Diets.....

[Loopy53]

Good morning, I would like some generalised advice on diet, I was wondering if anybody could help?

I'm male, 65 and have been clear of Hep C for nearly three years (undiagnosed for 40 years.) I'm cirrhotic, initial Fibro score being 64.4 kPa @ 2014. Now reduced to 23 kPa (last week.) LFT's were all within normal range last time checked.

My two main problems; I suffer from dreadful fatigue and can fall asleep at the "drop of a hat" and find it difficult to get through the day without a nap. Secondly, I have trouble controlling my weight, I'm not underweight or losing weight, the complete opposite is the problem, I seem to gain weight very easily and have trouble shifting it. I've dieted a lot and have resorted to "calorie counting" and a fitbit. Even though I expend a lot more calories than I consume I still put on weight which is very frustrating (all that hard work and suffering for nowt lol.) So, my question, could either of the above problems be liver related and if so could they be improved upon with a "special" diet, rather than just relying in (failing) mainstream diets?

Thanks for taking the time......

[Hidden]

My advice, discuss with your doctor and see a dietitian.

[jojokarak]

Wow congratulations on reducing your score so much 😁

I am 2 years post transplant and I have the same kpa score as you now 23 .. I was only told a few months ago and since have done a lot of talking with dietians and doctors and it was the food I was eating, the thing is after a major operation they tell us to eat all the good stuff and then don't tell us to stop lol

Anyway last couple of months I have changed a lot I eat lean meat, veg, fish, I changed milk from full fat to semi skimmed, changed from full fat cheese to 50%, how much hidden fat is in every day products it's amazing I now check the fat and saturated fat in everything, we are only supposed to eat 20g of saturated fat in a day and in most products and in one meal you have your limit ... There is an NHS site/app you can check out which will give you loads of information I have lost 8kg in 8 weeks by just cutting things out and that's without exercising fully just brisk walking . Continue the good work x

[Hidden]

Hi Loopy53

We do have a general publication on Diet and Liver Disease that may be of use to you, here is the link;

britishlivertrust.org.uk/wp...

However, If you have a liver condition, there are some special considerations you may need to make in your diet to stay nutritionally well and to help to manage your condition. Some of these are specific to certain liver diseases, others relate to how advanced your liver disease is. We therefore always suggest that people should discuss their specific dietary needs with their own doctors in the first instance. Your specialist may then in turn chose to refer you on to a hospital registered dietitian for more specific guidance.

We do hope that is helpful.

Warm wishes

Trust1

[Hidden]

Hello Loopy53, the only thing I can really suggest, is that you get checked out for type 2 diabetes. (That's if you don't have it already) Because your liver is now cirrhotic, it can become insulin resistant. Diabetes can cause fatigue and you will become sleepy. Being over weight may also be a contributing factor for diabetes as well. Ask your GP if you can have a blood test just to either rule, out or confirm this.

Failing that, report this to your GP anyway. Good luck.

[Loopy53]

I'm not grossly overweight, BMI around 27 I think, I'm also regularly checked for type 2 diabetes. My main area of weight gain is my stomach, which appears distended, howrver thete is no ascites present. Is there anything else "liver related" that could be causing disension?

[Julie8]

Get your glucose checked cause being prediabetic can slow down your weight loss.

[Skertchly]

Eat and be merry. Avoid stress and negative people. Have one good meal a day. (About 6-7 pm) sleep whenever you feel like it. Biscuits porridge cake coffee tea are all good. You can set up a new regime now your retired.

[Radnor]

3 weeks ago tomorrow I went to Royal Liverpool Liver Centre.2016, fatty liver,2017, severe fibrosis, now cirrhosis.I wanted a second opinion because I had no follow up appointments and the only advice given was lose weight. I managed to drop 2st , I have ME and fibromyalgia so I am pretty inactive. If I over do it I get pay back big time, crash and end up in bed for a week or more. I wanted to lose weight and retrain my eating habits. Only eat when hungry, test this as being thirsty also can give the same feeling. Reduced my portion size and reduced the naughty stuff. I was on methotrexate for 7 years, great for my psoriasis and psor. arthritis, its highly toxic and has caused the liver damage. I stopped it almost a year ago.I discussed not hearing anything with my GP, e said my liver bloods look normal I .I researched all the hospitals within travel distance and asked for a referral to the Royal. Everything was very well organised, had a fibroscan and then sent to see the consultant.I was taken aback as I was seen by the Hep. Professor. My GP must have stated my concerns, I only waited 7 weeks for the appointment. He must have worded it as I wanted a second opinion too. He first of all said I now have cirrhosis. he aknowledged to I had lost some weight however this next part is what may be of interest to you. Of course my liver is still functioning, he explained it is a silent disease, so its often in the late stages when people are diagnosed. It is not just a case of losing weight . The only way to remove fat from the liver is to ensure I burn fats. I appreciate people have a problem with the way to do this, however unless someone is a Professor of the Liver, I am inclined to be guided by him. Our bodies are fuelled first by carbohydrates. BUT, if these are not eaten then the second fuel source becomes FAT. A lot of low fat foods are loaded with carbs too plus the no animal fat school of thinking has totally been debunked! A lot of Synthetic fats are now the bogie man!. The cholesterol hype of the 80's and 90's has been medically proven to , butter is healthier than Flora!

I know that the Atkins type diet works, I have done this in the past and lost 4 stone each time I was full of energy then and was never hungry.If no carbs are available the body then processes fat for energy etc Keto diet is the modern equivalent today. I spent hours researching , discovering all the preparation required and also being shocked by the no of carbs in a simple tin of soup! I went through my cupboards, fridge and freezer. No more Heinz Ketchup ,branston pickle etc Aunt Bessie is sacked , along with all cereals, rice, breads, pasta and so on. I gave away 4 very large carriers of food! This way of eating can reduce BP too, so a monitor is essential Its also simple to confirm if your actually burning fat instead . Urine sticks measure Ketones in the urine. It tells you if your body is in ketosis. I started last Thursday I had a couple of bad headaches in first 2 days, expected. Felt a little flui again normal A lot of fruit is also a no no, its full of natural sugars ie carbs. Melon,strawberries blackberries are the lowest. Dark green veg is fine, sweetcorn is also packed with natural carbs. You can eat as much fish,seafood, meat, hard cheese ,eggs and dairy You can even have a cheeseburger, simply substitute the bun with lettuce leaves! It was not all doom from the meeting. Prof said if I lose fat, it will come off my liver too. If I can stay low carb he would expect me to still be around in 20 years time! This way of eating is also the best way to prevent diabetes due to obesity. So many people associate liver disease with alcohol, everyone on here knows different.I expected my fod bill to be horrendous, but it was actually the same! Just totally different. I have told my friends and family its a biscuit and cake free zone too. They all said without exception, keeping you is what matters, not being offered a bickkie . I am fortunate I don't drink, went off even the smell when I contracted EBV. Christmas brew anyone? After reading this your pen name may be apt, but I am giving it a try. be glad when the dessert ads reduce on telly,lol. That said a mature Aberdeen Angus sirloin takes some beating! Hazel

[skay1957 in reply to Radnor]

I just read your reply and what you are doing to lose weight with the low carb diet. I am in the U.S. I agree with you on the diet. However in my case, when I first was diagnosed 1 year ago as early cirrhosis I read everything I could on improving my condition, to do everything I could in my power to live as long as I could, improve my outcome. I went on the low carb diet and over 4 months lost about 40 lbs and felt great once I got over the initial shock of the diet itself. My problem was when I went back to the hep doctor my test results were all pretty normal now, with a low mead score, however, in discussing my prognosis she gave me no encouragement that I would live any longer than I would if I had not lost the weight, that the damage was done and it couldn’t be reversed. She really discouraged me from even continuing on to eat right and lose weight. When I left her office I was so discouraged. It was like she literally killed everything in me. Needless to say I stopped the diet and I spiraled down and have gained all the weight back. It’s been about 8 months of self pity and depression about it. I am trying now to not let what she told me to continue to affect me. In hindsight I should not have let her discourage me like she did because she is the liver specialist. I know I have self deteriorated my liver over the past 8 months. I feel like I am in the worse condition now. I had pretty much given up but I am beginning to come out of the depression and starting to feel like I am going to try again with this diet and change doctors too. By the way, I have nonalcoholic cirrhosis due to diabetes, my weight, and years of Ibuprofen use for arthritis. I don’t drink. I did stop all nonsteroidal meds for arthritis. Bottom line, I believe the low carb diet is the best diet for someone like me, too. I wish my liver doctor would have been like yours and encouraged me, saying I could possibly live years down the road but she didn’t, she said losing weight was great but it wouldn’t change anything and she had “no crystal ball”, that I would deteriorate at some point no matter what I did to help myself. Good luck.

[Radnor in reply to skay1957]

My daughter came with me to this appointment. She said he was quite rude to you Mum, especially about your weight! I said he was saying it like it was. He threw down a gauntlet as I saw it. If someone challenges me I to tend to win lol. If I had been told to go low carb when I only had NAFLD I could likely have reversed the damage. Like you I have arthritis and joint problems so exercise is too painful Swimming is out as I am self conscious about my psoriasis, If it stops my cirrhosis from advancing then it is more than worthwhile. I have never had a fat belly until the last few years. I wasn't slim but was well proportioned with curves in the right places. Middle Age Spread has been used to describe how fat accumulates here as we age. My school friend from way back was always perfect physique. In just 4 years she gained 3 stone and it was all on her tum! She became a sweet stuff addict. She didnt like putting weight on so decided to go back to how she used to eat. Now all the fat has gone and she has way more energy. I was surprised I wasn't pre diabetic, but this diet helps this a lot. Losing weight is beneficial for the heart too Of course cirrhosis isnt curable, except with a transplant Any surgery is more risky with a high BMI, so it seems appropriate to be as fit as we can be? You know this diet works, so worth it anyway. The cry of all Drs in the UK is lose weight!!! you definitely need to change to a more empathetic specialist. . Like me you have discovered you have cirrhosis early. So many only find out when they are in the latter stages. I have allowed myself one small concession, I was having 3 sugars in tea and coffee. I dropped to one on the day I saw him. I despise artificial sweeteners , I can detect them in even tiny amounts. One flat sugar is my vice now. If it stops me being in ketosis , will have to remove it.Get back in the saddle and get to feeling better again. Hazelx