Hello Dr. Laule,

I was diagnosed with N.A.S.H (Non-alcoholic steatohepatitus) after having received a biopsy during surgery for a Pheochromacytoma. It has been 4 years since I was diagnosed. I had my left adrenal gland removed and now seem to have no other issues with the tumor. I do still however have an on-going challenge with the N.A.S.H. I understand I have to lose weight and exercise and I do my best. I also take milk thistle to assist my liver and do not drink anything alcoholic. I stay away from chemicals and try to eat organic, lots of whole grains. Is there anything else I should be doing or can do to assist my liver? My father passed away from liver problems although he was a heavy drinker for many years and I am not. I understand the causes are different however, I believe the effect is the same. I have been told I am boarder line cirrhosis. I take a anxiety medication because I periodically are afraid of suffering the same fate as my father. Do you have any thoughts or ideas you can share? Thank you very much for your time.

Sincerely,

MD

Dear M.D:

NASH is often associated with a prediabetic state called “metabolic syndrome,” and so it is very important to do as you suggested, lose weight and exercise more. There are supplements that I add to help with the diet and weight loss, when appropriate. I won’t go into those, since I do not have a detailed medical history for you. I would mention that we do have a weight loss clinic we operate, in which we individualize diets for people based on their metabolic type, and their food likes and dislikes. I take a thorough medical history, and usually order some laboratory testing, then our Naturopathic Doctor, Dr. Charlo Vogt, works with me to develop a diet (really more of a lifestyle change) personalized for you.

I usually suggest alpha lipoic acid to help protect the liver, as well, in doses up to 600 mg. daily. It comes in a sustained release form that makes that dosage easier to manage. Alpha lipoic acid can cause hypoglycemia, if you already have tendencies in that direction. If hypoglycemia is a problem, I would suggest checking the archives at www.futurevisionsfoundation.org for the “ask the doctor” topic of hypoglycemia. That was archived many years ago, but should still be pertinent.

If you have gastrointestinal symptoms of bloating, excessive gas, alternating diarrhea and constipation, colon cramping, etc., I would also suggest getting a complete digestive stool analysis, in particular, a culture which will look at the amount of beneficial organisms in your gut, as well as any pathological bacteria and/or yeast you might be growing. Some of these organisms are toxin producers, and the toxins go straight to the liver via the portal vein. Treating abnormal organisms growing in the gut with appropriate natural treatments, antibiotics, or antifungals, plus adding probiotics, can be very helpful and quite important in treating NASH. This type of stool analysis is done by only a handful of specialty laboratories around the nation.

Sometimes a hepatic function profile, which you have no doubt had done, will also show signs of obstruction of bile flow, indicated by elevated alkaline phosphatase and bilirubin levels. There are herbs like dandelion root and globe artichoke which help promote the healthy flow of bile in that case.

My most recent patient who had NASH now has completely normal liver function studies, and is doing quite well. It is definitely reversible for many people. While yours has advanced to cirrhosis, and may not be fully reversible, it is probably possible to help it considerably. It’s certainly worth the effort to try.

I hope you find this hopeful. I could give you even more specific information at an appointment for medical evaluation. Call 870-741-9596, if you would like to pursue this more

Sincerely,

Alice R. Laule, M.D.

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