The New Liver Killer: Silent, Sneaky, Deadly
Scarring on this vital organ could lead to many more transplants by 2020
Over 45 percent of people surveyed randomly can’t point to the location of their liver, the American Liver Foundation reports. Of those who can identify their liver, very few have a clear idea of the true condition of that vital organ.
Perhaps it is time we all learn, as a new killer may be poised to become the #1 reason for liver transplants by 2020.
NASH — or nonalcoholic steatohepatitis — occurs when fat in the liver causes inflammation, which leads to fibrosis, or scarring. Left untreated, it progresses into liver cirrhosis. With no obvious symptoms of the disease, patients often learn their liver is compromised only when the remedy is a transplant.
“It’s as if an alcoholic’s liver condition was created, but alcohol isn’t a factor,” explained Dr. Julie Spivack, a gastroenterologist and hepatologist in Fairfield, Connecticut.
“We can’t distinguish it from an alcoholic’s liver,” she told LifeZette. “Only patient history determines whether it is NASH or not. This is a consequence, not a disease. It wouldn’t exist without previous conditions, so that’s where we need to focus change.”
Over 80 percent of NASH patients are overweight and diabetic. Other factors that put someone at risk include high blood pressure, high triglycerides and high cholesterol.
Dr. Peter Traber, who has dealt with liver disease as a hematologist himself for 30 years, ended up developing the condition. Traber, 6’4" and a former college football player, had to reduce his exercise regimen because of an ankle injury. In doing so, he added 50 pounds to his athletic playing weight of 240 pounds.
Elevated enzymes on a routine blood test indicated a fatty liver; he also was diagnosed as pre-diabetic.
Traber thought about his responsibility to his children and decided to take action. He immediately made dietary changes and lost 40 pounds. After losing only 25 pounds, he effectively reversed his early fatty liver disease.
Losing just 10 percent of body weight can reverse 90 percent of early NASH that has not yet developed into extensive fibrosis.
- Maintain a healthy weight or lose weight.
- Follow a healthy diet, high in lean protein, low in carbohydrate like starch, and low in added sugar.
- Avoid excessive alcohol.
- Avoid nutritional supplements, herbal remedies and drugs that can damage the liver.
- Avoid all illicit drug use.
- Discuss liver health with your doctor.
Traber’s company, Galectin Therapeutics (NASDAQ: GALT), is currently in Phase 2 studies for a drug to reverse fibrosis. It is estimated that 2 million unaware Americans have advanced fibrosis and as many as 25 to 30 million have earlier stages of the disease.
"The Heart Association has made us very aware of heart disease, and all the precursors, like elevated triglycerides and blood pressure, but the average person doesn’t understand the complex liver," said Traber. "We can’t live much more than a day without a liver, because it processes everything we digest and distributes the proper fuel to the body."
Researchers are investigating fast food, sugars, artificial sweeteners and high fructose corn syrup as possible contributors in the 20 percent of cases where patients are not obese. These food products would be commonly used by overweight patients as well.
"All excess carbs and sugars get converted and stored as fats," Spivack explained. "And, if you are storing fat, you have it in the liver. You don’t have to be overweight to be eating excess carbs and sugars."
Traber agrees, pointing out anyone who eats high fat fast food is probably also drinking a diet soda (artificial sweeteners) or regular soda (high fructose corn syrup) as they ingest that meal.
The good news is, awareness is growing. Spivack sees more and more internists and primary care doctors noticing blood work in the elevated range and referring patients to specialists.
Traber encourages taking immediate action to tackle obesity and Type 2 diabetes. Exercise is also important.
"Set the goal of 10 percent first," he said. "Part of the problem is those ‘ideal’ weights from charts … We know we can’t get there and we’re never going to be ready for a casting call on 'Baywatch,' so we don’t bother. We need to act anyway."
Pat Barone, CPCC, BCC, MCC is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating.