Get your liver healthy again
Q: My doctor told me that my last blood test showed elevated liver enzymes, and I may have nonalcoholic fatty liver disease. What should my next steps be and how serious is this? -- Freddy G., Denver
A: Nonalcoholic fatty liver disease, or NAFLD, is quite common in the U.S. Around 25% of adults have NAFLD -and about 20% of those folks have a more advanced stage called NASH (nonalcoholic steatohepatitis), in which hepatitis is causing inflammation and swelling, and even cirrhosis.
NAFLD often coexists with other health challenges -- from obesity to insulin resistance and diabetes, as well as increased alcohol use and hypogonadism in men (that’s low testosterone). You don’t say what the possible causes were in your case, but if you have any of those conditions, or very high blood levels of LDL cholesterol or triglycerides, you’re a candidate for NAFLD. However, there are times when someone has NAFLD without being obese or having metabolic syndrome.
In any case, the next steps are to make certain lifestyle and medical changes pronto, and to get further tests to confirm the diagnosis.
Increased physical activity; improved diet (no saturated-fat foods, red or processed meats or ultraprocessed or sugary packaged foods) and taking prescribed medications to control blood glucose, blood pressure and blood lipids may slow progression of or even reverse NAFLD.
You also may need to reduce or eliminate your alcohol intake, even if you are not a problem drinker.
Next, you may get a scan -- ultrasound, CT or MRI, or a newer form of ultrasound testing called transient elastography -- to assess the amount of fat in your liver and its stiffness. You can also ask your doctor to check your testosterone levels. A new study shows that in obese guys with low levels of testosterone and Type 2 diabetes, testosterone therapy normalizes hormone levels and reduces NAFLD.
Whatever you do, don’t delay. Follow up, take steps to live more healthfully, and you will be able to protect your liver -- and your life.