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Liver & Pancreas Disorders Message Board

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hi all !:)
I have a fatty liver with inflation due to alcohol .. Although I have not felt any obvious symptoms! The doctor wrote me ursodeoxycholic acid Twice a day for two months While following a diet free of carbohydrates.
Do refrained from drinking completely?After reversing fatty liver Or I can drink again moderate?
Hi & sorry you've got this health issue popping up.

Both alcohol and carbs are notorious for causing fatty liver, which has reached epidemic levels in America over the past few decades. Sugary sodas full of High Fructose Corn Syrup are just as bad as beer, so if you regularly consume both sodas and beer (or other alcohol) then this would be a double whammy for fatty liver.

I'm sure your doc would advise avoiding alcohol completely (as well as the excess carbs) so long as evidence of fatty liver remains. Once your fatty liver is under control, moderation would be the key to avoiding a flare of fatty liver once again.

Whether or not you truly need to go teetotal for life depends largely on both your future carb consumption, and if you truly can go back to moderate drinking, without getting carried away and going off your moderate, low-consumption diet.

If you can keep carbs low and alcohol consumption moderate, this may work, but I would want a followup exam after 6 months to a year to see if your liver is packing away excess fat again.

Bottom line... If you want to have your cake (or soda) and eat/drink it too (cake/sodas = carbs), you probably would do best avoiding all alcohol. If you truly enjoy moderate tippling and wouldn't miss the cake/sodas/carbs, then this might also be doable.

The proof is in the pudding... I'd want another ultrasound at 6-12 months into whatever path you take to insure your liver remains normal (ultrasound the best diagnostic for fatty liver). So long as you're normal, then life is good!

Best of Luck as you work your way through this.
Hello BillinSD thank you for replying :)
I am a follower of your responses.
Is it possible to tell the story of your success in reversing fatty liver and back to drink in moderation?
Thank you again.
Hi & glad you find my posts interesting.

I was a Joe Six-Pack (beer) for many years and never had any trouble with this. Liver enzymes were always normal. I also have never had a sweet tooth and never cared for sodas. I prefer unsweetened Ice Tea with meals during the day. Never cared for desserts after dinner either.

In my mid 50s, a new sweetheart turned me on to Margarita's, & I started drinking these when we would date. I also became fond of orange juice and started drinking this with breakfast every day. A large 20oz glass. What I didn't realize was that mixed drinks are made with soda or margarita mixer, which is full of high fructose corn syrup, and orange juice is absolutely loaded with fructose, containing nearly as much as soda. My new girlfriend & I would dine out often, and she also liked to share her desserts with me.

When I suddenly became ill, I figured I had simply gotten too old to drink anymore and got clean. I also started studying alcoholic liver disease, trying to find out what went wrong. What I learned was... Alcoholic Fatty Liver is always the first stage of alcoholic liver disease, and fatty liver was also rapidly becoming a major problem, even for those who don't drink at all due to all the sodas and sweets that have become a major component of the modern diet.

I also read about age related iron accumulation in males, and the role of iron in both alcoholic liver disease and non-alcoholic fatty liver and metabolic syndrome. I had never had a ferritin (stored iron) test before, and when I requested this be added to my labs, found mine was up near 200. The upper limit for ferritin set by most labs is for clinical iron overload, and for optimal health, many recommend keeping ferritin out of triple digits (less than 100). As I had been a blood donor in the past, I started donating again to lower my iron as insurance against progression of disease.

I also found a couple supplements that appeared to be fairly well documented at liver protection. SAM-e & PPC (polyenylphosphatidylcholine) appeared to have the best evidence & track record, and I started on low doses of these.

I stayed clean until my fatty liver had resolved (confirmed by ultrasound), but like most X-Drinkers, was tempted to test the waters with alcohol again, and eventually I did relapse back into moderate drinking. I was careful to avoid excess carbs and sugars, and watched my liver enzymes closely. I learned the GGT liver enzyme was the most sensitive for liver inflammation (never knew this before), and asked for a GGT to be added to my blood labs every time they were drawn, in addition to ferritin to watch iron.

I eventually found I was back to where I had been before I got sick, & apparently could drink moderately without raising my GGT or other enzymes. I really don't know how much of a factor my iron reduction or supplements played, but I've stuck with them throughout, keeping my ferritin below 100.

It's important to consider I'm not a doctor and everyone really should follow their own doctor's advice above all else; including asking about any supplements you are considering, and whether or not you are healthy enough for blood donation if ferritin is over 100. You're results may not be the same as mine... This has simply been my own experience.

Fatty liver is the first stage of several different types of liver disease, and both excess carbs and alcohol are strongly associated with development of fatty liver disease. Some may be able to tolerate one or the other, but I've found they are a very bad mix. Others may find limiting both excess carbs and alcohol to be the only way to better health. Chronic liver disease is a devastating condition to try and live with, so put your health above both excess carbs and alcohol if this is what it takes to stay healthy.
Thank you very much I am grateful to you .:).. I've softened me a lot of fear of fatty liver disease
And I am very happy for your success and return to normal life again.
hi BillinSD

changed my nickname probably Forum Rules!

It is now Two months..With a healthy lifestyle in addition to physical activity

I've examined the liver Ultrasound.
Liver returned to normal size. With simple fatty liver.

The results of liver enzymes:
Alt: 11
AST: 13
GGT: 10
ferritin: 221 ( normal 25 to 400)

Ast up Alt !?

Enzymes low as possible because of ursodeoxycholic uncertain.

I will repeat the test after a month ..

I read a lot of horror stories on the Internet about the return of fatty liver faster than the previous and evolution to cirrhosis of the liver
Just think of the return of moderate drinking makes me feel frustrated and fear because of these stories

Is there a scientific explanation for the setback fatty liver and returning faster than the previous?
AST floating slightly over ALT isn't supposed to be significant when both are well within normal range, so I wouldn't sweat this.

Ferritin of 221 is interesting though. The upper limit for the normal range is set quite high by most labs and is the threshold for clinical iron overload. The "optimal" range is believed to be substantially lower... Double digits are better than triple. The liver is the bodies primary storage site for excess iron and excess iron is known to contribute to liver inflammation, particularly where alcohol is concerned.

Alcohol increases absorption of dietary iron, and over time, accumulations can occur that are a bad mix with additional alcohol. This may explain why liver inflammation might return swiftly in those who resume drinking after resolving their alcoholic fatty liver.

Unfortunately, there isn't a good way to get rid of iron accumulation other than through whole blood donation. I started donating blood many years ago and noticed it did seem to help reduce my liver symptoms. Don't know how you feel about needles, but the one they use down at the blood bank is a big one. About the size of a pencil lead. It really doesn't hurt much more than the one they use to draw labs with, but it is impressive when you first see it.

Each blood donation drops ferritin by 50 points, so you might pull your numbers down into double digits with 3 donations or so over the next 6 months. The iron is in the red cells, so you must donate whole blood and not plasma or platelets.

Once excess iron has been bled off, it usually only takes a couple of donations a year to keep ferritin out of triple digits. I really believe lowering my iron helped reduce inflammation in my liver. Always wise to ask your doc if you're healthy enough to donate. There are videos online you can search for if you want to see what the donation experience is like.
Thank you BillinSD respond faster .:). You are a treasure trove of information ..
I understood from your response:
If that AST up Alt within the normal range .Nothing to worry about

And that excess iron (ferritin) is the cause of fatty liver development and the return to alcoholic hepatitis ..
I can not donate blood ..
But I read that IP-6, cabbage, turmeric contributes to the reduction of iron stores
I don't know that excess iron actually contributes to causing fatty liver, but there is substantial research excess iron exacerbates liver inflammation from alcohol. Daily drinkers almost always develop fatty liver to some extent, but it seems inflammation only occurs in a fraction of this population.

IP6 is supposed to reduce inflammation from elevated iron by mopping up free/unbound iron. Turmeric/Curcumin, is supposed to work much in the same way, though I haven't heard of cabbage helping with this. I take IP6 and Curcumin and it seems to slow my accumulation of iron, but I still have to donate blood a couple times a year to keep ferritin out of triple digits.

Coffee & Tea consumed with meals greatly reduces absorption of dietary iron, but I don't know of any way to substantially reduce iron accumulations other than blood donation or "therapeutic phlebotomy", which a hematologist can prescribe if you can't donate blood.

It may be tough getting a referral to a hematologist for therapeutic phlebotomy when iron isn't clinically high (out of range in labs), but if you can get into a hematologist, he/she may prescribe phlebotomy in a symptomatic patient with ferritin over 200. A friend of mine at work gets phlebotomies from her hematologist to keep her ferritin around 50. She was referred to hematology from her oncologist who believes elevated iron might predispose a recurrence of her cancer.
Can't thank you enough Bill.
I read your articles and your responses to alcoholic liver disease.
i do not have fatty liver culture .. Now I have a lot of information.

I knew it's not a problem to return Moderate drinking but the problem is the high level of stored iron (ferritin), which will lead to inflammation of the liver back to drink.

Cabbage read about it a lot and its role in the chelation of iron overload.

I'm going to try the cabbage for a month and tell you the results.
OK, let us know how this turns out.

Curcumin & Quercetin are other known iron chleators.
Hello Bill
What about the endotoxin and
sensitivity to alcohol Kupffer cells
It may be one of the reasons for the return of fatty liver and its development to inflammation
Along with high ferritin like when you go to drink

What is the treatment endotoxin and internal infiltration intestines of alcohol?
Hello everyone ..:)
to those who follow the subject has reached a very important results:
You have to search for the causes of fatty liver back faster
than the former and turned to inflammation or fibrosis .. found that liver affected by the presence of fatty liver for the first time do not know the extent of damage done to them .. FibroSens and biopsy are not accurate in the detection of simple fibrosis. When you return to test drinking exacerbated the damage and develop fibrosis.

I read a lot about the experiences and stories of others in return for moderate drinking after a fatty liver .. and how it came back quickly and its development to other symptoms indicate hepatitis ..

It is not wise to go back to drinking again .. moderate drinking does not deserve the risk.

There is no way to ever "Safely" return to alcohol once your liver has been damaged.
Liver disease is a complicated group of diseases.
There are no easy answers.

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