Newly Diagnosed with Fatty Liver Disease

[waterstop]

Just diagnosed with Fatty liver disease and need to gain weight. My BMI is too low. So I need to learn what to and not to eat. I had a 4.9 result from the elastography test. and am looking at bringing that down and my weight up . I need education.

[MINTVCX]

Strange. Fatty liver can be a problem of slim people (low BMI) due to some genetic factor or alcohol. Was it fibroscan? I mean 4.9 kpa? If yes it is well in normal range so I do not know why you would like to decrease it? Please see some good hepatologist to make everything clear. In amature opinion if weight is not your case (typical is) maybe some more tests are needed to find the cause of your fatty liver. Good luck.

[waterstop in reply to MINTVCX]

Thank you for responding. I have, what I thought, is a good gastroenterologist. However, am currently looking for a hepatologist, specializing in fatty liver disease, as well as a nutritionalist...... surprisingly, not easy to find. I want to gain weight eating a liver friendly diet, but what exactly is that? I am extremely healthy, an infrequent drinker, and only on Crestor for a cholesterol that was about 220....now less than 200. I don't want to leave this go for another year and have it worse when I could have changed my diet or lifestyle & made a difference. I am very involved in my own health care & don't want to rely on "wait til next year" when I can start doing something about this NOW. Any info is appreciated as I am just starting my investigating.

[waterstop in reply to MINTVCX]

Saw my Primary Care today & he is sending me to USF(University of Southern Florida) to a hepatologist. Do you know if the Fibroscan Test is the same as the Shear Wave Elastography Test.? My GI performed the Shear Wave test(ultrasound) & the results were 4.9 E(kPa) along with another result of 307.4 ACE (d/Bm). He never discussed the 307.4 value & was only elated that the value of 4.9 E(kPa) was below 5. I'm trying to determine what this 307.4 value is as I read the other blogs. I assume that is why my Primary Care is referring me.

[MINTVCX in reply to waterstop]

SWE (Shear Wave Elastography) has different scale than fibroscan. But similar method maybe even better than fibroscan (it is combined with ultrasound so it is possible to see the part of the liver is measured). Anyway as you write below 5 kpa for SWE is normal range. About fat level I do not know the scale for SWE and unit. You have to check this with hepatologist.

[timotur]

I have a similar diagnosis-- borderline NAFLD, 4.7% fat in liver, BMI: 22, eat well and exercise a lot, but have high cholesterol-- TC: 225, LDL: 158, HDL: 68, TG: 55. Ratios are good, but persistently high LDL. Trying to treat it without statins-- red yeast rice, plant sterols, and niacin, wil recheck in a few weeks.

[waterstop in reply to timotur]

Thank you for your reply.Tried the red yeast rice, niacin but no plant sterols. Fought taking the statins for about 4 years. most Dr.s would not have me on statins because my ratio is great. HDL: 75- 80 however LDL was over 100. However, my primary put me on 10 mg Crestor about two years ago did not like the LDL . Right now, I just want someone who really knows this disease, to advise me what I should, or should not be eating!!

[timotur in reply to waterstop]

Waterstop: I am very much the same. Good numbers except for LDL. I've managed a few times to get it down from the 150's to the low 130's, but it takes extreme dietary discipline. About 10 years ago, I was able to reduce it using niacin and eating bran with flaxseed oil, and not eating anything after 6pm, water only. There's a lot of ideas on Youtube, perhaps take a look at those.

[MINTVCX in reply to timotur]

May I ask what test does show 4.7% fat? Was it biopsy?

[timotur in reply to MINTVCX]

Yes, it was an MRI, with/without contrast. The fatty area is in the dome, under my right rib cage. I can feel it when I lay on my stomach, discomforting, but not painful.

[MINTVCX in reply to timotur]

So I assemu it was somehow calculated as some local fatty part of the liver that is about 4.7% of the entire organ. But I am guessing only. I think fibroscan calculates rather the average value of couples measurements. For example I have some focal fatty parts (with high probability) which were seen on ultrasound (heterogeneous increased echotexture) but this is not typical. Fibroscan shows 237 CAP which is between S0/S1 so around 11% (scale for fibroscan).

[timotur in reply to MINTVCX]

Evidently, MRI is the best imaging tool to diagnose mild steatosis cases acc to this article…link.springer.com/article/1...

I was a little taken aback by having to do an MRI instead of an ultrasound, but now I see why the Heptologist ordered one.

[Pops35]

a "healthy" diet can get you into trouble. Vitamin A toxicity from over eating carotenoid rich veggies, dairy, organ meat, eggs, etc. is a serious problem with liver disease. Many cases of fatty liver are actually vitamin a toxicity which will not be tested by your doctors. blood tests are not reliable or diagnostic. you can have low serum retinol and high levels in your liver. google the love your liver program if you want to know how to reverse your liver disease. you need to eat adequate protein, low fat, low fructose, and moderate/high soluble fiber food while avoiding high carotenoid veggies and high animal based VA. i got cholestatic liver disease by drinking a lot of carrot juice and dairy. I have reversed it using the above diet. a lot of misinformation on what is actually good for your liver, for example, herbal supplements like milk thistle and "antiinflammatory" supplements like turmeric. very bad in long term for your liver. supplements like zinc and lactoferrin are helpful. good luck!

[waterstop in reply to Pops35]

Thanks so much. I do take tumeric root in my smoothies, however no supplements. I do take zinc in the form of Sambuca gummies. I will google the "love your liver" program and see what they have to say. Thank you very much.

[MINTVCX in reply to Pops35]

I would say eggs (not too much) are genarally healthy while getting suplements like zinc and lactoferrin without deficiencies is not very good idea (like other wonderful suplements).I would stick with healthly, normal diet recommended by your dr.

[Pops35 in reply to MINTVCX]

i agree. I go to a doctor who checks my zinc levels in blood and hair tests. I was seriously deficient as are many with liver disease. Problem is how many doctors do you know who test for mineral status? How many have ANY nutrition training? medical doctors are drug dealers, not nutrition experts. the last person i would take diet advice is from a medical doctor. if you do a pubmed search for lactoferrin and liver you will find some good info on how it helps repair bile ducts which is a good thing, and deficiency is neither here nor there. and just some food for thought, what color is fatty liver? yellow. what color is betacarotene and retinol? orange/yellow. deficiencies are a problem, but not near the problem that toxicities are. look up the nih liver injury database. commonly referred to has dili, hili, and sili. drug/herb/supplement induced liver injury. most of the drugs prescribed by medical doctors are on that list. some of those commonly prescribed drugs can and have, routinely, caused severe liver injury. and the herbs the alternative health doctors use also on that list, many of them. herbs are mostly toxic and i feel sorry for those taking them thinking they are helping their liver. just awful! the first rule of liver disease, stop poisoning yourself!

[Cat551]

I’m in a similar position, mild NAFL. Although, my last US showed no trace of fatty liver at all. I lost 8 lbs in the fall by restricting carbs, not dramatically but to under 130 net a day. Now I can’t put any weight back on. I feel like I’m eating constantly to maintain my 118 lbs. I also have high cholesterol, LDL and LPa. My cardiologist wants my LDL to be under 70 and I can’t do it without statins (Zetia and Crestor). My dad had his first heart attack at 29, and passed away at 46, so I have a strong family history and must be careful.

I eat mostly a Mediterranean diet, no red meat, and light on the white meat. I usually have two vegetarian or vegan meals a day. I don’t worry about carbs as much, but try to eat whole grains and watch to not overdo each day. I also don’t fixate as much on fat intake (about 30-35% of calories) as long as it’s healthy fats, but limit my saturated fat intake to under 7% of my daily calories. I try to eat organic when I can. I use the free version of MyFitnessPal from time to time to monitor my nutrition. To maintain my weight, I add almond butter to smoothies, eat nuts, avocado and put some EVVO on my steamed veggies. Yes, lean fatty liver disease is real, and a genetic mutation. We have a double whammy with the high cholesterol, but at 67, I try to tell myself things can always be worse.

[waterstop in reply to Cat551]

I'm going to get a second opinion and am going to a nutritionist. What really scares me is the CAP of 307 even though the kPa is 4.9. I don't want to wait for a year and have the results worse when I could have made modifications for the past year.

[waterstop in reply to Cat551]

How high was your total cholest prior to you taking Crestor & for how long. what was your “good “ to “bad “ ratio? Mine has always been less than 1 & the Dr. always wanted me to go on a statin because my LDL was always just over 100. triglycerides are around 60. I argued w/ my doctor for about 3yrs. to not go on the statin but finally caved in & went on the statin. …… 10 mg daily brings the LDL down to about 95. All liver related enzymes are well below normal. BP is normal. Do we need genetic testing to see if this is genetic ? I’m trying to stay on a Mediterranean way of eating however I can’t afford to lose wt. I need to gain wt. & can’t seem to. I am working w/ a dietician & have an appointment w/ a hematologist @ Cleveland Clinic in Sept. I realize @ 70 yrs old things could be a lot worse. However I need to get to the bottom if this & need to know

I’m going in the right direction. I get between 175-200 minutes of vigorous exercise 3-4 times a wk as well. I don’t believe I’m the normal NASH patient. If this is a genetic mutation, why does it all if a sudden show up now? About 1.5 years ago I started to drop weight fast( about 10 lbs). The thought was cancer. However I felt great. after all the testing fatty liver was discovered. I read it in one if my CT scans. It was never mentioned by the Dr. until I brought it up & moved on it myself. Because I had none of the risk factors except a slightly elevated LDL & Chol. it was dismissed. After the GI Dr. performed the Shear Wave Fibroscan. ( 4.9 EkPa & 307 ACE)

& the Ct scans over the last 1.5 yrs showing fatty liver he said I had NASH . He said to come back in 1yr. So you see I’m going to Cleveland Clinic to set this all straight. I was told that at my age 70 the goal was to have the liver last for another 20 yrs.Well I wanna make sure I’m doing the right thing so it does last that long. Not fitting the normal mold of the individual that has a fatty liver I need help doing that. Not, just come back in a yr.!!!