Fatty Liver Naturopathic Protocol

Fatty Liver Naturopathic Protocol

This Fatty Liver Naturopathic Protocol is provided as information for patients of HealthMasters Naturopath Kevin Tresize ND as part of a treatment plan to assist patients with understanding of their treatment plan and should not be substituted for medical advice, diagnosis or treatment. It is important to note that this is a summary only and is intended to assist discussion between practitioner and patient as part of consultations. This Fatty Liver Naturopathic Protocol may be changed to suit the individual requirements of the patient and should not be substituted for medical advice, diagnosis or treatment.

HealthMasters Naturopath Kevin Tresize ND

 

Overview:

1. Definition

2. Aetiology and Risk Factors

3. Signs and Symptoms

4. Core Treatment

5. Alphabetical Reference of Nutritional Support

6. Supportive Lifestyle Programs

7. Diet and Lifestyle

8. Point-of-care and Pathology Testing

9. Pharmaceutical Treatments

 

1. Definition

It is normal for the liver to contain some fat, but if fat accounts for more than 10% of the liver’s weight, then liver function may be impaired and serious complications may develop.  Fatty liver may develop into inflammation of the liver (steatohepatitis, non-alcoholic steatohepatisis (NASH) or Non-alcoholic fatty liver disease (NAFLD), scarring and hardening of the liver, and eventually, liver cirrhosis and liver failure.  In developed countries, the incidence of fatty liver is 15-20% of the general population (much higher in obese individuals). Fatty liver is the most common cause of abnormal liver function tests in adults and children.

Commonly NAFLD is associated with a high waist measurement (a marker of increased visceral adipose tissue) and is associated with metabolic syndrome and Type 2 Diabetes. Fat accumulates in the liver as excessive free fat fatty acids (triglycerides) from the diet and from adipose stores overflow and fats are eventually deposited in organs including the heart, liver, pancreas and muscle mass. Fat accumulation is referred to as lipotoxicity, as these tissues are rendered highly insulin resistant and unable to produce energy efficiently. In the case of the pancreas, lipotoxicity eventually lead to beta-cell failure and decreased insulin output. Fatty organs, especially fatty liver, are associated with increased visceral adipose tissue (VAT), dyslipidaemia (disordered cholesterol and triglyceride levels) and altered blood sugar metabolism, all hallmarks of metabolic syndrome and diabetes.

 

Figure 1 Fatty Liver Naturopathic Protocol at HealthMasters Metagenics

Figure 1: Triglycerides from the diet and fatty acids from the adipose tissue accumulate in the liver to increase fat deposits (lipogenesis) that inhibit fat burning and contribute to increased cholesterol output (VLDL) and insulin resistance. This sets up a vicious cycle that interferes with cholesterol circulation and compounds cardio-metabolic risk. 

Key: TG – triglyceride, CM – chylomicron, HSL – high sugar level, FA – fatty acids, NEFA – non-esterified fatty acids, VLDL – very low density lipoprotein.

 

2. Aetiology / Risk factors

Common risk factors that to the incidence of fatty liver include

  • Diabetes mellitus
  • Malnutrition, severely overweight
  • Metabolic disorders, such as metabolic syndrome
  • Dietary factors; deficiency of protein, which high fat and high sugar
  • Hazardous chemicals exposure (cleaning products, weed killer)
  • Toxic mushrooms
  • Chronic use of drugs (especially painkillers and cortisone)
  • Infections, including intestinal bacterial overgrowth
  • Lack of oxygen, insufficient physical activity
  • Pregnancy: For an unknown reason and rarely, cirrhosis fat may appear at the end of pregnancy

 

3. Signs and Symptoms

Common signs and symptoms of fatty liver include

  • Enlarged liver
  • Discomfort over the liver
  • Weakness, fatigue, lethargy
  • Confusion and poor concentration
  • Gallstones composed of cholesterol and bile salts
  • Adiposity, especially in the abdominal area
  • Metabolic Syndrome
  • Constipation
  • Fatty foods cause indigestion
  • Regurgitating bitter fluids
  • Food and chemical allergies/intolerances
  • Difficulty losing weight
  • Elevated cholesterol and triglycerides
  • Immunological disorders (e.g., allergies, frequent infections, increased inflammatory response in the body, autoimmunity.)
  • More severe: Fluid retention, muscle wasting, jaundice and liver failure.

 

4. Core Treatment

4.1 Protect and support liver function: induce antioxidant and detoxification enzymes, enhance insulin sensitivity and mitochondrial function

High Potency Taurine, Glycine and Magnesium for Cardiovascular Health - 1 serve twice daily

Milk Thistle and BCM-95 Turmeric for Liver Support - 2 tablets twice daily

 

4.2 If overweight or obese

Shake It Practitioner Weight Management Program

PLUS

Cocoa, Cinnamon and Chromium for Metabolic Syndrome - 1 tablet twice daily

 

4.3 Liver Chemical Clearance Program for ongoing liver maintenance – (refer to detoxification protocol)

Milk Thistle, Green Tea & Amino Acids for Optimal Detox - 1 scoop in 200mL water twice daily

PLUS

Detox Greens - 2 scoops in 200mL water twice daily

PLUS

Milk Thistle and BCM-95 Turmeric for Liver Support - 2 tablets twice daily

 

4.4 If with nauseated when eating fats (sign of poor fat digestion)

Liver and Gall Bladder Support - 1 tablet twice daily

 

4.5 Prevent liver inflammation, scarring and cirrhosis 

Herbal Liver Protection - 1-2 capsules daily

 

5. Alphabetical Reference of Nutritional Support

Formula Catch Phrase

Key Benefits

Cocoa, Cinnamon and Chromium for Metabolic Syndrome Cocoa, cinnamon and gymnema blended with nutrients to mitigate the impact of insulin resistance, including increased visceral fat and fatty liver. Cocoa (45% polyphenols) enhances glucose uptake, insulin responses and mood balance, whilst antioxidant cinnamon reduces post-prandial blood sugar levels. B vitamins, zinc and chromium support glucose transport and overall energy metabolism. Gymnema is included to manage sweet cravings and taste.
Detox Greens Herbal and nutritionally based ingredients to support gastrointestinal mucosal integrity, detoxification of heavy metals, balance acidity, enhance digestion and healthy probiotic balance, whilst enhancing kidney and lymphatic detoxification. Spirulina is assisting removal of toxicity induced by: heavy metals: arsenic, mercury, chromium, cadmium, lead, fluoride, Insecticides. This formula also contains prebiotic compounds improving the microbiome.
Herbal Liver Protection A high strength standardised extract of Silybum marianum to offer antioxidant liver protection, assist normal detoxification and maintain healthy liver function.
High Potency Taurine, Glycine and Magnesium for Cardiovascular Health Magnesium with activated B vitamins and chromium combine to enhance detoxification and support healthy metabolism, via methylation, essential to detoxification & managing homocysteine levels, as well as supporting insulin sensitivity.
Liver and Gall Bladder Support Herbs and nutrients combine to support bile flow. Many toxins are released through the liver and gall bladder, supporting healthy bile production and flow better assists the elimination of wastes.
Milk Thistle and BCM-95 Turmeric for Liver Support This combination of herbs enhances the detoxification of environmental toxins, essential for patients undergoing the Liver Chemical Clearance Program. The actions of these herbs aim to modulate all phases of detoxification, mitigating oxidative stress that may occur from phase I activity and promote conjugation of toxins in phase 2, increasing glutathione and reducing toxin reabsorption through the inhibition of beta glucuronidase.
Milk Thistle, Green Tea & Amino Acids for Optimal Detox This formula is the central component for all detoxification programs. In a low carbohydrate rice protein base blended with milk thistle, gardenia and green tea, it supports liver and gallbladder function to induce antioxidant and detoxification pathways. Other key ingredients in the formula include Gardenia jasminoides binding Lipopolysaccharide Milk thistle increasing phase II detoxification enzymes and Green tea as it increases anti-oxidant and anti-inflammatory defence in the presence of toxins.

 

6. Supportive Lifestyle Programs

Supportive Lifestyle Program Description
Shake It Practitioner Weight Management Program Disordered glucose tolerance, insulin resistance and consequently disordered appetite leads to abdominal weight gain. This carbohydrate-controlled, ketogenic fat loss program is an essential approach for those with severe insulin resistance, who will usually also be overweight or obese. Reducing dietary glycaemic load will reduce insulin release and help patients lose abdominal adipose tissue, thus helping to minimise the risk of many chronic illnesses. This strategy also helps to reduce cravings for food and drink. This program utilises Milk Thistle, Green Tea & Amino Acids for Optimal Detox as a meal replacement, as toxins are liberated from fat mass during significant weight loss. This formula helps to neutralise and support the clearance of toxicity.
Liver Chemical Cleanse program This four week program is appropriate for individuals requiring additional liver support to improve their health. In addition this program will help to support those people who may have been exposed to heavy metals or chemicals due to occupation or environmental causes. This program incorporates specific nutrients and herbs that may enhance the removal of heavy metals and support optimal liver function. For details, see DETOXIFICATION protocol.
Wellness and Healthy Ageing Program This program recommends a low glycaemic load diet with lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with healthy ageing and chronic disease prevention.

  

7. Diet and Lifestyle

Dietary and lifestyle guidelines may assist in the management of fatty liver:

  • If overweight or obese, weight reduction is essential.  The Shake It Practitioner Weight Management Program is a safe fat loss program that improves insulin signalling, burns fat, and helps to lower blood triglycerides and support healthy cholesterol levels.
  • Patient education about potential sources of toxicity, including plastics and household chemicals, may adversely affect the liver, and for this reason a comprehensive, integrated detoxification program is essential for treatment of the liver.
  • It is essential to restrict alcohol intake, especially if this aggravates liver sensitivity.
  • To encourage effective liver detoxification increase dietary intake of high-sulphur foods (e.g., garlic, onions) and foods containing indole-3-carbinole (e.g., cabbage, broccoli, cauliflower).
  • Beneficial lifestyle modifications include increased physical activity, stress management and smoking cessation.

 

8. Point-of-Care Pathology Tests 

Test / Screen Interpretation Guidelines
Liver Function Test (LFT)

This is a blood test that measures serum levels of any of several liver enzymes. An elevated liver function test is a sign of possible liver damage.

Normal Values:

Albumin: 32-45g/L

Total bilirubin: <20mol/L

AP (Alkaline Phosphatase): 25-100U/L

GGT (Gamma Glutamyl Transferase): <30U/L

LD (Lactate Dehydrogenase): 110-230U/L

AST (Aspartate aminotransferase): <40U/L ALT (Alanine aminotransferase): <35U/L

Liver biopsy In this procedure tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope. The presence of fatty infiltrations in the liver sample is indicative of fatty liver disease.
Liver ultrasound Ultrasound imaging of the abdomen can reveal liver enlargement and other pathological changes indicative of fatty liver disease.

 

9. Pharmaceutical Treatments

There is no specific pharmaceutical treatment for fatty liver available. Management of concomitant symptoms and causative factors (e.g., diabetes, hypertriglyceridemia) is the focus of pharmacological intervention.

x