I got some blood work done today, figured I'd do it while I was in the ER. Apparently it's normal but I take everything doctors say with a grain of (sea) salt. My naturopath diagnosed me with a fatty liver but the doctor said that my blood work doesn't indicate that I have one. From what I've researched I believe I have some sort of autoimmune/ intestinal permeability (the ER doc had never heard of leaky gut etc so I'm skeptical). I don't know what any of these numbers mean so I'm hoping someone knowledgeable can shed some light. Thanks!
The doctor will only diagnose fatty liver due to elevated liver enzymes. Many obese and metabolic syndrome types have fatty liver without elevated liver enzymes (like 60% iirc). This does not mean that your Naturopath is correct, but he/she could very well be.
I would recommend being just as skeptical about naturopathy as you are of other "doctors." Normal liver enzymes are strong evidence against fatty liver, but of course not definitive. Discuss with your naturopath the basis for his/her diagnosis of fatty liver. Is your liver enlarged? The size of the liver can be estimated by palpation (feeling) or percussion (sounding). Have you had an abnormal liver ultrasound? Sometimes fatty liver shows up on ultrasound. Are you having problems with blood clotting? The liver normally makes blood clotting factors in the presence of vitamin K. Do you have evidence of abnormal carbohydrate metabolism, such as episodes of low blood sugar or an elevated hemoglobin A1C? Weigh all the evidence before you accept a diagnosis of fatty liver.
Finally, your potassium (K) level is at the lower end of the normal range. Blood potassium level is not necessarily a reflection of total body level of potassium, but a potassium supplement probably wouldn't hurt.
What makes you think you have autoimmunity? Self-diagnosing autoimmunity is always tricky. What were you in the ER for? And what made your naturpath think you have fatty liver, when you seem to have normal liver enzymes?
I would go and get my inflammation markers tested (CRP, ferritin, Sed rate) and blood sugar markers (A1c, fasting BG) and self-test post-prandial BG (1 and 2 hours). And also get your lipid profile done, to put everything into context.
What's shown is just the hepatic and metabolic panel.
I don't know a doctor who would even order an ultrasound based on those ALT and AST numbers. If you're worried about it, eat Paleo religiously, don't take NSAIDs or other medication unless you really need it, and stop or drastically cut back on alcohol. I was diagnosed with fatty liver in December, and in less than 3 months of doing those things it was completely gone.
(It is true, though, that other labs besides ALT and AST are important. But from my reading those are the two most crucial.)