I have been diagnosed with fatty liver since a couple of years now and only recently starting doing something really concrete about it. I am 33 years old and overweight (250 pounds for 5'11) and have been dealing with a binge eating problem for about 10 years now... I am seeing a psychiatrist since about a year now and it helped me a lot. I have been an avid jogger for many years and recently resumed working out seriously. Since the new year I have the best intentions in mind and started eating much better and eating well is slowly becoming a habit. I still have few binge episodes but they are pretty far apart from each other now.
Last summer my blood tests showed that my ALT levels were very high (around 120) wich was an alarm trigger for me to do something about it and deal with my binge eating ASAP..
The thing is that I'm losing weightr VERY slowly, even if I'm doing everything right.. could this be caused by damage to the liver?
I keep hearing that the solution to cure fatty liver is to lose weight, okay, but let's say the liver is clogged from being fatty and does not work properly, how are you supposed to do ?? it's like you'.re stuck in a vicious circle...
I read that Lemons, artichokes and green tea are very good to cleanse the liver, but should I eat them with a very strict diet in order to do a complete detox or I can eat normally.. And does the liver regenerate anyway even if we eat normally ??
also, very important question: Would you recommand a High protein, low fat/low sugar diet like "Ideal Protein" ? I know it is harder on the liver and on the kidneys, but so is fat around the belly, so wich one prevails ??? Some people seem to say it is not good, some people seem to say it cures the fatty liver because of the low fat/sugar intake. I would like to do it only for 2-3 weeks so I can cut 10-15 pounds and have a headstart on my weight loss, I dont plan on staying on it very long... does anybody have precise answers or recommandations on the matter?
thanks in advance, and sorry about the bombardement of question!
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"...Currently, no specific dietary program can be recommended, although diets low in fat and carbohydrates and supplemented by probiotics may be appropriate...."
"Pharmacologic therapy of NASH is limited and no specific therapy is currently approved for treatment. Although it seems intuitive that insulin-sensitizing agents should be effective, thiazolidinediones (glitazones) may only be partially effective[47,48] and metformin not at all. Vitamin E seems to improve liver histology in patients who have NASH but not diabetes mellitus; additional studies are needed. A preliminary trial of pentoxifylline improved aminotransferases and liver histology.".
I think your exercise and weight loss diet are the right approaches to fatty liver disease. If it is alright with your doctor you might ask whether Vitamin E would be OK to take. I have seen other references which suggest that it may be beneficial in patients with fatty liver who are not diabetic.
I understand your impatience about the rate of weight loss but it seems that the slower you lose weight the more likely it is that it will stay off. I do not believe that your liver is diseased to the point where it would significantly affect your ability to lose weight. While an ALT of 120 might seem high to you it might be characterized by some physicians as moderately elevated.
"Does AST and ALT measurements indicate for liver function?
It is important to clarify that ALT and AST levels do not reflect the function of the liver, even though they commonly are referred to as liver function tests or LFTs. They only are used to detect inflammation due to injury or damage to the liver from any source. Even in conditions when AST and ALT are very elevated, the liver may function properly."
What blood tests are done to detect liver function?
The blood tests that truly reflect the liver function are the following:
Coagulation panel (prothrombin time or PT, and international normalized ratio or INR): These tests measure blood's ability for normal clotting and prevention of bleeding and bruising. This is the function of certain proteins called clotting factors that are produced in the normally functioning liver.
Albumin level (hypoalbuminemia): Albumin is a very common protein found in the blood with a variety of functions. It also is produced only in the liver, and if its levels are lower than normal it can be suggestive of chronic liver disease. Of note, other conditions may also cause low albumin levels.
Bilirubin: This byproduct of the routine destruction of red blood cells occurring in the liver is released as bile in the feces. Elevation of the bilirubin can suggest liver dysfunction.
Platelet count: Low platelet count (thrombocytopenia) has many causes, one of which can be advanced liver disease."
If you want to try and get an understanding of the state of your liver function you can ask your doctor about running those tests listed above.
If I were you I would keep doing what you're doing and when you lose 20 pounds get tested again and I believe you'll see significant improvement.
Fatty liver can be due to alcoholism when it is called Alcoholic fatty liver disease and the other one is Non alcoholic fatty liver disease, which is due to obesity, diabetes and high triglyceride levels. This can progress to cirrhosis of the liver and can be associated with hepatocellular carcinoma. So, prevention or cure is by avoiding alcohol and treating diabetes, obesity and high triglyceride levels. Discuss these options with your consulting doctor.
Wow Mikesimon, thank you for the elaborate and very informative answer! That helped a lot! and is actually pretty encouraging
That is exactly what I plan to do. quite frankly I have been on the high protein diet for a week now and already shred 7 pounds.. I know most of it is water weight so I don't get too excited, but I plan at stopping at 20 and do the rest more slowly and "naturally".. I already feel much better except that I do have a mild pain in the upper abdomen, coming and going.. I hope it's nothing bad, but I know that the liver is working hard, and I feel good overall..
I cannot remember the albumin level in my last blood test, but the doc mentionned nothing about it, so I guess it's fine.. I do have an appouintement on april 2nd for another blood test to check for improvement so I'll have a good idea then
I know that losing weight fast can lead to putting the weight back on afterwards, that's why it's the second time that I'm doing this diet... But one thing is different now, I learned how to cook, and changed my eating and exercise habits a few months prior to doing the diet, so the transition was smooth, and I don't miss junk! In fact, I feel pretty good..
DrAnitha, to answer more specific questions, I barely drink at all, only socially maybe one or twice a month, sometimes not at all, but being a binge eater, I know it is NAFL for a fact.. I have done Hepathit tests, all came back negative, so were trigleceryte levels and tests for diabetes.. only thing was the ALT level very high. I cut out alcohol completely now for it's never something that was very needed in my life
So now I'm adressing the problem at the root, and treating the obesity, cause from what I understand fat around the belly is the worse... My doctor told me there was no danger to the diet, but I would like a second opinion on the matter: can losing weight fast precipitate cirroshis?
Thank for both for your valuable inputs! Only one week left!
I am unaware of any information that suggests that rapid weight loss can precipitate cirrhosis but I never specifically looked for information about that issue. Of course, we all know that, as a general rule, moderation is the best approach. I wouldn't go nuts and starve myself to death but a determined exercise routine and a conscientious weight loss plan shouldn't harm your liver.
I looked around for some recent information on Fatty Liver and Vitamin E and I found this from Nov 7, 2011. It appeared in medscape.com.
Combination Antioxidant Therapy May Help Fatty Liver
[November 7, 2011 (National Harbor/Washington, DC) — A combination of vitamin E and alpha lipoic acid (ALA) can improve the inflammatory and steatosis scores in patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis, according to the results of a study presented here at the American College of Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course.
ALA and vitamin E should be considered as therapy in patients with nonalcoholic fatty liver disease and nonalcoholic steatohepatitis to reduce inflammation and the profibrogenic effect on the liver to preclude end-stage liver disease and hepatocellular carcinoma," said P. Patrick Basu, MD, MRCP, AGAF, FACG, assistant clinical professor of medicine at Columbia University College of Physicians & Surgeons in New York City, clinical professor at Hofstra University Medical School, and division chief of the Department of Gastroenterology and Gastrointestinal Endoscopy at North Shore University Hospital in Hempstead, New York...."
Levels of various markers were assessed at baseline and at 6 months. Combination therapy (combination therapy consisted of 300 mg ALA + 700 IU vitamin E) for 6 months reduced triglycerides to reference levels (<160 mg/dL). Compared with placebo, combination therapy also resulted in a 43% difference in change of triglyceride levels from baseline, a 71% difference in change of steatosis scores from baseline, a 51% difference in change of retinol binding protein 4 (RBP4) from baseline, and a 63% difference in change of homeostasis model assessment (HOMA) scores from baseline.
The only scores that remained unchanged with antioxidant combination therapy were fibrosis scores. In all the other cases, the combination of ALA plus vitamin E was more effective than ALA or vitamin E alone.
"In conclusion, no matter what you do, how you squeeze the data, this trial is statistically significant, and this is [using] over-the-counter, very inexpensive drugs," he told Medscape Medical News. The regimen should have no adverse effects, he added.]
As noted Marty these are over the counter products and they're inexpensive. I'd ask your doctor if he approves of you trying ALA and Vitamin E. It looks promising and at worst it looks harmless.
Thanks again mike, i Will definitly have a look at those! :)
As for the question about cirrhosis, I read that its controversial, and that the risk is very low.. I also read that my diet was even known to reverse fatty liver in some cases.. so who knows..
Another thing I gathered though is that the "worsening" of the fatty liver could be only temporarly increased, because of the additional workload on the liver. I read about a lot of people, specially on this website, that saw their enzymes level go trough the roof during a diet, only to come down to a normal level once they got off of it and reached a healthy weight...
Anywho, like you suggested, ill cut off around 20 pounds and then just maintain a healthy lifestyle... I don't plan on staying on it for months, and so far I'm feeling good.
I have a blood test scheduled at the beginning of April to have an overview of the situation.
Thanks a bunch for the info, as soon as I have updated I'll keep you posted!
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