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:
-
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.
-
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.
-
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.
-
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!
Related Questions
Does Cross-Tapering an SSRI Lead to Immediate Symptom Deterioration?
A 22-year-old female with a diagnosis of obsessive-compulsive disorder (OCD) along with a medical history that includes epilepsy, a non-active pituitary microadenoma, autism spectrum disorder (ASD), mild major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD) is seeking advice regarding her medication regimen. Her current prescriptions are as follows: - Fluvoxamine, 150 mg taken at night - Sertraline, 50 mg taken in the morning - Lamotrigine, initially 50 mg in the morning and 75 mg at night (currently being increased to a target dose of 100 mg twice daily) - Melatonin, 10 mg before sleep - Supplementary vitamins including vitamin D, vitamin C, vitamin B12, along with ferrous gluconate and valerian root. Since beginning fluvoxamine for her OCD treatment in November 2023, she gradually adjusted her dosage to the existing levels. Recently, she initiated a cross-taper to sertraline, citing that the fluvoxamine was only partially effective. This adjustment commenced on January 31st, with her increasing the sertraline by 25 mg weekly while concurrently reducing the fluvoxamine by 25 mg every four days. As of today, she is taking 50 mg of sertraline and has cut her fluvoxamine down to 150 mg as of Wednesday. Over the past week, she has experienced a notable rise in her OCD-related obsessions and distressing intrusive thoughts, as well as heightened compulsions. She queries whether these intensified symptoms could be a consequence of the medication switch. Although she feels that it might be premature for such rapid changes to occur, she wonders about the timeline for noticing fluctuations after starting sertraline or tapering fluvoxamine. While she's aware of general timelines for improvements on SSRIs, there seems to be insufficient information regarding the effects during a cross-tapering process. She expresses gratitude in advance for any insights that may be shared.
Persistent Nighttime Illness with Fever, Rapid Heart Rate, and Chest Discomfort Over Two Years
**Demographics:** **Age:** Thirties **Gender:** Male **Height/Weight:** 2.0 m (6’7”), 95 kg (210 lbs) **Region:** Europe **Health Background:** Mild Bronchial Asthma (well managed) **Medications:** Regular asthma inhaler (both morning and evening), as needed rescue inhaler **Substance Use:** None **Exercise Routine:** Engages in consistent gym workouts and plays soccer --- **Primary Concern:** Repeated nighttime occurrences of severe symptoms including fever, rapid heartbeat, and lung/chest pain lasting for approximately two years. --- **Current Health Issue:** For the last two years, I have been subjected to unexpected bouts of illness that generally manifest at night after sleeping for a few hours, though I occasionally notice symptoms appear in the evening. In between these episodes, I feel completely well, healthy, and without any symptoms. The frequency of these episodes varies greatly, ranging from one week to two months apart, but there has been a noticeable increase in their occurrence recently. --- **Typical Episode Symptoms:** - Generally feel fine in the evening, though I might sometimes feel slightly off. - Awaken during the night with pain in the chest/lungs, significant fatigue, and a fast heart rate. - Heart rate escalates from approximately 40 beats per minute to as high as 100 beats per minute at rest. - Experience severe chills, a fever, and muscle aches. - Notice a dry mouth and a sense of dehydration. - Followed by heating sensations and a fever that can reach just under 39 °C (102 °F), disrupting my ability to sleep. - My Apple Watch consistently indicates: - Increased breathing rate - Raised body temperature - Accelerated heart rate - Diminished heart rate variability The day after these episodes, I still feel unwell with a continued elevated heart rate. Symptoms typically begin to improve by evening and are largely diminished by the following day, though I still feel fatigued and stressed. --- **Investigations Conducted:** - Pulmonary assessment - Cardiac assessment - Comprehensive blood tests (which included checks for inflammation) - Autoimmune tests All tests returned normal results. A pulmonologist advised taking a daily maintenance inhaler for asthma; for about four to five months after starting it, I experienced no episodes. However, they have resurfaced and have been recurring for the past year. --- **Inquiry:** What potential medical conditions could lead to recurring, flu-like episodes characterized by fever, tachycardia, chest or lung discomfort, with complete recovery in between occurrences? Are there particular diagnoses or tests I should discuss with my healthcare providers?
Concerns About Trazodone for Anxiety Relief
Hello everyone, I’m a 27-year-old female experiencing anxiety-related insomnia that has persisted for about a month. My sleep has been severely disrupted, averaging only four to five hours per night. I frequently wake up every hour and struggle to drift back off. This situation has led to me waking up each morning with a racing heart and feeling unsettled throughout the day. To seek some relief, I recently visited urgent care, where a doctor prescribed me Trazodone at a dosage of 50mg to assist with my sleep issues. However, after doing some research online, I discovered that the medication may carry significant risks, including the potential to exacerbate heart palpitations and arrhythmias. This has made me hesitant to start taking it. I’m reaching out to see if anyone here has experience with Trazodone. Is it generally considered safe? Have others encountered adverse effects related to heart issues while using this medication? This is particularly concerning for me, and I would appreciate any insights or experiences you can share.
Seeking Clarity on My Mental Health Episodes
Summary: As someone diagnosed with a mental health disorder, I’m seeking guidance on understanding the symptoms I displayed in a recorded episode relevant to my recent BPD diagnosis. Background: I’m a 32-year-old female with limited knowledge about mental health, yet I've accumulated diagnoses like they’re collectibles. I use humor to cope, though I hope it doesn’t cause offense. I was unaware of terms like PTSD or C-PTSD until diagnosed at 25, a realization that has prompted this self-reflection; I apologize if my jokes miss the mark. I first encountered PTSD symptoms around age 19, but it felt normal to me, despite my frustrating journey through severe depression starting in 4th grade, anxiety spirals by 5th grade, and restless nights filled with sleep disturbances. Panic attacks by 9th grade further compounded my struggles. The concept of mental illness was a vague notion in my life; after each new diagnosis, I would learn about it, often with surprise, as if it were news to me. It’s a little humorous in retrospect, given my previous ignorance, but I’ve received some significant diagnoses over the years, often accompanied by medication that requires identification. Main Inquiry: Normally, I would consult my therapist regarding this matter, but due to a family situation on her end, I don’t want to add to her stress. I documented myself during a panic attack and shared the footage with both my psychiatrist and therapist prior to viewing it myself. This recording contributed to my BPD diagnosis, which marks my fifth mental health diagnosis. During our initial meeting, my psychiatrist pointed out traits related to Axis II but didn’t elaborate until the video prompted a deeper discussion about BPD and the implications for my treatment plan. Both of my therapists, including one I’ve seen for over a year, concurred based on the video that the BPD diagnosis was warranted. I personally resonate with the diagnosis, quite fitting my experiences. Interestingly, I am relieved that I found out about it only after the clinical diagnosis, as I would have likely self-diagnosed long before. Now that I’ve viewed the video, I find myself uncertain about interpreting certain mental health symptoms, such as dissociation or catatonia. This uncertainty brings me to this subreddit, as I'm eager to gain more insight into the video and understand its significance in regard to my BPD diagnosis. I contemplated hiring a transcriber adept at strict verbatim transcriptions. Would that be a useful approach? Any suggestions on resources or methods to help me decipher the behaviors displayed in the video, especially concerning important timestamps or events, would be greatly appreciated. Additionally, my curiosity intertwines with necessity; the video, along with two audio recordings, is being provided as evidence in an upcoming court case. Understanding what transpired in those recordings will be crucial.
Feeling Anxious About Recent Health Concerns
Hello everyone, I hope you're well. To give you some background, I'm a 32-year-old woman residing in the UK. I've undergone two cesarean sections and have had various ultrasounds in the past. For several years, I've dealt with irregular menstrual cycles and occasional spotting between periods. Although I sought medical advice and underwent several tests to investigate these issues, nothing conclusive was found. Last year, I underwent a hysteroscopy, followed by an ultrasound. While the hysteroscopy results were normal, the subsequent ultrasound revealed a small accumulation of fluid in my uterus and a thickened area of the uterine lining. The gynecologist reviewed the ultrasound results and suggested that the fluid might be residual from the hysteroscopy, assuring me that there was no cause for concern. Still, she recommended scheduling a follow-up ultrasound six months later. I recently had this follow-up scan, and unfortunately, the findings were similar—there was still a small amount of fluid and an area of thickening in my uterus. The doctor advised that I need to return to consult with a gynecologist to investigate why these issues persist. Naturally, I’m filled with worry, and it's taking a toll on my appetite. As I await my consultation with the gynecology team, I can't shake this anxiety. Could this be a sign of cancer? I would appreciate any support or advice during this stressful time. Thank you for listening! xx