Not dead yet!
Well-Known Member
I've been meaning to talk about liver health for a while now, but I don't want to be preachy and salesman like. It's just that I have improved my condition lately and I hope it helps others. I don't see much about liver health on this forum yet. I did search for liver in the title of posts and found a video about it and a couple of other mentions.
https://www.healthrising.org/forums/media/14-foods-that-cleanse-the-liver-youtube.204/
The video author didn't mention the two highest in choline foods: liver and eggs. In my family, eggs and liver are combined. Liver and onions, finished with scrambled eggs, and a side of tomatoes from the garden. I suppose it could be a side of cruciferous veggies, but lycopene has good liver effects too. I recently started eating liver again and I wanted to give a hint about cooking it too: curry with liver and onions is divine if you already like curry. Goes well with eggs too.
Another excellent post about liver health from this forum: https://www.healthrising.org/forums/threads/pretty-liver-detox-graphic.3926/ Great background materials.
It has been demonstrated that low choline diets (such as when a person with a gut disease undergoes TPN) cause reversible "fatty liver." : https://www.ncbi.nlm.nih.gov/pubmed/11531217
I could kvetch that it's only a n=8 trial, but it's humans we're dealing with, not lab rats. Could also kvetch that they're already sick, and maybe healthy people would not have this effect, but there are several objections to that idea. Much of the rest of this article deals with some of the objections to it.
Choline is now considered in the twilight zone of "essential nutrient with Adequate Intake level" but "not a vitamin." Huh? Okay so it's doubletalk then. Basically not enough research exists for them to set a real RDA, but they acknowledge that they need to research it more because it has a strong enough influence on human health. A 1300+ page report from 1998 that gave choline this status: https://www.nal.usda.gov/sites/default/files/fnic_uploads/DRIEssentialGuideNutReq.pdf
OK so digging deeper, how is it possible that I have a deficiency in a rich country surrounded by good clean food and clean water? I find some clues:
From: https://www.ncbi.nlm.nih.gov/pubmed/26773011
"Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes."
Quotes from that article:
1. Bacteria can be using up the choline I eat. "In addition to free choline, phosphatidylcholine has been identified as a substrate for trimethylamine production by certain intestinal bacteria, thereby reducing host choline bioavailability and providing an additional link to the increased risk of cardiovascular disease faced by those with NAFLD" There is a lot more detail in the PDF (free) of this article about this, its relation to the function of macrophages, the effect it has on artherosclerosis and heart disease, etc. If that's your issue, this may provide some clues for you. For me, it gives me a clue why I might have low choline despite eating eggs regularly. It wasn't until I was also eating liver that I overcame this hurdle... maybe. A person isn't a scientific lab so being sure of that is never going to happen. I do however, feel much better with both liver and eggs in my diet than just eggs alone.
2. Estrogen imbalances may be affecting my liver. Well, that much is obvious. Estrogen is processed by the liver, it's one of the jobs of the liver. That's why we have so many women suspicious of estrogen containing drugs. Despite what medicine tells us we can feel it is making our body wierd. Setting that aside, let's talk about choline. "he enzyme PEMT plays a key role in the
synthesis of hepatic phosphatidylcholine, as demonstrated by PEMT knockout mice developing hepatic steatosis because of reduced TG excretion (36). Interestingly, the PEMT gene is under estrogenic control (37), which explains why premenopausal women were less likely than postmenopausal women or men to develop hepatic steatosis during a controlled feeding trial that included a phase of depleted choline intake (38). However, some premenopausal women were insensitive to this protective effect, and subsequently this has been demonstrated to be due to 2 single nucleotide polymorphisms that reduce estrogen binding in the promoter region of the PEMT gene." Um, wow. So the anti-hirsutism drug (spironolactone) may be doing more for me than I realize. I will need to discuss this wth my doctor and my endocrinologist. But sadly I doubt if they will grok this kind of in depth theory. They generally look like frightened deer in headlights when I talk of something like this. But I have to try.
3. I may be genetically incompatible with a high fat diet (ketogenic). "Animal studies have supported the concept that host genetics predispose one to a choline-utilizing gut microbiota that leads to less choline bioavailability and subsequent increased risk in NAFLD. Feeding a high-fat diet to mice that are genetically predisposed to NAFLD leads to low plasma phosphatidylcholine concentrations. " Because we've had this fight before, I'll specify that my failure on any diet does not impugn the diet itself. I think it's best that I know what is best for me and do that without having to defend a lifestyle or diet. I have enough problems. However, I should point out that it isn't ever clear when scientists talk about a high-fat diet, whether they mean the "Donut-diet" (high fat / high sugar) or a keto diet (high fat / low sugar and carbs). This passage again, fails to specify which one, so we'd have to go find the research to be sure. For me, this explains why it's possible that I have a diet that supposedly deals with NASH and yet it fails on me. Both vegan and keto have had limited or bad effects on my liver health, actually only fasting has ever helped my liver pain. That is consistent with the idea that the bacteria are the issue. Fasting reduces the quantity of gut bacteria temporarily.
I happen to find reading research very useful and motivating. If you don't like it as much, then take it as read that "liver is good for you" and choline is an up and coming blockbuster vitamin that should probably be on every supplement website already. And that it has helped me to recover about 40% of my energy:
* I am showering now. I was so debilitated, I had to have baths prepared for me for nearly the past year. I couldn't stand up long enough to shower.
* I don't wake up feeling like I have a hangover. I am still tired, but the "don't move or you'll have exploding pain" sensation is gone.
* I can go shopping about once a week. I still am careful not to overdo it. But I was able to shop for 4 hours the first time, and 6 hours the next time.
* I can go outside an not sit all day. I take a daily foray into the sunshine now. I literally couldn't do that before. If I did I'd have to sit down immediately upon going outside. And the sun would be like a fire in my eyes. I can do it now.
* Best of all I'm tired at the right time of the day (circadian reversal is in remission), and I'm not ravenously hungry while being sick at the thought of eating anything simultaneously. There is a sense of "satisfied" with my food that has been missing for a long time.
What changed?
1. I fasted for about 5 days, and then went off all drugs except a couple of essentials.
2. I developed liver pain and had it tested by CT scan. The drugs were masking the pain. Results: I have NAFLD and/or NASH, a CT scan can't distinguish them, and my liver values AST/ALT don't merit further tests right now.
3. I did a lot of reading into what could be causing this. Obviously too many drugs. But how did my body fall so far behind? Something is missing fromt he picutre.
4. I started eating liver again and almost immediately it helped. Maybe choline is only part of it. Maybe there are other things in liver that are helping me also. It's pretty clear we don't know all we should know about maintaining our health. I eat liver every day now. I precook what I need for several days and freeze anything over that needed for a day or two.
I still have to be careful about hypoxia. I will probably not get off of a the CPAP while sleeping, maybe ever. When I forgot (getting too brave!), I woke feeling worse and it took hours to "wake up." But the pain was still better.
So partial success in reversing this illness, reported here.
Suggestions are welcomed, as are links to more research. I fear no chemical formulas!
Edit reason: I added emphasis to the "block of text" areas to help readability.
https://www.healthrising.org/forums/media/14-foods-that-cleanse-the-liver-youtube.204/
The video author didn't mention the two highest in choline foods: liver and eggs. In my family, eggs and liver are combined. Liver and onions, finished with scrambled eggs, and a side of tomatoes from the garden. I suppose it could be a side of cruciferous veggies, but lycopene has good liver effects too. I recently started eating liver again and I wanted to give a hint about cooking it too: curry with liver and onions is divine if you already like curry. Goes well with eggs too.
Another excellent post about liver health from this forum: https://www.healthrising.org/forums/threads/pretty-liver-detox-graphic.3926/ Great background materials.
It has been demonstrated that low choline diets (such as when a person with a gut disease undergoes TPN) cause reversible "fatty liver." : https://www.ncbi.nlm.nih.gov/pubmed/11531217
I could kvetch that it's only a n=8 trial, but it's humans we're dealing with, not lab rats. Could also kvetch that they're already sick, and maybe healthy people would not have this effect, but there are several objections to that idea. Much of the rest of this article deals with some of the objections to it.
Choline is now considered in the twilight zone of "essential nutrient with Adequate Intake level" but "not a vitamin." Huh? Okay so it's doubletalk then. Basically not enough research exists for them to set a real RDA, but they acknowledge that they need to research it more because it has a strong enough influence on human health. A 1300+ page report from 1998 that gave choline this status: https://www.nal.usda.gov/sites/default/files/fnic_uploads/DRIEssentialGuideNutReq.pdf
OK so digging deeper, how is it possible that I have a deficiency in a rich country surrounded by good clean food and clean water? I find some clues:
From: https://www.ncbi.nlm.nih.gov/pubmed/26773011
"Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes."
Quotes from that article:
1. Bacteria can be using up the choline I eat. "In addition to free choline, phosphatidylcholine has been identified as a substrate for trimethylamine production by certain intestinal bacteria, thereby reducing host choline bioavailability and providing an additional link to the increased risk of cardiovascular disease faced by those with NAFLD" There is a lot more detail in the PDF (free) of this article about this, its relation to the function of macrophages, the effect it has on artherosclerosis and heart disease, etc. If that's your issue, this may provide some clues for you. For me, it gives me a clue why I might have low choline despite eating eggs regularly. It wasn't until I was also eating liver that I overcame this hurdle... maybe. A person isn't a scientific lab so being sure of that is never going to happen. I do however, feel much better with both liver and eggs in my diet than just eggs alone.
2. Estrogen imbalances may be affecting my liver. Well, that much is obvious. Estrogen is processed by the liver, it's one of the jobs of the liver. That's why we have so many women suspicious of estrogen containing drugs. Despite what medicine tells us we can feel it is making our body wierd. Setting that aside, let's talk about choline. "he enzyme PEMT plays a key role in the
synthesis of hepatic phosphatidylcholine, as demonstrated by PEMT knockout mice developing hepatic steatosis because of reduced TG excretion (36). Interestingly, the PEMT gene is under estrogenic control (37), which explains why premenopausal women were less likely than postmenopausal women or men to develop hepatic steatosis during a controlled feeding trial that included a phase of depleted choline intake (38). However, some premenopausal women were insensitive to this protective effect, and subsequently this has been demonstrated to be due to 2 single nucleotide polymorphisms that reduce estrogen binding in the promoter region of the PEMT gene." Um, wow. So the anti-hirsutism drug (spironolactone) may be doing more for me than I realize. I will need to discuss this wth my doctor and my endocrinologist. But sadly I doubt if they will grok this kind of in depth theory. They generally look like frightened deer in headlights when I talk of something like this. But I have to try.
3. I may be genetically incompatible with a high fat diet (ketogenic). "Animal studies have supported the concept that host genetics predispose one to a choline-utilizing gut microbiota that leads to less choline bioavailability and subsequent increased risk in NAFLD. Feeding a high-fat diet to mice that are genetically predisposed to NAFLD leads to low plasma phosphatidylcholine concentrations. " Because we've had this fight before, I'll specify that my failure on any diet does not impugn the diet itself. I think it's best that I know what is best for me and do that without having to defend a lifestyle or diet. I have enough problems. However, I should point out that it isn't ever clear when scientists talk about a high-fat diet, whether they mean the "Donut-diet" (high fat / high sugar) or a keto diet (high fat / low sugar and carbs). This passage again, fails to specify which one, so we'd have to go find the research to be sure. For me, this explains why it's possible that I have a diet that supposedly deals with NASH and yet it fails on me. Both vegan and keto have had limited or bad effects on my liver health, actually only fasting has ever helped my liver pain. That is consistent with the idea that the bacteria are the issue. Fasting reduces the quantity of gut bacteria temporarily.
I happen to find reading research very useful and motivating. If you don't like it as much, then take it as read that "liver is good for you" and choline is an up and coming blockbuster vitamin that should probably be on every supplement website already. And that it has helped me to recover about 40% of my energy:
* I am showering now. I was so debilitated, I had to have baths prepared for me for nearly the past year. I couldn't stand up long enough to shower.
* I don't wake up feeling like I have a hangover. I am still tired, but the "don't move or you'll have exploding pain" sensation is gone.
* I can go shopping about once a week. I still am careful not to overdo it. But I was able to shop for 4 hours the first time, and 6 hours the next time.
* I can go outside an not sit all day. I take a daily foray into the sunshine now. I literally couldn't do that before. If I did I'd have to sit down immediately upon going outside. And the sun would be like a fire in my eyes. I can do it now.
* Best of all I'm tired at the right time of the day (circadian reversal is in remission), and I'm not ravenously hungry while being sick at the thought of eating anything simultaneously. There is a sense of "satisfied" with my food that has been missing for a long time.
What changed?
1. I fasted for about 5 days, and then went off all drugs except a couple of essentials.
2. I developed liver pain and had it tested by CT scan. The drugs were masking the pain. Results: I have NAFLD and/or NASH, a CT scan can't distinguish them, and my liver values AST/ALT don't merit further tests right now.
3. I did a lot of reading into what could be causing this. Obviously too many drugs. But how did my body fall so far behind? Something is missing fromt he picutre.
4. I started eating liver again and almost immediately it helped. Maybe choline is only part of it. Maybe there are other things in liver that are helping me also. It's pretty clear we don't know all we should know about maintaining our health. I eat liver every day now. I precook what I need for several days and freeze anything over that needed for a day or two.
I still have to be careful about hypoxia. I will probably not get off of a the CPAP while sleeping, maybe ever. When I forgot (getting too brave!), I woke feeling worse and it took hours to "wake up." But the pain was still better.
So partial success in reversing this illness, reported here.
Suggestions are welcomed, as are links to more research. I fear no chemical formulas! Edit reason: I added emphasis to the "block of text" areas to help readability.
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