fatty liver

[leadinglady]

I don't drink alcohol - maybe once every 3 months? But cirrhosis and alcoholism run in my family. The only thing I can think is that some medication I've been on in the past did something to my liver. I was told a week ago I have a fatty liver! Which medication would have been the likely culprit from my laundry list? I'm taking Zyprexa and Paxil now and have been on Paxil the longest. I am obese so I know that could be a cause too but I've been obese for a long, long time. The only difference now is having been on all these medications!

Add Seroquel to my list of ex-meds.

[Silver]

Obesity alone can be plenty of reason. Did your GP say "fatty liver," NASH, or something else?

[AirMarshall]

http://www.rxlist.com/

Paxil does not show fatty liver as a reported side effect, Zyprexa lists it as "Rare" = less than 1 in 1000 cases reported. Feel free to research the rest of your meds at the excellent site above.

I've been through the fatty liver merry go round in the last year. Probably more to come in the next couple months when I go to see my internist again.

Many of our meds can cause raised liver enzymes which may indicate any number of problems. Most of those can be ruled out by crosschecking other blood tests including Complete Blood Count, Complete metabolic panel, along with electrolytes. The definitive test is to take a needle biopsy of the liver (OUCH!). More commonly doctors will order a CT scan. Ultrasound is not as reliable because the density variation is fairly low making it hard to read. What they are looking for are large globules of fat deposits in the liver.

The most common causes of fatty liver are drinking alcohol and obesity. The danger is that fatty liver can progress to cirrhosis of the liver and destroy your liver. This is more common for drinkers, and actually fairly rare for non drinkers. The good news is that if you stop drinking, and/or can lower your weight the liver can often repair itself, and not progress to cirrhosis.

a.m.

[fluffybirdie]

I have fatty liver, too. Which is kinda funny because I'm a slim person. I was kind of like "what do you mean my liver is fat?!" I was a big drinker and have worked hard to clean that up. I take Wellbutrin which is pretty hard on the liver, so even though my enzyme numbers have improved my doc thinks I may just have to live with fatty liver. It should repair on it's own slowly. I take milk thistle pills and try to take good care of my health in other areas.

So in the end, fatty liver is not anything to panic about. But good luck getting it fixed up!!

[wifezilla]

Fructose and High Fructose Corn Syrup appear to be culprits in fatty liver disease.

" A study recently published in Hepatology shows that fructose-laden water (10% wt/vol) decreases liver fat breakdown and causes lipid accumulation in rats.

This change wasnt observed in glucose-fed rats. The rats that drank liquid fructose, unlike those getting glucose, had extra leptin in their blood. However, their livers did not behave as expected given the high levels of leptin, a hormone that generally accelerates fat oxidation in the liver and reduces its synthesis.

The researchers concluded that the fructose-caused lipid accumulation and fatty liver was caused by resistance to the extra leptin. The resistance to leptin decreased the action of a specific receptor (PPAR-alpha), which controls fatty acid oxidation. The researchers noted that because PPAR-alpha activity is lower in humans than in rats, liquid fructose ingestion could cause even worse effects in humans. "

http://www.diabeteshealth.com/read/2007/05/18/5198.html

More if you are interested

http://www.sciencedaily.com/releases/2007/...70315123558.htm

http://www.ncbi.nlm.nih.gov/pubmed/18395287

http://jn.nutrition.org/cgi/content/abstract/138/8/1452

[AirMarshall]

In other words.... don't drink from glass bottles with metal tubes.

a.m.

[wifezilla]

I wish I had some human studies to site, but they just keep looking for a connection to fat consumption and their results are inconclusive (and they ignore the piles of evidence that fats do not make you or you liver fat unless it is artificially hydrogenated). There is a lot more incentive to finding a drug for treatment than there is to give the advice to stop drinking pop and eating crap with high fructose corn syrup in it.

There is a strong tie to metabolic syndrome, insulin resistance and type 2 diabetes..

"Insulin resistance plays a central role in the pathogenesis of NAFLD and is defined as a diminished ability to clear glucose at a given insulin concentration. 13 While not all patients with NAFLD meet strict metabolic syndrome criteria, most have biochemical evidence of insulin resistance. 9 The fundamental defect in the metabolic syndrome is an impaired insulin-mediated suppression of lipolysis, with a net increase in circulating free fatty acids (FFAs). They, in turn, impair insulin signaling in striated muscle and lead to a decrease in insulin-mediated glucose disposal. FFAs also inhibit glucose utilization and promote gluconeogenesis, thus increasing blood glucose levels and causing the pancreas to secrete more insulin. Eventually, the pancreas can no longer meet this demand and insulin levels start to drop. 8 Thus, the two key metabolic abnormalities associated with insulin resistance are hyperinsulinemia and high levels of circulating FFA 14 (see "The role of fat in liver disease"). 15-18"

Of course, we all know one way to combat those issues.

"Obesity is the most common risk factor for NASH. The National Heart, Lung, and Blood Institute guidelines for weight management are generally considered the standard of care in the United States. 37 Excess adiposity originates from an imbalance of caloric intake and utilization and from food with high glycemic indices such as high-fructose beverages. Perhaps the most important dietary intervention is to reduce intake of fructose, which is preferentially converted to triglycerides and has been implicated in the obesity epidemic."

http://www.fpronline.com/article.cfm?ID=387

There is, of course, absolutely no harm in stopping your consumption of fruit juice, gatoraid, soda and other drinks containing fructose and high fructose corn syrup. Even if I am completely wrong, the worst that would happen is you have a little less damage to your tooth enamel. If I am right....

[leadinglady]

No NASH that I'm aware of, just a fatty liver by elevated liver enzymes.

Interestingly enough, I am pretty much a soda addict, so the corn syrup article weighs heavily on my mind right now!

I am undergoing workup for gastric bypass and hopefully will have that done in March, so I'm really praying that it helps clear up the fatty liver. Just the thought of liver problems, knowing how my mom and sister died, is really bothering me.