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Fatty Liver
Hello B and D,
My husband who is 54 years old has had NAFLD and NASH for over 20 years and monitoring it by doing blood tests twice a year. He has high cholesterol (could be from paternal genes but I believe it is from his fatty liver). He has done current tests that I would like to share with you that are showing gall bladder with inflamed walls and high LDL. He stopped taking Crestor 5mg daily about 2 months back. Would love to hear your feedback. Thank you. -
9 Replies
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[Blood Tests 1_Redacted.pdf]
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[Echo Exam of Abdomen _Redacted.pdf]
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Hey ,
Thank you for sharing his labs! Since you mentioned your husband does a check up every 6 months, perhaps you could share his previous cholesterol and GGT values as well.
Billiary congestion can cause high cholesterol values. Genes as well. If there is a genetic component and if he has trouble lowering cholesterol with a healthy lifestyle, with these numbers, checking for genes could provide you more insight into how well he can manage certain lifestyle factors.
Other factors play a role as well. For example insulin resistance can elevate cholesterol and is often seen in patients with NAFLD. We can’t directly see insulin levels on your lab, but HbA1c an glucose are often used to get a sense of insulin levels. Through a functional medicine lens, his glucose and HbA1c do show insulin resistance is at play to a degree. Unfortunately, the best way to measure insulin is still, measuring insulin. Having fasting insulin levels measured is something I would recommend. Here you can find more information.
An underactive thyroid could also contribute to elevations of cholesterol, since the liver slows down breaking down cholesterol as well. Has he ruled out an hypothyroid state? If not here is a video about how to test for that.
Could you tell us more about his life? How long is he struggling with this? How does he eat & drink? How is his sleep? Is he stressed? Does he have an active lifestyle? Is or was he sick? How has his weight changed over the years? Are there other symptoms present?
Billiary Congestion & Inflammation
Fortunately the echo exam doesn’t show traces of gallstones, but there is inflammation. I would advise you to make sure his serum vitamin D levels are in range. Vitamin D influences a lot of the inflammation regulating genes and genes related to his immune system. Do you know if they have been measured recently?DHA & EPA can help resolve inflammation. Omega 3’s might be helpful in reducing the inflammation as well.
Low normal White Blood Cells(WBC)
The WBC are low normal which might be indicative for some kind of infection. His eosinophils on the other hand are high. Eosinophils elevate with allergic reactions or parasites. Also nutrient insufficiencies can cause lower WBC. Nutrients like vitamin D, zinc and vitamin A.If you could tell us a little more about your husbands life, it would help us to provide you with some more customized advise.
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Hello Daniel,
Thank you for getting back to me.
He has a moderate work and lifestyle stress, no other symptoms, weight fluctuates 2 to3 kilos max currently hovering around 80.5 kgs and his height is 183cm. Been on and off Statins for last couple of years, he is back on them again and he takes 5 mg Crestor daily. He goes to the gym 5 times a week from Mon to Fri for an hour + before breakfast (weight resistance and cardio with stretching). Diet is animal protein, vegetables and tubers like yams, cassava, and sweet potato. No consumption of legumes, rice, potatoes or wheat-based products. Minimum sugar intake. Paternal family history of heart attacks, high cholesterol and diabetes. -
[Fouad tests.zip]
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Hey ,
I will take a look at your labs more thoroughly later. I did see fasting insulin was measured in 2022. That’s great! I often recommend my clients to have a fasting insulin between the 4-7 mIU/L. Back then his fasting insulin levels were 14.
I didn’t see a thyroid panel somewhere (I could have missed it of course, I didn’t see all the lab tests yet), but it would be worth looking into.
You did mention you thought the fatty liver could be the cause of his high cholesterol and I agree. If he has been weight stable over all these years, if he never really gained weight and if he was mostly physically active his whole live, I do believe it is worth checking his genes.
Many people believe the main function of LDL and HDL is to transport cholesterol, but LDL and HDL main function is to transport phospholipids and fatty acids. High LDL and HDL also means more fat transport. When fat is dropped in the liver, this could then cause a fatty liver as well.
There is something called cholesterol induced fatty liver disease (click here if you like to learn more). It would be interesting to know the variations of your husband’s APOB, LDLR, LDLRAP1 and PCSK9 genes. Some variations cause elevations in cholesterol.
If he uses statins, he will benefit from Coenzyme Q10 as well. CoQ10 is critical for endothelial function in the lining of blood vessels. I usually recommend 100mg of the ubiquinol form. Having serum vitamin D levels up in the 50 ng/mL.
Again, I need a little time to work through all your labs and I will come back to you later!
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Hello Daniel, I don’t believe he has done a thyroid panel.
I will look into what you have suggested on the above. Thank you so much. -
Hey ,
I have taken a look at the lab reports you shared with me and I’m glad you shared them. There are a lot, so it will take me a little longer to digest all the reports, but I wanted you already give some important pearls:
The Detoxygen gene report already provides a lot of unique insights. It’s very important to realize that genes and variations of genes don’t determine a future. The way to look at these reports is that they emphasize a unique way of living for this person to their benefit.
The Detoxgen Report from 2019 shows your husband has a genetic variation on his ApoE gene. This can contribute to elevations in cholesterol. The most common ApoE variations are called ApoE2, ApoE3 and ApoE4. The ones carrying the ApoE4 gene are at more risk for certain diseases like high cholesterol or Alzheimer’s disease. The test doesn’t name the variation, so I can’t tell if the variation measured in this test is actually ApoE4, but the test shows a gene variation on the ApoE gene that has a disadvantage for the carrier. Again, this emphasizes that some lifestyle choices impact your husband more than others. It is not a guarantee for the development of certain disease states!
The test shows also a genetic disadvantage in producing an enzyme called SuperOxide Dismutase (SOD2 it is called in the test). This enzyme is a powerful enzyme that is needed to remove a special type of free radicals called Reactive Oxygen Species (ROS).
Everybody produces ROS because ROS is created when we burn energy.
‘Slower’ working variations in genes that produce superoxide dismutase are also associated with higher levels of cholesterol as well.
There is definitely a genetic component.
What can you do?
To a degree, you can overcome this problem by providing the body with more nutrients to build superoxide dismutase. Manganese is one of those nutrients. Having a diet rich in antioxidants becomes also very important. Having a diet rich in Omega 3s is something he could benefit from as well. I usually recommend my clients take 1000 mg of EPA+DHA.Exercise increases energy burning. In his case, if he is working out aggressively, you can recommend him to focus on moderate medium-intensity workouts. His body can benefit from this since the free radical production goes up when we exercise.
There are more genes involved in cholesterol metabolism of course, but the ApoE disadvantage and the SOD2 disadvantage can contribute.
In his personal case, choosing organic foods will impact his health more as well. There is another gene (GSTM1) which usually helps detoxify pesticides, but your husband is missing this gene. It is a regularly often occurring deletion of this gene, but this cocktail of genes plays into each other and can create an extra impact on his health with certain lifestyle choices.
GGT
His GGT lab value is in the lab values consistently elevated. Statins can cause elevations in GGT. So does oxidative stress. It is therefore hard to see if the elevations of GGT are triggered by statins or oxidative stress from some other source.GGT usually elevates when the body is in need of more glutathione. Supplementing with Glutathione can be something you could consider.
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Hello Daniel,
THANK YOU SO MUCH for going thoroughly through the lab tests.
If I can recap, he should take the following:
-DHA & EPA, Omega 3’s, I have at home Nordic Naturals ultimate omega.
-Glutathione
-Coenzyme Q10
Which brands would you recommend for the above three? I hope I didn’t miss any.
Should he continue on his statins?
Once again thank you!
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