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Suggest treatment for fatty liver

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Posted on Thu, 20 Mar 2014
Question: Dear Doctor My name is XXXX and I'm 33 years old. I had jaundice when I was 8 years old. I was diagnosed with fatty liver in 2006. I'm a non smoker and non drinker. I used to do LFT and Lipid profile every 6 moths. Sometimes the values are normal and sometimes mildly elevated. one time the SGPT value went up to 100 and came down to 37. However, this time when I did my blood test I found that it came back to 110. But when I consulted my physician, he said that this could be due to the fact that I had a jaundice and no need to take any medication and repeat the test after one year. My hepatitis A, B and C tests are negative. I did an ultrasound scan too. Here are the results Blood test result SGPT-110 U/L (normal 12-49) Alkaline phosphate - 74 (normal 45-129) Bilirubin-2.5 mg/dL Triglycerides-196 mg/dL Cholesterol-239 mg/dL HDL- 50 mg/dL Ultra sound scan result Liver- normal in size, ecogeinicity increased, no ascites etc. Multiple calculi seen in the gallbladder with largest one measures 4 mm. No other problems with gall bladder Final conclusion from Ultra sound is FATTY LIVER and cholescistis (spelling may be wrong). My urine color Morning: dark yellow/yellowish orange, day time: light yellow/pale straw yellow, when I drink lots of water: no color I was in India (I'm from India) for one month vacation and used to eat a lot of oily food. Do you think that this is a reason for elevated lipid profile and LFT? How can I get back to normal values. I used to exercise regularly, but since November I'm not exercising because of winter (I'm currently residing in Canada). Please help me doctor Thanks XXXX
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Answered by Dr. Enrique Molina (3 hours later)
Brief Answer: weight loss, medications Detailed Answer: Hi XXXXXXX The fact that you have fatty liver and elevated liver tests, mainly the bilirrubin and SGPT is obviously concerning, particularly if you have had this for many years. First of all, if the liver enzymes levels fluctuate, I would definitely suggest you getting checked for "autoimmune liver disease", and a liver doctor or GI doctor can check you for this diseases by routine blood tests (such as ANA, AMA, ASMA, immunoglobulins). If the diagnosis remains unclear, a liver biopsy may be needed. you may certainly have both diseases (fatty liver + autoimmune liver disease). For fatty liver disease the treatment is basically to lose weight through healthy diet and exercise. since your cholesterol is high, taking medications to lower cholesterol may also help. Vitamin E has been shown to help decrease the inflammation in fatty liver disease. The goal is to bring the enzymes down to normal (eliminate the inflammation in the liver), which with years can lead to cirrhosis of the liver (which means you may develop irreversible scarring of the liver). I don't think the oily food would have had a larger impact; but I feel you need to be investigated further in these lines. hope that helped, let me know if you have any other questions
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Enrique Molina (4 hours later)
Dear Doctor Thank you very much. I have done ANA and Compliment tests (C3, C4 etc) in 2011. Everything was normal. My ESR always in the normal range. Regarding my bilirubin, it's always high and as per my medical records it's in the range 1.5 to 2.5. As I mentioned in my previous question my liver enzymes are normal or close to normal 90% of the time. Only 2 times it's crossed 100 mg/gL. Otherwise between 37-55 mg/dL. My weight is 65kg and height is 165 cm. what are the foods that promotes liver health? Look forward to hearing from you. Regards XXXX
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Answered by Dr. Enrique Molina (4 hours later)
Brief Answer: control cholesterol Detailed Answer: Ok I understand. I also see that you are not overweight, so it all relies on controlling your cholesterol and triglyceride levels through diet and exercise and possibly with medications (at your doctor's discretion). There is no particular food that is recommended to "promote liver health", however you should definitely avoid alcohol, fatty meals, fried meals. Coffee is supposed to be good for the liver, and a natural supplement called "milk thistle" has been suggested to help, however the clinical data is scarce. If despite controlling your cholesterol/triglycerides you have random elevations of your liver tests, I would suggest visiting again a specialist, and considering a liver biopsy. Hope that helped
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Enrique Molina (2 hours later)
Dear Doctor Thank you very much for your quick reply. As you know I'm in Canada right now and I cannot consult a GI with out my physician's reference letter. My physician asked me to redo the blood test next year and he has not given any medication. I have consulted a gastroenterologist in India in 2009 and 2011. Both times he asked me to do exercise and avoid fried and fatty foods. Yesterday I have sent my test report to my family doctor (GI) in India through my wife. As you suggested, he also told me to avoid fatty/fried foods and take medication for high cholesterol. Going to change my lifestyle, by changing eating habits and going to continue exercising from today onwards. Hope this will improve my health condition. Thanks for your help and support. I really appreciate it. Best regards XXXX
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Answered by Dr. Enrique Molina (12 hours later)
Brief Answer: good Detailed Answer: you are very welcome. let me know if you need any further help, take care
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Enrique Molina

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Practicing since :2004

Answered : 364 Questions

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Suggest treatment for fatty liver

Brief Answer: weight loss, medications Detailed Answer: Hi XXXXXXX The fact that you have fatty liver and elevated liver tests, mainly the bilirrubin and SGPT is obviously concerning, particularly if you have had this for many years. First of all, if the liver enzymes levels fluctuate, I would definitely suggest you getting checked for "autoimmune liver disease", and a liver doctor or GI doctor can check you for this diseases by routine blood tests (such as ANA, AMA, ASMA, immunoglobulins). If the diagnosis remains unclear, a liver biopsy may be needed. you may certainly have both diseases (fatty liver + autoimmune liver disease). For fatty liver disease the treatment is basically to lose weight through healthy diet and exercise. since your cholesterol is high, taking medications to lower cholesterol may also help. Vitamin E has been shown to help decrease the inflammation in fatty liver disease. The goal is to bring the enzymes down to normal (eliminate the inflammation in the liver), which with years can lead to cirrhosis of the liver (which means you may develop irreversible scarring of the liver). I don't think the oily food would have had a larger impact; but I feel you need to be investigated further in these lines. hope that helped, let me know if you have any other questions