Concerns About PBC and Heightened Anxiety
Hello Reddit medical community! I’m a 21-year-old transgender male, standing at 5’8” and weighing around 200 pounds. I've struggled with weight for most of my life but am now making significant strides to improve my health. During a physical examination in January, my doctor discovered some elevated levels in my liver enzymes, leading to a referral to a hepatology nurse practitioner. I had my appointment recently, and the NP diagnosed me with non-alcoholic fatty liver disease (NAFLD). Fortunately, I’ve managed to lose five pounds, and my liver enzyme levels have decreased. I feel optimistic about overcoming this condition. However, one of the tests indicated a positive result for anti-mitochondrial antibodies (AMA+). The NP suggested a liver biopsy, which is set for later this month. She also ordered an INR test to check for bleeding risks during the biopsy, and those results came back normal. Additionally, she ordered a retest for AMA, with the following outcomes: - Mitochondrial M2 antibodies: negative - Anti-Sp100: 0.6 / negative - Anti-gp210: 0.6 / negative - Bilirubin: 0.5 / normal - Alkaline phosphatase (ALP): 55 / normal I am currently experiencing no physical symptoms whatsoever. Unfortunately, the communication from the nurse practitioner has been quite lacking. I have reached out for clarification but haven’t received any reply. This situation has triggered significant health anxiety for me, which had been under control prior to these developments. I find myself questioning the necessity of the biopsy. As a college senior, I wish to focus on my studies rather than worry about my health. I keep fearing the worst, and the inadequate communication from my NP is not easing my concerns. I turn to the Reddit medical community for guidance, as my NP isn’t providing the support I need. I’m open to any questions you might have. Thank you in advance for your help!
Answers (1)
9/14/2025, 11:10:40 PM
OpenHealth AI
It's great to hear that you're taking steps to improve your health and have already experienced some success in your journey. Your concerns about the liver biopsy and the accompanying anxiety are completely understandable, especially since the communication from your healthcare provider has not met your expectations. Let's break this down to address your key concerns and help you find a path forward.
Main Points:
- Understanding your condition: You've been diagnosed with non-alcoholic fatty liver disease (NAFLD) and have experienced improvements, but the positive AMA result has raised concerns.
- Biopsy necessity: The biopsy is a common procedure to assess liver health and rule out other potential conditions, especially when antibody levels are abnormal.
- Managing anxiety: It’s crucial to find ways to manage your anxiety as you prepare for the biopsy.
Explanation:
Non-alcoholic fatty liver disease (NAFLD) is often linked with factors like obesity and can lead to increased liver enzymes. The presence of anti-mitochondrial antibodies (AMA) can indicate further investigation is needed, sometimes to rule out conditions like Primary Biliary Cholangitis (PBC). The liver biopsy helps determine the extent of liver damage, ensuring that you're on the right treatment path.
The good news is that your recent lab results are mostly normal, which suggests that serious liver disease is less likely. However, the biopsy is essential for a thorough understanding of your liver's health.
Next Steps:
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Educate Yourself: Research NAFLD and AMA in trusted sources such as the Mayo Clinic or American Liver Foundation. Understanding your condition can reduce anxiety and prepare you for discussions with your NP.
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Communicate Your Needs: Consider sending a follow-up email or calling the NP’s office again to express your need for clearer communication regarding the biopsy's necessity and details. You deserve understanding and reassurance.
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Anxiety Management Techniques:
- Mindfulness and Relaxation: Practice deep breathing exercises, mindfulness, or guided imagery to help manage anxiety. Apps like Headspace or Calm can be useful.
- Physical Activity: Since you're already on a weight loss journey, continue with regular exercise, which has been shown to reduce anxiety.
- Reach Out: Talk to friends, family, or mental health support groups about your feelings. Sharing can alleviate some of the burden.
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Focus on Support: If these feelings persist, consider speaking to a mental health professional for coping strategies targeted at health anxiety.
Remember, you're not alone in this. Your proactive approach to your health is commendable, and taking these steps can help reduce anxiety as you navigate your situation. Let me know if you have more questions or need reassurance along the way!
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