Fatty Liver

by David Mendosa Patient Advocate

I have a fatty liver. There aren't any symptoms, but the sonogram that I just had confirmed it. My doctor suspected it when a couple of my liver enzymes were too high in late September for the first time.

The question now is whether I have NASH. That's what people usually call it, because it's shorter than nonalcoholic steatohepatitis for which it stands.

While it isn't normal to have fatty liver, about a quarter of Americans have it. By itself it probably causes little harm or permanent damage. But NASH is serious and can lead to cirrhosis, which permanently damages the liver so that it doesn't work well any more.

Cirrhosis of the liver is a well-known consequence of alcoholism. But I don't even drink as much as I should otherwise for my health, as I wrote in my article on "Alcohol and Diabetes" .

Turns out that fatty liver and cirrhosis are yet more consequences of diabetes. Insulin resistance is one of the suspect factors that can cause it. At least half of those of us with type 2 diabetes have fatty liver disease, says Julian Whitaker, M.D., in the October 2005 issue of his newsletter. Dr. Whitaker has written several books including Reversing Diabetes. Another source, the "Second World Congress on the Insulin Resistance Syndrome" says that 50 to 70 percent of people with type 2 diabetes have fatty liver.

What to do? Dr. Whitaker says that rapid weight loss might actually damage my liver more. My doctor agreed and that I slowly lose weight. "Lose five pounds before I see you again in a month," he told me. I'm trying. We all know how easy that will be.

What else? The best resource that I have found on the subject, the government's "Nonalcoholic Steatohepatitis" says, "avoid unnecessary medication." That reminded me that one of the reasons why my doctor checked my liver enzymes in the first place is because of the niacin I have been taking to help control my cholesterol. So I asked him if I should stop the niacin. He said no, but it's my body and I stopped anyway. To compensate for it I added a couple of capsules of psyllium husks to my diet and I started eating oatmeal for breakfast again every day as I wrote about in "My Favorite Low Carb and Low GI Foods" .

The same resource says that there are no specific therapies for NASH. But antioxidants - particularly vitamin E, selenium, and betaine - are being studied. I already take 70 mcg of selenium daily in my multi-vitamin and 600 IU of vitamin E. Metformin, which I already take for my diabetes, also is a proven treatment for fatty liver, according to a recent article in The American Journal of Gastroenterology.

I didn't forget to look into alternative medicine. My fundamental guide here is "The Natural Pharmacist" that Steven Bratman, M.D., developed. It is the only even-handed and well-researched site on alternative medicine that I know of. The article there on "Liver Disease" focuses on milk thistle (silymarin) and SAMe (S-adenosylmethionine). It looks to me from reading "The Natural Pharmacist" that they may have similar effectiveness but milk thistle is much less expensive.

An excellent, albeit a bit technical review article in Alternative Medicine Review by Lyn Patrick on "Nonalcoholic Fatty Liver Disease". One of the treatments detailed here is magnesium, which again I am already taking.

So a couple of days ago, about the time I started to lose weight, I started taking milk thistle for my fatty liver. I'll let you know how I do in thinning both my body and my liver.

Update (9-1-06)

Researchers in Japan reported at the American Diabetes Association's 66th Scientific Sessions in June that a drug that some people already take to help control their blood glucose will also treat nonalcoholic fatty liver disease (NAFLD). This is the most common form of fatty liver, which I have.

The drug is Starlix (nateglinide). I wrote about when it first appeared six years ago.

The Japanese researchers have now concluded that "Nateglinide may decrease liver fat content and may be beneficial for the treatment for NAFLD in patients with IGT [impaired glucose tolerance] or type 2 DM."

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.