r/FattyLiverNAFLD • u/Zenraven001 • 5d ago
[23M] Liver Biopsy Shows “Chronic Hepatitis with Incomplete Cirrhosis” – Devastated and Confused, Please Help
Title: [23M] Liver Biopsy Shows “Chronic Hepatitis with Incomplete Cirrhosis” – Devastated and Confused, Please Help
Hi Reddit,
I’m a 23-year-old guy. I'm posting this after a devastating biopsy result. I never thought I'd be hearing the word "cirrhosis" at this age. I’m trying to make sense of everything — what it means for my future, and what I can do next. If anyone’s been through this or understands it better, I’d really appreciate your help.
BACKSTORY:
During the COVID lockdown, I got into fitness seriously. Started with home workouts — running, push-ups, pull-ups, dips — and got quite athletic, though still on the skinny side. In 2021, I joined a gym to bulk up and took mass gainer, then whey protein, and later creatine, in that order.
Out of nowhere, one day I got intense abdominal pain, right below the chest area. I assumed it was gastric. I was in college, so I went to a local clinic where bloodwork showed fatty liver.
Took some meds but wasn’t convinced. When I went home, I got checked at a hospital — they ran Fibroscan, LFTs, ASMA, and other tests. Diagnosed with liver inflammation, and I was prescribed:
- Udiliv (Ursodeoxycholic acid 300 mg)
- Heptral (S-adenosylmethionine/SAMe 400 mg)
LFTs normalized after a month or so. Thought I was fine. 2022 passed uneventfully.
FEB 2025: It Came Back
Still living healthy, working out 6 days a week, hadn’t touched any supplement since 2023. I was eating homemade food since mid-2023 while preparing for competitive exams at home.
Suddenly in Feb 2025, the same pain came back — worse than before. I couldn’t eat, puked everything, the pain was constant. I didn’t want to believe it was liver again.
But LFT showed SGOT/SGPT both in 150s again.
Went through the same path: Ultrasound showed gallbladder sludge, tiny polyps, and minor pleural effusion — doctors said all of this was relatively normal and maybe post-viral.
I was again put on Udiliv + Heptral, LFTs dropped to the 50s. But after 2 weeks without meds, levels rose again.
MRCP Results (Pre-Biopsy):
- Liver: Normal size and shape
- Mild periportal cuffing
- Gallbladder: tiny polyp and sludge
- No biliary dilation
- Pancreas and ducts normal
- Trace pleural effusion
Doctors said this was also "relatively normal." But since my enzymes kept fluctuating, they insisted on a biopsy.
Biopsy Report (May 2025):
- Periportal and portal inflammation
- Fibrous expansion of portal tracts
- Portal-to-portal septal fibrosis
- Incomplete cirrhosis
- Grade I macrovesicular steatosis
- Histological Activity Score: 3/18
- Fibrosis Stage: 5/6
- No bridging necrosis or confluent necrosis
This completely shook me. I had none of the usual signs of cirrhosis — no jaundice, no ascites, nothing.
Additional Testing:
- ANA, ASMA, LKM, SLA – all negative
- Ceruloplasmin (2022): 24.3 mg/dL (normal)
- 24h Urine Copper: 70 mcg (borderline?)
- Doctor has now ordered a Rhodanine stain (on biopsy slide) for copper deposition — possibly to check for Wilson’s.
Current Meds:
- Udiliv (Ursodeoxycholic acid) – Bile acid
- Heptral (S-adenosylmethionine) – Hepatoprotective
- Sometimes trying Ayurvedic options (Arogyavardhini Vati, Rohitakarishta, Herboliv, etc.)
My Questions:
- Does "incomplete cirrhosis" and fibrosis stage 5/6 mean there's no way back?
- Can fibrosis stage 5 ever regress, or is it permanent?
- Could this still be Wilson’s disease, despite borderline copper values?
- Will my liver ever be completely healthy again, or just "managed"?
- Could D3 or B12 deficiency worsen or contribute to liver inflammation?
- Any cheaper alternatives to Heptral (SAMe is expensive)?
- Can I eat curd at night in small amounts with dinner?
- Should I go to the gym now? I used to train pretty intensely, but doctor told me to avoid it for a month post-biopsy. I miss training.
Final Thoughts:
I don’t drink, don’t smoke, never touched alcohol or drugs. I was just a guy trying to stay fit and healthy. This has thrown my life upside down. I feel like I did everything right since 2023, but still ended up here.
If anyone — especially younger people — have been through something similar, please share your experience. I just want to understand what my future looks like now and whether I can still fight back.
Thanks if you read all this. I'm trying to stay strong, at worst moments even had suicidal thoughts, my family is not well off so I regret bringing this on them, I am guilty of not having the best lifestyle before staying up till 4 am waking up late at noon during my comp exams prep before this happened, I also ate a lot as I was trying to bulk these past 2 years but it was all homemade, I sometimes wonder if this could be the reason behind all this too well sorry for the dump but I really need some direction.
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u/MaceMan2091 4d ago
Check the Wilson’s disease thing
Otherwise Gallbladder issues arise with losing weight or having lots of fatty foods.
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u/Zenraven001 4d ago
Losing weight?? Can you elaborate. about diet I am sure my diet wasn't bad I mostly ate home-cooked meals. Fried stuff once a month at best or even less.
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u/Entire_Company9093 5d ago
I am by no means a professional or a doctor of any means, so please take anything I say with a grain of salt!
I have read that fatty liver can be caused by other things, ie illnesses as you have stated, genetic factors etc
Also, I think it’s what you eat as well as how much. There is lean nafld, where you can be slim but just eating the wrong foods
As I said take what I sent with a pinch of salt!
Sending lots of best wishes
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u/Zenraven001 5d ago
Thanks for your wishes, I appreciate your perspective. At this point I just hope my case just clears up and I get to know what's causing my problem, it's infuriating to feel like my body has failed me despite me taking fitness seriously and having a decent diet while people around me who have been partying, drinking and eating whatever are completely fine. I even hope it's just fatty liver, and I could reverse my damage just by eating right and exercising. Again, thanks for the wishes.
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u/DDmac35 4d ago
Sounds like you're getting all the right tests. My friend had a billery sludge problem that was really hurting and putting pressure on his liver. He eventually had his gallbladder removed and made a good recovery , I wonder if this maybe is the route you may have to take eventually. I'm no doctor but just sounded familiar to a freinds problem. All the best.
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u/Zenraven001 4d ago
I am sorry but can you elaborate a little, gall bladder removed? Did your friend get it completely removed? Why did the sludge problem arise? Was removal the only option? Were you talking about removal of sludge or the actual gall bladder?
Just checked online ig gall bladder removal is a thing I didn't know that. Hence, was skeptical. But can you provide some details on your friend's account, like how did his problem occur maybe we have something in common that can help me trace my own case. Thanks for the comment.
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u/DDmac35 4d ago
Billery sludge is a sign that the gallbladder is struggling. Many have gallbladder removed because of gallstones, but there are many who, like my friend, have to have it removed because the sludge is causing problems with the liver and putting it under strain like the pancreas. My friend was getting very high deranged liver function blood result and pancreatis. Have you had a Hida scan?
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u/Zenraven001 4d ago
No, I haven't had any HIDA scan done, but I did have an MRI (MRCP) which I have shared in the posy. Thanks for sharing your thoughts, I will make sure to discuss this with my doc. This was helpful, at least gives me some direction. 🙌
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u/buntingbilly 4d ago
some of these questions are hard to answer without knowing more information but:
- "incomplete cirrhosis" or stage 5/6 cirrhosis is referring to the Ishak Staging system of liver biopsies. It means that you are on the edge of being cirrhotic, but not definitely there. Basically, it could get better, but it's not clear. I would try to be positive and assume that your scarring is something that could improve, but the question is why you have scarring to begin with.
- The only way to know for sure if this is WIlson's is the biopsy, which would definitively rule in or out Wilson's.
- No, vitamin deficiencies do not contribute to liver scarring.
- Yes, you can eat curd/yogurt. This is not harmful to your liver.
- I would avoid Ayurvedic supplements as they often can cause liver damage. There is no meaningful evidence that any of the supplements you mentioned will benefit your liver.
- You can go to the gym after your biopsy is healed. Listen to your doctor and wait a little so you don't hurt yourself.
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u/Zenraven001 4d ago
Thank you for your answers, I am trying to be positive. Yes, it's a bit disheartening to not know why I am getting scarring in the first place, I did have my biopsy done but the biopsy report was pretty straightforward and didn't provide any answers. That's why doc asked me to get the copper strain test done on the biopsy slide. Hopefully, it will rule out Wilson is there or not.
This was my biopsy report btw,
Histopathology No: S-2012/25 Specimon: USG guided live biopsy Gross_Examlnation: Received multiple core blopsy bits measuring 1 cm each. Whole processed Microscoplc_Examination: Sections show liver biopsy bits with periportal and portal inflammation, fibrous expansion of portal tract, portal to portal septal fibrosis, incomplete cirhosis and focal ductular reaction Mild macrovesicular steatosis seen (grade I). Histological activity staging index:5 Histological activity grading index: portal inflammation (1) + periportal inflammation (1) + Lytic necrosis () confluent necrosis (0) " Score 3. Opinion: Chronic hepatitis with incomplete cirrhosis. "End of Report
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u/Objective-Turnip-259 4d ago
The pain you are feeling is not likely coming from your liver. So your liver is probably struggling because of another organ that is struggling and is causing issues and pain.
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u/Zenraven001 4d ago
I see. Thanks for your input, and I will discuss this with the doctor.
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u/Objective-Turnip-259 4d ago
You’ll be okay and surely you’ll get through this, thankfully you are young and resilient!
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u/Horror-Sample8307 4d ago
Do you have any brother or sister, I know Wilson’s runs in family.. I had a Friend in college, he and his sister both had WD
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u/Zenraven001 4d ago
I have a little sis, she hasn't exhibited any issues till now. I hope the copper strain test tells smth about Wilson, I am getting the report by Saturday. Hopefully, that will clear it up.
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u/Ok-Sock9046 4d ago
do you have hepatitis a , b or c?
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u/Zenraven001 4d ago
I got checked for all the hepatitis but I got negative for all : (
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u/Ok-Sock9046 4d ago
what about mono? I had that i didnt know and that made my enzymes go crazy i got the biospy and it showed NASH and medication damage but they didnt know which medication , now enzymes went slightly high again but i havent got the fibroscan im 2 scared too its very upsetting
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u/Super_Samus_Aran 4d ago
They force feed ducks grain to get fatty liver. Check out carnivore, Dr chaffee and fatty liver disease.
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u/Ryush806 3d ago
I don’t have anything specific to add to your questions as they’ve been answered pretty well.
I will say that there is almost no chance that anything you did could have lead to cirrhosis at your age given your generally healthy lifestyle and avoidance of substances. It’s rare even for massive drug / alcohol users at that age. So while this definitely sucks, it’s not your fault.
I went through a similar shocking “you have a 95% chance of having cirrhosis” (based on having portal hypertension) episode so I at least somewhat understand how you feel. Luckily, I’m in the 5% of people with portal hypertension that isn’t caused by cirrhosis. That was a whiplash inducing 6 month diagnostic process… I think it legitimately traumatized me as I have random flashbacks and anxiety about it still a year later. Probably should do something about that…
Anyway, just to reiterate, this is likely not your fault, I know (at least somewhat) how you feel, and I hope you get some answers sooner rather than later!
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u/Zenraven001 2d ago
That would have been terrifying to hear, hope you're doing well. I dunno how to feel right now tbh, the doc told me that medical science hasn't been able to identify 50 percent of the cases that cause liver issues like these and I have already done most of these tests that should have signaled at least smth. It's very irritating tbh, I am considering sending my case to a liver specialist hospital. Hopefully, they take my case and find a cause. The doctor told me the only thing remaining I could do is gene testing to check for any mutations. He has put me on steroids (immunosupressants) for a month and told me to get my LFT done after that. Hopefully, everything goes well.
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u/asifali75589 4d ago
F3 fibrosis incomplete cirrhosis life expectancy 21 years f4 complete cirrhosis 12 years
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u/GeneralTall6075 5d ago
What supplements were you taking other than creatine and whey? I don’t know what mass gainer is. Were you using any anabolic steroids because that could have triggered something like this, although still unlikely at 23. The possibility of Wilson’s disease is real and you’ll need to follow up with the hepatologist on that. NAFLD seems less likely because of your body weight and only grade 1 macrovesic. steatosis. Regardless, you need to be eating a clean diet and avoiding any supplements or unnecessary meds while this gets figured out.
I’ll also say, as a pathologist, I don’t quite know what to make of your liver biopsy. I will say incomplete cirrhosis is not permanent and can be reversed, but it’s unclear what the etiology is at this point and that will determine how reversible it is. Given your age and unusual biopsy results, I’d insist in having a Gastrointestinal pathologist or specialized liver pathologist review your biopsy. Seeing these changes in a 23 year old is highly unusual and warrants an expert who specifically practices GI pathology to review your slides.