45 replies to this topic

[youandme]

NAFLD - Non Alcoholic Fatty Liver Disease
NASH - Nonalcoholic Steatohepatitis
The texts mention these two terms in unison...are they one of the same...some texts suggest NASH is progression from NAFLD.


Ive just been diagnosed with having fat in the liver, by ultrasound

My Cholesterol/lipids are ok and in normal range..Im thin & eat lots of veg..and low fat, therefore something else ? is causing this disease.

I have multiple Autoimmune diseases. Therefore I believe there is some connection ..although not direct(not autoimmune liver antibodies)..

The Doctors really dont know much about why its happenning to me.
The Usual obese person who has poor diet does not apply to me as a cause.

On the other hand what can one do to help one who has a fatty liver from progressing all the way to Liver failure ?

Well conventional medicine currently have zero treatments available...(story of my life recently lol)

The only advice I have found so far to help a little apart from the usual yet unhelpful "Exercise and a low fat diet" is a Vitamin E study that seems to suggest it is helpful in reducing the fat buildup in approx 43% of those studied.

http://www.antonnews...er-27-2009.html

"A recent study presented at the meetings of the American Association for the study of Liver Diseases in November 2009 showed that daily vitamin E use at a dose of 800 mg a day for one year in non-diabetic patients with NASH resulted in less fat cells within the liver than comparator arms with pioglitazone or placebo. There was no improvement in scarring at the end of the year with vitamin E use."

So a little improvement is better than none.
However Id rather have a lot of improvement..enough to visually see a decrease of fat cells on the ultrasound picture.

Another idea on the cause ..is that the Liver is not processing the lipids correctly anymore..for some reason yet to be nailed...though Im sure the Autoimmunity is a likely factor.

So Im going to try taking Vit E straight away 800mg a day...(Im assuming the antioxidant is the property that helps)
Also probiotics. Also Powdered fibre (fibresure) with every meal.
Ive read that Synbiotic Treatments seem to help Fribrosis/cirrhosis.

Rodent Study..I know I know
http://grande.nal.us...p;therow=786415

Human Study !
http://informahealth...910600601178709

"Conclusions: Short-term synbiotic treatment proven to modulate gut flora significantly improves liver function in patients with cirrhosis. Benefit is unrelated to reduction in endotoxaemia and may be mediated, at least in part, by treatment-related induction of IL-6 synthesis by TNF-α."

So Synbiotics may have a positive effect.


Im also taking Niacin 100mg one per day to improve good cholesterol..should I continue with it ?

If anyone else has suggestions on how to reduce fat in the Liver please do post your ideas along with any relevant study.

[youandme]

Wow no responses

I guess no one else here has fatty liver...Im a little surprised, I thought there would be few at least.

Looks like Im on my own.

Edited by youandme, 07 December 2009 - 04:49 AM.

[rwac]

Looks like Im on my own.

I wouldn't say that.
I'm pretty sure I used to have NAFLD too.

I think a low carb diet (esp. paleo) helped a lot. Especially removing fructose from my diet.

Additionally, the 6-week cure works very well to get rid of fatty liver.
But you should already have adjusted to a high-fat low-carb diet before starting it.

[rwac]

My Cholesterol/lipids are ok and in normal range..Im thin & eat lots of veg..and low fat, therefore something else ? is causing this disease.
...
Another idea on the cause ..is that the Liver is not processing the lipids correctly anymore..for some reason yet to be nailed...though Im sure the Autoimmunity is a likely factor.

I didn't see that at first.

Your liver is struggling to handle fructose, causing fatty liver.
What has your fructose intake been like ?

There's really no way to sugarcoat this, I'm afraid you're going to have to switch your diet to much lower carbs, higher fats.

[FNC]

It's not that no one else has it, it's probably because people don't frequent this part of the forums as frequently as they do others (i.e. lifestyle, nutrition, supplements etc...)

It has been a concern of mine for a while that in total, ImmInst has over 60 forums/sub forums, as a result, some areas get less exposure than others.

On the NAFLD issue, perhaps silybum marianum may be of use.

Edited by Fabien, 07 December 2009 - 05:55 AM.

[youandme]

Thanks for your posts rwac

Ive eleminated Fructose long time ago.

One potentially contributing factor is aspartame..I was almost addicted to chewing gum..and would go through a tub of 50 chewing gum pieces a day (a whole tub full) then I found out that they were putting aspartame in them...suffice to say Ive stopped that habit!

How does eating high fat foods clear a fatty liver ..curious to understand how it works ?

Im on low fat low carb low/no sugar diet currently.

Thanks

Edited by youandme, 07 December 2009 - 06:45 AM.

[youandme]

Your right..I had wondered where to put this post....still I do like the forums even if there is some overlap.
I spose people arent like me..I always jump to viewing the latest posts.

I should say Ive got some milk thistle..and its on the cards to try..yet Im still trying to figure out if this is some metabolic issue I have.

It's not that no one else has it, it's probably because people don't frequent this part of the forums as frequently as they do others (i.e. lifestyle, nutrition, supplements etc...)

It has been a concern of mine for a while that in total, ImmInst has over 60 forums/sub forums, as a result, some areas get less exposure than others.

On the NAFLD issue, perhaps silybum marianum may be of use.

Edited by youandme, 07 December 2009 - 06:47 AM.

[rwac]

How does eating high fat foods clear a fatty liver ..curious to understand how it works ?

Im on low fat low carb low/no sugar diet currently.

Thanks

So where do you get your calories from ?
High protein diets are a bad idea too.
How low is your "low carb" diet ?

You want to get your body burning fat instead of glucose. Once you switch to using fat, you'll find it easier to burn body fat, including the fat in the fatty liver.

Here's a good link.
http://wholehealthso...r-reversal.html

[rwac]

Also, 800 mg vit E is a lot, perhaps too much ?
Take a full spectrum vit E instead, perhaps.

Are you taking anything else that might be stressful to your liver, medication perhaps ?

[youandme]

Hi rwac

No meds to stress the liver ! (only taking thyroxine presently)

The only thing I was concerned about was the amount of Chewing gum I was going thru with apsartame in it ! (a whole tub a day) Ive now cut it out completely

I dont add sugar to anything...my diet is whole oats/linseed/almonds/lecithin with water, a little honey.

White Tea
Purified Water
Fish
Vegetables (with each meal..no potaotes)
Various beans.
Chicken, Lamb, Beef
Low fat Yogurt with Lactobacillus GG
Salads
Fresh Fruit, Apple, Banana, Plum, Apricot, Cherries (no citrus)

NO BREADS.

Occasional Cocunut water
1-2 pieces of 80% Dark Choc per day

Also take Fibersure..sprinkled with each meal.

Its actually to me a quite balanced diet..low on sugar (no carbs at all)..some fat with the meat.

Supplements:
Sitosterol complex (just started)- Help keep the LDL down a bit
Niacin 100mg x 1 per day - To try and get the HDL up a bit (noticed this is always low(borderline) in my bloods !)
Omega 3 gelcap EPA 350mg DHA 250mg x 3 per day
B12 5000mcg sublingual 1x per week

About to start:
TMG (Betaine) Hopefully help metabolize that fat in the Liver

Thinking about:
Apple Cider Vinegar Tablets - Help with keeping LDL lower and get HDL higher
Had thought of red yeast rice..but conflicting studies..some says statins help autoimmunity same say it causes it..if I were to use it ..I would take a lower dose and monitor LFT's

NAC again ??..I know its not the flavour at the moment.but would it help the Liver ?

Anything else that might work with these ?


Tomorrow going for an insulin blood check, as well as fasting glucose and usual tests.

[rwac]

You should consider cutting out the beans, oats and fruit for a couple of weeks.

Fruits have fructose !!!

Get your carb/sugar intake low, under 20g for two weeks, that should help your liver.

[youandme]

Well I just realised that my 'honey' love is perhaps helping a fatty liver to occur thanks Rwac for the heads up.

http://www.ajcn.org/.../full/88/5/1189

Fructose is a simple sugar found in honey, fruit, table sugar (sucrose), and high-fructose corn syrup (HFCS).

The consumption of large amounts of dietary fructose also can rapidly induce insulin resistance, postprandial hypertriglyceridemia, and blood pressure in humans more than starch (or glucose) does in controls (3, 5, 6). Moreover, it is a potential risk factor for fatty liver disease (7).

Your liver is struggling to handle fructose, causing fatty liver.
What has your fructose intake been like ?

There's really no way to sugarcoat this, I'm afraid you're going to have to switch your diet to much lower carbs, higher fats.

[youandme]

I stopped taking ALA about 18 months ago when I ran out...

However fell across this study hinting at a possible use for fighting a fatty Liver

http://www.ncbi.nlm....pubmed/18972440

"Alpha-lipoic acid decreases hepatic lipogenesis through adenosine monophosphate-activated protein kinase (AMPK)-dependent and AMPK-independent pathways."

CONCLUSION: These results show that ALA prevents fatty liver disease through multiple mechanisms, and suggest that ALA can be used to prevent the development and progression of nonalcoholic fatty liver disease in patients with insulin resistance.


Mods perhaps rhis thread should be moved to regimens ? What do you think.
Id expected at least one other person to be fighting this fatty liver disease to post..

[niner]

Mods perhaps rhis thread should be moved to regimens ? What do you think.
Id expected at least one other person to be fighting this fatty liver disease to post..

Most of us read the forums using the Active Topics button, so we see new threads in all forums, other than the forums that we have filtered out.

Here's something on NAFLD & resveratrol. Interesting that they use a high carb, fat-free diet to induce NAFLD.

BMC Gastroenterol. 2008 Sep 9;8:40.
Resveratrol inhibits nonalcoholic fatty liver disease in rats.

Bujanda L, Hijona E, Larzabal M, Beraza M, Aldazabal P, García-Urkia N, Sarasqueta C, Cosme A, Irastorza B, González A, Arenas JI Jr.

Department of Gastroenterology, University of Country Basque, Donostia Hospital, Centro de Investigación Biomédica en Enfermedades Hepáticas y Digestivas, San Sebastián, Spain. medik@telefonica.net

BACKGROUND: The prevalence of nonalcoholic fatty liver disease (NAFLD) is high. NAFLD is linked to obesity, diabetes mellitus, and hypertriglyceridemia. Approximately 20% of patients with NAFLD will eventually develop cirrhosis. Our purpose was to investigate whether resveratrol decreased hepatic steatosis in an animal model of steatosis, and whether this therapeutic approach resulted in a decrease in tumor necrosis factor alpha (TNF-alpha) production, lipid peroxidation and oxidative stress. METHODS: Male Wistar CRL: Wi (Han) (225 g) rats were randomized into three groups. A control group (n = 12) was given free access to regular dry rat chow for 4 weeks. The steatosis (n = 12) and resveratrol (n = 12) groups were given free access to feed (a high carbohydrate-fat free modified diet) and water 4 days per week, and fasted for the remaining 3 days for 4 weeks. Rats in the resveratrol group were given resveratrol 10 mg daily by the oral route. All rats were killed at 4 weeks and assessed for fatty infiltration and bacterial translocation. Levels of TNF-alpha in serum, hepatic malondialdehyde (MDA), oxidative stress (superoxide dismutase, glutathione peroxidase, catalase and nitric oxide synthase) and biochemical parameters were measured. RESULTS: Fat deposition was decreased in the resveratrol group as compared to the steatosis group (Grade 1 vs Grade 3, P < 0.05). TNF-alpha and MDA levels were significantly increased in the steatosis group (TNF-alpha; 33.4 +/- 5.2 vs 26.24 +/- 3.47 pg/ml and MDA; 9.08 +/- 0.8 vs 3.17 +/- 1.45 muM respectively, P < 0.05). This was accompanied by increased superoxide dismutase, glutathione peroxidase and catalase and decreased nitric oxide synthase in the liver of resveratrol group significantly (P < 0.05 vs steatosis group). Bacterial translocation was not found in any of the groups. Glucose levels were decreased in the group of rats given resveratrol (P < 0.05). CONCLUSION: Resveratrol decreased NAFLD severity in rats. This effect was mediated, at least in part, by TNF-alpha inhibition and antioxidant activities.

PMID: 18782455

[youandme]

Thanks for your post niner

Seems that perhaps a common thread in any positve liver fat moving supplements are that they all have high antioxidant properties

Vit E, ALA, and Res

The problem of choice I have now is which supplements out of those 3 should I concentrate on trying. ?!


You noted the fat free high carb diet...I noted the fasting as well !!

Edited by youandme, 16 December 2009 - 09:55 AM.

[youandme]

A quick google throws up heaps of studies indicating that a high fat diet induces liver injury and fatty liver
So if anything there are conflicting ideas.

http://www.scienceda...71101144851.htm


Also that depletion of Immune T-regs play an important role in the pathogeneisis of fatty liver disease.
This maybe part of the missing link for me.

Edited by youandme, 16 December 2009 - 10:28 AM.

[rwac]

A quick google throws up heaps of studies indicating that a high fat diet induces liver injury and fatty liver
So if anything there are conflicting ideas.

http://www.scienceda...71101144851.htm

"High-Fat Diet Makes Mice Susceptible To Liver Injury"

We are not mice. Normal human diets are nothing like mice diets.

Edited by rwac, 16 December 2009 - 11:24 AM.

[youandme]

Rwac

Yes so many studies are done on mice..yet can we trust some of them ...none of them... or all of them.

The problem I have with your suggestion to eat a high fat diet...is simply one of fear..
If your wrong then Im toast..I may only get one chance with this.

So at the moment I have an inability to act one way or another..hoping light will show me the best way to go......was hoping someone who also a fatty liver may post...or someone who has some human studies to back up the best diet to follow.

In the meantime...Ive started ALA 2x 300mg, along with Probiotic and Fibersure....

Im still eating meat...with veg...higher on the broccoli.(trying to increase butyrate production)
Cut down fruit intake...and cut out honey (my fav).

Drinking filtered water and white tea, and a new one dandelion tea which I alternate daily root/leaves
Also Drinking Cocunut Water.

Breakfast Im using Rice Milk with added calcium...

And thats about it for the moment...no pasta..no beans...no bread.

[niner]

Seems that perhaps a common thread in any positve liver fat moving supplements are that they all have high antioxidant properties

Vit E, ALA, and Res

Of these three, Res is the outlier. It's a pretty weak antioxidant, and most of its biological effects are receptor-mediated rather than based on antioxidant behavior.

You noted the fat free high carb diet...I noted the fasting as well !!

Yeah, that's really odd. Seems counter-intuitive that fasting would contribute to NAFLD. I wonder why they chose that?

[niner]

Yes so many studies are done on mice..yet can we trust some of them ...none of them... or all of them.

And the winner is... Some of Them! In particular, I would question studies that put mice on a diet that they have not evolved to eat, like a high fat diet.

The problem I have with your suggestion to eat a high fat diet...is simply one of fear..
If your wrong then Im toast..I may only get one chance with this.

How about a middle road: Use more olive oil. Cut out the high-GI carbs and use more olive oil. This will push your triglycerides down a lot, and that is exactly what you want. If you aren't already doing it, I would add 2-3 grams of fish oil per day. This too will help triglycerides. These things will probably push your HDL up as well, which is also good. This is basically what I did, diet-wise, and although I don't have my test results handy, my trigs and HDL moved a lot, both in the right direction, upon adopting this sort of diet. It isn't really high fat, and it isn't ketogenic, I just increased good fats (olive oil, coconut oil, avocado, some nuts, some butter) cut back on polyunsaturates, and cut down as much as reasonable on the high GI carbs. (sugars, white flour, white potatoes, white rice)

So at the moment I have an inability to act one way or another..hoping light will show me the best way to go......was hoping someone who also a fatty liver may post...or someone who has some human studies to back up the best diet to follow.

In the meantime...Ive started ALA 2x 300mg, along with Probiotic and Fibersure....

Im still eating meat...with veg...higher on the broccoli.(trying to increase butyrate production)
Cut down fruit intake...and cut out honey (my fav).

Drinking filtered water and white tea, and a new one dandelion tea which I alternate daily root/leaves
Also Drinking Cocunut Water.

Breakfast Im using Rice Milk with added calcium...

And thats about it for the moment...no pasta..no beans...no bread.

This sounds pretty good. Sounds a lot like what I do, although I can't give up beans entirely. I've pushed pasta down a lot, but it's not entirely gone. No white bread, but I do occasionally have whole wheat or sourdough, even a little rye. But get yourself a large bottle of some good olive oil, and put some in a dispenser on the table; that makes it convenient to put it on all manner of things. I don't even think of it as "fat"; I think of it as something that's very good for me and makes everything more enjoyable to eat. My bloodwork and bp are certainly agreeing so far. As far as fruit goes, look into berries as a possible substitute for the large fruits. They are loaded with good compounds, and light on sugar at the same time. You could add some resveratrol; 250-500mg/d of 98+%.

[Lufega]

I remember researching this for a Aunt who has fatty liver. I recall reading something about a hormone imbalance. The body compensates by trying to ramp up cholesterol synthesis in the liver to make up for this deficit and the result is fatty liver. I also remember reading that high dose lecithin will correct it.

Milk thistle is a no brainer in this case and taurine is also hepatoprotective.

Edited by Lufega, 19 December 2009 - 05:30 AM.

[youandme]

Hi Lufega
Thx for your post
Yes Ive got some Milk Thistle I should take it in any case.

Taurine & Lecithin - Im using a Breakfast product which has it in..however with so many supplements Id like to find a Liver Tonic perhaps powder..or mixed dry herbs that has some of the better known liver supps.

lots of reasons found in this recent study that influence NAFLD....one of them low HDL..hyperuricemia=(elevated uric acid-can be caused by high levels of fructose!).......another was consumption of marine products ! (WHY)?

Ive not had my uric level checked...so will do now...my brother has gout ! hmmmm

A hospital-based case-control study on influencing factors of nonalcoholic fatty liver disease

http://www.ncbi.nlm....p;ordinalpos=11

12 of 18 factors were used to construct a model, ten of which were the risk factors and two were protective factors of NAFLD. Risk factors included obesity (OR=6.35), hypertension(OR=3.82), dyslipidemia (OR=2.95), decrease of HDL (OR=2.85), hyperglycemia (OR=2.82), increase of ALT (OR=2.80), hyperuricemia (OR=2.35), HBsAg positive (OR=1.99), family history of fatty liver (OR=1.79) and frequently intake of marine products (OR=1.58), and protective factors included tea drinking (OR=0.72) and exercise (OR=0.90). CONCLUSIONS: There are many influencing factors of NAFLD, and life styles are the key factors. Genetic background may also play some roles in NAFLD.

Edited by youandme, 19 December 2009 - 06:52 AM.

[youandme]

niner thanks for posting

It sounds like Im on the "middle of the road" diet..which should be pretty good at helping to normalise bad LDL..
and without any studies maybe is a as good as one can get.

Basically Ive cut out any refined sugar...cut out honey - fructose laden (was using heaps at brekky)
Mints/chewing gum laced with aspartame...(was using 50 pieces a day!)

Its a low carb diet ..no pasta..no bread...low on the beans...no potato..lot less fruit..was eating 3 apples..a banana..plum etc per day

Still eating the meat and veg and brown rice.

Im taking Niacin 100mg per day for raising HDL..however Id like to push it up higher..might go 150mg.?!

We use Virgin Olive Oil..however wife says you cant have too much as it would be bad for me !...I will have to add more to our cooking when I help her out there

I love advocado...so I should get into it a bit more.

Edited by youandme, 19 December 2009 - 06:28 AM.

[youandme]

Of course any diet gets challenged if one has to celebrate Xmas ..but for mylifes sake..I will stick to the either the turkey and veg or fish..and forgo the after meal delights.

On another note..has anyone got or know of a blood count graphing software..preferably free.

Id really like to chart (hopefully progress) of my bloods..including LFT's and Chol, Sugar, Insulin results.

I get tested about once a month as my health is so crap..so I should be able to build up a picture of what is hopefully working and what may not.

[youandme]

Fructose "The Bitter Truth" - A hepatic/body toxin if ever there was one.!

[James Cain]

A quick google throws up heaps of studies indicating that a high fat diet induces liver injury and fatty liver
So if anything there are conflicting ideas.

http://www.scienceda...71101144851.htm


Also that depletion of Immune T-regs play an important role in the pathogeneisis of fatty liver disease.
This maybe part of the missing link for me.

Most high fat diets used in animal studies are actually a mix of high carb (usually sugar) and high fat (usually polyunsaturated vegetable and/or hydrogenated oils). Science Daily makes it very difficult to track down the original study so it would be difficult to comment on this specific paper, but I'd be willing to suggest that this is the case. As it turn out, and partially what has already been said on this thread, excessive carbohydrate intake, fructose, polyunsaturated fats, alcohol, and many drugs increase the susceptibility of the liver to accumulate fat and fibrotic tissue, resulting in NAFLD and further into NASH. These researchers used endotoxin to stimulate an immune response and inflammation, though this usually isn't a problem for most people unless they have increased intestinal permeability. You mentioned an auto-immune disorder, and many of them are associated with increased intestinal permeability which would mean any metabolic insult to your liver would further be potentiated by your increased absorption of endotoxin. You best bet would be to avoid the major negative factors (the list above--also niacin (mentioned on this thread) can be hepatoxic in higher doses) and include some things that are beneficial to the liver such as increased saturated fat, negative energy balance (diet or exercise leading to weight loss), and various herbal supplements such as milk thistle and silymarin.

[rwac]

On another note..has anyone got or know of a blood count graphing software..preferably free.

Id really like to chart (hopefully progress) of my bloods..including LFT's and Chol, Sugar, Insulin results.

You could use a spreadsheet like Gnumeric (It's free)

CRON-o-Meter is good, but it doesn't have space to enter all those things.

[rwac]

Here's a neat study.

Page 1
Efficacy and Safety of Oral Betaine Glucuronate in Non-alcoholic Steatohepatitis
A double-blind, randomized, parallel-group, placebo-
controlled prospective clinical study
Federico Miglio, Lucio C. Rovatib, Antonino Santoro, and Ivo Setnikarb
International Drug Division, Hospital S. Orsola-Malpighi, Bologna (Italy), Department of Clinical Pharmacology b, Rotta
Research Laboratorium, Monza (Italy), and Department for Development and Regulatory Affairs, Rotta Research Laboratorium,
Monza (Italy)
Summary
In a prospective, randomized, double-blind therapeutic trial, 191 patients with non-alcoholic
steatohepatitis were treated for 8 weeks daily b.i.d. orally either with betaine glucuronate combined with
diethanolamine glucuronate and nicotinamide ascorbate (Ietepar ®) (96 patients) or with
undistinguishable placebo capsules (95 patients).
The verum treatment effectively reduced by 25 % hepatic steatosis p<0.01) and by 6 % hepatomegaly p
<0.05), while placebo did not significantly reduce the disorders. Verum was also more effective than
placebo on discomfort in abdominal upper right quadrant. The global efficacy of treatment was rated by
the doctor “very good" or “good" in 48 % of verum treated patients and only in 17 % after placebo (P of
difference = 9 x 10-6). 52 % of patients self-rated efficacy as “very good" or “good" after verum and
only 34 % after placebo (P of difference 0.017). The verum treatment provoked a significant reduction
of the increased liver transaminases (ALT, AST and γ-GT) while placebo was ineffective. Adverse
events were recorded in 10 % of verum-treated patients and in 7 % under placebo (no significant
difference). In both groups the adverse events were mild and transient, did not require treatment
discontinuation and were undistinguishable from common symptoms of liver disorders.
In conclusion, the 8-week treatment with betaine glucuronate combined with diethanolamine
glucuronate and nicotinamide ascorbate was found effective in non-alcoholic steatohepatitis, a disorder
for which the hitherto pharmacological interventions were poorly and inconsistently effective

http://74.125.155.13...amp;as_sdt=2000

[JLL]

Peter @ Hyperlipid has some comments on this.

Can you post your macronutrient ratios here? If your wife is very conservative with fat, you might consider pointing her to some relevant studies/blogs on the matter. Also, usually low-fat thinking comes packed with the idea that PUFAs are good and saturated fats are bad, which probably won't help your liver any.

[youandme]

Thanks James for your input !

I agree with pretty much most of your post.

The only question marks are...fasting causes Fatty Liver.
I noticed the Mouse study where they induced NASH by fasting.
And then recently heard that those people who have lapband sugery develop fatty livers as well.

Why would sudden reduction in food intake induce a fatty liver ?