Advice needed please

[Nannynobbs]

I have NASH caused through my diabetis and have been told my jaundice levels have gone up from 16 to 23. Am trying to loose weight, have lost 2 and a half stone, but more to loose.

 

[chalup]

Welcome to the forum. Most of us type 2's have this or had it. The only real treatment as far as I know is a low carb diet and weight loss. I had to look it up lol mostly I have seen it referred to as NAFLD. Non alcoholic fatty liver disease. I will tag @daisy1 to send you some info that is well worth the time to read it over.

 

[Freema]

I have NASH caused through my diabetis and have been told my jaundice levels have gone up from 16 to 23. Am trying to loose weight, have lost 2 and a half stone, but more to loose.

so fine that you´ve lost so much... welcome here NannyNobbs

 

[Indy51]

@Nannynobbs - I'd like to give you references to a blog by a man who has made an extensive study of liver health (trying to keep his own illness under control). He has 2 particular posts that I recommend for people with your diagnosis:

Fatty Liver & Its Treatment:
http://hopefulgeranium.blogspot.com.au/2013/01/fatty-liver-and-its-treatment.html
Dietary Recommendations for Liver Health:
http://hopefulgeranium.blogspot.com.au/2012/10/my-dietary-recommendations-for-liver.html

(The guy's name is George Henderson and his completely self-taught ability to research health and nutrition impressed the University of Technology Auckland so much that they hired him as a research assistant!)

 

[daisy1]

@Nannynobbs

Hello and welcome to the forum Here is the basic information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will come along and help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 210,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[DavidGrahamJones]

I have NASH caused through my diabetis and have been told my jaundice levels have gone up from 16 to 23. Am trying to loose weight, have lost 2 and a half stone, but more to loose.

Welcome to the forum. My liver function was wrecked after taking Rosiglitazone, prescribed after I rebelled against Metformin over ten years ago now, I had non alcohol fatty liver. Each annual check my liver function would remain less than normal. Last year somebody suggested I took Milk Thistle, I was very skeptical at first but I'm of the opinion "don't knock it if you haven't tried it". I took it for six months and my last liver function test was normal. Even my GP commented that she couldn't understand it although the liver is an organ that can "repair itself" (I suppose depending on how damaged).

Only anecdotal I know, might be worth considering along with the other good advise being given

 

[ickihun]

Welcome to the forum. My liver function was wrecked after taking Rosiglitazone, prescribed after I rebelled against Metformin over ten years ago now, I had non alcohol fatty liver. Each annual check my liver function would remain less than normal. Last year somebody suggested I took Milk Thistle, I was very skeptical at first but I'm of the opinion "don't knock it if you haven't tried it". I took it for six months and my last liver function test was normal. Even my GP commented that she couldn't understand it although the liver is an organ that can "repair itself" (I suppose depending on how damaged).

Only anecdotal I know, might be worth considering along with the other good advise being given

I hope you dont mind but I'd like to tag @Liam1955 as Milk Thistle sounds very useful. Thank you for sharing.

 

[Liam1955]

@DavidGrahamJones - Thank You that is reassuring to know, having read your post about Milk Thistle. I just started taking it yesterday (Sunday) as it was suggested by the Liver Specialist who I saw 2 weeks ago to get my results from 3 different scans and a Liver Biopsy = I have some Fibrosis and NAFLD. I blame the Methotrexate and Biological Drugs that I have been taking for the past 10 years for the condition Psoriasis and Psoriatic Arthritis.
Thank You @ickihun for tagging me.

 

[col101]

Milk thistle and other herbs like St Johns wort can help longer function. However please be aware that they can stimulate the liver to detoxify the body of drugs one example being the contraceptive pill so it may be worth consulting a doctor or pharmacist first. Good luck

 

[Liam1955]

@Nannynobbs - Hello . I have only recently (2 weeks ago) been given the diagnosis of NAFLD and some Fibrosis of my Liver after having a Liver Biopsy and 3 different scans.
The Liver Specialist suggested taking Milk Thistle and instructed me to lose at least 1 stone (or more) in weight and to follow: A Low Fat Diet. (I only weigh in at 13 stone presently!)
I believe taking Methotrexate and 3 Biological Injectable drugs for the past 10 years for the treatment of Psoriasis and Psoriatic Arthritis is responsible.
I only began taking Milk Thistle yesterday and so pleased to read the posting from @DavidGrahamJones on Milk Thistle.

 

[chalup]

@Nannynobbs - Hello . I have only recently (2 weeks ago) been given the diagnosis of NAFLD and some Fibrosis of my Liver after having a Liver Biopsy and 3 different scans.
The Liver Specialist suggested taking Milk Thistle and instructed me to lose at least 1 stone (or more) in weight and to follow: A Low Fat Diet. (I only weigh in at 13 stone presently!)
I believe taking Methotrexate and 3 Biological Injectable drugs for the past 10 years for the treatment of Psoriasis and Psoriatic Arthritis is responsible.
I only began taking Milk Thistle yesterday and so pleased to read the posting from @DavidGrahamJones on Milk Thistle.

Are you sure you're not me?? I can't seem to function without the biologics but I put my foot down about 6 months ago on the methotrexate. Nasty stuff I have been on for over 15 years. My hair sucks, I am positive it put me into menopause at age 37, it makes me feel ill even when injected and it doesnt help my skin at all any more. I am on stelara now but I lost access to it for about 6 months last spring. My skin got a pasi score of 90. I looked like I had second degree burns on about 80% of my body and felt like it too. Oddly enough my PA did not really flare. My diabetes however went insane. I also have NAFLD discovered through a liver biopsy because I was taking methotrexate. The report had also questioned whether I was alcoholic or had had hepatitis (no to both) due to mild fibrosis. That was about 10 years ago. I now absolutely refuse to take methotrexate any more.

 

[Liam1955]

@chalup - Hello . I have had Psoriasis for 42 yrs, but there was nothing much to see except for the odd couple of patches here and there. But, I had used Steriod based creams for about 25 years plus. I was diagnosed Type 2 in 2000 (16 years) and it was in 2002 that my LFT blood Tests started going up and coming down, and my Psoriasis changed into something with a vengeance every time it erupted. At that time I was on a drug called Acitretin and remained on that for a good 5years or more. It seems with me drugs work for so long and then suddenly stop. I took Methotrexate tablets 25mg and folic acid tablets for 18 months - it cleared my Psoriasis, but then stopped working. Next began using the Biological Injections. First it was Stelara used it for 18myths and cleared my skin 99% but had 5 chest Infections and 5 Antibiotic courses in 8 months, so it got stopped.Found out I had Aneamia and was put on iron tablets (still taking them 4 yrs later) Then went onto using Humira for 9 months, this brought out pain in all my joints and the Psoriasis erupted worse than ever before. My LFT blood tests were going erratic but ignored by Doctors. Then went onto Cosentyx (biological) and have been on this since March this year and my Psoriasis is slowly erupting. Was referred to see a Rheumatologist in January as I have Arthritis - but Rheumatologist does not know which type? At first she though Psoriatic Arthritis, but changed her mind. So having more tests done: X Rays and Bone Scans. Dermatologist referred me in February this year to see a Liver Specialist as my LFT blood tests were going crazy.
Have had Fibroscan got a score of 10, had Ultrasound Abdominal Scan, had MRI Liver Scan with Contrast and was told there is something wrong with my Liver. So had Liver Biopsy 3 weeks ago and 2 weeks ago got the diagnosis Fibrosis with NAFLD.
I don't drink Alcohol and used to be a vegetarian up until a year ago. I weigh 13 stone and was told to lose another stone or more and follow a low fat diet. And try Milk Thistle tablets.

 

[chalup]

Yeah, isn't modern medicine wonderful. I have done methotrexate, humira, embrel, amevive, cyclosporine, remicade (best for joints), back to humira and now stelara which has been magic for my skin but not so much the arthritis. Every single one of them failed in time, usually after a year or two. I also have used topical steroid creams for almost 30 years, often with occlusion, and was blown off when I asked if it could have anything to do with the diabetes. I have had pneumonia and chest infections more times than I can count. I think that the medication that is fantastic at first then stops working thing is an almost universal thing with psoriasis and PA. I thought remicade was my saving grace but after a couple of years it too failed spectacularly Right now stelara is keeping me about 99% clear which is amazing but I am running out of options for when it inevitably stops working. I have not heard of Cosentyx. People mostly seem to think psoriasis is just a rash. It can be crippling when severe. I came close to ending up in a wheelchair at one point and I don't ever want to go back there again. I have many scars on my hands and other joints from the skin splitting open.

 

[Freema]

Welcome to the forum. My liver function was wrecked after taking Rosiglitazone, prescribed after I rebelled against Metformin over ten years ago now, I had non alcohol fatty liver. Each annual check my liver function would remain less than normal. Last year somebody suggested I took Milk Thistle, I was very skeptical at first but I'm of the opinion "don't knock it if you haven't tried it". I took it for six months and my last liver function test was normal. Even my GP commented that she couldn't understand it although the liver is an organ that can "repair itself" (I suppose depending on how damaged).

Only anecdotal I know, might be worth considering along with the other good advise being given

thank you that is fantastic... even though they knew in the old days htat Milk thistle does help the liver it has been almost forgotten thank you for telling us about such an amazing result...

 

[George_Henderson]

Hi @Nannyhobbs,
I am author of the blog linked above by @Indy51
NASH is an inflammatory form of NAFLD; anything that reduces NAFLD will help (low carb, intermittent fasting, weight loss), milk thistle is indeed effective.
Probiotics are specifically helpful around the inflammation that distinguishes NASH from NAFLD. There is a point in all liver diseases - NAFLD, alcoholic liver disease, viral hepatitis - where the liver becomes excessively sensitive to "bad bacteria" signals from the gut. To reduce these, find a good probiotic product, and eat fermented foods like sauerkraut regularly.
There may be some trial and error involved in finding the right probiotic product and type of fibre for your specific digestion. Butter and coconut oil also contain fats that protect the gut and have "good bacteria" type effects.
Best wishes.

 

[Nannynobbs]

Milk thistle and other herbs like St Johns wort can help longer function. However please be aware that they can stimulate the liver to detoxify the body of drugs one example being the contraceptive pill so it may be worth consulting a doctor or pharmacist first. Good luck

thank you that is fantastic... even though they knew in the old days htat Milk thistle does help the liver it has been almost forgotten thank you for telling us about such an amazing result...

thank you,

 

[Nannynobbs]

Hi @Nannyhobbs,
I am author of the blog linked above by @Indy51
NASH is an inflammatory form of NAFLD; anything that reduces NAFLD will help (low carb, intermittent fasting, weight loss), milk thistle is indeed effective.
Probiotics are specifically helpful around the inflammation that distinguishes NASH from NAFLD. There is a point in all liver diseases - NAFLD, alcoholic liver disease, viral hepatitis - where the liver becomes excessively sensitive to "bad bacteria" signals from the gut. To reduce these, find a good probiotic product, and eat fermented foods like sauerkraut regularly.
There may be some trial and error involved in finding the right probiotic product and type of fibre for your specific digestion. Butter and coconut oil also contain fats that protect the gut and have "good bacteria" type effects.
Best wishes.

Thank you

 

[Nannynobbs]

Thank you to everyone who has replied. I am working through all of these, but is it possible to reduce my jaundice levels please?

 

[Freema]

Thank you to everyone who has replied. I am working through all of these, but is it possible to reduce my jaundice levels please?

I already har bought this milk thistle but didn´t dare try to take those pill.. but now I am not afraid...

wish to ask you it it has done anything for your blood glucose at all..has it become easier to keep levels lower for you ?

a new theory is that the liver is more involved in creatig insuline resistence than previously thought , so maybe it is essential to keep ones liver as healthy a possible...

 

[George_Henderson]

Thank you to everyone who has replied. I am working through all of these, but is it possible to reduce my jaundice levels please?

By Jaundice, do you mean bilirubin levels, or the symptoms of jaundice (yellow skin and itching)?
If the symptoms, all these tips should help. MCTs, fats from coconut oil, and butter and cream, have been specifically used to treat jaundice. If the bilirubin count, it should go down as liver improves - however, some people have genetically high bilirubin and this is not harmful, as bilirubin is an antioxidant similar to vitamin C.