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Showing posts with label NASH. Show all posts
Showing posts with label NASH. Show all posts

Tuesday, 18 July 2017

Why Checking Your Iron Level Is so Crucial for Optimal Health - MUST READ

  • One in 3 reading this likely has a serious overload of a mineral that may be more dangerous to your health than lack of vitamin D. That mineral is iron.  Iron overload is incredibly common and likely as dangerous to your health as vitamin D deficiency, as it creates excessive free radicals that damage your mitochondrial DNA, cell membranes and electron transport proteins. 

June 12, 2016 

Story at-a-glance

  • Iron overload is incredibly common and likely as dangerous to your health as vitamin D deficiency, as it creates excessive free radicals that damage your mitochondrial DNA, cell membranes and electron transport proteins
  • Iron overload is easily diagnosed by measuring your serum ferritin. Lab normal levels are correct and should be between 20 and 80 ng/ml; between 40 and 60 ng/ml is the sweet spot
  • Iron overload is easy and inexpensive to treat. Most adult men and non-menstruating women would benefit by donating blood two to three times per year to keep their mitochondria healthy

By Dr. Mercola
One in 3 reading this likely has a serious overload of a mineral that may be more dangerous to your health than lack of vitamin D. That mineral is iron.
Making matters worse, few physicians fully appreciate the danger of excess iron, which Gerry Koenig, former chairman of the Iron Disorders Institute and the Hemochromatosis Foundation,1 discusses in this interview. Koenig’s personal story is a powerful illustration of what can happen to someone with excess iron.
Approaching his 50th birthday, he'd lost a lot of weight, worked out, and felt healthy. By age 55, he was in good shape, but he did drink more than recommended. Eventually, during a physical exam, he found out his liver enzymes were high.
"The doctor recommended I stop drinking," Koenig says. "I stopped drinking. But I got sick again ... Turned out I had hemolytic anemia. My red blood cells were breaking down.
I didn't know what that meant, nor, apparently, did my doctor. They never tested my iron ... Finally I had an episode where I went to the hospital. I had encephalopathy, a pretty serious condition ... They said I would need a new liver.
I didn't get an iron test until the eve of my liver transplant in 2005 ... By chance I ran across a Scientific American article. It described something called hemochromatosis, which I didn't know anything about. I decided I would have the test.
As it turns out, I have a single gene for one of the variants for hemochromatosis — C282Y. Because of that, I decided to look into it more and started researching it ... I've been doing that for the last 11 years."


Are You at High Risk for Iron Overload?

Most all adult men and non-menstruating women have damaging levels of iron. However, there is a genetic disorder called hemochromatosis which causes your body to accumulate excessive and dangerously damaging levels of iron.
If left untreated, it can damage your organs and contribute to cancer, heart disease, diabetes, neurodegenerative diseases and many other disorders.
The good news is iron overload is easy and inexpensive to treat. By monitoring your serum ferritin and/or gamma-glutamyl transpeptidase (GGT) levels, avoiding iron supplements and donating blood on a regular basis, you can avoid serious health problems.
Sadly, many doctors are severely underinformed about iron overload. Hence the problem tends to go undetected.

How High Is Too High?

The serum ferritin test measures your stored iron. I strongly recommend all adults to get your iron tested (serum ferritin test) on an annual basis. I believe iron overload is every bit as dangerous to your health as vitamin D deficiency.
Just don't make the mistake of going by what's considered "normal."2 In some labs, a level of 395 nanograms per milliliter (ng/ml) falls within the normal range, which is FAR too high for optimal health. In reality, you're virtually guaranteed to develop disease at that level.
Ideally, your serum ferritin should be somewhere between 20 and 80 ng/ml, certainly no higher than that. As a general rule, somewhere between 40 and 60 ng/ml is the sweet spot for adult men and non-menstruating women.
Unfortunately, few besides children, premenopausal women who lose blood through monthly menstruation, and those with acute blood loss like a bleeding ulcer, have these ideal levels.
"Even some premenopausal women (if they're not under control) will go up to 60 or 70, which is dangerous if they get pregnant. There's a greater chance of poor outcomes in the pregnancy.
The U.S. is 35th in the world in infant survival. It's a terrible situation when you look at the numbers. There's no reason for this. There's no reason for us to have a population that's so unhealthy given the access to medical care that we have,"Koenig says.
Again, if your iron level is high, the solution is to simply donate your blood. If you're an adult male, you'll want to donate blood two to three times a year once your levels are normal. If ferritin levels are over 200 ng/ml, a more aggressive phlebotomy schedule is recommended.
Although your local blood bank may not realize this, recent U.S. legislation allows all blood banks to perform therapeutic phlebotomy for hemochromatosis or iron overload. All you need is a doctor's order.

Recommended Lab Tests

While a full iron panel that checks serum iron, iron-binding capacity and ferritin can be helpful, you really only need the serum ferritin test. It's fairly inexpensive — typically less than $40.
Your doctor can write you a prescription for it, or you can order it from Koenig's website, HealtheIron.com. They recently also added a (GGT) test.
GGT measures liver enzymes, which can tell you if you have liver damage. It can also be used as a screening marker for excess iron. The free iron measured by GGT is also great indicator of sudden cardiac death.
"If you only took that marker (GGT), you have an indication of iron that's not well-bound. When you have iron in the serum, it's generally bound by transferrin, which carries two iron atoms through the serum.
Ferritin can hold 4,000 to 4,500 iron molecules and put those inside the cells. If those measures are high, they’re risky, because you don’t know how well your body is going to hold on to that iron when the cells fall apart over time hemolysis or catabolism.
Our diet is the biggest factor today that's really causing this problem. It's not so much that we're eating too much iron; it's that the iron we have in our body effectively can harm us. That's where the GGT comes in. It's a surrogate measure of free iron."
For women, a healthy GGT level is around 9 U/L, whereas the high end of "normal" GGT lab ranges are generally 40 to 45 U/L for women. For men, Koenig recommends a level of 16 U/L (normal lab ranges for men is 65 to 70 U/L).3
"Women with GGT above 30 U/L have higher risk of cancers — breast cancer, all kinds of cancers — and they will have high risk of autoimmune disease," Koenig warns.

What Causes Excess Iron Buildup?

Besides having one or both genes for hemochromatosis, you may also end up with high iron levels for the simple fact that most people don't excrete iron very well. So what's the biology behind iron loading?
Ninety percent of the energy your body creates is by burning carbs or fat with oxygen in your mitochondria to produce adenosine triphosphate (ATP). You need oxygen to burn the fuel because it goes through the Krebs cycle. Ninety-five percent of the time, oxygen is converted to water.
But anywhere from 0.5 to 5 percent of the time, you're going to develop what's called a reactive oxygen species (ROS). The first one is superoxide, which then transforms to the next ROS, which is hydrogen peroxide.
Here's the key: when you have excess iron in your blood, the chemical reaction (Fenton's reaction) doesn't produce water. Instead, the excessive iron catalyzes the formation of hydroxyl free radicals, which are the most potent and destructive free radicals known to man. They will decimate your mitochondrial DNA, mitochondrial electron transport proteins and cellular membranes.
This is how iron overload accelerates every major disease we know of. That's how it causes the pathologies, especially in liver and cardiovascular disease. Believe me, very few health care professionals understand the molecular biology of this reaction, which is why virtually no one is sounding the alarm about excessive iron levels. This is why you need to share this article with your friends and family as you can literally save many of their lives.
It is absolutely vital to confirm that you have safe iron levels, and once they are in a safe range, continue to monitor them so they don't rise. Remember, you don't have to have hemochromatosis to be affected. According to Koenig, iron levels have literally DOUBLED in the general population over the past four decades.
“Serum ferritin was not measured for the first National Health and Nutrition Examination Survey (NHANES I,4 1971 to 1974) was done. But during NHANES II5 (1976 to 1980), they measured ferritin. The male serum ferritin was under 100 nanograms per milliliter (ng/ml). Now the median is close to 200 ng/ml. In some minorities, it’s a lot higher ...
If you look at the scales of premature death and infant mortality in African-Americans versus whites, that big difference can be accounted for by this one element. Hispanic-Americans live longer than white Americans. They also handle the iron a little bit better,” Koenig says.

Beware of High Iron, High-Carb Diet Combination

If you eat a lot of net carbs (total carbs minus fiber), the situation is exacerbated. Unfortunately, most reading this are burning carbs as their primary fuel, which adds another 30 to 40 percent more ROS on top of the hydroxyl free radicals generated by the presence of high iron.
"What people generally have when they eat better, in terms of slowing those little fires down before they become a raging fire, are antioxidants," Koenig says. "The most important one is glutathione. If you don't have good cellular health, including glutathione, those fires (inflammation) will just self-ignite and you'll have a chain reaction of effects that go on until you're really sick.
That happened to me. I got peripheral neuropathy. They try to say it's a diabetic problem, and I never had diabetes. Both of my legs were on fire. The pain was unbelievable. You wind up going to a specialist for that, a neurologist. But when the membranes on your neurological system essentially flare up and melt, the pain is unbearable. But nobody connected that to the iron."

Hemochromatosis, Another Iron-Damaging Disease

About 1 in 3.5 or an estimated 100 million people in the U.S. have the single gene for hemochromatosis. But not all of them get sick with an iron overload disorder. If you have both genes for hemochromatosis, then your risk of developing iron overload and associated health problems rises significantly.
Approximately 1 million people have the double gene variant (C282Y/C282Y), which is considered the genotype most predictive of liver disease complications. However, this only becomes a serious problem if significant iron overload occurs before a diagnosis is achieved and proper treatment can be administered.
Each year there are roughly 36,000 deaths from liver diseases and about 6,000 liver transplants. Most all of these cases are affected by excess iron, whether or not they have a hemochromatosis genotype.
The primary cause for liver transplantation and liver death is non-alcoholic fatty liver disease (NAFLD), a condition that can advance to non-alcoholic steatohepatitis (NASH) and cirrhosis. Excess dietary fructose is likely a primary contributor or initiator to NAFLD these days (especially in children and young adults), but high iron is another major culprit that triggers insulin resistance and disease progression.
Certainly, if you combine a high-sugar diet with excess iron, you’re asking for trouble. That will create a powerfully poisonous, deadly synergy that will accelerate just about any pathology. If you’ve read this far, you probably know more about this problem than your physician. High iron simply isn’t brought to their attention in the medical literature. The reason I know about it is because I’ve been personally affected.
My dad has beta-thalassemia and he gave me the gene, which is a form of hemolytic anemia (similar to sickle cell anemia). As a result of that, my red blood cells die faster than normal, and I’m prone to excess iron. My dad had a ferritin level of 800 when I diagnosed him 20 years ago.
He would be dead by now if we hadn’t taken measures to correct it. He’s now 90 years old. He was recently hospitalized with pneumonia. His doctor did an iron test, which came back “low,” despite being well over 200 ng/ml! They were about to give him an iron injection when my sister intervened and stopped them. Had she not been there, he might have ended up another medical error statistic.

Key Treatment Points

To reiterate, the three keys to control this situation are:
  1. Lower your net carb intake and increase your consumption of healthy fats, including animal-based omega-3, to switch over to fat-burning mode and protect your mitochondria. This will help to radically reduce reactive oxygen species (ROS) and secondary free radical production.
  2. Regularly screen for iron overload with a serum ferritin or GGT level to confirm that you don't have excess iron, and if you do, donate blood to lower your levels.
  3. If you are an adult male or non-menstruating woman, make sure that you donate your blood at least twice a year.
Relying on antioxidants to indiscriminately suppress ROS can backfire, as ROS also act as important signaling molecules. They're not all bad. They cause harm only when produced in excess. You're better off lowering the production of them rather than squelching them after they're produced.
So optimize your ROS levels biologically rather than relying on vitamins and supplements. Eating healthy fats can make a bigger difference than you might think, especially if you have high iron. Koenig explains:
"There was a very interesting group of studies on captive U.S. Navy dolphins. The dolphins had metabolic syndrome. Very, very high ferritin (serum iron). They were unhealthy. Metabolic syndrome in any population is a sign of potential risk of going from diabetes to heart disease. They cured it by providing them good fish to have plenty of fats, where they had been getting fish with poor fats ...
If anybody remembers the film 'Lorenzo's Oil,' that's where children have brain damage as a result of having this metabolism that doesn't create a good mixture of fatty acids in the cell linings. If the cell linings are damaged, particularly if it happens in the brain ... you're going to get hurt
... If you have leakage of iron from subcells, lysosomes, and/or red blood cells (hemolysis) ... it will shoot the ferritin level up high as an indication of risk. That’s when action should be taken. But it’s hard to find specialists. We need a couple of thousand general practitioners who know about this.”

Be Mindful of Food Combos That Promote Iron Retention

Here are a few other tips and suggestions regarding diet. Eating vitamin C-rich food with a meal that has iron will increase iron absorption. If you're anemic, this might be a good thing, but if you struggle with high iron, avoid combining foods high in vitamin C and iron. On the other hand, calcium will bind to iron, limiting absorption.
It impairs iron, so to speak, so if your iron is high, consider eating iron-rich foods with foods high in calcium. Interestingly, curcumin (derived from turmeric) acts as a potent chelator of iron and can be a useful supplement if your iron is elevated.
"For most people that works well. Your body is designed to not over-absorb non-heme iron, which is elemental iron. That's the iron inside vegetables and fruits. If you do something to enhance that absorption, the body will take it in.
The iron from meats you can’t control very well. We’re the only country in the developed world, together with Canada, to put 44 parts per million of elemental iron in our grains and flours.  The other one is the U.K. They put 16.5 parts per million. That’s a lot of iron, and [many] don’t need it,” Koenig says.

More Information

To learn more, I recommend visiting HealtheIron.com, where you can also order your serum ferritin and GGT tests or either of their special FeGGT-LifePRO™ test panels. If either serum ferritin or GGT is elevated, you need to take action. The treatment couldn't be simpler. Unless you're a menstruating woman, simply donate blood two to three times a year. If you cannot donate blood due to restrictions for hemochromatosis, get your doctor to write you a prescription for therapeutic phlebotomy.
Every blood bank can do that for you and many will do it free of charge, so shop around. Otherwise, a typical charge ranges from $30 to $90, which is still fairly inexpensive considering the health benefits. Most people with moderate iron overload will require no more than two or three such treatments a year to keep this risk under control.
There's also a really informative book called "Dumping Iron: How to Ditch This Secret Killer and Reclaim Your Health," which is a well written and easy to understand resource. Remember, high iron may not only be as common, or more, than low iron. It's also more dangerous, and may actually be a factor in a significant number of diabetes, heart disease and cancer cases.
Unfortunately, nearly every physician is still clueless about this, and so you need to be your own advocate if you suspect (or know) your iron is too high.
I believe correcting elevated iron levels may be just as important, if not more so, than optimizing your vitamin D. If you have high iron, you definitely have the pedal to the metal when it comes to speeding up disease and aging. Koenig is a perfect example. He ended up needing a liver transplant as a result of iron overload. In conclusion, Koenig notes:
"If your doctor tells you that you have fatty liver disease, you probably have high iron, high ferritin. He probably will not test you for that. Get the test. You can see some benefit by donating blood, or changing your diet. On my website, I have about 700 publications. If you want to dig into it, it's a section. Find out how to reduce [your iron] by diet alone. It's been done and done successfully."

http://articles.mercola.com/sites/articles/archive/2016/06/12/iron-overload-disorder.aspx

Saturday, 19 July 2014

The food that saves you from liver cancer



You have a one in four chance of experiencing liver problems that can lead to liver cancer. But a study at Oregon State University shows that there’s a food you should be eating that can protect your liver and your life.
LiverAccording to the American Liver Foundation, more than 70 million Americans have a fatty liver. That liver condition can turn into a potentially fatal condition, including the disease known as steatohepatitis (NASH). It can also lead to cirrhosis and liver cancer.
The dietary fat that can save you is an omega-3 fatty acid found in fish called DHA (docosahexaenoic acid). In lab tests, the scientists found that DHA supplementation can reduce the accumulation of proteins implicated in liver fibrosis by more than 65 percent.
“A reduction of that magnitude in the actual scarring and damage to the liver is very important,” says researcher Donald Jump. “Many clinical trials are being done with omega-3 fatty acids related to liver disease. Our studies may represent the first to specifically compare the capacity of EPA versus DHA to prevent NASH. It appears that DHA, which can also be converted to EPA in the human body, is one of the most valuable for this purpose.”

Up to 40 percent of people who develop nonalcoholic fatty liver disease end up with NASH. That can then lead to cirrhosis of the liver and, later, liver cancer.

Friday, 7 December 2012

Does a Fatty Liver Cause a Pot Belly?


Jul 13, 2011 | By Matthew Busse

Does a Fatty Liver Cause a Pot Belly?
Photo Credit Photos.com/Photos.com/Getty Images

Fatty liver, or nonalcoholic fatty fiver disease, is a health condition affecting approximately 10 to 20 percent of Americans, reports the National Digestive Diseases Information Clearinghouse. The condition itself rarely causes any symptoms or visible changes, but fatty liver disease may often be a precursor to more serious liver conditions. If you suspect you are at risk for fatty liver disease, consult your doctor for a diagnosis.
 

Definition

 
Nonalcoholic fatty liver disease, often abbreviated NAFLD or simply called fatty liver, is characterized by the accumulated of excess fat in the liver, as the name suggests, explains the the National Digestive Diseases Information Clearinghouse. While the fat deposits may cause the liver to become slightly enlarged, the effect is not usually visible. Fatty liver is typically diagnosed by a liver biopsy, a procedure in which a sample of liver tissue is removed with a long needle and examined under a microscope.

Symptoms

 
Fatty liver usually does not cause any symptoms and often goes undiagnosed. Fatty liver does cause weight gain or changes in fat accumulation in the rest of the body, such as a pot belly. Left untreated, however, fatty liver can eventually lead to inflammation of the liver, a condition known as nonalcoholic steatohepatitis, or NASH, warns the Harvard Medical School. The inflammation resulting from NASH can damage the liver, leading to scarring of the liver, known as cirrhosis. Severe cirrhosis can lead to liver failure.
 

Causes

 
Rather than cause visible symptoms such as a pot belly, fatty liver may actually be caused by a pot belly or obesity. Although the exact mechanism causing fatty liver disease is poorly understood, it appears to be linked to obesity and insulin resistance. In fact, among obese individuals, the rate of fatty liver disease is between approximately 60 to 75 percent, reports an article published in the January 2005 issue of the medical journal "Digestive Diseases and Sciences."
 

Treatment

 
The best available treatment for fatty liver disease is weight loss. No treatments are known that can directly treat fatty liver disease without reducing the underlying risk factor of obesity, according to the article published in "Digestive Diseases and Sciences." Additionally, weight loss can help with many of the other health risks associated with fatty liver, including insulin resistance and diabetes.

http://www.livestrong.com/article/491594-does-a-fatty-liver-cause-a-pot-belly/

What Vitamins Help to Fight a Fatty Liver?

Mar 28, 2011 | By Marcia Veach


What Vitamins Help to Fight a Fatty Liver?
Photo Credit Jupiterimages/Photos.com/Getty Images
Fatty liver refers to fat buildup in liver cells. While scientists aren't sure why this happens, fatty liver is often found in people who drink too much alcohol. It's also found in people who are obese, have diabetes or high triglycerides. Then it's called nonalcoholic fatty liver disease, NAFLD, or nonalcoholic steatohepatitis, NASH. Fatty liver disease causes inflammation and scarring of the liver, which may lead to cirrhosis. Treatment includes triglyceride, weight and blood-sugar management. Some supplements may also help control this disease.
 

Vitamin E

The inflammation associated with fatty liver disease causes the liver tissues to become abnormally stiff and fibrous. As this progresses, the liver can be permanently damaged and unable to do its job, which is to produce substances for use in food digestion, manage red blood cell reprocessing, store vitamins, build proteins and clear toxins such as alcohol and bacteria out of your system. Vitamin E is an antioxidant, meaning it helps to reduce inflammation. In a study reported in the May 6, 2010, issue of the New England Journal of Medicine, 84 patients who were given 800 IU of vitamin E daily had improved liver enzyme numbers and inflammation, though no improvement was found in the fibrosis of the liver.

Vitamin C

Vitamin C is another antioxidant. A 2005 study reported in the Turkish Journal of Gastroenterology found that taking a combination of vitamins C and E "is a safe, inexpensive and effective treatment option ..., with results comparable to those obtained with ursodeoxycholic acid," a prescription medication most commonly sold as Actigall. As of late 2010, the National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK, considered vitamins E and C as experimental treatments for NASH, and the agency was still carrying out clinical trials to determine the effectiveness of vitamins and other supplements in treating the disease.
 

Other Supplements

Among the other supplements being studied by the NIDDK are selenium and betaine. In June 2006, a report in the Journal of the American Academy of Family Physicians included betaine, along with vitamins E and C, among treatment options for those with NAFLD. While admitting that these supplements, like many other treatments, decrease liver enzymes and reduce the amount of fibrosis or inflammation in the liver, the report concluded that no treatment significantly lessened the incidence of fatty liver disease.

Fatty liver disease can generally be managed by healthy eating habits that keep your weight down, and your triglycerides and blood sugar under control. NAFDL only rarely progresses to become a serious medical issue, but if you have this condition or suspect you may have it, consult your physician before taking more than the recommended daily dosages for vitamins C and E or other supplements

http://www.livestrong.com/article/314733-what-vitamins-help-to-fight-a-fatty-liver/

Fatty Liver and Elevated Liver Enzymes



Could a Fatty Liver Cause Elevated Liver Enzymes?
Mar 28, 2011 | By Suzanne Robin 
    
Suzanne Robin started writing professionally for the Wiley "Dummies" series in 2001. She has co-authored seven books for the series and acted as developmental editor for several more. She has also worked as a registered nurse in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology. Robin received her registered nursing degree from Western Oklahoma State College.
 

Could a Fatty Liver Cause Elevated Liver Enzymes?Fatty liver, which is an accumulation of triglycerides--a type of fat--inside the liver, occurs in a number of disease processes. Fatty liver disease that causes liver damage is divided into two types: alcoholic fatty liver, which occurs in people who abuse alcohol and non-alcoholic steatohepatitis, also called NASH.

Sometimes NASH is called non-alcoholic fatty liver disease. Between 2 to 5 percent of Americans have NASH, and another 10 to 20 percent have fatty liver. The main cause of NASH and fatty liver is obesity. Elevated liver enzymes often reveal liver disease in people who feel well.
 

Types

The blood tests normally done to assess liver function include two enzymes, alanine aminotransferase, also called ALT, and aspartate aminotransferase, or AST. Both ALT and AST are found in cells outside the liver, but ALT is found mostly in the liver and kidney while AST is also found in the heart and skeletal muscle, brain and pancreas.

Cause

Damage to the liver causes ALT and AST to leak into the blood in larger than normal quantities, but damage to other tissues can also cause elevated levels, particularly of AST, in the blood. But strenuous exercise can also raise AST levels three-fold and ALT by 20 percent. Liver enzymes also average 40 to 50 percent higher than normal in obese patients.
 

Classifications

Medical practitioners generally consider levels up to five times higher than normal to be a mild increase in liver enzymes. While NASH is the most common cause of mild elevations in liver enzymes, medications, viral hepatitis, autoimmune hepatitis and other disorders can also cause the rise. Liver enzymes 15 times higher than normal, over 1,000 International Units per liter normally occur in acute hepatitis, poisoning with acetaminophen or other toxic medications or decreased blood flow to the liver, also called ischemic liver or shock liver. Elevations 100 times higher than normal levels occur from medication overdose or ischemic liver injury.
 

Treatment

Treatment of fatty liver depends on the cause. Alcoholics must stop drinking to stop liver damage, while losing weight may help if you're overweight or obese. High cholesterol and triglyceride levels normally respond to medications such as statins, niacin or fibrates.
 

Considerations

If alcoholics stop drinking, fatty liver may reverse itself in as little as six weeks. Losing as little as 10 percent of your weight can help decrease fatty liver. While up to 40 percent of people who have hepatitis C have normal ALT levels they may still have ongoing infection and could benefit from treatment


References

http://www.livestrong.com/article/313172-could-a-fatty-liver-cause-elevated-liver-enzymes/

What Causes Fatty Liver?


 Apr 10, 2010 | By Tina M. St. John, M.D.
 
 
 

What Causes Fatty Liver?
Photo Credit wurstplatte image by Daniel Fuhr from Fotolia.com
Abnormal accumulation of fat in liver cells causes a condition called fatty liver or steatosis. Fatty liver is important because it can trigger an inflammatory reaction, which may cause liver scarring and possibly cirrhosis. Steatohepatitis is the term for fatty liver disease with inflammation. Many conditions can cause fatty liver; frequent causes include excessive alcohol consumption, obesity and a high-fat diet. Fatty liver not related to alcohol use is called nonalcoholic fatty liver disease or NAFLD. If the condition is causing liver inflammation, it is called nonalcoholic steatohepatitis or NASH.

Excessive Alcohol
 
Excessive alcohol consumption is a common cause of fatty liver disease. Alcohol impairs the liver's normal metabolism of fat causing fat deposits within liver cells. Alcohol-related fatty liver may progress to alcoholic hepatitis.

Obesity
 
Obesity is strongly associated with fatty liver disease. Excess dietary fat and increased fat from body stores can cause fat buildup within the liver. As the rate of obesity has increased, so too has the rate of nonalcoholic fatty liver disease. In a 2008 review article published in "Clinical Science," Drs. David Preiss and Naveed Sattar reported an estimated 20 percent to 30 percent of adults in developed nations have NAFLD.
 
Type II Diabetes
 
Type II diabetes is associated with an increased risk for steatosis. The risk is highest among type II diabetics who are overweight and have poor blood sugar control.
 
Hepatitis C Infection
 
Infection with the hepatitis C virus may contribute to the development of fatty liver disease. This is important because the coexistence of chronic hepatitis C infection and fatty liver can accelerate liver disease progression. In a 2010 article published in "Nutrition and Metabolism," Dr. Silvia Mirandola and her colleagues note that approximately 50 percent of people with chronic hepatitis C have steatosis.
 
Medications and Supplements
 
Certain medications and supplements may cause steatosis including amiodarone, methotrexate, tetracycline, diltiazem, tamoxifen, valproic acid, cortisone, prednisone, highly active antiretroviral therapy (for HIV), and high doses of vitamin A.
 
Protein Malnutrition
 
Severe dietary protein deficiency can cause fat accumulation in the liver. Anorexia nervosa, prolonged fasting and restrictive low-protein weight loss regimens may cause fatty liver disease via protein malnutrition.
 
Wilson's Disease
 
Wilson's disease is an inherited disorder characterized by the accumulation of copper in the body. Copper accumulates in the liver causing progressive damage. Fat also commonly infiltrates the liver of people with Wilson's disease.
 
Lipid Storage Disorders
 
Hereditary disorders that interfere with the normal storage of body fats often cause steatosis. Examples of such disorders include Niemann-Pick disease, Gaucher's disease, Weber-Christian syndrome and abetalipoproteinemia.
 
Pregnancy
 
Acute fatty liver is a rare complication of pregnancy. With this condition, fat accumulates in the liver during the late stages of pregnancy. The disorder varies in severity, but is generally progressive until the baby is delivered. Although rare, this condition can be life-threatening.
 

References
http://www.livestrong.com/article/104288-causes-fatty-liver/

Fatty Liver Symptoms Diagnosis & Cure




Wednesday, 14 March 2012

Teetotallers can develop liver disease

ASK THE DOCTOR: Yes, teetotallers can develop liver disease

By Dr Martin Scurr



After a recent blood test my doctor told me I had a fatty liver, but gave little explanation. I would like to know how this came about, as I don’t drink, smoke or eat fatty food. Can you help? I am 75.

Mrs E. Goatcher, Sunbury, Surrey.

First, let me reassure you that your condition is very common — affecting up to one-in-five adults, mostly between the ages of 40 and 60. The official term for your diagnosis is non-alcoholic fatty liver disease, which, as the name suggests, occurs in people who drink little or no alcohol.

This is the most common liver disorder in Western society and, in most cases, produces no symptoms. It is caused by a build up of trigylcerides, a type of fat, in the liver. Patients with the condition often also suffer from obesity and type-2 diabetes, but this is not always the case.

There is a genetic link and evidence suggests the underlying problem is insulin resistance — this means your body has problems metabolising glucose, the main type of sugar in the body. However, a fatty liver doesn’t pose problems unless it progresses to non-alcoholic steatohepatosis (NASH). This is where fat builds up in the liver, causing inflammation and scarring.

While it’s not clear what actually triggers this next stage, excess weight certainly increases the risk. Symptoms include fatigue and right-sided abdominal pain (the liver sits at the back of the abdomen, on the right).

If it’s left untreated, over time, NASH can lead to liver cirrhosis — a more chronic scarring of the liver that affects the function of the organ and can be life-threatening.

 
But all this is two steps ahead of the condition you have, and my feeling is that, at the age of 75, you can be reassured and forget all about this diagnosis — there should be no significant complications and it will not shorten your life.

The only exception would be if someone with a fatty liver has diabetes or is obese, as these might be the factors that cause progression to NASH. You mention that you don’t eat fatty foods — in fact, this is not what makes a liver fatty; sugar is the main culprit.

The sugar in food and drinks is converted into fat and stored in the liver, which means anything with added sugar or added fructose (the fruit sugar piled into fruit juice) is a particular villain.

Note that I am not advising you to avoid eating fruit, just avoid cartons of fruit juice. But, aside from this, please continue as you were, and think no more of this condition.

http://www.dailymail.co.uk/health/article-2114017/Why-does-moving-arm-hurt-much.html

Wednesday, 23 November 2011

Fatty liver may be the next major health woe

By AUDREY EDWARDS
audee@thestar.com.my

Tuesday July 12, 2011


PETALING JAYA: Fatty liver is expected to be a major health problem in Malaysia due to the increasing affluent lifestyle and poor dietary habits.

Malaysian Liver Foundation president Tan Sri Dr Ismail Merican said these two factors were leading to many obese and overweight Malaysians.

“Fatty liver is not harmless.

“In fact it has been shown to progress to liver scarring, hardening and also liver cancer,” he said ahead of the upcoming 9th Liver Update which starts tomorrow and ends on Sunday.

“Lifestyle modifications like exercise and a healthy diet are effective in preventing fatty liver in most individuals,” he said.

He added that doctors and other healthcare providers should not only treat their patients with specific remedies but also educate them on healthy lifestyles.

Dr Ismail said most patients were asymptomatic and usually discovered the condition incidentally because of abnormal liver function tests or enlarged liver discovered when they saw the doctor for something unrelated.

“Elevated liver enzymes are found in 50% of patients with simple steatosis (fatty change).

“Some patients developed non-alcoholic steatohepatitis (Nash),” he added.

“It is thought that about 80% of individuals with fatty liver will not develop significant liver disease.

“The other 20% will develop Nash.From this, between 20% and 30% will go on to develop cirrhosis and end-stage liver disease, where the only real treatment is a liver transplant.”

The KL Hepatitis Day will be held on Sunday with the foundation carrying out free blood screening for hepatitis A, B and C at the Sunway Lagoon Resort and Spa Hotel.

There will also be a public forum to create awareness, counselling and subsidised vaccinations should they need it.

The Liver Update is organised by the foundation and Health Ministry.

It is a series of international scientific meetings designed to update the region on advances in the management of liver and hepatobiliary diseases, including liver transplantation and complex liver surgery.

http://thestar.com.my/news/story.asp?file=/2011/7/12/nation/9079964&sec=nation

De-liver me from illness

TRUE HEALTH
By Dr C.S. FOO

Wednesday June 29, 2011


The liver is a workhorse of an organ that exceeds even the heart in terms of sheer workload. Unfortunately, with modern day lifestyles, it has become prone to becoming ‘fat’.

IN an exercise of gratitude, let us place our left hand just over the lower ribs, on the right chest wall, and whisper, “Thank you, liver ... for all the things you have done in the past, is doing in the present, and will do in the future ... and I will not abuse you again.”

This reddish brown triangular organ may not pulsate nor gyrate, but it works harder than the heart, carrying out more than 500 known functions, and perhaps thousands more yet to be discovered.

Some of the more important roles include handling the nourishment and garbage that comes in from the mouth, neutralising drugs, toxins and poisons, replenishing enzymes and hormones, producing bile for digestion, storing ready energy (glycogen) for any sudden need, ensuring we do not bleed to death, etc ... the list is exhaustive.

Architecturally intricate, the liver cells are arranged in compartments, with blood vessels and bile channels crisscrossing like flyovers and underpasses that can be a model for townplanning.

A diseased delicacy

The Spy Who Loved Me chased after the bad hats and birds in skirts in his heyday. Today, Sir Roger Moore is still chasing birds (of a different kind), and screaming “fowl” over the mistreatment of ducks and geese harvested for foie gras.

In a documentary, he narrated the story of the depths of cruelty that these animals endured in captivity, the graphic nature of which is beyond the scope of this discussion (google foie gras/PETA/Roger Moore ... bon appétit).

In the final stages of fattening the liver, the birds are caged tightly and forcefed via a long tube that is inserted into the oesophagus, where a ball of high-starch feed is pumped into the stomach. The liver gradually and painfully balloons up with fat, enlarging to many times its normal size. Eventually, it ends up on a plate, a gourmet offering that literally melts like butter on the palate. This expensive delicacy is biologically an abnormal and diseased organ, called fatty liver.

Some members of the homo sapien family do have some similarities to our incarcerated feathered cousins, with one or two exceptions. Although not caged, a sedentary lifestyle sets the stage for obesity. Food of high caloric value and in excess amounts finds its way down the gullet without much compulsion. Foie gras of the human liver has become a fashionable and popular addition to the menu of chronic diseases of modern man.

The popular trend of undergoing annual medical check-ups is undoubtedly a wise move. In the minds of most, the purpose is to seek out trouble that may need rectification. Obviously, if a pressing problem is found, urgent and decisive treatment is warranted.


Cruel delicacy: Foie gras is actually the diseased, fatty liver of a duck ... Foie gras of the
 human liver has become a fashionable and popular addition to the menu of chronic diseases of modern man.

Cruel delicacy: Foie gras is actually the diseased, fatty liver of a duck ... Foie gras of the human liver has become a fashionable and popular addition to the menu of chronic diseases of modern man.

What if parameters like blood pressure, cholesterol, fats (triglyceride), blood sugar, etc, are only marginally above the upper limit (referred to as borderline)? What does one make of the instance of mildly elevated liver enzymes (AST, ALT and GGT)? What about that ultrasound report that is “normal”, except for the fine print that mentions a fatty liver?

Apart from a slight protuberance at the belly, there are no detectable signs or symptoms of the disease. Jokes abound about expanding waistlines, but this is no laughing matter as it is certainly a bag of trouble.

Interestingly, many a time, the medical report is forgotten, spawning complacency. Come the next and following years, the diligent process of “screening” is repeated, and the same findings are presented, with a sense of satisfaction that “everything is still ok”.

What is generally not appreciated is that the earlier medical test results that first implicated fatty liver is a harbinger of a family of chronic diseases like diabetes, hypertension, obesity, high cholesterol, heart disease, stroke and liver failure, if left unattended.

The fatty liver

One of the major functions of the liver is to process the oils that we imbibe. As an in-house refinery, it transforms the fats into useful components (yes, like cholesterol) to be distributed to various tissues in the body for usage or storage.

If the fat content in the liver exceeds 10% of its weight, then fatty liver takes centre stage. It is then not only a factory, but a warehouse for fats as well. Alcohol, by its injurious effects, causes fatty liver (alcoholic fatty liver disease), but many teetotalers also harbor a similar condition. Non-drinkers with butter livers are said to have “non-alcoholic fatty liver disease”, or NAFLD for short.

In our own backyard, we are facing an escalating weight problem, with the incidence of overweight (BMI 25 to 30) in adults doubling over the last 20 years (it now hovers around 30%). At this alarming rate, one can estimate the incidence of fatty liver to be at least one in 10 adults.

The root cause of NAFLD is overindulgence in the wrong kind of carbohydrates and fatty foods. Foods that spike the blood sugar (known as high glycaemic index items) are the kind of choices we make repeatedly on a daily basis, such as rice (especially Jasmine rice), white bread, potatoes, etc.

What goes up comes down even faster, as the blood sugar crashes. This is the result of an outpouring of insulin from the pancreas in a hurried attempt to normalise blood sugar.

However, due to a sedentary lifestyle, the blood sugar is not utilised and converts to fat, distributed to the middle (known as visceral or “hidden fat”). The fat cells in the tummy become so overfilled that excess literally drips out into the circulation to lodge at the next port of call, namely the liver.

Hence, fat begins to accumulate in the liver cells (steatosis), interfering with the many functions it has to perform.

Bashed by NASH

Of course, we can choose not to make a change to the recipe for better health. Sticking to the old ingredients is the perfect plan for undesired outcomes.

Fatty liver is relatively harmless in the early stages, but storing highly combustible material in the wrong place is hazardous over prolonged periods. The liver cells are not fat cells and are not meant to keep the excess fat. Forcing them to accumulate the fuel against their will eventually make them unhappy. They soon start a fire.

Fat in the right places can be burned for energy, but in a depot like the liver, the unstable fat stores undergo oxidation (peroxidation) and generate toxic chemicals that injure the surrounding tissues, setting up an inflammatory reaction.

The presence of fatty liver with inflammation is called NASH (non-alcoholic steatohepatitis). The blood test results are now not so okay, with the liver enzymes beginning to climb. The organ swells up, and now there might be a slight discomfort, over where the palm of gratitude was previously placed (refer to the opening sentence).

In the presence of repeated and prolonged inflammation, the liver structure loses its architecture, and normal tissue is replaced by fibrous strands. Eventually, the liver shrinks and hardens as cirrhosis sets in.

The organ is now unable to cope with all the demands placed on it, and begins to malfunction, a state known as liver failure. The outlook appears bleak, with a host of nasty complications waiting to explode.

Non-alcoholic fatty liver disease (NAFLD) is a spectrum ranging from mild fatty change to liver inflammation (NASH), eventually culminating into cirrhosis.

In the early and mild fatty liver stages, there is nothing much the medical caregiver can offer, except healthy lifestyle advice and good information. Throwing the switch for change is a personal choice. Unfortunately, many eventually contribute to statistics of modern disease because doing the right things can be difficult for some.

Although there are no specific medications, lifestyle change must be instituted so that early fatty liver can be reversed.

The ideal pattern of behaviour to ameliorate fatty liver involves a triad of:

> Exercise, at least 30 minutes daily.

> Select low glycaemic foods, keeping to good fats below 30% of caloric value.

> Supplementation based on scientific evidence (beware of poorly standardised herbal extracts and products with purity concerns, as these can potentially add to the toxic burden on the liver).

Taking smaller, frequent meals is better than large feasts as this places less demands on insulin, thereby avoiding large swings in sugar levels. Empty calories (eg carbonated beverages) and calorie-dense foods (eg muffins) just pile on the numbers, but do not contribute any significant nutritional value.

Choice of supplements should include broad spectrum antioxidants, vitamins and minerals. Glutathione is an important antioxidant enzyme (especially in liver cells), which require selenium, N-acetyl cysteine and other members of the antioxidant team to be replenished.

A bioflavanoid extracted from the seed of the milk thistle plant has shown promising results.

Alpha-lipoic acid works in concert with the other members of the antioxidant orchestra, enhancing the defences and recycling vitamin C, E, glutathione and co-enzyme Q10.

The danger of misreading information like this may spur the reader to trot off to the nearest pharmacy and fill up the shopping basket. The dosage, balance and ratios of nutrients must be safe and effective.

Seek advice from a nutritionally interested professional, rather than a DIY jigsaw puzzle.

Modern day livers are as stressed as the owners. The poor organ is working overtime, but we relentlessly choke it with processed foods, fake foods, drugs, alcohol, and what not. If ducks in the foie gras farm could talk, they would quack, “Stop the torture!”

http://thestar.com.my/health/story.asp?file=/2011/6/29/health/8962949&sec=health