Liver and Spleen Issues: Seeking Answers for Chronic Fatigue

Q: Liver and Spleen Issues: Seeking Answers for Chronic Fatigue

Hello： If you have not seen a hematologist, you can consult a hematology specialist to investigate the causes of anemia and splenomegaly. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-shun.

I apologize for the trouble, doctor?

Hello, doctor! I had an ultrasound that showed an enlarged spleen, a rough surface on the liver, and a portal vein measuring 1.15 cm.
There is also a hyperechoic nodule in segment 5 of the liver, which is currently being monitored.
I have a history of hepatitis B infection that was never treated, and my blood tests show negative for surface antigen, positive for surface antibodies, positive for core antibodies, and a hepatitis C result of 0.07.

I also have iron deficiency anemia, with a hemoglobin level of 7.8.
After taking iron supplements for six months, my levels increased to 12, but recent blood tests show anemia again, and the cause remains undetermined, which is quite frightening.
Last year, I underwent a colonoscopy and gastroscopy.
My hair falls out a lot every time I wash it, and I'm close to losing it all.

Doctor, I am in a lot of pain; I feel fatigued all day and can’t work, so I can only rest at home.
I feel very self-conscious, and my appetite is poor; I often don’t feel hungry, and sometimes just the sight of food makes me want to vomit.
Which specialty should I see? What tests should I undergo to find the cause of my symptoms? Please help me; I truly feel helpless.
I am regularly following up at Chang Gung Memorial Hospital and recently visited the Hepatology Clinic.
Is this issue related to my liver? Doctors say everything is fine, so why is my spleen enlarged, and why do I feel so tired and unwell?

Piqiu, 40~49 year old female. Ask Date: 2016/10/06

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: If you have not seen a hematologist, you can consult a hematology specialist to investigate the causes of anemia and splenomegaly.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/10/06

More Info

Chronic fatigue can be a complex issue, especially when it is accompanied by findings such as an enlarged spleen, rough liver surface, and the presence of nodules on the liver. Your history of hepatitis B infection, along with the current blood test results indicating anemia, adds further layers to your situation. Let's break down these issues and explore potential next steps.

Understanding Your Condition
1. Liver and Spleen Health: The liver and spleen are crucial components of the body's immune and metabolic systems. An enlarged spleen (splenomegaly) can occur due to various reasons, including liver disease, infections, or hematological disorders. The rough surface of the liver and the presence of a high echogenic nodule could indicate underlying liver pathology, possibly related to your past hepatitis B infection.

2. Chronic Fatigue: Fatigue can stem from multiple sources, including physical, psychological, and metabolic factors. In your case, the combination of liver issues, anemia, and possibly nutritional deficiencies (given your poor appetite and weight loss) could significantly contribute to your feelings of exhaustion.
3. Anemia: Your history of iron deficiency anemia, with hemoglobin levels fluctuating, is concerning. Anemia can lead to fatigue, weakness, and decreased exercise tolerance. It is crucial to identify the underlying cause of your anemia, which could be due to chronic disease, nutritional deficiencies, or gastrointestinal bleeding.

Recommended Actions
1. Consult a Hepatologist: Given your liver history and current symptoms, a hepatologist (a liver specialist) would be the most appropriate specialist to consult. They can perform a thorough evaluation of your liver function and structure, possibly including imaging studies like an MRI or CT scan, and may recommend a liver biopsy if necessary.

2. Hematology Evaluation: Since you are experiencing recurrent anemia, a hematologist can help determine the cause of your anemia. They may conduct tests to assess for iron stores, vitamin B12 levels, and other potential causes of anemia, including bone marrow function.

3. Nutritional Assessment: A dietitian can help evaluate your nutritional intake and suggest dietary changes or supplements to address deficiencies that may be contributing to your fatigue and anemia.
4. Psychological Support: Chronic illness can lead to feelings of helplessness and depression. Consulting a mental health professional can be beneficial to address any psychological impacts of your physical health issues.

5. Lifestyle Modifications: While it may be challenging, incorporating gentle physical activity, maintaining a balanced diet, and ensuring adequate hydration can help improve your overall well-being.
6. Regular Monitoring: Continue your follow-ups with your healthcare providers. Regular monitoring of your liver function tests, complete blood counts, and any imaging studies will help track your condition and guide treatment decisions.

Conclusion
Your symptoms of chronic fatigue, along with the findings from your ultrasound and blood tests, warrant a comprehensive approach to diagnosis and management. It is essential to work closely with specialists who can provide targeted care based on your unique health situation. Remember, you are not alone in this journey, and seeking help from the right professionals can lead to improved health outcomes and a better quality of life.

Similar Q&A

Fatigue and Drowsiness: Is It Mediterranean Anemia or Fatty Liver?

Hello Dr. Chen, I have been diagnosed with beta-thalassemia since childhood. I failed two blood tests before my military service, both due to "beta-thalassemia." Additionally, during a recent health check at my company, an ultrasound revealed "severe diffuse fatty ...

Dr. Chen Bozhang reply Family Medicine
Dear Mr. A-Shan, You mentioned a history of thalassemia, and recent health check-ups have revealed severe fatty liver with elevated levels of GOT and GPT, indicating that your fatty liver has led to chronic hepatitis. You often feel fatigued or sleepy, occasionally experience di...

Understanding Chronic Fatigue: When to Seek Specialized Medical Help

Hello, Doctor. I am deeply troubled by fatigue. I have to spend a lot of time sleeping every day, and I feel very tired and want to sleep again right after waking up. This has severely affected my academic performance. However, after examinations, including liver function and thy...

Dr. Xu Ruihong reply Gastroenterology and Hepatology
There are many causes of fatigue, including both physiological and psychological issues. If a thorough examination by a physician reveals no physiological problems, it may be beneficial to consult a psychiatrist to explore any potential psychological issues. Engaging in regular e...

Is Interferon Effective for Chronic Fatigue and Enlarged Spleen in Hepatitis C?

Frequent fatigue and splenomegaly, along with a diagnosis of hepatitis C, raises concerns about the effectiveness of interferon therapy. Interferon can be effective in treating hepatitis C, but the response varies among individuals. It is important to consult with a healthcare pr...

Dr. Yang Guojun reply Internal Medicine
Combination therapy for hepatitis C, involving interferon and antiviral medications, can achieve an effectiveness of approximately 70%.

Understanding Chronic Fatigue: Insights from Health Check Results

Hello, I am a sophomore male student. I have been feeling fatigued frequently for over three years, so I went to your hospital for a health check-up. Could you identify any abnormalities from the following data (only listing the more abnormal results) or provide some advice? Liv...

Dr. Hong Chuanqi reply Family Medicine
Hello, Da-Xiong. Based on the information you provided, there is no strong indication of liver disease or blood abnormalities. I recommend that you visit our Family Medicine outpatient clinic to discuss your concerns in person, as this may be more beneficial for you. Hong Chuanqi...