By Howard LeWine, M.D., Tribune Media Services The Medicine Cabinet
March 28, 2012
Q: A recent blood test revealed abnormally high liver enzymes. My doctor says I have fatty liver disease. I've started eating artichokes (after reading these were good for your liver), as well as cutting back on my food intake. I'm also eating lots of vegetables and beans, and plan to exercise more and drink less alcohol. Do you think these measures might help?
A: Yes, you're off to a great start
Having a fatty liver means that an excess of triglycerides (one type of fat) have accumulated inside liver cells. This condition is also known as steatosis. When the fat causes the liver to be inflamed, liver enzymes are released into the blood. Doctors call this steatohepatitis.
The primary causes of fatty liver are weight gain, overuse of alcohol, diabetes, and insulin resistance. Insulin resistance means that the body has become less responsive to rising blood sugar levels. To compensate, the pancreas has to make more insulin and send it into the blood stream. Higher blood levels of insulin slow down the normal turnover of triglycerides in liver cells, so they build up.
Most often, people with fatty livers don't have any symptoms. Like you, many people are diagnosed when a blood test shows elevated liver enzymes. Or a doctor detects an enlarged liver during a physical exam. Sometimes, a large fatty liver is seen on an ultrasound or CT scan of the abdomen when the test is ordered for some other reason.
Untreated steatohepatitis can progress to cirrhosis of the liver -- a serious condition where the liver becomes unable to do its job of cleaning toxins out of the bloodstream.
Eating healthier and decreasing alcohol use should help. But in my mind, it's not enough. I recommend complete abstinence from alcohol and cutting calories to lose weight.
Exercise is a must. You can start slow, but you do want to progress to a minimum of 30 minutes of dedicated aerobic exercise daily. An hour of moderate intensity exercise most days of the week would be best.
I'm not sure if eating artichokes will help. But they surely won't hurt as long as you don't dip them in butter or mayonnaise.
(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
(For additional consumer health information, please visit www.health.harvard.edu.)
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