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Type 2 LOW CARB AND LIVER DISEASE

Annb

Annb

Expert
Messages
9,313
Location
Western Isles, Scotland
Type of diabetes
Type 2
Treatment type
Insulin
I have read plenty of articles on how low carb can improve BG levels, and am trying hard to do this. So far, only temporary improvements, which go back to the usual after a week or so.

I do have NAFLD - have had since "Time Immemorial" it seems but, when diagnosed, was told that there was no treatment for it. Later a diagnosis of T2 was given with a rather gloomy prognosis. It seems I may well have had gestational diabetes when my sons were born over 50 years ago but it was never diagnosed and never went away.

I did see a snatch from an article on TV saying that some sufferers from liver disease had improved their conditions by low carb diets and was hoping that all the low carbing I have been trying to do over these last 2+ years might have helped my liver, but it seems not. Although I must say that without it, maybe the cirrhosis would have got worse - it hasn't. (US scan last Monday.)

I have been looking for information about liver disease and low carb and have found a fair amount that is optimistic but have found plenty that is pessimistic as well.

I have tried a carnivore diet, worked briefly but not for long. I have tried LCHF - worked for a while but can't reduce insulin, which keeps me putting on weight - currently 18st 8lb and rising. I have tried altering the timing of my basal insulin - worked for about a week. I know that exercise would probably help, but am riddled with arthritis and can barely move at the best of times. I refuse to think that I am a lost cause, however and, meantime, I am plodding on with as low carb as I can (any carb that I usually eat is high fibre to try to keep my bowel in some kind of order. Can't say that I never fall by the wayside, but not often). Whatever is the problem with my delinquent bowel seems to be exaccerbated by green veggies. Don't think that I can get close to zero carbs, although I do like meat and dairy and would like to be carnivore, it doesn't seem to like me too much.

The thing is - uncertainty about whether I am doing the right thing for my liver. Would zero-ish carbs be best, or would that just be a wasted effort?
 
I was diagnosed with NAFLD 25 years ago but after 7 years of seriously low carb I no longer have it.

I had exactly the same thing happen to me as you are experiencing. When I started low carb it worked briefly and I came off insulin. Then it didn't work so I went back on insulin. It continued like that for a year. I was on and off insulin like a yo yo. I stayed seriously low carb and calorie restricted all this time and in the end it worked.

I was a very skinny diabetic when diagnosed and insulin piled on the weight. To lose the weight I had to stay seriously low carb plus restricting calories.

All has been well until at Christmas I foolishly thought that I can up my carbs and my body will cope with them. All was well for over a month then suddenly I had sky high blood sugars.

So I am back on the 12g carbs max a day and restricted calories. I am experiencing the same roller coaster as before but know that it will work if I just give it time.

I think that, because you cannot exercise, it will take a lot longer but will happen in the end.
 
Krystyna23040 said:
I was diagnosed with NAFLD 25 years ago but after 7 years of seriously low carb I no longer have it.

I had exactly the same thing happen to me as you are experiencing. When I started low carb it worked briefly and I came off insulin. Then it didn't work so I went back on insulin. It continued like that for a year. I was on and off insulin like a yo yo. I stayed seriously low carb and calorie restricted all this time and in the end it worked.

I was a very skinny diabetic when diagnosed and insulin piled on the weight. To lose the weight I had to stay seriously low carb plus restricting calories.

All has been well until at Christmas I foolishly thought that I can up my carbs and my body will cope with them. All was well for over a month then suddenly I had sky high blood sugars.

So I am back on the 12g carbs max a day and restricted calories. I am experiencing the same roller coaster as before but know that it will work if I just give it time.

I think that, because you cannot exercise, it will take a lot longer but will happen in the end.
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When you say restricted calories, how restricted do you mean?
 
Antje77 said:
Tagging @JoKalsbeek , who did get rid of her liver disease by going very low carb.

Did you experience more bowel issues than usual on that?
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Yes - swinging between constipation and diahorrea. Bit of a pain in the neck - and elsewhere!

Thanks for tagging @JoKalsbeek, Antje. I'd be glad to hear of success using low carb.
 
Annb said:
When you say restricted calories, how restricted do you mean?
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I kept to 1200 calories as I didn't want to go too low and be short on nutrients. Even at that level the injected insulin made it harder to lose weight but it did go in the end.

As I am not overweight now - even with the recent carb fest - I have restricted calories to 1500/1600 a day. I will shortly need to up them as I am getting too thin again.
 
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Krystyna23040 said:
I kept to 1200 calories as I didn't want to go too low and be short on nutrients. Even at that level the injected insulin made it harder to lose weight but it did go in the end.

As I am not overweight now - even with the recent carb fest - I have restricted calories to 1500/1600 a day. I will shortly need to up them as I am getting too thin again.
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Ah - I have, ever since my 2nd son was born (1969) been putting weight on. I have been on very low calorie diets (900 a day) but it never worked. Calories obviously came from the wrong foods though and all these years I have carried lots of fluid along with the muscle that I used to have (and fat, of course). Still carrying lots of fluid, mostly in my legs, but also a lot of fat as well. Gave up counting calories since that didn't seem to do any good but over the last years have rarely eaten more than 1200 daily by my estimation. Now eating 2 meals a day to get calorie and carb intake down further (also to reduce the times I have to inject insulin).

Diabetes nurse, when I last spoke to her (many moons ago) thought that my body was going into Starvation mode and just hanging on to everything it could so the more I cut down, the more fat I put on. Not sure about that reasoning, but since I didn't have any alternative answer, other than low carb, I couldn't really debate that point. Low carb scared her. No idea at present what my HbAic is - the last blood test I had was at the hospital and they don't give results to patients. Anyway, that's all by the way, it's my liver I'm bothered about. I imagine, if I can get some weight off, it will help everything though.

Maybe if I try to keep down to 1000 calories, it would help. That means starting to count them again - I never was any good with numbers. I can use them, but often miscalculate. Not exactly innumerate, but marginal dyscalculia, I think. Brain freezes when someone asks me any kind of arithmetical problem so that I really have to take a deep breath and kick my brain into action. That's why I was glad to read that reducing carbs meant not needing to count calories. There's no emoji for <disappointed>, I see.
 
Very low carb is the way to go, if you get into dietary ketosis, then reduce your calories or even miss meals. Your body is forced to use it's stores of fats. I don't know your bowel complaint but i have Diverticuar disease, fibre is "supposed" to help this condition, but i've found quite to the contrary.
the problem with very low calorie diets, is that your body adapts to the calorie intake. So it is important to vary your intake along the way, this way your body doesn't think there's only 1000 calories a day so it'll drop non essential functions to compensate for that, instead it thinks ok i'll supplement from storage to cover this low intake. Expecting more calories in the near future, this keeps you in the fat burning phase. It's the same as intermittent fasting the body thinks ok didn't catch anything today so will cover, as something is sure to be caught tomorrow or the day after.
Obviously with Insulin this complicates things a little, which i have no personal knowledge of, but many on here do, and i'm sure can help point you in the right direction. And may even point out where i may be wrong.
 
Goonergal said:
@Annb have a watch of this video of Dr David Unwin talking on the subject. Back of my head’s in the audience somewhere!

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Thanks Goonergal. That's a very interesting video. I do think that low carb keeps BG a bit lower than it would otherwise have been, but not low enough to get away from insulin and I do think low carb will help my liver remain as it is rather than worsen. I just wish I could get that one step further and start to at least stop the development of the disease.

I've just worked out that the "Time immemorial" that I was talking about - when I was told I had a fatty liver was in 1999 - 24 years ago. It was discovered then because I had to have a US scan for something else. Goodness knows how long it had been in that condition before that. I had only had tiny amounts of blood taken to check for anaemia before that so the already existing diabetes and the fatty liver hadn't been noticed at that time. When the fatty liver was diagnosed, I was told that there was no way of improving it and it would only get worse, and it did, to the extent that I now have cirrhosis but now, nobody even checks what is happening, apart from an occasional US scan. Not that my experience is any worse than any other NHS patient these days.

So - onward and upwards. Keep trying, keep sticking to low carb as far as possible and hope for the best.
 
When you talk about low carb and it working for a while can you just clarify what you mean.
How low is low? Do you count the carbs? How long do you do it for and how consistently? It may simply be that you aren’t going low enough to overcome long term serious insulin resistance which you likely have. The nhs idea of low carb 130g ish a day or 40 a meal is often still far too much for many of us.

Is your insulin fixed doses or do you self adjust doses? This makes a difference how you approach low carb eating.
 
Annb said:
Yes - swinging between constipation and diahorrea. Bit of a pain in the neck - and elsewhere!

Thanks for tagging @JoKalsbeek, Antje. I'd be glad to hear of success using low carb.
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My fatty liver was so dense, they thought it was a massive tumor rather than "an abnormal stacking of fat on the liver". My endo told me there was nothing to be done about it, and he'd see me again when I needed pain relief. Palliative care for liver cirrhosis, basically; a death sentence A few months of low carbing later, my liver stats were greatly improved, and by the next check, a year on and on keto (20 grams of carbs or less, in my case), all numbers were perfectly normal and the only way to tell anything had ever been wrong, was to do an ultrasound. I gave my mom the same advice when her liver turned bad, and it worked for a while, but she couldn't keep the diet up due to other issues... So her numbers rocketed again. But yes, it can be done. Keep in mind that any change in diet'll mean your bowels have to get used to other ratio's of bacteria needed to process food. In other words, when I went carni for a while, I had the runs for a few weeks before things stabilised. ;) Give your guts a little time to adjust.

Good luck,
Jo
 
JoKalsbeek said:
My fatty liver was so dense, they thought it was a massive tumor rather than "an abnormal stacking of fat on the liver". My endo told me there was nothing to be done about it, and he'd see me again when I needed pain relief. Palliative care for liver cirrhosis, basically; a death sentence A few months of low carbing later, my liver stats were greatly improved, and by the next check, a year on and on keto (20 grams of carbs or less, in my case), all numbers were perfectly normal and the only way to tell anything had ever been wrong, was to do an ultrasound. I gave my mom the same advice when her liver turned bad, and it worked for a while, but she couldn't keep the diet up due to other issues... So her numbers rocketed again. But yes, it can be done. Keep in mind that any change in diet'll mean your bowels have to get used to other ratio's of bacteria needed to process food. In other words, when I went carni for a while, I had the runs for a few weeks before things stabilised. ;) Give your guts a little time to adjust.

Good luck,
Jo
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Thanks so much for the advice. I don't actually know what my blood tests show - just what the radiologist told me unofficially. The hospital never tells me the results of tests until I get another appointment in 6 months time, if then. I don't have an endo - don't think there is one on the Islands, resident or visiting.
 
HSSS said:
When you talk about low carb and it working for a while can you just clarify what you mean.
How low is low? Do you count the carbs? How long do you do it for and how consistently? It may simply be that you aren’t going low enough to overcome long term serious insulin resistance which you likely have. The nhs idea of low carb 130g ish a day or 40 a meal is often still far too much for many of us.

Is your insulin fixed doses or do you self adjust doses? This makes a difference how you approach low carb eating.
Click to expand...
Low carb to me is around 20 grams a day - sometimes 25. It worked pretty well right away, allowing me to reduce insulin by 10-15 units at each meal. Sometimes the reduced amounts were too much and by afternoon I was in, or approaching hypo level. It worked for about 2 weeks and then started climbing again.

My basal dose is fixed at a fairly high level - 58 units, but bolus doses I have to try to figure out for myself and that is a bit of trial and error. It's often around 60 units but I have managed with as little as 45, if the meal is small. For bacon and egg breakfast I will take 50 at present. For soup (home made) 45. Early morning I do drink tea with milk and don't dose for it, with the result that BG rises to about 13. Presumably partly an early morning dump of glucose from my liver. Trouble then is that I can't move much, so can't make use of it.

I tried keeping carbs low and changing the time of my insulin basal dose plus taking bolus doses half an hour before meals (by this time usually 2 meals a day - sometimes only one). It seemed to help for a few days but then it came back to my normal of high BGs from early morning to mid-afternoon and then dropping to near normal levels (7-8) and occasionally down into hypo territory again.

I am insulin resistant but I've checked and I am producing insulin so I am T2. I haven't given up on low carbs as a long term solution and I am persuaded that it will eventually benefit my liver function and, possibly my kidney function. Wouldn't mind if it would slow my pulse a bit as well (usually 80-90 bpm these days). It would help so much if there were some medical person here who could offer some kind of support/oversight, but there isn't. They do their best, I'm sure but they are all "old school" - not that I ever get to see anyone these days.

Maybe I just need to put up with using extra insulin meantime and give the low carb a longer period to work. I wish I knew what my HBa1c was. If I could see that it was coming down, I might feel less like giving up. I might try to twist someone's arm over the phone and see if the Diabetes nurse will look up my recent blood test at the medical clinic to see what it is.
 
Annb said:
Maybe if I try to keep down to 1000 calories, it would help. That means starting to count them again - I never was any good with numbers. I can use them, but often miscalculate.
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I am no good with numbers either so use Fatsecret to log my food www.fatsecret.co.uk
 
That's good that your frequent breakfast looks OK. I save all my frequently used foods which makes it really quick to check my day 's carb intake at the beginning of the day in case I have to make adjustments.

I also still have to weigh everything as I have never been able to judge the weight of food without using the scales..
 
Annb said:
Thanks for that link. I've just checked it out and it looks to be helpful. My frequent breakfast looks to be OK, as long as I stick to 2 meals.
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When I looked at the site to check my breakfasts, I was horrified to see that my frequently used food put me way over carbs but then I realised that I was missing the decimal points! I said I was no use with numbers. The advice from the site was that I should be eating 1700 calories a day. I think that is probably more than I have eaten for quite a while, so may reduce it to nearer the 1000 mark.
 
Today, I tested the bread effect again, just to reinforce the thought that the carbs in bread are far to much for me to handle. I took my normal amount of insulin and a fairly thick slice of toasted, home made wholemeal bread with butter. I have spent the rest of the day trying ot boost my BG which kept dropping too low. Eventually, when I was busy thinking of other things (a tiny stray dog which wandered in to the house which seemed to have lost its owner) BG dropped even quicker than the Libre cold keep up with and I was in a full blown hypo. Got it under control but for the first time ever, I think, I didn't bounce back and could only rest, wrapped in a blanket for the rest of the afternoon and evening. Even now - 11.40 pm - I'm still feeling a bit shaky. Nothing to do with protecting my liver, I know, but I needed to try to understand what carbs do to my BG. Today didn't enlighten me, I'm afraid.

I did bake off some fish and had that as the only meal today - just fish and nothing to accompany it, not even insulin but there's no carb in fish and BG was still only 5.9. BG rose to 8.3 after 2 hours and is still thereabouts. Tomorrow, I will have another look at carb content in things, but I think I can say with certainty that bread is out! I do have some very low carb bread on order, so I will test that when it arrives.
 
No bread today. Just bacon and eggs. Took reduced insulin (45 u) - just a guess at the amount. Trial and error is my way. I guess my guess was not far wrong. BG dropped fairly rapidly, but not too far because the starting point was pretty high. Still hungry though so I advanced my 2nd meal to lunchtime. Another guess at insulin (40 u) and had some reheated chicken and mushrooms with some extra spices and lemon juice. BG falling fast - Libre alarm just went off so I've given myself some more of the chicken and hope it will be enough. I'm hoping that I shan't need any more food today. When I can get the insulin balance right, I think I shall manage to get the carbs right down.
 
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