<s>[INST] Good Morning Doctor,I have been detected with fatty liver few years back recently after a health check up the doctor recommended sorbiline and l-ornithine.I had deficiency of B-12 and D-3 earlier which was treated with doses and i.v.The ESR reading is always elevated can the fatty liver can be the cause of this elev.ESR.My email is  YYYY@YYYY warm regards,ganesh kn [/INST] Thanks for query on HCM.The ESR is increased by any cause or focus of inflammation,so it might be elevated due to fatty liver.There are some specific cause of elevated esr like in pregnancy, inflammation, anemia or rheumatoid arthritis,sle.Keep in touch with your doctor to rule out any further cause.Check your b12,d3 level regularly every year. </s>