questions about NAFLD

[violetb]

I have recently been diagnosed w/NAFLD and it makes no sense!  I am underweight (5'7", 105lbs), have been a vegetarian for 30 years and a vegan for 15.  I drink a glass of red wine w/dinner most nights.  My cholesterol is low.  I never eat junk food.  It is so weird.  The way I found out:  I went in for a follow up xray after hip surgery and they found a gigantic shadow on my liver.  Even though I was sure it was some kind of mechanical malfunction, I went ahead and scheduled an ultrasound and they diagnosed from that.  From everything I've read on line, this makes no sense whatsoever.  The only thing I can think of:  Could this possibly be a temporary result from having to take narcotics during my post-operative recovery?

Prior to surgery I was taking a lot of ibuprofen on a daily basis due to hip pain.  This went on for 4 years!  Does anyone have any ideas for me?  My tendency is not to believe this diagnosis.

Thanks in advance
Violet

[pigeonca]

As i understand it, NAFLD goes along with metabolic syndrome, which unfortunately can happen to thin people - not as frequently as with overweight individuals, but it does happen - along with diabetes, heart disease etc.  My whole family has diabetes - I'm 5''5" and weigh 140, which is on the heavy side of normal but still quite normal, and have type 2 diabetes, as did my very thin mother, who was the same height as me but only weighed 112, and my formerly thin brother who for some reason started to put on weight in middle age.  I kind of agree with cured4sure? that you might be storing fat in your liver.  I know there have many reevaluations of low fat diets over the years, as well as reconsiderations of blood cholesterol, which doesn't relate that well to the cholesterol that clogs artery walls.  I wouldn't give up your vegetarianism - it's much kinder to animals and the planet than carnivorous regimes - but being vegan may be extreme.  Hope you feel better, and you too, cured4sure.

[cured4sure?]

Hi Violet,
I have NAFLD and I got it when I was 28, weighed 103 5'5", and was very athletic and eating well and getting a lot of exercise dx through elevated lfts and liver biopsy.  The sudden severe onset of my fatty lliver disease resulted in a misdiagnosis for hepc and interferon tx years ago, all which, combined with not understanding how I should eat having NAFLD, caused my obesity in later years.  In my family on my father's side everyone has NAFLD and dies from it in their 60s and they all have difficult to manage diabetes, some autoimmune and endocrine problems, and test positive for surface antigens to HCV though do not have it per the other tests.  The onset of my fatty liver also was marked by speckled AntiNuclear Antibodies 1:320 or higher, no AI hepatitis, positive for surface antigen, neg PCR, inconclusive RIBA.  In other words, I think there are other reasons that people get it besides the common reasons.  I don't know that a doctor can prove which came first, fatty liver or obesity, and I think the medical community makes assumptions based on misinterpretations of findings sometimes.  Obesity and fatty liver coincide, fatty liver makes it really hard for me to lose weight in comparison to other individuals.  Also, there are environmental causes (exposure to toxic substances) and I've found some research on possible genetic causes or predisposition, as in my family.  My last ultrasound showed severe steatosis (guess fat jiggles differently than regular liver tissue or damaged liver tissue so the ultrasound is a good test) and my biopsy confirmed it 100%.  I'm sorry to hear that you may have this problem.  The main thing is to be sure you have a good hepatologist or gi guy and you feel confident in his or her diagnosis.  I don't think drugs from surgery would cause this, but I'm not a doctor.  Actually, a vegetarian diet might be something to look at if you have metabolic problems.  I have to eat a decent amount of fat and very low carbs or my liver thinks my body needs to store fat and starts storing fat, converting the carbs to fat.  Also, when I was on a low iron diet with red meat restrictions after interferon I had high iron for years and my liver got much worse until the docs told me I could eat red meat.  This is my personal experience, but you should talk to your doc about your concerns with the diagnosis and perhaps ask why, from their perspective, this is happening to you.  Also, maybe google "metabolic syndrome" and NAFLD.  It'd be nice to think that we could solve the problem by simply losing weight, by chewing out overwieght patients, but someone would have to give me some good evidence to buy that one.  I am looking forward to research into autoimmune causes for it.

[VXman]

Found a website that may give you some answers or insights:

http://www.medicinenet.com/fatty_liver/article.htm