to be worried about DH's fatty liver... this is getting ridiculous now

[emeraldgirl1]

He was told two years ago that he had a fatty liver (blood tests taken for a random reason showed alarming high levels of liver enzymes - most associated with v heavy drinker but he drinks only about a bottle of wine a week maximum).

He was rubbish for 2 years and barely lost weight, but then had a wake-up call six months ago when I finally made him go to a specialist who said his liver enzymes were way too high and he had to try to lose weight and if he did not he would have to go on statins.

Good on him, he lost weight over these past six months, all come off the tummy which is where he always stored it.

He has just gone back for repeat blood tests and the liver enzymes have barely lowered.

Next step I think is a v v low-fat diet and if that doesn't help we'll know it's a genetic thing (which I suspect anyway as his granddad died of heart attack at 50) and medication will be the only option.

He's only 35 so statins seem a bit much :(

I'm just a bit fed up as he/we have worked very hard to lower his weight and it just seems like he is completely buggered thanks to his genes.

Anyone else have this problem and could a really low-fat diet help? He has a good diet now but it's a fairly high fat one.

please don't think of it like that.
The problem has been picked up and statins have been invented so that, with proper treatment, he will not die at 50 like his grandfather. That is a good thing.

A low-fat diet is probably not the answer. High carb diets (I.e., the traditional food pyramid) cause metabolic disorders, ergo a fatty liver.

It's taken my husband 4 years to see the light following hospital blood tests for medical trials for "slightly overweight" men revealed his triglycerides too high. :(

Get him to take a look at www.marksdailyapple.com

I agree with DolomitesDonkey. If he doesn't drink much then fructose is probably what is causing the problem, like ethanol it is only metabolised by the liver and is converted straight into fat. Get him off all sugar and fruit (except a few berries as the odd treat) and have him eat unprocessed food - meat, veg (especially green, leafy veg) and natural fats like butter and extra virgin olive oil.

Have a search for statins on John Briffa's blog - there is no evidence that statins reduce overall risk of death (which is the only thing you should really look at in a drug) and they actually have some pretty terrible side effects.

Thanks everyone... An update now that we have seen the print out of results... Ok, his triglycerides have come way down and are within normal range now. Cholesterol lowered too though still marginally high.

But the liver function tests are still way way off the scale high.

We are hoping that maybe this is because he has had fatty liver for many years up until getting his blood fats etc down this past 6 months and that maybe the liver enzymes are still high as a result of this long term fat and will come down now his fats are down.

He was tested for hepatitis two years ago and that was negative.

So if it is not as I am hoping then I don't know what the cause of the v high liver enzymes could be :(

Am pregnant and really would prefer to be avoiding all this anxiety!!!

I had very high liver enzymes due to a med they tried on me and in one month it really messed my liver enzymes up. Even after stopping the meds the numbers kept creeping up. They checked for hepatitis and everything. else they could think of
It took loosing weight and exercise and 2 years to get mine finally back to normal.
Now my triglycerides are really low, HDL is high and LDL is also above where it should be, we are thinking this is genetic for me. No way I can improve the LDL numbers, 5 hours as week of hard exercise and a restricted diet, fish oil and other supplements haven't budged it at all. I have pretty much given up. Still exercising (down to 4 hours) and still taking the supplements just in case.
I'm low risk for heart problems anyway as they checked my c-reactive protein (lovely and low)

California thank you so much for post!!

so you took 2 years to get your enzymes back to normal after they got messed up? That is really reassuring to hear, thank you. I guess it has only been a few months since DH got those fats out of his liver so it could take longer. I wish we had the previous results so we could see if they had reduced even a bit since 6 months ago!!!

I was shocked it took so long, I think the doctor was too, he would look a little freaked out when he'd read me the results. He sent me for blood every two or three months and it would drop slightly then go back to where it was and he was debating sending me to a specialist when it finally started coming down very slowly and not going back up.
I went online and googled what I could do/eat anything to try and reduce the levels. Theres quite a lot of info on diet and supplements for fatty liver. I would read and then google what I found and read opposing views before deciding to try anything.

could they refer him to a dietician to ensure he is eating at optimum for his condition?

I agree with Dolomites and Queenstromba. Fat is NOT the problem, it's carbs, especially fructose, sucrose (anything with "ose" on the end of the name), and grains...

Read The Diet Doctor blog, and Robb Wolf paleo blog and make up your own mind... it will go against all the advice you will get from most drs and probably all dieticians... but this is probably the diet your DH needs if he wants to avoid taking statins for the rest of his life.

Oh yes the Paleo diet is supposed to work wonders.
I am working on that part and have taken on much of it already. I will say I'm a work in process and getting better at it. Refined food are already out the door along with artificial sweeteners, High fructose corn syrup and most processed foods. Sadly I haven't given up Dairy, I do like yogurt and a small amount of cheese.

Well, statins aren't the end of the world, anyway, although I understand the desire to stay off meds. I've been on them since my 30s but, thanks to my genetics, my cholesterol would be high if I ate only lettuce. My 75 year old father has been watching his since he was about 20, long before most people knew what cholesterol even was!

I will add to the 'watch the carbs' chorus but caveat that with 'but don't eliminate them entirely'. Just make sure he's eating the right sort. Cutting any food group completely out of your diet is just as bad as too much of one.

He might benefit from the 'plate method' that many type II diabetics use to control their blood glucose without meds: regular sized dinner plate, fill 1/2 with veg, 1/4 with protein, 1/4 with complex carbs.

Thanks v much everyone for replies!

Yes, the low-carb advice is good, in fact that is the way that DH has lost the weight he has lost already. He has been eating good fats and low (but not no) carbs and the weight has slowly but surely come off.

So we are not too worried about his triglycerides any more, the worry is the liver and why the enzymes are still so very high.

He is hoping (assuming!) that it could just be that it may take the liver time to get back to normal from the inflammation caused by years of fatty liver.

I am very worried indeed that it is something more sinister :(

May be being irrational but pregnancy has that effect!!

Sadly I haven't given up Dairy, I do like yogurt and a small amount of cheese.
Worth having a look on The Diet Doctor blog California, it's Swedish, they love their Paleo/low carb diet WITH dairy... butter and cream especially, I think because although dairy is not a natural part of the human (adult) diet, it is esentially just natural animal fat and no different than eating the fat off the meat of the animal IYKWIM.

So we are not too worried about his triglycerides any more, the worry is the liver and why the enzymes are still so very high.

Emeraldgirl... what type of carbs is he still eating? If still eating grains (especially gluten containing ones), it maybe worth cutting these out totally for a few months to see what happens.

Thanks v v much Scotch - he is eating quite a lot of brown rice and quinoa and pure rye breads... but he does still also eat a little bit of white pasta. Do you think cutting this out could help reduce the liver enzymes/inflammation?

Gluten is highly inflammatory and a lot of people are sensitive to it in some way. He's almost gluten free now anyway so it's definitely worth cutting out the pasta and the rye bread to see if that helps. I'd also recommend fish oil supplements as omega 3 is anti-inflammatory and to cut out and vegetable oils other than olive oil, flax/linseed oil and coconut oil as they contain high levels of omega 6 which is pro-inflammatory.

The quinoa and pure rye breads aren't so bad, but brown rice is no different in carb content than white rice...

If he wants a bit of "stodge" he can have mashed swede for example. I served this up to my type I diabetic mum last week with cream & mint for flavour, the results on her blood sugars were quite extraordinary.

Doesn't seem to matter that I've been telling them this for 10 years, my dad still feeds her brown rice & pasta thinking it's "good".

The advice from diabetic clinics/NHS is quite shit - they still push carbs. :( What on earth is the point of doing a degree in nutrition if you simply repeat bad advice rather than researching evidence.

Cauliflower also makes a pretty good mash substitute, especially if it has cheese on top - I've fed it to my veg hating DP as part of a fish pie and he didn't notice the difference. If you have a food processor you can also make a good rice substitute from cauliflower. Cut the florets in half or quarters depending on size, put them in the food processor and pulse until they are in roughly rice sized pieces and then microwave in a closed tupperware box for 2.5 mins and let stand for another 2.5 mins.

Has he had any other tests? High liver enzymes can be caused by sarcoid (they are in our family).

Has the consultant encouraged him to lose any more weight or exercise more ?

Statins now seem to be prescribed quite regularly for Non-Alcholic Fatty Liver Disease

Thanks v v much Scotch - he is eating quite a lot of brown rice and quinoa and pure rye breads... but he does still also eat a little bit of white pasta. Do you think cutting this out could help reduce the liver enzymes/inflammation?

Mmmm, the brown rice, not really any better than white rice, with regard to it's effect on blood sugar/insulin response (ie the cause of metabolic disorder), infact, I've tested this out myself - I'm not diabetic but as suggested by some articles on The Diet Doctor blog, I bought a blood glucose monitor to run a series of experiments to see how different foods affect me (and my DH also had a go!) - result, a low carb meal with a portion rice added (brown or white) had a worse effect on both of us than a large serving of haggen daz, spiking blood sugar higher and for longer (right to the higher edge of "normal"). On a Paleo diet both DH and I have fantastic blood sugar levels and I think the experience of doing the testing for a few weeks was very, very instructive and worth while - a fantastic motivator (for lifestyle change) which I would recommend any one to do (cost is not huge, less than £50 for the entire kit).

This is not a reason to eat Haggen Daz (I did that purely as an experiment ), but probably a very good reason to cut the rice.

The advice from diabetic clinics/NHS is quite shit - they still push carbs. What on earth is the point of doing a degree in nutrition if you simply repeat bad advice rather than researching evidence.

Dolomites, THIS, exactly, but they are only giving people the advice they have been told too, even though there is mounting evidence that it's wrong.

I am a cynical person, and can see that profits from drug sales drive drug companies to keep pushing that low fat, high carb message - they can't make money out of telling people the modern diet is killing them, but they can make a killing (literately) out of diabetic, heart diseased, high blood-pressured, fat livered, gall-stoned people!