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Old 01-13-2013, 10:28 AM   #1
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Unhappy Fatty Liver- in Ultrasound

On a routine check up, my USG report says I have grade I fatty liver, with normal liver size. My MCV is94.6fl. AST is 19 u/l and ALT is 32 u/l . Alkaline phosphate is 68 u/l GGT is 28. They look normal.I drink about 3 to3.5 pegs daily. I have BP for which I am under medication and my LDL is180.
What i my picture like? Do I change my habits ? Is it safe to drink moderately again? I must start medicines for my cholesterol? What is the USG picture saying vis a vis my LFT profile ?
Would be glad to get some help and future advice.
Thank you much-G

 
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Old 01-15-2013, 04:45 AM   #2
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Re: Fatty Liver- in Ultrasound

What your usg shows is mild fatty liver which is actually more common than you would think but it won't necessarily progress to anything serious. Your LFTs are good but your mcv is a little high which may be because of the alcohol. Your biggest issue is your ldl is high and needs some work to bring it down but you also want to pay attention to your triglyceride levels, and HDL if it is low so you need to make some dietary changes (can be hard imo with the Indian diet because it tends to encourage high chol for susceptible people) and or go on meds. Your drinking is not excessively heavy but it is above what is considered healthy so you want to bring that down a bit too and if possible skip the alcohol at least a few days a week but addressing your chol is important and these things will help your liver also and reverse the fat, but high chol shouldn't be ignored regardless of the liver fat.

Last edited by captjane; 01-15-2013 at 04:47 AM.

 
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Old 01-15-2013, 09:12 AM   #3
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Smile Re: Fatty Liver- in Ultrasound

Thank you, Captain Jane. It has been a relief. My triglys is within range (135) and HDL looks good (45). One more question. Do you think Atorvastin (10) is safe , one daily, for the Cholesterol high? And some fish oil tablets ? I have been taking Omega 3 for a while thinking that's good for cholesterol. But it doesn't seem to be working by itself.And is Atocor safe on a mildly bright liver? Or will add to AST ALT problems? . Anyway I have started taking Atocor 10- one daily. And, it also looks like my Thyro ultra sensitive Eclia came to 7.4. So. I am taking Thyroxine-25. Is this OK? And you feel I can still tipple of and on moderately with all this without much worry? While thanking you for post 1 , hoping I can wait for your reply-

 
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Old 01-15-2013, 10:16 PM   #4
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Re: Fatty Liver- in Ultrasound

A couple of thoughts if I may interject here...

As Captain Jane mentioned, fatty liver is common and not all that alarming as long as inflammation (enzymes) are low. Adding statins/Atorvastin into the mix at low doses may not change things, but I would want follow-up checks on liver enzymes at 3 and 6 months to confirm inflammation does not increase. This has been the standard of care with new statin prescriptions, but some doctors are now leaving the follow-up studies to the next annual checkup, and this may not be wise.

Also... Fish oil/omega 3's and alcohol are a bad mix. At low doses of each there may not be problems, but researchers have actually used fish oil and alcohol to induce liver disease in lab animals. Fish oil can have anti-inflammatory benefits, but fish oil also oxidizes very easily, and acetaldehyde produced during alcohol metabolization can cause excessive oxidation of PUFA's/fish oil/omega 3's in the liver.

A recent large study has shown vitamin-E to be better than any medicine (metformin) at controlling inflammation in fatty livers, and anytime fish oils or omega 3's are supplemented, vitamin-E might be a wise addition to the mix, especially if alcohol consumption is to be continued. Google around on: fatty liver and vitamin-E for more on this.

My thoughts on statins are, if you or your parents have a history of heart disease, statins would be an important medication to consider. If there is no family history of heart disease but your cholesterol is high, it shouldn't hurt to try them and see if they cause problems. If you run into problems mixing statins, alcohol and fish oil, then a risk/reward analysis of each would be prudent.

Moderate alcohol consumption has been shown to give substantial protection from heart disease, and statins have too. If they don't mix well with you, you will need to decide which to give up to maintain the quality of life you desire, balanced against the risks involved. Ask your doctor if it would be safe to supplement vitamin-E, and you may be able to enjoy the benefit of all three (statins, alcohol and fish oil/omega 3).

Most important of all, is that you get follow-up blood labs to see how this combination is affecting your liver's health.

Best of Luck to you, and Stay Healthy!

Last edited by BillinSD; 01-15-2013 at 10:37 PM. Reason: typo

 
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Old 01-15-2013, 10:28 PM   #5
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Re: Fatty Liver- in Ultrasound

Yes it's safe to take the cholesterol meds, but your doc should do LFTs every so often while you are on it, but it's the same for everyone who takes them. Drinking in moderation is ok, so even if you cut back to 2 drinks a day it will make a big difference and it may help your bp to come down a bit as well, but obviously if you cut it down further it will be better for you, it may also be better to separate your chol med from drinking so your liver is not trying to process both at the same time. The thing that will make a big difference is reducing the saturated fat in your diet, and that comes from things like cheese, full fat milk, cream, fatty meat (instead of lean meat with fat cut off), coconut milk etc, anything with high levels of saturated fat will raise your ldl. Fish oil is good for lowering triglycerides but it won't control your ldl cholesterol, but it's good for you as long as your stomach can tolerate it because it can cause bad heartburn and stomach upset but if it doesn't bother your stomach then just take it anyway because it's high in omega3, or you could instead eat fish 2-3 times a week. Don't be too concerned, your liver is functioning normally and usually you wouldn't have a usg unless your enzymes were elevated to begin with or if your doc could feel it was enlarged but you don't have any of that.

 
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Old 01-17-2013, 11:51 PM   #6
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Cool Re: Fatty Liver- in Ultrasound

Thank you, Captain Jane, and Billin SD, for all your wonderful answers. Good, I could trip on Health boards and find you both. For a while Iam leaving Alc, and bonding with stat. Let me see the check up in another two months.
By the way, if I may ask, incidentally, my wife's report came up with an enlarged liver (but she has no alcohol issues) and her enzymes are fine , and low. Why so ? Unlike me she is a puritan. She is imagining many things. Is there any concern ? Hope this is not trouble ! Thank you again, Jane & Bill

 
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Old 01-19-2013, 09:46 AM   #7
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Re: Fatty Liver- in Ultrasound

Thanks for the kind words Gopikrishnan...

I assume your wife's "enlarged liver" would be due to excess fat in the liver, though there could be other causes and I would encourage you to ask her doctor if fatty liver is what he thinks is going on.

Fatty liver seems to be rapidly becoming an epidemic problem all around the world. I'm not too well read on the subject, but it seems high carbohydrate diets and increased sugar intake are more likely to cause fatty liver problems than actual fat in the diet. The big move away from saturated (animal) fat to polyunsaturated (vegetable oil) fat over the last couple decades may also be a factor.

The difference between having a fatty liver and having "fatty liver disease" is determined by whether or not the fat in your fatty liver is getting oxidized (lipid peroxidation) and causing inflammation. Low normal liver enzymes indicates oxidation is not presently occurring, but having excess fat stored in the liver may predispose one to lipid peroxidation if future metabolic events occur to trigger this.

Chemical exposures and many drugs and medications can trigger oxidation so it is best to monitor liver inflammation regularly as long as fatty liver exists. Vitamin-E is the liver's best tool to keep oxidation of stored fats under control and many doctors are now beginning to see the risk/reward profile of supplemental vitamin-E as a wise precaution against potential development of inflammation in patients with fatty livers.

Vitamin-E is available in both synthetic and natural forms and many believe the natural form of vitamin-E to be both safer and more effective than the synthetic form. Synthetic vitamin-E is typically the dry from found in multivitamins and tablets, where the natural form is typically found in the oil based "gelcaps". It should say "natural" on the label, but you can tell the difference by looking closely at the ingredient on the back.

Natural vitamin-E is: d-alpha tocopheryl... The synthetic form is: dl-alpha tocopheryl.

I'm not a doctor, and it's best to ask yours about starting new supplements but the evidence is quite compelling. More and more studies are now showing vitamin-E as the "best medicine" known to keep fatty livers from developing oxidative inflammation.

Best Wishes for good health for you and your wife.

 
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Old 01-24-2013, 10:33 AM   #8
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Wink Re: Fatty Liver- in Ultrasound

Dear Billin,
sorry that I did not reply earlier. What a nice, earnest and profound answer!
Like I said it is my good fortune to be able to be in contact with feeling guys like you. Am lying low at the moment.

Hope I have luck!

 
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