A weighty matter – What’s a fatty liver?

Rusty Berryhill was worried about his heart.
The 47-year-old New Albany man was carrying too much weight, and he had a family history of heart disease.
But what he needed to worry about was his liver.
“Something wasn’t right,” Berryhill, who first sought direction from his family doctor, who sent him to a cardiologist initially.
His stress test showed his heart was fine, but his blood sugars were edging closer to diabetes and his elevated liver enzymes and unbalanced electrolytes showed his liver wasn’t working right.
Further testing at Digestive Health Specialists in Tupelo led to a diagnosis in 2007 of NASH, nonalcoholic steatohepatitis. Fat building up in his liver had inflamed and impaired it.
Unfortunately, hepatologists like Dr. John Phillips in Tupelo are seeing more people with livers inflamed and scarred by too much fat because of the epidemic of obesity.
“Eventually it will be the No. 1 reason for (liver) transplant in the U.S.,” Phillips said.
In the most severe stages of the disease, fat deposits in the liver can cause so much damage they can lead to cirrhosis – the irreversible scarring of the liver most people associate with alcoholism.
“They look the same under the microscope,” Phillips said.
People often think of the risks of obesity as heart disease, stroke or diabetes. The same metabolic syndrome that puts people at increased risk of heart attacks and stroke – BMI over 30, high blood sugar, high cholesterol, high blood pressure – also put people at risk for NASH.
“It’s just one component that can seem so minor, but it can be so deadly,” said Carah Edgeworth, a nurse practitioner with Digestive Health Specialists. “You go from little bumps in liver enzymes to your only treatment being a transplant.”
Not everyone with fatty liver develops inflammation of NASH and scarring of cirrhosis, Edgeworth said. And elevated liver enzymes can indicate a number of different conditions, not just fatty liver disease.
Symptoms of fatty liver disease usually don’t appear until the process is advanced, Phillips said.
“If you’re obese and diabetic with high cholesterol, you need to have your liver enzymes checked regularly,” Edgeworth said.
People without risk factors should have their liver enzymes checked as part of their annual exam.
The good news is that losing weight will often reduce the workload on the liver. Vitamin E also has shown promise in helping people with the condition reduce their liver enzymes to normal levels – which indicates their liver is working better.
“This can all be prevented or controlled,” Edgeworth said.
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Like a lot of folks, Berryhill knew losing weight would be a good thing, but he made excuses for carrying nearly 270 pounds.
“I’m just a big guy,” he said he’d tell himself. “That’s just the age I am.”
Berryhill hit a turning point after seeing video from the state high school championship football game he officiated in December.
“It started affecting my happiness,” Berryhill said. ” I had a hard time enjoying golf and officiating.”
He also had a serious conversation with Edgeworth in January about the implications he was facing with his liver.
“She explained the importance of weight loss,” Berryhill said. “Now it was critical.”
Since January, Berryhill has lost 50 pounds and is nearly at his goal weight. His liver enzymes are normal.
He cut fried foods and alcohol – both for their calories and the extra work load they put on the liver. He dropped sweets and starchy foods for a focus on grilled and baked meats, veggies, fruits and whole grains. He eats five to six small meals and snacks throughout the day.
“I feel 10 to 12 years younger,” Berryhill said. Doctors had to reduce his blood pressure medicine because it was dropping so low it was making Berryhill dizzy.
Berryhill may be able to reduce his cholesterol medication if he maintains his healthy ways, too.
Berryhill’s success is just what his doctor ordered.
“Fatty liver can resolve with weight loss,” Phillips said. “If you are obese, take it seriously as a medical condition.”

Michaela Morris