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Diabetes with liver disease

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Glennigogs

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I have had chronic liver disease for many years now and am now stage 3 fibrosis: one step off cirrhosis. However because i am overweight and have a higher than normal Ha1C level I have had the keto diet thrown at me more than once by many medics and friends.
Many reputable sources on the internet, and indeed my liver team have advised me away from it, as the higher fat in keto is likely to worsen my fibrosis red meat is particularly toxic in liver fibrosis.
A more conservative low carb diet (around 100g daily) would seem the best for me, as this protects the liver more. This was recommended to everyone who attended a pre diabetes diet course I attended a few years ago.
Also, it is recommended to use rehydration tablets with amongst other things potassium in them if ketosis dehydrates you. Some blood pressure meds are contraindicated with potassium, so caution has to be exercised there.
So what do we do about this, other than keep contacting our liver team over something that is endocrinology instead?
Please bear this in mind if someone recommends keto diet to you. Check on these things. Please xx
I hope this doesn't come across as dictatorial, that the last thing I want it to be, but I am a bit neurodivergent and tend to omit the softer side in my written communications
Xx
 
Glennigogs did your team give you any reading to do which upholds their hypothesis that keto worsens liver disease? Whilst not necessarily stage 3, many members on the forum have found their liver enzymes have improved after adopting a keto (or low carb) diet.

For me, personally, if someone says to me to do, or not do for that matter, I ask for their rationale and some reading I can do to educate myself. As a stubborn old stick, the "Trust me, I'm a doctor" approach just doesn't work.

Again, personally, I haven't found it necessary to go as far as keto to demonstrate improved blood markers all round, so perhaps you might consider adopting a low carb approach and see how you go. You can always trim back a bit more if all is going well.

Looking at the Liver Trust website, the diet suggested there is largely in line with traditional advice - plenty carbs, less meat and watch the fats.

Hopefully, someone with more specific experiences than me will come along in a while to respond to you, but finally, on the topic of dehydration; I adopted my reduced carb diet whilst sailing in the tropics, so it was hot and steamy, as well as me weeing a bit more due to the reduced carb. I found I was fine just adding a bit of salt to meals. I didn't have to go hard core in terms of supplements.

Whatever you decide, good luck with it all.
 
@Glennigogs When diagnosed I could not bend over as I had a rock hard 'bay window' at waist level, It used to push my ribs out - it was really painful.
On a low carb diet I have lost 12 inches off my waist - I was almost spherical. I am 70lb lighter and I can pick things up off the floor and clean the bottom of the fridge.
I was never diagnosed with anything wrong with my liver, as I never had any sort of examination or testing for problems, but I know my anatomy and it was my liver.
On a low carb diet I have to add salt to my diet a couple of times a week at least, more now the heat is on, or I get cramps at night due to dehydration. Why, without salt, I'd be needing two pints of water I don't know, but that is what I have learned is the case.

It is all very well doctors - or anyone else for that matter - telling us their opinions and even setting out the reasons, but if what I experience is in direct contradiction to what I am told I would argue that it is me experiencing the pain and disability, and I'd rather it wasn't thank you very much!!
 
@Glennigogs - I'm very sorry to read about the stage 3 fibrosis of the liver.

I don't think you came across as dictatorial at all. But I think you wondered about this because you are warning people with diabetes, who are overweight, and liver damaged/with fribrosis - from non alcoholic fatty liver disease I take it? or not? - that going very low carb, upping fat, and eating red meat - is dangerous for this condition - is this right?

I got interested when I read the word 'toxic' in regards to red meat and the liver, and I was very curious how that could be, so I did a little bit of reading on the subject. (Keeps my mind off my current bung ankle, so I am quite pleased to read about something else!) I think if you wrote sugar, pasta, bread and rice, for instance, I might have been less surprised? But I see in my reading that those things are included too in diet deduction suggestions. (along with alcohol of course.)

I have to say - if it comes to keeping your medical professionals happy, and they want you not to eat red meat - then it could be prudent to do what they say! For many reasons - but in case you need them for surgery one day? You need to be compliant?

But it does seem that the argument against red meat is to do with triglycerides and the old saturated fat is bad for your heart and your blood glucose health idea. And what many folks, me included, have found is that argument does not translate to our blood lipid levels, let alone our blood glucose, and on further investigation the saturated fat is bad for you argument was never properly proved, and has indeed since been disproved. But this is highly controversial, and as I say - if your medical professionals who have your future well being at their disposal are saying not to eat something, than it is probably a good idea not to, even if it is nutritionally and biologically bunkum.

The idea that carbs are protective of your liver - I guess they are talking about soy, pulses and whole grains being heart and liver healthy? And not wanting you to take it out of your diet - which you would indeed be doing on a very low carb diet/keto way of eating. I would have said, personally, that those foods are healthy for high-carb tolerant folks, but anyone with type two has a big sign saying 'high-carb intolerant' over them.

Re-reading your post, I think though, you may actually only be in the prediabetes range? If that is the case, I can see why a not-so-low (moderate?) carb level has been suggested to you. As for prediabetics, some reduction in carbs can go a very long way. Especially wihen its sugar and high carb fruit? Which would be why a moderate rather than very low level was advised at a predibetes course.

Anyway. Yes - the best of luck with your management strategies indeed. (And keeping on the good side of medical professionals who insist on talking about diet!)
 
i am the same as you and i am using the newcastle diet proven to rid oneself of the disease.sops putting fat in the liver and pancreas .read roy taylors book
 
Hi @lawrence21360 - just popping in to remind - fat in the blood is 75% created and cycled by the body, not from the food eaten. So it isn't a case of 'putting' fat in the liver and pancreas from dietary fat. Blood lipids are way more complex than that - have a gander at the randle cycle online and you will get the picture for sure. (Which is how I came to understand the extraordinary complexity of the lipid glucose cycles of our blood glucose regulation system.)

In actuality - dietary carbohydrate is the thing, in excess for an individual, in combination with dietary fat - that we must eat to live to remind, that can really contribute to your blood glucose dysregulation. Not chewing on a pork rind.

I do want to add, as is prudent perhaps, that the newcastle diet does not necessarily rid one of type two! It has a significant failure rate, if I can use that school-time phrase for a disease and its potential remission. I have done this semi-starvation diet twice, and not been able to get into a healthy blood glucose state and stay there, with normal levels of insulin produced by my body to deal with the low carb way of eating I embark on. Sometimes there is too much deeply systemic damage, as is obviously my case. I do what I can, and have concentrated on healthy eating and keeping strong and fit. But that is not in the context of remission.
 
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