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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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Suggest treatment for fatty liver when diagnosed with high cholesterol levels

Answered by
Dr.
Dr. Tayyab Malik

Gastroenterologist

Practicing since :2009

Answered : 819 Questions

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Posted on Mon, 22 Aug 2016 in Digestion and Bowels
Question: I was recently diagnosed with fatty liver. I didn't think this was a big issue but the more I read online the more concerned I am about long term prognosis. since 2011 I have had intermittent bouts of high Alt levels. Nothing crazy high and it is usually in the high 40's low 50's. On ocasion it can go as high as 70 and as low as 25. I have had 3 ultrasounds over the last 5 years and all show a normal liver. no signs of any damage or fatty infiltration. my spleen is very slightly enlarged at 12.3 cm and has not grown or shrunk. platlets are normal so doctor says this is totally incidental and not an issue. likely i just have a bigger spleen. I have high cholestrol which the doctor thinks is responsible for the fatty liver. I am 5'9 and 160 pounds so am not overweight and have a healthy bmi. I am working on the cholestrol. started at 259 and now down to 210. my concern is that there are two types of fatty livers, XXXXXXX and simple steatosis. I have read XXXXXXX has a poor long term prognosis and simple steatosis is relatively benign. since my alt is elevated does that mean I have nash?
doctor
Answered by Dr. Tayyab Malik 1 hour later
Brief Answer:
Your Current presentation does "NOT" point towards (any severe form of) XXXXXXX

Detailed Answer:
Hi.
Thanks for posting your query at HCM.
XXXXXXX is usually observed in the setting of non-alcoholic fatty liver disease (NAFLD).
People with high cholesterol, high triglyceride, diabetes mellitus, overweight, poor diet are at risk for developing XXXXXXX

In severe form of XXXXXXX excessive fat is deposited in liver, liver becomes large and progressive scarring may occur. These factors may lead to liver cirrhosis which maybe observed in ultrasonography and/or a fibroscan. It maybe confirmed by take a liver biopsy.

However, in your case , you mentioned that your ultrasound came out normal , your liver function test were normal except for ALT. ALT levels of less than 85 are NOT of much concern. More over, your BMI is normal and your fighting the high cholesterol pretty good. in addition, your 35 and usually XXXXXXX is commonly seen in patients above 45. putting together, your NOT at risk for XXXXXXX or a severe form of XXXXXXX

you're advised:

-to maintain healthy diet and a low cholestrol / fat diet
-avoid alcohol
-avoid junk food and beverages
-test for Hepatitis B and C ( if not done previously)
-monitor liver enzymes and lipid profile
-exercise regularly

Hope to answer your concern.

Any further questions are welcomed
wish you good and sound health.

Regards
Dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Tayyab Malik 15 minutes later
is this something I can totally reverse? If so I can enjoy alcohol or do I need to abstain permantly?
doctor
Answered by Dr. Tayyab Malik 30 minutes later
Brief Answer:
Fatty Liver disease is reversible

Detailed Answer:
hi.
thanks for getting back to me.

Fatty liver disease is reversible provided proper diet and advice of treating physician is strictly followed.

important advice(s):

- limit over-the-counter (OTC) medications
- "as per now, its recommended to AVOID alcohol completely to speed up the process of recovery of fatty liver.
you may monitor liver enzymes and visit treating physician regularly
- AVOID high-fat and high-sugar food
- exercise regularly

Fatty Liver can be reversed in anywhere from three to six months to two years, depending on severity and adherence to a proper diet.

its a pleasure to answer your queries.
hope to answer your concerns.

wish you speedy good and sound health.

if no further questions, kindly close dialogue box and rate the answer.
thank you.

regards,
dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Tayyab Malik 52 minutes later
thanks for the reply. my doctor is making an assumption that it is fatty liver because he can't find another cause. is there anything else that can cause it. all hep tests were normal. thyroid tests were normal. celiac tests were normal.
doctor
Answered by Dr. Tayyab Malik 2 hours later
Brief Answer:
Increased cholesterol/alcohol are risk factor for fatty liver disease

Detailed Answer:
hi.
its a pleasure to answer your concerns.

as quoted by your treating physician, "fatty liver" is the most likely diagnosis in your case, as high value of liver enzyme ( ALT) is being observed since a considerable time. Moreover, your cholesterol level is high.

however, liver biopsy maybe needed to confirm the provisional diagnosis.
biopsy of liver is not usually indicated as per your current scenario.

therefore, as mentioned earlier, Fatty liver disease is reversible provided proper diet and advice of treating physician is strictly followed.

hope to answer your concerns.

wish you speedy good and sound health.

if no further questions, kindly close dialogue box and rate the answer.
thank you.

regards,
dr Tayyab Malik
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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