Fatty Liver Disease

Hello Doctor,
I am hoping you can help my husband. About 6 months ago my husband had a regular check up and was told he had abnomal liver values. After a sonogram, they confirmed that he has fatty liver disease. He was told there's nothing he can do about it except eat healthy and increase good fat. That would be fine except he's the most discipline healthiest person I know. He eats brown rice, tofu, steamed broccoli, fresh fruits, fish, chicken (all non seasoned except some olive oil and maybe some lemon to taste) and he takes multi-vitamins and fish oil on a regular basis as well as excercise 6-7 times per week. He does not drink alcohol at all (not even a beer here and there) nor does he take any medications. He did however had to be on some medications for T.B. exposure for about 8 months. This was 3 years ago and had his liver tested and everything was fine at that time. Also, he is a "natural" body builder and often rely on protein shakes and high proein diet. My questions are as follows: What could be causing this since most articles associate obesity and he is not with 7% body fat? Is there a treatment for this? If he does need to see a specialist for this, who do you recommend in Orlando Fl (he is currently being seen by a V.A. doctor).
My family and I truly appreciate any advise you may have for us. I am a student nurse and have seen what liver disease can look like. I am really concern. Please help. AnnaK.
    

[Thomas D Schiano, MD]

fatty liver in itself is nothing bad--it is steatohepatitis that is a problem.  it is difficult to tell the difference except on a liver biopsy.  sonograms are notoriously unreliable at calling this so if his liver enzyme blood tests are OK now I would not worry too much and he should continue his healthy current lifestyle.  i presume that he has had additional blood testing looking for viral hepatitis, etc.

[AnnaK1103]

Thank you doctor Schiano for a quick response. To answer your question, hepatitis had been ruled out. We are waiting for the result of another liver enzyme test. If it's still abnormal, I will have his doctor do a biobsy. Again thank you very much and God bless. AnnaK.  

[Thomas D Schiano, MD]

good luck