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Asking for Self, Male, 34 years old, Faisalabad
I've Non-Alcoholic Fatty Liver of stage 1 along High Blood Pressure, High Cholesterol and being overweight for 10 years, Blood Pressure & Cholesterol is well under-control by taking Medication. But fatty liver problem is there along overweight issue. I've read online about some researches done on Vitamin E, Metformin, Pioglitazone and Silymarin etc... Do drugs are really helpful in fatty liver?
Yes these drugs help,but you need to reduce your weight .Diet exercise and right medication all help in this regards
Before starting any treatment it's extremely important to visit a physician and start your treatment under his supervision to avoid any unnecessary side effects and other complications.
you can visit my clinic at Wilcare medical center Lahore
5_M model town extension Lahore
Patient
Post Owner
thanks for reply for advice.
I never use any medicine without doctor advice, even Paracetamol for headache.
I'll consult with my cardiologist about these drugs.
5 years ago
Salaam. Dear I would advice you to have yours blood sugar and uric acid levels checked by lab. As you have high blood pressure and cholesterol so I will request not to use vitamin E as it increase heart protein. Metformin was used few years ago, but not any more. Only pioglitazone have role in fatty liver disease..
You must decrease yours weight by decreasing yours diet, avoiding junk foods, breverag, decrease sugar intake, Do Walking for at least 30 minutes. Avoid oily, food and extra salt
. Must stop smoking if you are smoker
Patient
Post Owner
thanks dr sahib for reply.
my uric acid and sugar are well with normal range.
I'm already following your instruction like avoiding fatty, sugary junk foods. I don't smoke in-fact never smoked.
Doing brisk walk.
5 years ago
hi
i have been using Marham platform primarily for patient education and advise with an attempt to address health beliefs and myths lot of Pakistani patient have.I am so glad and pleased to see your post and find that there is increasing awareness and sense of taking responsibility of owns health.i will soon be launching a website with name yoursehat.com mainly with educational videos.
interesting question
NASH(nonalcoholic steatohepatitis) is an overgrowing problem in modern world possible leading cause of liver transplants in the modern world .it would be nice to have look at your LFTS or if you have Fibroscan or (ELF)ENHANCED LIVER FIBROSIS SCAN TEST.
i am not sure when you say stage 1 fatty liver disease what that mean ? is it there is stage 1 fibrosis? what about steatosis do you have abnormal LFTs raises ALT etc ?
as YOU KNOW AND POINTED OUT BY OTHER COLLEAGUES LIFESTYLE INTERVENTION BY FAR IS THE STANDARD TREATMENT.
if you are able to reduce some visceral fat its going to improve any inflammation(Steatosis) IN LIVER
there is clear association of INSULIN RESISTANCE AND OXIDATIVE STRESS WITH DEVELOPMENT OF STENOSIS which in turn results in fibrosis .and role of metformin is questioned more so pioglitazone also increase insulin sensitivity in peripheral organs mainly muscle and fat helping with less of fat accumulation in visceral tissues.
There is a recommendation of metformin and pioglitazone that is thiazolidinedione and vit E in NASH but only in advanced fibrosis cases under the supervision of hepatologist with regular yearly f.u with fibroscan (ELF) test this is recommended by NICE(national institute of clinical excellence a governing body advising about best possible evidence-based treatment in UK) .if you are over wt and have borderline blood sugars you can start taking metformin as its been widely used for metabolic syndrome (prediabetes) though research shows wt reduction and active lifestyle had better outcome than only metformin 48% risk reduction against 35%to prevent incidence of diabetes.(DPP) trial.
as far as Silimyrin is concerned there is no robust evidence it act as antioxidants but if it is beneficial its not backed by good size-randomized trials
use of hepatotoxic medication like statins is debatable but the consensus is if liver enzyme not too deranged twice normal some say thrice it is helpful
if you want to discuss i am happy to do that
i will inshallah start visiting consultancy from nest year on bimonthly bais in Lahore
00fourfour780ninesixseven81
Dr Kashif Ahmad
MBBS, MRCP(UK)
MRCP(E), MRCGP(UK) FRSPH
CCT(UK), PGDip Diabetes(Wales)
PGDip(London)
Patient
Post Owner
thanks for detailed reply.
Actually its written as Early Fatty Liver on report, Its my mistake not of respected doctor, saying Stage 1 .
LFT are normal, No I didn't have Fibroscan or ELF scan, SGPT is normal. Yes I'm overweight, I've acanthosis nigrican and dermatologist said its due to insulin resistance, so advised metformin. Current dose is 850mg twice a day. I've elevated lipid profile but not too much, has used atorvastatin 10mg daily for three year in past.
One thing is strange to me, when I'm on atorvastatin, my lipids remain in normal range, when I stop it the lipids go slightly up but not too high.
How can I take atorvastatin 10mg non-daily dose to keep it under normal range, as it also increases insulin resistance?
5 years ago
by the way i have always failed to understand why on earth physicians request serum uric acid on every patient. what information we gather from this and how helpful it is in predicting CV risk ?i think its waste of patient hard earned money for no relevant information.
if LFT are normal it would be wise to continue with statins , atorvastatin 10 mg is very small dose if it is showing therapeutic benefit fine otherwise it should be increased to 40 mg .increase metformin to 1 g twice/day , and try reducing weight by increasing activity.
regards
kashif
ATORVASTATIN IS NOT LINKED TO INSULIN RESISTANCE ITS VISCERAL FAT THAT CAUSES INSULIN RESISTANCE
Patient
Post Owner
So its clear that Visceral fat is the culprit not the atorvastatin.
thanks.
5 years ago
Aoa
Fatty liver & obesity are interlinked,,, all part of metabolic syndrome,
there is treatment available along with lifestyle modifications
Plz visit the clinic with reports so we can examine & manage accordingly
Patient
Post Owner
thanks Dr sahiba for reply.
Yes I'm working on weight reduction, by modifying diet and brisk walk. Going to start regular moderate exercise soon.
I feel more tired after walk than other persons, perhaps its due to hypertension.
5 years ago