Normal ALT/AST but enlarged liver/spleen
Nov ‘25 I went in to have an ultrasound on my abdomen for upper abdominal pain/nausea. They found my liver and spleen enlarged, confirmed on CT scan. The following 6 months Fibro scan showed Cap of 204, Fibrosis F2. Went to gastro had an egd to rule out portal vein hypertension. EGD was normal apart from a few polyps. No infections, no viruses. I get sent to rheumatologist to rule out autoimmune hepatitis/lupus. All of those tests come back negative as well. My last ALT was 15 and ALT was 17.
I fly to my nearest hepatologist, who basically says it’s “fatty liver that’s backing up into the spleen” and he wants me to start zepbound. I’m confused on so many levels. If my cap was high then that would mean I have fatty liver, but I don’t. I am morbidly obese so I wouldn’t be surprised by fatty liver but all of this is so confusing. I am losing weight, I don’t touch sugar, I eat in a deficit and high fiber. I’ve lost about 30lbs since my diagnosis without GLp1 so I don’t really want to go that route but he was very adament I just start taking GLp1. But I feel like they’re missing something.
Has anyone had something like this happen before?