Testing results and thoughts

New Canadian member here . Have been reading for a while on my journey if I have PSC or not . Details are 38 year old male , tests every 2 weeks . high LFT off and on since 2016 but consistent last 7 mths . ALP always 300-700 u/l . ALT 60-300 u/l , ast 60-200 u/l ALT always higher than AST . Billi 20-35 umol/l ( usually high side of normal to just over normal) . GGT 400 -1200 umol . Used to be a social binge drinker since 20 always in great physical shape with no other medical conditions , a lot of NSAID use last 2 years due to a few surgeries ( which I use to think could cause it . Fast forward to tests last 6 months Ultrasound completely normal *possible thickness to common bile duct was noted , this lead to MRI which they said was MrCP but I had no dyes injected or anything this was completely normal ,noted with specific reference to no evidence of structure to duct or to evidence of PSC . Seen a specialist GI who sent me to Hep specialist at transplant hospital who sent me for FibroScan (6.2 Kpa) and biopsy , this came back as “Mild portal fibrosis with *nonspecific alterations “ . “ also says can’t rule out or diagnose small duct or normal PSC with exam. Now I’m waiting for specialist to see me about this result . Last 7 months have been totally healthy for me no meds no Alcohol and no changes to labs from 2016 . I have also over this time been tested for every antibody and blood test available a few times . they told me with everything being neg or within normal ranges . Now I sit and wait , I’m convinced I have at least small duct PSC but I’m not sure what to think anymore as I have zero preexisting factors . Thoughts on this journey ?

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It can be hard to get a conclusive PSC diagnosis in the early stages. Your doctors have ordered the usual diagnostic tests although the MRCP really should be done with and without contrast to get the full picture. Options from here are to either keep an eye on things with periodic bloodwork and yearly MRCP, or to pursue an ERCP. ERCP is another method of imaging the ducts but is invasive with many potential side effects.

Do you have IBD? Even without symptoms, you should probably get a colonoscopy done if PSC is suspected. An IBD diagnosis would also strongly point the finger towards PSC.

Also ask your doctor to check fat soluble vitamin levels. This is an issue you really want to catch early and, if levels are low, strongly indicates there has been ongoing cholestasis.

Thanks for the reply , no IBD and not sure about the Vits . The doc illuded to colonoscopy after biopsy if PSC suspect .

Canadian here aswell.

What city?