Help me heal my fatty liver? IKYANMD
August 23, 2013 2:42 PM   Subscribe

I'm a 57 year old Mexican woman with "fatty liver". My liver enzymes are elevated (790.4) and I'd like to heal this fatty liver but it hasn't changed in the past 8 months. I am diabetic, non smoker- non-drinker, 150 lbs, I am mostly vegetarian and exercise 3 times a week. I am on insulin and janumet. Thanks (I know you are not my doctor)
posted by kikithekat to Health & Fitness (17 answers total) 4 users marked this as a favorite
No one here is going to have better suggestions for you than your primary care doctor. There is a whole work-up that you may or may not have had done to establish the cause of your liver enzyme elevation. Without that information, we can't say anything helpful at all.
posted by killdevil at 2:47 PM on August 23, 2013 [2 favorites]

Response by poster: what is the name of the work up so I can request it please
posted by kikithekat at 2:51 PM on August 23, 2013

The work-up is probably just the Complete Metabolic Profile, which may be what they took in order to determine your enzyme levels. Did you doctor not say what he thought the cause was? Did you have any symptoms that led them to check your enzyme levels?
posted by Lutoslawski at 3:05 PM on August 23, 2013

Medically supervised fast. Check the scientific literature - it takes you to ketogenesis to remove fats on liver.
posted by zia at 3:08 PM on August 23, 2013 [1 favorite]

This subject has come up on one of the podcasts I listen to, the Dr Rob show. The episode that talks about it is here:
posted by photoexplorer at 3:30 PM on August 23, 2013

If you haven't done so already, can you consult a hepatologist?
posted by florencetnoa at 3:30 PM on August 23, 2013

Lots of medication elevates your liver enzymes, even over the counter ones (like tylenol!). Make sure you tell your doc about *everything* you are taking.
posted by bensherman at 3:38 PM on August 23, 2013 [2 favorites]

I'm going to try to be a little more explicit since your AskMe question history implies you were told you have "elevated liver enzymes" as the result of a work-required blood test but haven't had this problem looked into further. You should go see a primary care doctor and tell them what you've told us. There's a long list of things that can damage your liver's cells, causing liver enzymes to leak out into your bloodstream where they can be detected by blood tests. On that list are nasty things like Hepatitis C and autoimmune hepatitis as well as a bunch of less severe possibilities.

Any primary care doc will know what tests to get to figure out what's going on. Please go see one as soon as you can.
posted by killdevil at 3:50 PM on August 23, 2013 [1 favorite]

NASH is a difficult topic but as an insulin dependent diabetic it's quite tricky to treat, especially considering that your weight is very reasonable. The metabolic panel isn't going to add any new information. Last time I checked NASH was still a diagnosis of exclusion so medication side effects, hepatitis B&C must have already been examined as potentially responsible.

Weight loss and exercise are the only things I've seen that had any firm evidence for helping, I'm afraid.
posted by hobo gitano de queretaro at 3:55 PM on August 23, 2013

I don't even resemble a doctor, so please don't take my word for it, but in the past week I heard comment somewhere -- M- or N- Public Radio or The Today Show, almost certainly -- that having a cup of coffee or tea in the morning may stimulate the processing of one's fatty liver enzymes by virtue of the caffeine therein, or something along those lines.

Again, I have no idea whether this even resembles a valid suggestion, just passing it on.
posted by mr. digits at 4:43 PM on August 23, 2013

I think you should go back to the doctor who gave you the test and ask what to do.

When you say, "liver enzymes are elevated (790.4)", are you reading this off the test results? To make billing and other things easier, everything the doctor does is assigned a code. The coding system is called ICD-9-CM. The 790.4 code means "Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase".

If you were to look up those first words, you'd find a wikipedia article like this one. It talks about the normal and too-high range, which should also be on your test results. This would give you an idea of how big a problem you have.

But still you should talk to the doctor because of some of the other things in that article -- the causes. The causes are serious problems, and your doctor must explain what to do to protect your liver. I think, the problem isn't a high number. The high number tells you there is a problem. You must fix the problem (cause) to lower the number.
posted by Houstonian at 5:17 PM on August 23, 2013

Response by poster: Hustonian I think you're right! it's not 790.4 I think.. I've attached the image, can someone look at it? here is the link
posted by kikithekat at 5:50 PM on August 23, 2013

I think the doctor was ordering the test that has the code 790.4 -- that is the test code number, not the test result. Did the doctor ask you to not eat or drink for 8 hours and then he drew blood? That would be the test. He sends the blood to a lab, and then they give him the test results on another piece of paper.

If you did not take a blood test, I think he wants you to. You make an appointment with him, and no food or water for 8 hours. Then, he talks to you about the test result when it comes back (about a week later). If the test result is not good, he tells you what to do to make it better.
posted by Houstonian at 6:16 PM on August 23, 2013

Response by poster: Yes, I fasted for 8 hours then they drew my blood. He said it was elevated but I didn't get the exact number.. The furst time I had the test was about 8 months ago. The most recent time (that image I uploaded) was about 10 days ago.
posted by kikithekat at 6:27 PM on August 23, 2013

790.4 on that page you posted is the code for the diagnosis, as Houstonian said.

The page also says "RUQ US", which stands for right upper quadrant ultrasound, meaning that you have not just been diagnosed based on blood work - the ultrasound would show fatty liver.

Weight loss is the only thing you can do, and it will help with your diabetes too - so I would focus on that if I were you. As you probably know, both of those issues can cause some really serious complications in the long term.

I know you gave your weight and your diet and mentioned exercise, but that doesn't tell the whole story. If you're my height (5'3") and you're 150, you're overweight. If you're a vegetarian who eats a diet of cheese puffs and ice cream, you're not eating healthy. If your exercise is walking around the block and the rest of the week you're sitting at a desk or on a couch, you need more exercise.

Maybe none of these things are true, but I'm just making the point that more information is needed here to know what you might need to do to improve your health. Like others here I would recommend talking further to your doctor about this, and also requesting a referral to a dietician if you have not seen one already.
posted by treehorn+bunny at 6:36 PM on August 23, 2013

Response by poster: OK, i just checked, my true height is 5'4", and I am 137 pounds. I'm not skinny, but I'm not fat. I eat mostly whole foods, salads, brown rice and beans, yoghurt, fruit,almond butter, pistachios, peanuts, I eat fish about once a week, and meat about twice a meat. I don't eat any red meat. I cook almost all my meals, and I eat out about once a month.

I walk to the local gym, average 3 times a week 1 mile each way (2 miles today), I do a 60 minute aerobics class, I do weights twice a week.

I'd like to lose weight I guess then. I guess I will completely cut out meat, and walk more
posted by kikithekat at 6:48 PM on August 23, 2013

With those stats, you're not overweight. Therefore, I doubt losing weight would fix this. Also, cutting meat from your diet doesn't automatically make you lose weight.

Please find a way to talk to a doctor about this, rather than trying to 'fix' this yourself.
posted by Ms. Next at 3:23 AM on August 24, 2013 [2 favorites]

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