medications as needed: - NAC - Adderall (used as an additional dose 3-4 times weekly) - Klonopin (under 7 times a year) I'm experiencing some symptoms that potentially relate to these conditions, including shortness of breath when lying flat, ongoing fatigue, and some muscle weakness. However, given my existing health issues, it’s challenging to determine if these are new developments or notable concerns. Here are my queries: 1. Should I arrange an earlier appointment with my primary care physician, or is it acceptable to wait until my annual check-up in January? 2. Are there particular follow-up tests or lab evaluations I ought to inquire about? 3. Should I be more vigilant in monitoring my symptoms or on the lookout for warning signs? Thank you for any insights you can provide; your assistance is greatly valued!
Answers (1)
8/5/2025, 5:51:01 PM
OpenHealth AI
Thank you for sharing your situation; it sounds like you’re dealing with several concerns, and it's understandable to seek clarity on how to proceed. Here’s a summary based on your queries:
- Consider an earlier appointment with your physician due to the incidental findings and your current symptoms.
- Request specific follow-up evaluations tailored to your liver health and overall symptoms.
- Monitor your symptoms closely for any changes that may require immediate attention.
Explanation
Incidental hepatic steatosis indicates fat buildup in the liver, often linked to weight and metabolic factors. Given your weight and existing conditions (like PCOS and hypothyroidism), it’s important to address this proactively. Your shortness of breath, especially when lying flat (orthopnea), ongoing fatigue, and muscle weakness raise potential concerns. These symptoms may be related to your current conditions or could indicate something that needs further assessment, such as heart or lung issues.
Next Steps
-
Schedule an Appointment: Given your symptoms and findings, contacting your primary care physician sooner than January is advisable. They can provide personalized insight and evaluate your symptoms.
-
Follow-up Tests: Discuss the following with your doctor:
- Liver function tests to assess the health of your liver.
- Consider a fatty liver ultrasound to visualize the liver condition.
- Evaluate for any potential gastrointestinal issues that could be causing your symptoms.
-
Vigilance in Monitoring Symptoms:
- Keep track of your fatigue levels, shortness of breath, and any new symptoms (like changes in appetite, weight fluctuations, or abdominal discomfort).
- If you experience severe or worsening shortness of breath, chest pain, or any other alarming symptoms, seek immediate care.
By taking these steps, you can address your health proactively and ensure any new concerns are effectively managed. Remember, taking care of your health is a journey, and staying attentive to these details is key. Thank you for checking in, and I wish you the best on your health journey!
Related Questions
Seeking Guidance on Persistent Chest Discomfort After Extensive Testing
I'm a 43-year-old male, standing at 5'11" and weighing 180 pounds. My journey began around March to April of 2025 when, despite regularly hitting the gym four times a week, I was struck by severe chest pain along with frequent belching and a tight feeling in my diaphragm. At times, the pain became so intense that I feared it might be a heart attack. **Medical History:** In May 2019, I received a diagnosis of **PVS** and have since been under the care of a cardiac electrophysiologist. Upon experiencing these new symptoms, I consulted my EP, who conducted an EKG right then and set me up with a 7-day heart monitor. The results showed no irregularities. Subsequently, I was directed to a cardiologist, who carried out both a **stress test** and an **echocardiogram**, both of which yielded normal findings. Afterward, I returned to my primary care physician, who speculated that my gallbladder might be involved. An **ultrasound** was performed but revealed no issues. I then requested a **chest X-ray**, which also came back normal. My PCP then considered the possibility of a **hiatal hernia** and referred me to a gastroenterologist; unfortunately, that appointment took almost **five months** to materialize. In the meantime, my symptoms persisted, prompting me to cease weightlifting and switch my focus to **cardio and running**. Surprisingly, these activities didn’t exacerbate my symptoms, though the chest pain remained constant. When I finally saw the gastroenterologist, they suggested an **upper endoscopy**, which took another roughly three months to arrange. During this procedure, I was diagnosed with **Eosinophilic Esophagitis (EOE)**, a condition I had not previously experienced. The doctors also placed a pH monitoring device for acid reflux assessment, which indicated **no unusual acid exposure**. Following this, I began a treatment plan that included a swallowed steroid inhaler and an increased dosage of **omeprazole**. Sixty days later, I underwent another endoscopy, which showed that the EOE had largely resolved, with minimal residual symptoms. Unfortunately, my chest discomfort persisted without any improvement. It has now been about **a year** since these issues emerged, and I still have not found substantial relief. A recent chest MRI completed at a dedicated imaging center revealed no abnormalities. I entertained the idea of **costochondritis**, but again, the MRI did not support that hypothesis. The only minor relief I find comes from consciously pulling my shoulders back and expanding my chest. I continue to experience discomfort around my **diaphragm** and tenderness in the area of the **xiphoid process**. My PCP prescribed a steroid pack, which was somewhat beneficial for the pain but failed to alleviate the pressure or constant discomfort. At this juncture, I feel quite lost and uncertain about my next steps. I would greatly appreciate any insights or experiences from others who have faced similar issues. Additionally, if there are any physicians here willing to offer advice, I am open to traveling to find the answers or relief I'm desperately seeking.
Understanding the Reality of End-Stage Pancreatic Cancer
Navigating the complexities of end-stage pancreatic cancer can be overwhelming, and I'm seeking clarity on what lies ahead. My mother, who is 59 years old and weighs about 115 pounds, received her diagnosis of terminal pancreatic cancer in October 2025. Unfortunately, she has largely rejected the option of chemotherapy and is consuming her pain relief medications—specifically oxycodone and morphine—at an alarming rate. While I’m not worried about the dosage, the severity of her pain has reached a level that is becoming unbearable. Despite this, she is adamant about avoiding any hospital treatment, even though that's where she would receive the most effective pain management. I’ve attempted multiple times to get her medical attention, calling both hospitals and emergency services. However, due to her refusal for assistance, they have also turned us down. It was explained to me that taking her against her will could be considered kidnapping. After consulting with various healthcare professionals, I have been informed that her time may be measured in days or weeks. There’s also a chance that she could slip into unconsciousness, leaving me deeply unsettled. I am already in a state of mourning, yet I am desperate to understand what to expect in the coming days. It is crucial for me to prepare myself—emotionally and mentally—so that I can help ensure her comfort in these final moments. Plans are underway to engage hospice care, but the uncertainty fills me with apprehension. This is my mother, and I want to alleviate my fear so I can provide her with the support she needs as she nears the end of her journey. I yearn to be present for her without being entirely consumed by grief before she passes away. Any guidance or insight you could provide would be invaluable. I'm at a loss for what steps to take next and truly desire to navigate this situation with as much grace and readiness as possible.
Prolonged Miscarriage: Over Four Weeks In
A 35-year-old woman managing Type 1 diabetes with an insulin pump has been experiencing a challenging period marked by a recent miscarriage. This occurred just shy of ten weeks into the pregnancy, following an extremely positive pregnancy test, although medical confirmation had not yet been obtained. The physical symptoms were quite severe, with substantial bleeding that included large tissue clumps and blood clots observed during a shower. The size of these clots was rather alarming, comparable to a fist, causing blockage in the drain. Initially, for the first three to four days, there was heavy bleeding, requiring three pads daily. After that, the situation gradually improved, and around a week ago, she reached a point where only a pantyliner might suffice. Despite the reduction, bleeding persisted intermittently, mainly noticeable upon wiping, with instances of no blood at all, leading to inconsistencies in her experience. Recently, she has been feeling bloated and has noticed a resurgence in bleeding, necessitating the use of pads twice daily. Additionally, she has been experiencing light cramps and has developed acne. A subsequent pregnancy test revealed continued positive results. Now, with over four weeks of bleeding, she reached out to her physician’s office. However, the response was not one of concern, suggesting that she could schedule a visit at her convenience if she felt the need. The cost of visiting a doctor or urgent care deters her from seeking immediate professional help unless absolutely warranted. Overall, she reports feeling generally well, but is seeking advice from others. Is there cause for alarm, or is it feasible to let things unfold naturally? Could this miscarriage have evolved into her menstrual cycle instead? Additionally, it's worth noting that she occasionally finds small blood clots on the toilet paper after wiping. Since the onset of this situation, she has abstained from sexual intercourse.
Exploring Inositol and CoQ10 for Managing PCOS Symptoms
As a 28-year-old female, I have faced the challenges of polycystic ovary syndrome (PCOS) since my teenage years. Starting from the age of 16, I have dealt with highly irregular menstrual cycles, occurring anywhere from three to eight months apart. My diagnosis has been substantiated through two ultrasounds and blood tests revealing elevated androgen levels. Despite maintaining a healthy diet and leading an active lifestyle—balancing my work as an environmental biologist with gym sessions alongside my husband—I continue to wrestle with weight management. Other symptoms impacting my daily life include significant hair loss, unwanted facial hair, and persistent fatigue. In my journey to manage PCOS, I previously sought counsel from a gynaecologist, who primarily suggested hormonal birth control as the main approach to alleviate my symptoms. Although I adhered to this recommendation for several years, the hormonal changes negatively impacted my mood, leading me to discontinue its use. Another alternative proposed by my gynaecologist involved androgen blockers, but these are not suitable for me since my husband and I plan to start a family in the next two to three years. Recently, my research led me to discover that supplements like Inositol and CoQ10 might effectively combat insulin resistance and lower androgen levels. They are purported to improve various symptoms associated with PCOS, including the regulation of ovulation, all while boasting minimal adverse effects. I am curious about the viability of these supplements as alternatives to hormonal birth control or androgen blockers in managing my PCOS symptoms.
Seeking Clarity on My Spinal Tap Results: A Bit Anxious
I am a 31-year-old woman experiencing a continuous headache for the past four months, accompanied by feelings of nausea and exhaustion. I take Lexapro each day to manage my mental health. I have a history of migraines and headaches, but this recent episode doesn't align with my previous experiences. Here are the findings from my spinal tap: - **Opening Pressure of Cerebrospinal Fluid (CSF)**: 9 cm H₂O - **Presence of Red Blood Cells (RBCs) in CSF**: 2,570 - **Total Protein Level in CSF**: 107 mg/dL - **ACE Level in CSF**: 4.4 - **Other Tests on CSF**: Results were normal. - **Brain MRI and MR Venography**: Both tests yielded normal results. - **Blood Test Results**: Normal results were obtained. Given these results, I'm feeling a bit uneasy and I’m hoping to better understand what they might indicate about my health.