I am a 32-year-old male. My height is 5.6 feet and weighs about 90 kg. I have fatty liver and high cholesterol- 166, and LDL - 223. I wanted to ask is this cholesterol because of fatty liver? And is there any supplement that I can take for the liver?
Welcome to icliniq.com.
Well, the fatty liver and high cholesterol are both different problems. However, both can simultaneously occur at one time and affect each other in different ways.
It seems the main problem you have is weight. High cholesterol and fatty liver disease are possibly due to overweight. The preferred initial therapy is weight loss by at least 10% of your current body weight. Means you should lose at least 9 kg weight in the coming six months. You can achieve this by taking low-caloric diets, and regular exercise.
Since you already have high cholesterol with higher weight, the treatment is usually required. But I want to know about the liver function tests which will show the impact of fat in the causation of liver damage. I suggest you some investigation including liver function tests, thyroid functions test, and diabetic status and then after those investigations, I would be able to give you the best advice to treat all things in one.
I also want that you should share with me more about your health. Do you take alcohol? If no then fine, if yes, then tell me the frequency and the concentration of it? Do you already tried some weight loss? Have you checked your diabetes and liver function tests? Were they abnormal? I want you to share the reports if you have already.
Any family history of diabetes, obesity, or cardiac problem? Does anyone have hypertension and cholesterol issues? How about your diet? How many calories you consume on a daily basis? All the above information is required and will help us to evaluate your problem completely.
Nonalcoholic fatty liver disease (NAFLD). Metabolic syndrome.Investigations to be done:
Complete blood count. Complete lipid profile including triglycerides. HbA1c (glycated hemoglobin). TSH (thyroid-stimulating hormone). ANA (antinuclear antibody) profile. Liver function tests. Serum albumin, creatinine. Ultrasound abdomen.Probable diagnosis:
NAFLD.Regarding follow up:
Follow up to discuss the reports and give further information.
Thank you doctor,
I am sending you the test. I have not had alcohol since 5 years. I do not have diabetes but I have a family history of diabetes. I also had anxiety and fast heartrate a month ago and was taking Yohimbine for fat loss. I was 103 kg earlier but now I am 90 kg.
Welcome back to icliniq.com.
Thanks for sharing the reports (attachment removed to protect patient identity). It seems high likely that you have fatty liver disease which is causing some inflammation called steatohepatitis - steato means fat and hepatitis mean inflammation. In other terms, it is called as Non-alcohol steatohepatitis NASH.
Well, I want that you should know that NASH is a diagnosis of exclusion and should require a thorough investigation to rule out any other liver cause for abnormal liver function tests. Thats why I suggest you those investigations.
From treatment point of view, I suggest you start Vitamin E 400 mg twice daily for three months. This will improve your liver function in coming period of time. But the most essential treatment for correction of obesity, fat-related liver steatohepatitis is weight loss which you are already doing. I suggest to continue with whatever ways you were doing reducing your weight.
For you lipids, I suggest you to start tablet Rosuvastatin 10 mg at night time daily. I would see you in two weeks with some investigation.
NASH.Investigations to be done:
HbsAg. HCV antibody. Serum albumin. Fasting lipid profile (after 14 hours of fasting).
Thank you doctor,
I will start on vitamin E. Can I take curcumin, flaxseed, and choline for fatty liver? I have researched about choline and it shows promising results in two weeks. I have a loss of appetite, is it normal?
Welcome back to icliniq.com.
Yes, as long as there is no harm you can try this. Actually, I did not have experience with choline, curcumin, or flaxseed, thats why I am not in the state to recommend or not to recommend you. But I wish this will help. You can send me any data /study regarding the role of choline and others in fatty liver disease, I would be happy to read that and would then can give you the advice.
Well, it is not uncommon to have a loss of appetite with NASH. If you have severely reduced appetite you can take tablet Domperidone 40 mg half an hour before meals thrice daily for two weeks.
I hope this helps.
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