Tuesday, August 28, 2012
When I went for my yearly physical in June of 2011, part of it was a blood test. I went back to my Doctor for the blood test results two weeks later and she was NOT happy with my Liver Enzyme readings. They were higher than she was comfortable with and my iron was WAY HIGH! I was taking One-A-Day vitamins for women and had bought the one with iron by mistake. I stopped taking that and went back for another blood test a couple of months later. The iron problem was corrected, but the other enzymes were still high. I started drinking a Detox Tea and also the juice of a lemon in my tea or water daily. In May of 2012, I had the blood test repeated and the enzymes were still up. My Dr. was leaving for another job and I saw a new Dr. in July of 2012. Once again, the liver enzymes were high and this time, the new Dr. sent me to a Gastroenterologist. This appointment was yesterday. I should also mention, that I had an ultrasound of my liver and there weren't any signs of possible cancer..........no growths or masses. This was a relief, but not a "For Sure" that cancer was not a possibility.
The Gastroenterologist looked over all of my previous test results and did a complete history of other medical conditions. Then she asked me how much alcohol I consumed. My family doctors had asked the same question. This is because cirrhosis is the most common liver problem and is usually caused by too much alcohol consumption. I told her that I do have wine or a lite beer every so often (maybe once/week or every other week). This is definitely NOT problem-drinking. This ruled out alcohol as the cause. Then she told me about Fatty Liver Disease. I have been over weight for the past 30 years. Nonalcoholic fatty liver disease was rarely diagnosed before 1980. But today, NAFLD is believed to affect as many as 30% of adult Americans. NAFLD is not a single disease. It's a spectrum of disorders, all marked by the accumulation of fat inside liver cells. Under the microscope, this fatty buildup looks just like alcohol-induced fatty liver disease, but it occurs in people who consume little or no alcohol.
NAFLD usually causes no symptoms and few, if any, complications. However, some with NAFLD go on to develop serious problems. The exact cause is unknown. Its emergence as a recognized and increasingly common disorder coincides with the epidemics of obesity and Type 2 diabetes. Both are associated with insulin resistance.
Obesity and insulin resistance, in turn, are implicated in "Metabolic Syndrome," a group of risk factors that increase the risk of cardiovascular disease, including a large waist and high triglycerides (a type of blood fat). Some experts consider NAFLD a symptom of metabolic syndrome.
The leading theory about NAFLD is that it's a result of metabolic changes driven by insulin resistance. More fat stays in the liver, accumulating in tiny sacs in the liver cells.
In its simplest form, NAFLD is just fat in the liver cells. This condition is called steatosis. While steatosis is not normal, it causes no symptoms and by itself is usually harmless. However, 5% to 20% of people with steatosis will develop a more serious form of NAFLD called nonalcoholic steatohepatitis, or NASH. In NASH, the fattened cells cause inflammation, swelling and cell death.
NASH is usually a relatively stable condition with few symptoms. Most people don't know they have it unless it shows up during a blood test or imaging procedure performed for other reasons. But unlike steatosis, NASH is not harmless.
In some, it progresses slowly, over the years to decades, sometimes causing vague complaints, such as fatigue, discomfort in the upper right abdomen or a sense of being unwell. Underlying these complaints may be a cascade of serious damage to the liver that culminates in massive scarring and impaired liver function called cirrhosis, the most advanced stage of NAFLD. Cirrhosis is irreversible and can lead to liver failure or cancer.
NASH is most closely associated with obesity, Type 2 diabetes and hyperlipidemia (high blood levels of triglycerides or cholesterol)---conditions that, along with hypertension, constitute metabolic syndrome.
But not everyone with obesity, Type 2 diabetes and abnormal lipids has NASH. And some people with NASH have none of these risk factors. This suggests that genes and other factors play a role.
There's no cure for fatty liver disease or NASH. Treatment is aimed at reducing or preventing further fatty buildup and addressing underlying risk factors, such as obesity, diabetes and hyperlipidemia.
Lifestyle changes such as weight loss and a healthy diet can help. You may also want to talk to your doctor about medications to lower blood sugar and cholesterol and vitamin E supplements.
People with NASH should not drink at all. And people with simple fatty liver---that is, steatosis---should at least minimize their alcohol comsumption.
It makes sense to avoid exposure to other liver toxins and to get immunizations against hepatitis B and A. But the most important measure of all is SLOW, STEADY WEIGHT LOSS---and that requires a balanced, calorie-restricted diet along with regular exercise. It's another example of how lifestyle choices improve health.
According to the Gastroenterologist, my readings are NOT high enough to be scared. They will be monitored on a monthly basis. When they start to go down, they will be monitored less often. I am to lose weight and exercise and drink in moderation (I am already on that road). And, because I am on a pain medication that is also an anti-inflammatory, I am to take that ONLY AS NEEDED. N-SAIDS and Tylenol and CELEBREX, etc. are all very hard on our livers. I hope that this informations helps some of you and maybe answers some questions.