What did your physician say you should do about Fatty Liver (or NASH)?

[HelenHU]

Thanks for all your responses yesterday!

Next question...when you were first told about your raised liver enzymes or given the fatty liver diagnosis, what did your doctor advise you to do? Lifestyle changes, treatments etc?

[jetjetjet]

My gastro DR. found that i was High stage 3 cirrhosis due to APS and diet {i did drink years ago almost 8 years, But i am Diagnosed NASH } before so as i got my aps under control {as much as possible } i started exercising more to Target it it dropped to med stage one , this was measured with Fibroscan done at office appointments -with regular ultrasound and blood work . I do this every 6 months { I go again the 12 TH of July and i don't expect good results as exercise has fallen off due to having flares - muscle spasms- INR problems and other related things } They didn't change my meds as i take plenty now HA .My first DR was a women she was good and she was learning about the APS then she left and the next was just horrible, now i have a young women and she is proving to be the best yet but we will see how i make out . i also I have a diabetes and nutrition Person that keeps me {some what in line } she tries . So it is working so Far !! Hope this helps and anything else or questions feel free to ask .

[Hidden]

Lose weight eat healthy and try and reduce blood pressure

[Joscott71]

Change diet no alcohol and excerise

[Joscott71]

Change diet, excerise and no alcohol.

[AllHis in reply to Joscott71]

I liked your first answer better! Lol (Laugh out loud!)

...no exercise

[AllHis in reply to AllHis]

It reminded me of a gal I worked with in a gift shop. There was a plaque with an encouraging poem, "Don't Quit." A customer was looking for a gift for her friend who was a recovering alcoholic. You should give him this. "Don't Quit."

[mrsmerlin]

Alter my diet (exercise is difficult swing to other health issues) but exercise was recommended, she arranged for the physiotherapist to send me exercises that can be done while sitting,

She went through my medication and suggested alternatives for some.

I was also given the BLT leaflet on NAFLD and recommended to use the forum for support

[Maladjusted]

No advice given at all

[Teresann in reply to Maladjusted]

Same here. Nothing about fatty liver was explained to me. What little I have learned has been through my own research.

[tnmtlady in reply to Maladjusted]

same here not even mentioned.

[tnmtlady in reply to Maladjusted]

same here nothing said about me having a fatty liver.

[Joycemluc in reply to Maladjusted]

Same here. 20 years and not one of my docs showed any concern about fatty liver. No advice at all.

[mauschen]

No advice initially but when my liver was massive I was told to lose weight. No consideration was given to my hypothyroid status which makes losing weight really difficult.

[jan-ran]

Sorry a day late replying. I can't say I was given any advice or treatment for nafld. I think this was because it was assumed that diabetes (the reason for nafld) is a progressive disease which can only get worse, and so will the liver problem. The only advice I was ever given for diabetes was eat a balanced diet, exercise and drink in moderation.

[JoyHazel]

I haven't had high liver enzymes. My GI told me to lose 25 lbs, stay under 3 grams of sodium, and exercise/weight train.

[Moonsts in reply to JoyHazel]

I didn't even get this much information.

[TLC777 in reply to Moonsts]

Me either!

[angelatonew]

Initially they kept pressing me about my alcohol consumption (probably did not differentiate between alcoholic liver and NAFLD - as I am almost a tee totaler this was a bit distressing! Very little advice then (and not much has changed in 25 yrs - not even weight loss was mentioned as I've never been that overweight). I have had Metformin suggested previously but declined and took matters into my own hands eventually. Nutritional advice still seems vague/rare amongst the 'medical model of care'

[TLC777 in reply to angelatonew]

I was told find something to live for and loose weight.

I’m a bit overweight but most people don’t think I am; internal fat I guess.😐

Although I do know I have a few extra lbs

[Lz152]

Was just told to lose weight. No explanation or other direction given :{

[Moonsts in reply to Lz152]

It was the same for me.

[Grandma17]

My doctor said if I lost 25 pounds it would pull the fat out of the liver ...it can be reversible in earyl stages I have mild fatty infiltration of the liver test aren't very high on enzymes but a little over

[Peachiej]

I was told that a lot of people have a fatty liver and it's not a big deal. Meanwhile, the whites of my eyes are slightly yellow. I had my gallbladder out in July and was told I did not have gallstones. The walls of my gallbladder were thickened. I'm thinking it's all related. I eat healthy ever since my gallbladder attack and I'm not overweight. Next week I'm having a physical and going to have my LFT's checked. I also take milk thistle everyday.

[Rsf232]

I've been strongly advised to have bariatric surgery. I was just diagnosed with advanced NASH with bridging fibrosis, so I've been told that I have a little window of time to hold off cirrhosis by losing all the excess weight now. So they want to remove 85% of my stomach with a sleeve gastrectomy. Yippee.

[nash2 Partner in reply to Rsf232]

Scary and any surgery has risks but the current research shows significant benefits for NASH patients

[Mariah1203 in reply to nash2]

really a liver disease patient can undergo bariatric surgery?

[nash2 Partner in reply to Mariah1203]

Hi Mariah it isn't recommended for most patients but for very obese people who have failed at lifestyle change or other medical complications, it is being done, and results are being reported as successful. One would need a very careful medical team, but it is regarded as a potential tool. Here is one link that discusses it.

conscienhealth.org/2017/12/liver-function-improves-after-bariatric-surgery/

[katqueen68 in reply to nash2]

I wanted bariatric suegery but was told my liver is too stiff. Wish I could find a better surgeon.

[Cats2018 in reply to Mariah1203]

As nash2 commented, sometimes bariatric surgery is the only way a NASH patient is able to lose weight. I was fortunate enough to be able to attend the 1st National NASH Day conference locally, sponsored by my local Institue for Liver Health right after my diagnosis. Among the speakers was a bariatric surgeon who spoke about obese patients who are unable to lose weight any other weight. He confirmed that. It does improve the NASH. It’s not the 1st choice, but sometimes is necessary.

[Moonsts]

I had ongoing little sick things for many years. My Dr threw up her arms (literally) and said she'd do a hep c test. Bingo! Knock me over with a feather!!

I was given the bums rush through tests, biopsies etc. Then fast tracked onto Harvoni. I had NASH with stage 2 fibrosis as well as the hepc. I cleared the virus but not effects of an ill liver.

Now I'm on disability because of bad ibs and diverticulitis. I can sleep all day. Yet can't fall asleep at night. I have a hard time making any plans. I don't know how I'll feel.

Once a very social and outgoing person, I now lie in bed and watch tv or sleep. I was told lose weight. Assuming that will fix everything. I have lost 20 pounds so far and want to do another 20.

There's so much more to this story of mine. I just don't have the energy.

[Cats2018]

Lose weight at reasonable pace, avoid sugar, alcohol, starchy carbs, exercise. She offered participation in a clinical trial which includes monthly visits (she is a hepatologist), blood tests, periodic scans, MRIs and included a liver biopsy which confirmed stage 3 NASH

[pal4life in reply to Cats2018]

Sounds great, where you based at ? Would love to consult this doc

[Cats2018 in reply to pal4life]

I’m in Mesa, Arizona and the doctor I’m seeing is at The Institute for Liver Health in Chandler, Arizona. I don’t know if the clinical trial I’m in is still open. I started in the trial in June 2018.

[RosaRugosa]

When my elevated liver enzymes were first noticed, I was told to go on a very low fat diet where I got most of my calories from carbs: grains, veggies, fruit. This advice was given to me about 25 years ago.This diet was supposedly going to reduce my excess weight, help my type two diabetes, and help my inflamed liver. I followed the diet carefully, but my problems gradually got worse. My doctors insisted that wasn't I following the diet closely enough, so I tried harder and harder. Eventually, I was on an all-vegan diet where I wouldn't even eat oats because they have more fats than most grains.

After decades of following this very strict diet, it turned out the doctors had prescribed the diet without any data being available. Studies on this type of diet were finally completed, and said this was a terrible diet for someone with my type II Diabetes and NASH. Way too much carbs, too much fructose. I should have been eating monounsaturated fats, instead of as little fats as possible.

I suspect following this diet so closely is one the reason my NASH turned into life-threatening cirrhosis. And, now many people seem to think my health problems are my fault, because I ate "the wrongs things", even though I ate what my doctors told me to eat. This leaves me very discouraged and angry.

I would like to have bariatric surgery, but I currently am not healthy enough to qualify. I don't know what I could do to make myself healthier so I could qualify.

[Sallywolf]

When i first was told about my enzymes i was told nothing. They had me go in monthly for bloodwork to monitor them so i knew it was serious but they never acted lile it. Decades later when they confirmed nash all they said was diet and exercise. Well i already was exercising a fair amount and my diet was healthy. They refused to be specific.

Now that it has progressed to cirrhosis they still have nothing to say to me

[utep99]

Change eating habits (no fast food) follow a Mediterranean Diet best you can and eat clean as possible. Exercise Exercise and more exercise. Lose weight and keep a eye on your liver once cirrhosis develops there is no cure except transplant eventually.

[huldc]

got to completely change your lifestyle, eat properly (lose some weight), regular exercise, sleep early (this is really important for people have liver issue), maintain emotion stability, if possible, keep the stress level to minimum and get good supplement live Livolin Forte (this really help my liver recovery)!

[skippy5 in reply to huldc]

Hi huldc,

Do you still recommend Livolin Forte?

[spmc]

My doctor said not to worry about it at all when I had blood tests. But I was thinking that sounds a bit wrong and then I researched it and found out it's quite a deadly disease if not treated with diet and exercise

[Herman7275]

Hi my decision was surgery & loose 2/3's of my stomach or a low fat diet and exercise . I opted for the diet. loose 125# in a year do it their way and keep it off. stay on this diet rest of my life, It has lessen my fatty liver and fibrosis and some of my cirrhosis. plus I feel better than I have in 35 years. I stay very close to diet and eat 2 meals a day. Check it out , it will help, if I can do it anyone can, I am Ron...

[Herman7275]

I had a fatty liverse , fibrosis f2-f3 & cirrhosis, he said he wanted me to loose 125# do it their way and keep it off , so since 2019 I have been on low carb diet !!! Lost 75lbs and reversed fatty liver & some fibrosis & even some of cirrhosis. And exercise!! I am 70 yrs old , you can do it too!!

[DCguy2023]

THANK YOU for the inspiration and advice.

[BU2B]

To be quite honest my primary care physician was pretty much useless and any advice I got came from dr.'s and medical staff AFTER I was already in hospital. For me it was more hepatic and gastro specialists and the National Fatty Liver Foundation that were the most help - Not my PCP. Now I have a pretty good team but I really don't think that my primary care physician at the time knew what to do or how to treat or give advice on anything other than symptoms and not cause.