A large human liver surrounded by construction scaffolding. The top half is polished, green and healthy, but the bottom half still has some yellow fat or cracks being repaired by tiny workers. It symbolizes progress but unfinished work.

3 Months In: My Elastography Results & Why “Better” Isn’t “Fixed”

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If you think reversing fatty liver is a straight line from “Sick” to “Healthy,” look at my calendar.

In April, I was diagnosed.
In June, I figured out why and thought I was on the right path.
In November, I thought I had failed.
In December, I barely crossed the line.

This journey isn’t a sprint; it’s a jagged line. Here is the data from my first 9 months, and why the “messy middle” was so frustrating.

The “Perfect” Start (May – July)

After the shock of my diagnosis in April (AST 63 / ALT 86), I went all in.

For two months, I was a machine. I stopped guessing and started tracking everything with Cronometer:

    • Calories: ~2,200 (Maintenance/Eucaloric)
    • Protein: 140g (To protect muscle)
    • Net Carbs: 215g (Mostly fiber-rich)
    • Added Sugar: Only 18g/day (down from my “Moose Tracks” days)
    • Fiber: 40g/day
    • Fat: 70g (only 18 saturated)

I also started swimming 3 days a week. I felt great. I felt “fixed.”

The Data: The Good, The Bad, and The Confusing

I went back for bloodwork in June and an Elastography (FibroScan) in July. Here is what happened.

Bloodwork values showing up-and-down results for AST and ALT

The July Elastography: A Massive Win

While the bloodwork in June showed I was “better” but still elevated, the Elastography gave me a huge boost.

  • CAP Score (Liver Fat): 188 dB/m.
    • Context: This is actually excellent. Anything under 238 is considered S0 (no significant fatty liver). The diet had emptied the fat “bathtub” rapidly.
  • Stiffness (Fibrosis): 6.1 kPa.
    • Context: This is borderline. It’s consistent with F0-F1 (no significant scarring), but it showed my liver was still under some stress.

The November Setback: “Can I Really Not Have a Cheat Day?”

I walked into my November blood draw confident. I had maintained my healthy habits. I was lifting weights. I was eating well.

The Result: My enzymes went UP.
AST jumped to 47. ALT jumped to 54.

I was devastated. I had barely changed anything, yet I was arguably “sicker” than I was in June. I spiraled a bit. Is this permanent? Can I really not have a single cheat day?

Looking back, I identified two culprits for this spike:

  1. The “Halloween Hangover”
    This test was taken on November 6th. Less than a week prior, I indulged in some Halloween candy. For a normal person, one day of candy means nothing. For a “Lean Liver” phenotype like me, that immediate spike in fructose might have caused a flare-up of inflammation. We operate on a razor’s edge.

Cronometer data showing my halloween candy consumption

  1. The “Gym Noise” (Critical Lesson)
    I had lifted weights 3 days prior to the blood draw. What most doctors don’t tell you is that AST and ALT are also found in muscle tissue. When you break down muscle (hypertrophy), you release these enzymes into the blood.
    I wasn’t necessarily damaging my liver; I was damaging my chest and back muscles, and the blood test couldn’t tell the difference.

The December Correction

I refused to accept the November numbers as my new baseline. I tightened the screws and made two adjustments for the final month of the year:

  1. The Daily “Walking Cure”: I made sure I walked every single day (7,000 steps). Even if it was just 20 minutes. No skipping. This low-impact movement improves insulin sensitivity without tearing down muscle.
  2. The “Rest” Period: Before my December 30th test, I stopped lifting weights for 5 days. I wanted to know what my liver was doing, not my biceps.

The Result:

  • AST: 37 (Normal)
  • ALT: 40 (Normal)
  • GGT: 17 (Optimal)
A large human liver surrounded by construction scaffolding. The top half is polished, green and healthy, but the bottom half still has some yellow fat or cracks being repaired by tiny workers. It symbolizes progress but unfinished work.
cartoon generated by Nana Banana Pro

The Takeaway

I am finally “in range,” but barely My ALT of 40 is technically “normal,” but optimal is usually under 30. This isn’t a disease you cure and forget. It’s a metabolic state you manage. For the lean person, the margin for error is small. A few weeks of inactivity or a return to high fructose, and those numbers will creep right back up.

If you are stuck in the “messy middle” where your numbers are bouncing up and down:

  1. Don’t Panic. Healing isn’t linear.
  2. Check Your Variables. Did you lift heavy weights before the test? Did you have a “cheat weekend” right before the draw?
  3. Trust the Protein. My diet (High Protein, Low Fructose) cleared the fat (CAP 188) long before the enzymes settled down.

Download the Grocery System that helped me clear the fat (CAP 188) in 3 months.

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