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  #1   ^
Old Sat, Jun-06-15, 18:21
1DogDay's Avatar
1DogDay 1DogDay is offline
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Posts: 630
 
Plan: LCHF <20g
Stats: 206/182/170 Female 5' 4"
BF:
Progress: 67%
Default Elevated liver enzymes?

Hi Everyone,
I've been dancing in and out of dieting for a long time and never seem to get past a certain point (like 12-18 lbs.) and then give up for one reason or another.

I seriously want to give the low carb/ketosis another go but my last ketosis type diet (Ideal Protein) left me with elevated liver enzymes (to the tune of 3 or 4 of them being elevated to 5 times what they should be, and the remaining ones also out. I have no solid proof that it was the diet that caused this but they were good a few months beforehand and really bad during (that's what made me stop the diet).

I had to be tested for hepatitis, had an ultrasound and a CT scan. After that we still have no idea why, so I'm going to see a Gastroenterologist in 1 month to find out more. My liver enzymes are considerably better now but still out, and one (GGT) is 70, should be 40 max. There was no sign of fatty liver disease in the CT scan and I'm told it would show if I had it.

So my question is, does anyone know if ketosis is ok for me right now? My current doc (where I am for the summer) says ketosis is not good for anyone as it's too hard on the body and not maintainable so I can't get a straight answer from him.

When not on the diet I tend to eat really poorly if under stress (which I am now) so it's gluten free deserts, chocolate, ice cream, and crap like that. I don't buy bread or bring bad foods into the house per se but manage to get in the crappy stuff when I'm out so I truly want to nip it in the bud sooner than later.

Thanks for you help and hope someday I will get it together and get it done so I can help others!

Last edited by 1DogDay : Sun, Jun-07-15 at 10:27.
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  #2   ^
Old Sun, Jun-07-15, 03:57
JEY100's Avatar
JEY100 JEY100 is online now
Posts: 13,368
 
Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
BF:45%/28%/25%
Progress: 134%
Location: NC
Default

The list of what Causes Elevated Liver Enzymes is very long.
http://www.mayoclinic.org/symptoms/...es/sym-20050830

Did you rule out medications, inc. statins and Tylenol? As you can see, many reasons are not diet related.
I have a friend with Fatty Liver Disease and Am forever sending her articles about how refined carbohydrates (and not fat) contribute to NAFLD. She can't give up her sugar..and wine..just continues "to try to work on eating better" and continues to have elevated enzymes. Accept that your liver is not functioning well, that impacts its ability to "clean house" and many aspects of your health, like hormone levels, so "Do or Don't Do. There is No Try"

Suggest you eat whole real foods, cut out all refined processed foods, so that your diet is naturally lower in carb than what you have been doing. Doesn't have to be Ketogenic...but you should eliminate "the crappy stuff"! And eat more eggs and liver

This is an update recently sent that included some good info about CHOLINE in the diet:
Treating Fatty Liver Disease with Ketogenic Diets. Much good diet advice in this one short article I know my friend won't follow it (sigh)... but I hope you will

http://www.ketogenic-diet-resource....er-disease.html

Last edited by JEY100 : Sun, Jun-07-15 at 06:53.
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  #3   ^
Old Sun, Jun-07-15, 06:27
Kristine's Avatar
Kristine Kristine is offline
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Posts: 25,581
 
Plan: Primal/P:E
Stats: 171/146/150 Female 5'7"
BF:
Progress: 119%
Location: Southern Ontario, Canada
Default

I agree with Janet. I can tell you almost for certain that ketosis won't hurt your liver any more than processed gluten-free sugary crap does. I'm reminded of the Dr Lustig video on YouTube in which he pointed out sugar's similarity to alcohol in terms of how the liver has to process it. If you fear for your liver, ditch the sugar.

Best of luck.
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  #4   ^
Old Sun, Jun-07-15, 07:39
leemack's Avatar
leemack leemack is offline
NEVER GIVING UP!
Posts: 5,030
 
Plan: no sugar/grains LCHF IF
Stats: 478/354/200 Female 5' 9"
BF:excessive!!
Progress: 45%
Location: UK
Default

Most of my liver enzymes are good, but I have had a high ggt (pre low carb) cutting out processed carbs (especially sugar) completely for 3 straight months, plus taking high dose milk thistle and my ggt went from over 250 down to a few points above normal.

A ketogenic diet doesn't cause high liver enzymes.....however, if you have an existing liver issue, it may be possible that ketosis caused additional stress on your liver.

My advice would be 3 months of a whole foods diet, 100 carbs a day to keep out of ketosis. Absolutely no cheats, in order to allow your liver to heal. During this period supplement choline and milk thistle.
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  #5   ^
Old Sun, Jun-07-15, 08:03
teaser's Avatar
teaser teaser is offline
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Posts: 15,075
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
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http://ajcn.nutrition.org/content/87/5/1141.full

Quote:
Effect of a dietary-induced weight loss on liver enzymes in obese subjects1,2,3

Abstract

Background:Weight loss was shown to be associated with improvements in liver enzymes and improvements of nonalcoholic fatty liver disease. However, some evidence also shows that liver enzymes may transiently increase immediately after a dietary-induced weight loss.

Objective:The aim was to assess the outcome of liver enzymes after a low-calorie diet (LCD) as well as during a follow-up period and to identify predictors for potential changes in these liver enzymes.

Design:In this post hoc analysis of an existing database, liver enzymes were assessed before and immediately after a highly standardized soy-based meal replacement LCD providing 800 kcal/d, as well as 32 and 60 wk after the end of the LCD.

Resultsata emanating from 147 obese subjects (104 women and 43 men) without known hepatic disease were included in this study. The LCD led to a median weight loss of 12.1 kg (range: 7.7–27.6 kg). In men, a significant decrease in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was observed immediately after the LCD, whereas, in women, these enzymes increased significantly, although mildly; however, this increase was transient. Sex was the only identifiable predictor of these changes in liver enzymes.

Conclusions:This study showed that mild, transient increases in ALT and AST values can be observed immediately after an LCD in women, but not in men. These changes are probably of multifactorial origin and may be considered as benign as long as they remain transient.


Quote:
The percentage of subjects with abnormal (>2 times the ULN) ALT values is shown in Figure 2⇓. ALT values were abnormal in 21% of women (0% of men) at the end of the LCD. At the same time, 17% of women had an ALT value ≥ 3 times higher than the ULN reference range (not shown in the figure). Finally, AST concentrations were abnormal in only 9% of women and 0% of men at the end of the LCD.


Quote:
The LCD was a commercially available soy-based meal replacement (Nutrilett/Scan Diet; Nutri Pharma, Oslo, Norway). The LCD provided 800 kcal/d (45% from proteins, 38% from carbohydrates, and 17% from fat) and supplied all nutrients according to recommended dietary allowances.


Some similarity to the Ideal Protein diet, this is also a protein sparing modified fast, but with a higher carbohydrate content. Not as ketogenic--that 38% carbohydrate didn't didn't protect those susceptible from the increase in liver enzymes. Ideal protein products contain some soy, another similarity besides the low calories.

A lot of the problems that occur with fatty liver aren't due to the triglycerides stored in the tissue. Triglycerides are metabolically inert. Elevation of free fatty acids at inappropriate times (when glucose is elevated at the same time) causes all sorts of trouble. An elevation of fatty acids is inevitable during weight loss. You might have two options--either put up with another temporary elevation of liver enzymes, if you want to pursue weight loss as aggressively as you did with the Ideal Protein diet--or take a more moderate approach, maybe something a little less aggressively ketogenic, like Protein Power or a non-ketogenic Atkins approach.

This is of course just teaser's edumucated guess and not to be misunderstood as an attempt at online amateur doctoring.
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  #6   ^
Old Sun, Jun-07-15, 08:28
1DogDay's Avatar
1DogDay 1DogDay is offline
Senior Member
Posts: 630
 
Plan: LCHF <20g
Stats: 206/182/170 Female 5' 4"
BF:
Progress: 67%
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Thanks for such detailed responses! I have tried Googling and not come up with as much info as you all have .

They say I do NOT have fatty liver disease as if I did it would have shown up on the CT scan. I do know about the meds that cause elevated liver enzymes, but am only on compounded thyroid and compounded hormone cream...nothing else. I did take some SAT (by Thorne) to heal my liver, after the tests, at the suggestion of my Naturopath, and it really helped to bring down the enzymes, along with good eating.

I did see in Janet's MAYO Clinic link that the following can cause elevated liver enzymes:

celiac
hypothyroid
obesity

I have all of those and have also had Epstein Barr virus and Mononucleosis as an adult (20's and 30's)!

At the first sign of elevated liver enzymes I had not had a glass of wine for 3 months so it can't be drinking. The previous tests, 9 months before were fine and I had been drinking wine then (1-2 glasses a day max and not everyday). I had however taken more than normal ibuprophen for excruciating neck pain but the doc (the one I like in Scottsdale) said the amount I took is not enough to create the elevation and I had stopped taking it more than a month before the blood work was done.

One possibility is that when losing weight I often had a glass of kombucha (store bought from the health food store), which I used to replace my wine and I actually liked it better than wine. It only has 2 carbs so I could drink it and still lose nicely. It is fermented, and the homemade stuff can cause liver toxicity (I didn't know that at the time), and one of my docs (the Naturopath) has also seen the store bought one cause problems for his patients too. I strongly suggest you don't drink this stuff - I though it was good and healthy as it is touted as such.

Thank you for this Kristine: "I can tell you almost for certain that ketosis won't hurt your liver any more than processed gluten-free sugary crap does." I wondered if that could be the original cause of it however when I wasn't on the diet (and was eating sweets) my liver enzymes were fine, and then after being on the diet for three months, they were off the charts but I completely realize it could be and probably is something else!

I hear you Janet that I just have to DO THIS, not try. I don't know why it's so hard but I do feel like I'm ready. I feel like doing ketosis (Atkins) might be best as I seem to do better with some kind of strict structure, not just me doing it on my own.

Last edited by 1DogDay : Sun, Jun-07-15 at 08:37.
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  #7   ^
Old Sun, Jun-07-15, 10:23
1DogDay's Avatar
1DogDay 1DogDay is offline
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Posts: 630
 
Plan: LCHF <20g
Stats: 206/182/170 Female 5' 4"
BF:
Progress: 67%
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PS ~ the enzymes that are out now are:

ALP and GGT, ALP (alkaline phosphatase) is 10% above the max is should be and GGT is 75% above the max it should be.
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