So, the doc says my elevated liver enzymes are probably due to fatty liver.
What this can eventually lead to:
Fatty liver may cause no damage, but sometimes the excess fat leads to inflammation of the liver. This condition, called steatohepatitis, does cause liver damage.[…]
An inflamed liver may become scarred and hardened over time. This condition, called cirrhosis, is serious and often leads to liver failure.
Things I’m supposed to do about this:
- Lose weight – safely! That usually means losing no more than one or two pounds a week.
- I am so not obese. But I now have something to wave at my friends who say “pishposh, you don’t need to lose weight, you anorexic queen.” “fuck you, I don’t want to die any earlier than I have to.”
- Lower your triglycerides through diet, medication or both
- Mine are 24x, 200-500 is high. This means avoid cholesterol and eat fewer calories. Especially fat, saturated fat, and see below.
- Avoid alcohol
- I’m a lightweight, whom, by the standards of most people I hang out with, barely drinks. But even small amounts are bad. Lovely. Well, So be it.
- Control your diabetes, if you have it
- My blood sugar is normal, but that’s getting to be a rarity in my family.
- Eat a balanced, healthy diet
- Busted. More veggies, fewer boca burgers. But that’s hard. Le sigh
- Increase your physical activity
- I may have to enter into permanent triathlon training mode. On the plus side, if I ever do an Iron Man, most people will not know whether to think I’m crazy or awesome and studly. Probably both. I’ll just think I’m crazy.
- Get regular checkups from a doctor who specializes in liver care
- That’ll be the next step
The “good” news is that most of the steps involved also help with the other whammy for me, heart disease.
Screw stem cells, I want gene cleansing therapy and I want it now. =)
Ya, genetics will get you every time.
I need to schedule my fasting blood test — just had my physical — but I’ll actually be a little surprised if anything scary shows up on it. My family runs to plump, muscular people with low blood pressure, low cholesterol, and no heart disease. While you, who are active and slender, need to worry about all these issues!
Any royal heritage? I’ve heard the thesis, and been promulgating it recently, that peasant ancestors imparted genetics which work better for famines and comparatively low food availability, whereas ancestry from the nobility didn’t have to deal with that as much, and micro-evolved to handle regular and ample food availability.
None at all, that I know of, down any of the 4 grandparent branches.
I think some of these (such as high triglycerides) can be helped by supplements too.
Hope it all works out.
Yeah, not checking out any time soon, but being responsible about such things is still a goal. =)
i had the same diagnosis last year… i started exercising a little more (walking instead of taking public transport to work), and ate less (not really healthier, though i did eat less fatty foods)… it seems to have worked, fyi…
Yeah, I have not been doing the healthy eating thing for awhile now. I am upping my exercise. Diet would be good too. Food around where I work is generally not impressive on a nutrition angle.
i hear ya… i think for lunch i was having balance bars, that seemed to help.. it wasn’t great and superhealthy, but more to the point it wasn’t fatty and unhealthy.
and i laid off the szechuan fatty double cooked pork 🙂
Increasing your fiber intake (aim for ~40g/d) is great for your liver and cholesterol, especially when combined with eating more “bitter” foods like artichoke, dandelion greens, pure cranberry juice. The bitters stimulate your gall bladder to release bile (which is made out of old cholesterol/hormones) and the fiber ‘soaks it up’ so that it is not reabsorbed in you intestine.
There are some pretty good nutraceutical liver support formulas out there that would probably help.
If you have insurance, you might want to think about finding a good naturopathic doctor.
hope you’re doing ok.
thanks for the advice and concern. How would you compare naturopathic to alleopathic medicine, and the training received by specialists in each?
Which state do you live in??
in some states, naturopathic medicine is not a licensed health field, and anyone can call themselves a “naturopath”.
In licensed states/provinces, Naturopathic physicians receive 4 years of pre-medical education, and 4 years of med school training. They learn the same basic medical training as “normal” medical doctors, only they practice under different philosophies.
Whereas “normal” allopathic medical doctors focus on recognizing and treating specific pathologies, naturopathic doctors specialize in health promotion and disease prevention utilizing nutrition and lifestyle management, as well as the treatment of disease with safe complementary and alternative medicines, such as herbs, acupuncture, and homeopathy.
A Naturopathic doctor is not a replacement for your family doctor, I use both.
some medical doctors are opposed to naturopathic treatment, as there has been long standing rivalry between the two philosophies.
But, if you live in a licensed state, and find a good naturopath, you are in safe hands.
That sounds like a really nice kind of dr to have. When I try to discuss that kind of thing with my current MD, I get handed separate sheets of paper, with mostly concurring and occasionally conflicting advice on how to manage my HDLs, LDLs, and Triglycerides that is totally not customized to me in any way shape or form.
Thats my favorite part of naturopathic medicine, I don’t think i have ever went in for an appointment for less than an hour, unless i was just getting a shot or something.
If you’re really worried about your liver, you could always get a more detailed report from a hepatologist/gastroenterologist. I’m curious about exactly how elevated your LFTs are – there’s quite a range when one says “elevated.”
Also, what is the breakdown of your cholesterol tests (eg. LDL vs. HDL) – that can also help determine a good plan of action.
I agree with the comments about getting more fiber in your diet. One regimen I’ve heard of is popping a handful of almonds (or healthy nut of your choice) along with a dose of Metamucil. Vegetables are a great source of insoluble fiber, but you really want soluble fiber for a greater cholesterol absorbing effect.
I would also seriously think about medication. Increasing fiber intake coupled with a simple statin can work wonders on your cholesterol and is a mainstay of therapy for younger people who have a genetic predisposition towards high cholesterol.
Finally, exercise is always a good thing, but I wouldn’t go out and sign up for an Ironman for health reasons. There’s a certain point of exercise beyond which you don’t really get any additional cardiovascular health benefits, and actually starts putting stress on your body (eg. joints). Do it if you want to do it for yourself, but don’t do it for “health reasons.”
LDL – 160
HDL – 26 (I think)
My liver enzymes were like 90. “slightly elevated” he says. He didn’t propose medicine. But we’re still waiting on the second liver enzyme test.
Hmmm…
Yeah, those liver enzymes don’t really say anything at that level. I wouldn’t even notice them if I saw those values on a full work-up. Still, the fact that they are chronically elevated may be an interesting thing to pursue. Do you have a alkaline phosphatase or gamma glutamyl transferase level?
I would definitely be more focused on your cholesterol. Those values, coupled with your triglycerides puts you at a fairly high total cholesterol level. Start with the changes that are simpler: less saturated fat, more soluble fiber, try omega-3 fatty acid supplements, or even just downing a teaspoon of olive oil everyday.
I wish I had the discipline to be an annorexic queen.
Right there with you… sorta. =)
I’m damned if you’re having problems. 😛
Heh. What are your actual blood results showing?
Darned if I know. Heh.
I take it you are lacking in the health insurance?
I recently got it with this job. I should go for a general checkup soonish.
My view: you have a proposed but not confirmed diagnosis, and your living patterns do not at all fit this proposed diagnosis. I think it’s quite likely that the proposal is A) wrong, or B) requires more verification and understanding.
Sure, if you need this an excuse to take your food healthiness up a notch, go for it, but I’m doubting. I think you need cross examination.
i forgot to ask, did you confirm this w/ an ultrasound or anything?
My Mom is a scrawny athletic lady, and she also has problems with high cholesterol. She tried taking all the fat out of her diet, and her cholesterol actually got worse. Apparently when the body has to produce it’s own fat, it produces the bad type. Instead now she is being careful to get a reasonable amount of vegetable oils and I think she is doing better.
coffee
Do you drink coffee? They have found that drinking coffee reduces liver enzymes (and reduces the risk of alcoholic cirrhosis by ~20% per cup per day). I don’t think that drinking 5 cups/day reduces the risk of cirrhosis by 100%, but 4 cups a day does reduce it by 80%. This isn’t to say that alcohol is causing the elevation in your enzymes, but coffee does lower liver enzymes and may be worth trying. And they have found that it’s not the caffeine (but probably kahweol and cafestol), so you could drink decaf if you prefer…