Fatty Liver

ickihun · Feb 21, 2017

Me too @Liam1955 . I'll prove this to you when I see you next. I had enzymes of 220 and a liver scan deemed fatty liver in 2015. 2016 I reduced them to 22 on strict lchf. They were 88 because of carby christmas on jan'17. In april I'm due a retest which should be in 50s. Not so strict low carbing this year due to heart investigations, arteries don't like severe diets. (Fluctuating diets, I'm refering to).
Low carb and no fruit sees me out of the NAFLD bracket.
Remember my mum and her horrific fruit diet. She's still not listening! Hence still has fatty liver. She's 70yr old next year! She said she doesn't care.

NoCrbs4Me · Feb 21, 2017

When I was first diagnosed with type 2 my ALT was 62. On a LCHF diet my ALT was 19 on the most recent check.

lindisfel · Feb 21, 2017

Hi, There can be several causes of fatty liver and more than one strategy to deal with it. Mine isn't caused by carbs, at worst I was only slightly overweight but now have a BMI of 21.8. My GGT is still in the 70's and two months of probiotic use did not make any difference. One has to follow the best advice for them, if it does not work try another approach but don't give up. atb Derek

ickihun · Feb 21, 2017

lindisfel said:
Hi, There can be several causes of fatty liver and more than one strategy to deal with it. Mine isn't caused by carbs, at worst I was only slightly overweight but now have a BMI of 21.8. My GGT is still in the 70's and two months of probiotic use did not make any difference. One has to follow the best advice for them, if it does not work try another approach but don't give up. atb Derek

Are you on alot of meds @lindisfel . I appreciate meds make a huge difference to liver enzyme output too.
I'm hoping my painkillers don't hamper my efforts.

Bluetit1802 · Feb 21, 2017

Can I ask a question of you "fatty liver" experts?

My ALT has never been higher than 28, currently it is 24. My GGT is currently 14. It wasn't measured earlier than this.
I had a BMI of 31 when diagnosed 3 years ago.

Does this mean that despite being just in the obese category and diagnosed with T2 I never had a fatty liver, and still haven't? BMI is now 21 by the way and following a LCHF diet. No meds.

ME_Valentijn · Feb 21, 2017

Bluetit1802 said:
Does this mean that despite being just in the obese category and diagnosed with T2 I never had a fatty liver, and still haven't? BMI is now 21 by the way and following a LCHF diet. No meds.

I was just wondering the same thing. My liver function gets tested at least once a year due to being on long-term antibiotics, and has only shown a mild elevation for one of the enzymes once, which went back down on the next test. But elevated blood glucose even while restricting carbs seems to get blamed a lot on fatty livers - or is that something a bit different than the medical condition of a fatty liver?

ickihun · Feb 21, 2017

I believe early signs of fatty liver is raised enzymes in a cheap blood test. If elevated an ultrascan can show the fatty liver. Hence fatty liver disease.
The blood test is used to monitor it. Further increases induce further investigation or high level of enzymes cause concern.
My 220 to 22 assured me of a healthy liver, gp too.

Bluetit1802 · Feb 21, 2017

ickihun said:
I believe early signs of fatty liver is raised enzymes in a cheap blood test. If elevated an ultrascan can show the fatty liver. Hence fatty liver disease.
The blood test is used to monitor it. Further increases induce further investigation or high level of enzymes cause concern.
My 220 to 22 assured me of a healthy liver, gp too.

Thanks, but why then are people looking at their ALT and GGT figures?

kokhongw · Feb 21, 2017

Bluetit1802 said:
Thanks, but why then are people looking at their ALT and GGT figures?

I think having fatty liver doesn't necessarily means that it is inflamed, just that the risks for inflammation and scarring are significantly higher.

https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547086/all/Liver_function

Multiple serum chemistries assayed to assess hepatic function and/or injury.

Tests indicative of: 1) liver inflammation: ALT (alanine aminotransferase) and AST (aspartate aminotransferase); 2) cholestasis or biliary obstruction: bilirubin (total includes both direct and indirect bilirubin), ALP (alkaline phosphatase) and GGT (gamma-glutamyltransferase); and 3) synthetic function: albumin and PT (prothrombin time).

Abnormal liver function due to non-alcoholic fatty liver disease (NAFLD) is common in diabetes.

Recently, combined patented algorithms (Fibrotest [FibroSURE in the U.S.]) have been made commercially available. Used to assess the presence of liver fibrosis.

ickihun · Feb 21, 2017

Bluetit1802 said:
Thanks, but why then are people looking at their ALT and GGT figures?

ALT is a measure of enzymes in blood. GGT is to monitor bile duct output and alkaline output.

ickihun · Feb 21, 2017

kokhongw said:
I think having fatty liver doesn't necessarily means that it is inflamed, just that the risks for inflammation and scarring are significantly higher.

https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547086/all/Liver_function

Inflammation and scarring can occur with long term high enzyme outputs (long term fatty liver)

Liam1955 · Feb 21, 2017

lindisfel said:
Hi, There can be several causes of fatty liver and more than one strategy to deal with it. Mine isn't caused by carbs, at worst I was only slightly overweight but now have a BMI of 21.8. My GGT is still in the 70's and two months of probiotic use did not make any difference. One has to follow the best advice for them, if it does not work try another approach but don't give up. atb Derek

Hello @lindisfel and Thank You for your opinion - which I value highly . The Liver Specialists did say Low Fat Diet, I mentioned to him that I know of a lot of Diabetics who follow the LCHF Diet, his replied: No, not to follow that diet. your (meaning mine) Cholesterol is 3.7 and Better to keep that low with Heart Disease in your Family.
And how many times do we read and it is in daisy1's welcoming Information given to Newbies: 'We are all different and what works for one may not work for another' .

Bluetit1802 · Feb 21, 2017

kokhongw said:
I think having fatty liver doesn't necessarily means that it is inflamed, just that the risks for inflammation and scarring are significantly higher.

https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547086/all/Liver_function

These tests are all included in my liver function tests that I have records of going back 10 years (thanks to on-line test results) None of these has ever been anywhere other than well within the quoted standards. (Bilirubin, ALT, albumin, Alk Phos )

I must conclude I have never had a fatty liver. Unless anyone can dispute this for me.

lindisfel · Feb 21, 2017

Hi Ickihun, I am taking different meds to what I was and thought meds like statins and warfarin caused this problem. I do have three large gall stones filling my gall bladder but don't think I have bile duct disease. I am on 150mg eplerenone per day now because Conn's syndrome has caused suspected left ventricular problems and suspected heart failure which may be a cause of higher GGT? On the other hand I do not know what stuff my adrenal 30mm tumour is pushing out besides 20x the normal aldosterone. I treat each day as a gift but I was born in 1939. Am having to wait for an echo cardiogram but even urgent cases are having to wait now. regards Derek

ickihun said:
Are you on alot of meds @lindisfel . I appreciate meds make a huge difference to liver enzyme output too.
I'm hoping my painkillers don't hamper my efforts.

BrianTheElder · Feb 21, 2017

Liam1955 said:
Hello @lindisfel and Thank You for your opinion - which I value highly . The Liver Specialists did say Low Fat Diet, I mentioned to him that I know of a lot of Diabetics who follow the LCHF Diet, his replied: No, not to follow that diet. your (meaning mine) Cholesterol is 3.7 and Better to keep that low with Heart Disease in your Family.
And how many times do we read and it is in daisy1's welcoming Information given to Newbies: 'We are all different and what works for one may not work for another' .

Your liver specialist obviously knows more than I do. But it's pretty well been discredited that a high fat diet causes high blood cholesterol, although the total cholesterol may be raised for a short time when you start.. A lot of people on here eat a high fat diet, but concentrate on the make-up of the lipid profile, rather than total cholesterol. Keeping triglycerides low is the best target imo. By the way, my family history of heart disease on my father's side is dreadful, but I prefer to follow the science.

Liam1955 · Feb 21, 2017

Sorry @Piccyman - Best not to ask me for anymore advice then!

ickihun · Feb 21, 2017

lindisfel said:
Hi Ickihun, I am taking different meds to what I was and thought meds like statins and warfarin caused this problem. I do have three large gall stones filling my gall bladder but don't think I have bile duct disease. I am on 150mg eplerenone per day now because Conn's syndrome has caused suspected left ventricular problems and suspected heart failure which may be a cause of higher GGT? On the other hand I do not know what stuff my adrenal 30mm tumour is pushing out besides 20x the normal aldosterone. I treat each day as a gift but I was born in 1939. Am having to wait for an echo cardiogram but even urgent cases are having to wait now. regards Derek

I'm awaiting my echo results but very slow in coming. Had it done in early january. More need for cardiology willcome about after 40yrold + health checks and hereditary heart problem fears. God help us!

Liam1955 · Feb 21, 2017

BrianTheElder said:
Your liver specialist obviously knows more than I do. But it's pretty well been discredited that a high fat diet causes high blood cholesterol, although the total cholesterol may be raised for a short time when you start.. A lot of people on here eat a high fat diet, but concentrate on the make-up of the lipid profile, rather than total cholesterol. Keeping triglycerides low is the best target imo. By the way, my family history of heart disease on my father's side is dreadful, but I prefer to follow the science.

Hi. I remember in December 2016 my GP telling me my HBA1C had shot up because of taking Morphine and he said my Triglyerides (is it spelt right?) Was up 2.2 and that was needing to be watched. I am having loads of blood work done next week to check my GGT and ALT levels.

Bluetit1802 · Feb 21, 2017

Liam1955 said:
Hi. I remember in December 2016 my GP telling me my HBA1C had shot up because of taking Morphine and he said my Triglyerides (is it spelt right?) Was up 2.2 and that was needing to be watched. I am having loads of blood work done next week to check my GGT and ALT levels.

If your next blood work includes a cholesterol/triglyceride test, do make sure you fast for it otherwise your trigs will be raised. That applies even if you are told it isn't necessary to fast. Fast anyway.

Liam1955 · Feb 21, 2017

Bluetit1802 said:
If your next blood work includes a cholesterol/triglyceride test, do make sure you fast for it otherwise your trigs will be raised. That applies even if you are told it isn't necessary to fast. Fast anyway.

Thank You . For that advice I will Fast, as I cannot remember when I last had a fasting blood test. And Yes it does include Cholesterol check with being on this "New Diet".

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