OpenHealth Q&A

Get answered by medical professionals

Could It Be NAFLD or Something Different?

8/8/2025, 9:10:30 PMMale25-34

Hello everyone, I'm a 26-year-old female and recently underwent an ultrasound due to ongoing discomfort near my bellybutton, which sometimes radiates upwards into my upper right quadrant. The results indicated "increased parenchymal echogenicity" and my liver is enlarged at 18 cm, alongside a diagnosis of an umbilical hernia. While I understand that the pain likely originates from the hernia, the revelation regarding my liver has left me quite anxious, prompting me to search online for information (which I now realize may not have been the best choice). Most sources I found pointed to non-alcoholic fatty liver disease (NAFLD), and the literature all suggests that it stems from poor diet, lack of exercise, or excess weight. However, I am within a healthy weight range (5’8” and 130 lbs), maintain an active lifestyle, steer clear of alcohol, do not take any medications, and primarily consume whole foods, indulging in fast food only once or twice monthly. Moreover, my family has no documented history of liver issues, which adds to my concern. Could this actually be NAFLD, or is the underlying issue something entirely different? I'm alarmed by the potential severity of the liver findings. I also had blood work done, including metabolic tests and a CBC, with liver enzyme levels returning to normal; AST is at 19 and ALT is at 21. I haven’t done a lipid panel yet—should that be my next step? Additionally, I would appreciate any guidance on what my subsequent actions should be, as well as critical symptoms to monitor for. I should mention I also have a pituitary cyst; however, previous evaluations (nearly a year ago) indicated it was stable, not exerting pressure on any structures, nor producing hormones. Thanks in advance for your help!

VaccinationNutritionWellness

Answers (1)

Cony

8/8/2025, 9:10:52 PM

OpenHealth AI

It’s understandable to feel anxious about liver findings, especially when you have been living a healthy lifestyle. The ultrasound results indicating increased echogenicity and liver enlargement may raise concerns about non-alcoholic fatty liver disease (NAFLD), but given your healthy weight, active lifestyle, and normal liver enzyme levels, it’s reassuring that you are likely doing many things right for your liver health.

Explanation:

  • Increased Parenchymal Echogenicity: This may suggest fat accumulation in the liver, but it can also occur in other conditions. It’s not definitive for NAFLD, especially since you have normal liver enzymes (AST and ALT).
  • Liver Size: An enlarged liver (hepatomegaly) can be due to various reasons, including benign conditions and not just fatty liver disease. Your hernia may contribute to the discomfort, but it might not be directly related to the liver condition.

Next Steps:

  1. Follow-Up Testing: A lipid panel can provide insight into your cholesterol and fat levels, which can help assess cardiovascular health and potential contributors to liver conditions. It’s a good next step given your concerns.
  2. Monitor Symptoms: Keep an eye on any new or worsening symptoms, such as:
    • Persistent or increasing abdominal pain
    • Jaundice (yellowing of skin or eyes)
    • Unexplained fatigue or weakness
    • Nausea or loss of appetite
  3. Maintain Lifestyle: Continue your active lifestyle and balanced diet. Consider consulting with a nutritionist for additional dietary support specific for liver health, even though your current diet seems healthy.
  4. Stay Informed: Keep a record of your symptoms and any test results for future discussions with your healthcare provider. This will help in assessing any changes over time.

Reassurance:

It’s encouraging that your blood work is normal and you lead a healthy lifestyle, which is significant for liver health. The findings should be monitored but do not immediately indicate severe disease. Focus on the next steps and trying to manage any worry you have by staying informed and proactive about your health. Let me know if you need more assistance!

Related Questions

Understanding Esophageal Polyps

I’m a 33-year-old woman who recently discovered a polyp located at the base of my esophagus. I’m wondering if anyone has insights on what the possible pathology results might indicate? Feel free to share your thoughts in the comments.

AgingWellnessInternal Medicine
Male25-34
8 minutes ago

Pushing Boundaries or Overdoing It?

For several years, I was an active competitive cheerleader, which meant my body was constantly in motion and often sore due to rigorous practice sessions, especially during competition periods. When I transitioned to college and stepped away from cheerleading, I paused my workout routine. This hiatus led to feelings of guilt over my inactivity and sparked a desire to shed some pounds. Consequently, I began monitoring my food intake, utilizing a scale to track my macronutrients. I focused on increasing my protein consumption, something I previously struggled with due to my picky eating habits regarding meat. Around the same time, one of my roommates was dealing with disordered eating, which influenced my own mindset and behaviors, pulling me into a similar downward spiral. During a difficult couple of months, my eating habits fluctuated between consuming limited meals and intermittent fasting. Ultimately, I managed to break free from that harmful cycle and began to enjoy healthier, more balanced meals once again. Simultaneously, my sleep schedule was severely lacking, averaging only 3 to 5 hours each night. Post-Thanksgiving holiday, I established a more consistent routine in December, committing to daily workouts to alleviate the guilt and anxiety surrounding food and boost my sense of productivity. My regimen included a 30 to 45-minute workout, a brief stretch, a 20-minute incline walk, along with several local trail walks spanning about 4 to 6 miles. However, this rapid increase in physical activity took a toll on my body. I developed a pump bump on my right heel and suffered from severe Achilles tendinitis in my left ankle, which became so swollen that the tendon was not visible. A visit to the podiatrist revealed the issue stemmed from a bone growth at the front of my ankle joint, potentially a remnant of a previous cheer injury. I was advised to switch to shoes with a higher heel, take anti-inflammatory medication, and engage in physical therapy. Though the swelling subsided and the pain lessened in the interim, I was eager to get back to college and get into my fitness routine. Upon returning, feeling as though I had fallen behind, I ramped up my workouts significantly. I started a regimen that included an hour of weightlifting followed by over two hours of inclined walking on the treadmill, aiming to burn more than 1,000 calories from Monday through Friday, with weekends reserved primarily for rest, featuring an abdominal workout and leisurely walks. Regrettably, my roommate's calorie tracking habits led me to regress into similar behaviors. I avoided using the food scale this time, hesitant to return to previous unhealthy patterns, yet I still substantially reduced my caloric intake, attempting to keep it below 1,000 calories while burning over that amount through exercise. My approach included moderate meals Monday through Thursday, reserving weekends for larger meals and occasional treats. On weekdays, I typically consumed a third of a banana before workouts, engaged in three hours of intense exercise, then took an energy drink before classes. Post-class, I’d have some cucumber or a piece of fruit before dinner, which generally consisted of protein, a whole-grain English muffin, and salad. If I had room left, I’d enjoy a Greek yogurt for dessert. So far, this strategy has yielded favorable results; I've lost almost 14 pounds since my last checkup in mid-December, and my stomach discomfort has lessened. However, after a 10-mile walk this past Sunday, I began to experience significant pain in my right shin, assuming it might be shin splints but continuing to work out as usual. The week has been challenging, caught between the urge to maintain a 1,000-calorie burn while grappling with persistent pain, even while at rest. The discomfort is concentrated on the front part of my shin, spanning about the size of a quarter, and is painful to touch. Movement aggravates the sensation, making it hurt to walk or even lift my leg while sitting. There's noticeable swelling and warmth, and the pain seems to intensify in the evening, causing discomfort even when resting in bed. I sought care today, and while an X-ray showed no significant issues—a relief—the physician suspects it might be tendonitis. I was initially fearful of a stress fracture, having heard stories of athletes pushing through such injuries, resulting in more severe complications. Given that the X-ray was clear, I am reassured, but I'm still anxious to continue my workouts, as I feel uneasy just remaining inactive and eating without sufficient exercise. I would appreciate any insights into my situation and whether it appears to align with the diagnosis in terms of allowing me to continue training—perhaps avoiding excessive incline walking during this time.

ExerciseAgingWellness
Male25-34
58 minutes ago

Prolonged Exposure to Magnets: A Query about Safety

Hello everyone, I’m a 26-year-old male and I have a question regarding my work habits. I habitually carried a magnet attached to my hard hat to pick up metal shavings and manage wiring diagrams. Given that these magnets are positioned close to my head, I’m wondering about the safety implications. Are there any research findings related to long-term exposure and potential harm? I can't help but notice that when I carried the magnets, I experienced more intense headaches, though it coincided with the hot summer months, leading me to think dehydration might have played a role. I also do not have any medical implants or serious injuries, apart from a previously torn ACL. I'm intrigued about the matter, particularly since my current magnets are quite weak, and I'm considering upgrading to more powerful ones.

AgingWellnessLifestyle Changes
Male25-34
1 hour ago

Struggling to Increase My Weight

At 5 feet 7 inches tall and weighing 130 pounds, I’m a 17-year-old male who has been grappling with weight gain for the past year and a half. Despite my efforts, I’ve only managed to add 10 pounds during that time. My daily caloric intake sits between 1,500 to 2,000 calories, yet I find it challenging to consume more than that without feeling nauseous. I work out regularly, hitting the gym approximately three to four times each week, and I also engage in a lot of basketball. Despite my dedication, I feel like my strategies for gaining weight simply aren't effective. What would be the most straightforward and quickest way for me to pack on some extra pounds?

Weight ManagementNutritionLifestyle Changes
Male25-34
1 hour ago

Should I Be Concerned?

Greetings everyone. I’m a 22-year-old woman seeking some guidance. For as long as I can recall, I have noticed these "lumps" on my scalp. They generally match my skin tone and appear stable, showing no signs of growth or change in size. Their height ranges from approximately 1/32 to 1/16 of an inch, if measured generously. I’m curious to know if these should raise any red flags for me. Thank you for your input!

WellnessFamily MedicinePreventive Medicine
Male25-34
1 hour ago