Brief Answer:
NAFLD

Detailed Answer:
Hello and Welcome

I appreciate your concern

The fatty liver or NAFLD (Non alcoholic fatty liver disease) which you have described represents a continuum spectrum of conditions involving fat deposition and macro-vesicular hepatic steatosis without significant alcohol intake.

NAFLD is a diagnosis of exclusion. ALT levels, ultrasound abdomen and fibroscans are usually done to monitor for steatohepatitis development or progression to fibrosis.

The following conditions must be ruled out first before going for NAFLD workup.

-Alcoholic and viral Hepatitis
-Drug induced Hepatitis (tamoxifen, amiodarone)
-Autoimmune Hepatitis
-Wilson disease and Hemochromatosis


Initial treatment in all forms of NAFLD are at improving the co-morbidities of central obesity, dyslipedemia, hypertension, and diabetes
None of the currently proposed therapies (other than bariatric surgery for significantly high BMI) are likely to change the natural history of NAFLD. These include the lethecin or fish oil or Omega 3 fatty acids that you described. I would advise against taking these as the liver is already overburdened with fat, even though they may have some degree of benefit , the overall application of these medications in your case should be avoided.

Vitamin E, Pioglitazone and metformin have shown benefit in NAFLD. I can share the studies regarding these medications, if you want them.

You may discuss these options with your treating physician.


Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

---

Brief Answer:
Explained

Detailed Answer:
Hello again.

No need to pay me for that. I am happy to share those studies for free.

PIVENS STUDY

Pioglitazone , Vitamin E, placebo
96 weeks
Adults
with XXXXXXX
without DM, cirrhosis, Hep C, heart failure
limited alcohol intake over previous 5 years
Randomized trial
Pio group: 80
Vit E group: 84
Placebo: 83
Sanyal et al, New England J of Medicine

Vitamin E vs placebo
Improvement:
43% vs 19% (Significant improvement)
(Steatosis, lobular inflammation, hepatocellular ballooning and fibrosis)

Pioglitazone vs placebo
     Improvement:
     34% vs 19%
     Improvement not significant

PIVEN Study conclusion:

Vitamin E was superior to placebo in adults with XXXXXXX and without DM
Pioglitazone may have a role in treating patients with biopsy-proven XXXXXXX however long term safety and efficacy has not been established.

I am collecting more material on NAFLD/NASH and would be presenting it soon in a medical conference. Would be happy to share the updates with you when they are available.


Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

---