Fibroscan - Moderate Fibrosis, or Non Alcoholic Fatty Liver

[ThailandRyan]

So lets start this topic off with the disclaimer that I don't belief I am personally fat, but then that's my view.  Had my annual full physical program at my local big box hospital here in Bangkok yesterday, an all day affair starting early morning.  After having fasted all night and then arriving at the hospital bright and early after walking through the nice morning rain we were having, it was off to the get my lovely blood pressure checked and my height and weight.  Initial weight was 98 kg, with a height of 180.7 cm.  The blood pressure was a lovely 117/70 with a pulse of 66. 

 

The fun was then started with a trip to see the vampire and have three vials of blood taken, I can only assume for his use at lunch time as he climbed back in the box he came out of.  After labs it was on to scan this, scan that of which one was a Fibroscan of my liver.  That was a fun scan as it took her over 30 minutes to actually get some good scans as my ribcage is very thick.  Then it was off to X'ray this and that, and only then I was allowed to eat a mid morning meal.  A return to the testing center, after a nice brunch, was then done and my physical was then started and completed by a wonderfully cute female doctor.  Of course she needed to wait on the blood test results for a look at the full lab report before she could complete my Medical Certificate, and the one I also needed for my DLT Licenses. I was then taken over where an EKG was completed as well as completing a 20 minute jog on the treadmill to have an Echo Stress test completed as well as a few more exams.  Then off to see the Doctor regarding the Fibroscan results.  Her first impression was to ask a series of rather personal questions regarding drinking, smoking, diet, and life.  After this interview I was given the news that my Fibroscan showed a moderate fibrositis, 3rd stage Steatosis, also known as a fatty liver.  As someone who drinks very little, she called it Non-Alcoholic fatty liver, which she indicated was due to a combination of being overweight, a diabetic and genetic factors.  This was then also taken up by the Endocrinologist I saw a few minutes later who reviewed my Diabetic test results, a fasting glucose of 110, and an A1C of 5.8, which in his words was very good blood sugar control for a Type 2 Diabetic.  All my labs were reviewed and the only labs that were out of whack were my Cholesterol, which was slightly elevated at 195, my HDL and LDL which were just above and below where they should be, and my Triglycerides which were at 170. 

 

The reason for this OP is to ask the question of other than my diet, and exercise regime which is already pretty tight, what else besides the pills he was pushing (Atorvastatin for the Lipids, and putting me on Trulicity to get the blood sugars tighter) has anyone been succesful with in reducing the fatty liver, or does anyone really care.

 

The cardio tests and everything else done over the course of the morning and the day were deemed to be good, and I was told that I should continue to watch my diet as my arteries looked like they were starting to thicken.

 

Has anyone else been told they have a fatty liver, now I am only 55 years old, and this worries me to some degree.  Doctors all want me to get down to 80kg of weight, which for my size as a former Track and field athlete throwing the hammer, shot put and discus, would make me look like a scarecrow.  Hope you all are healthy and well. 

[tonray]

7 minutes ago, ThailandRyan said:

Doctors all want me to get down to 80kg of weight, which for my size as a former Track and field athlete throwing the hammer, shot put and discus, would make me look like a scarecrow. 

What is your body composition ? In other words, is your 98 kilos pretty solid muscle or is a large % of it jelly-like and not taut and firm ? If the former you are correct and you are not considered fat..if the latter...for your height...you should correctly be considered a bit fat. Just my 2 cents. 

[Saltire]

Firstly I would love to know where you went for this and how much it cost as this is what I need at some point. I just came back from a break in Hua Hin and had a whole series of tests at a lab but no face to face with a doctor. PM if you don't want to put it in a post.

 

My situation is very similar. My solution to high readings for fatty liver and control of Type 2 diabetes was a ketogenic  diet for more than 2 years now. 20 Kg down so far, need about 5 or 10 more to hit target. Came off 1500 mg Metformin after the keto diet weight loss. Daily fasting blood sugar 90 - 100. Practice intermittent fasting (eat between 10 am and 4 pm only) which can also help fatty liver.

 

After some research on the current statins situation I came off them completely after almost 10 years. No real change on lipids, in fact they sound very similar to yours, just a bit on the high side.

 

Only meds now are Amlopine daily for blood pressure and an aspirin a day as a result of some stents put in 10 years ago.

 

 

 

[ThailandRyan]

30 minutes ago, tonray said:

What is your body composition ? In other words, is your 98 kilos pretty solid muscle or is a large % of it jelly-like and not taut and firm ? If the former you are correct and you are not considered fat..if the latter...for your height...you should correctly be considered a bit fat. Just my 2 cents. 

Body composition is good fairly solidly built, and I still lift weights as well as jog 40 km a week.  Only spot a bit jiggly is in the belly, but that will go away with some more hard work.  It has been an uphill battle for staying the way I am after having a double lumbar fusion, and a triple neck fusion of C3/C4/C5, and three knee surgeries over time to repair torn ACl, PCl, and MCL.  Add in a bit of spinal stenosis/arthritis, but I still push on.  

[tonray]

2 minutes ago, ThailandRyan said:

Body composition is good fairly solidly built, and I still lift weights as well as jog 40 km a week.  Only spot a bit jiggly is in the belly, but that will go away with some more hard work.  It has been an uphill battle for staying the way I am after having a double lumbar fusion, and a triple neck fusion of C3/C4/C5, and three knee surgeries over time to repair torn ACl, PCl, and MCL.  Add in a bit of spinal stenosis/arthritis, but I still push on.  

Don't sound overweight...but did you ever consider that your jogging that much and continued weight lifting are contributing to your joint and back issues ? There are many different types of low impact exercise one can do and still stay fit

[ThailandRyan]

4 minutes ago, tonray said:

Don't sound overweight...but did you ever consider that your jogging that much and continued weight lifting are contributing to your joint and back issues ? There are many different types of low impact exercise one can do and still stay fit

Yes Sir, you are correct in that aspect.  I do try and use a treadmill, and swim here when I can in my condo pool. I also take long 8 to 10km walks on Saturday morning around the area early in the morning with my GF and we always get the weekly fruit and veggies from a local Talad, and have a bite to eat and some coffee to start off the day.  Low impact is the way to go.  I tried Bike riding but it really flared up the low back.

[ThailandRyan]

18 minutes ago, Saltire said:

Firstly I would love to know where you went for this and how much it cost as this is what I need at some point. I just came back from a break in Hua Hin and had a whole series of tests at a lab but no face to face with a doctor. PM if you don't want to put it in a post.

 

My situation is very similar. My solution to high readings for fatty liver and control of Type 2 diabetes was a ketogenic  diet for more than 2 years now. 20 Kg down so far, need about 5 or 10 more to hit target. Came off 1500 mg Metformin after the keto diet weight loss. Daily fasting blood sugar 90 - 100. Practice intermittent fasting (eat between 10 am and 4 pm only) which can also help fatty liver.

 

After some research on the current statins situation I came off them completely after almost 10 years. No real change on lipids, in fact they sound very similar to yours, just a bit on the high side.

 

Only meds now are Amlopine daily for blood pressure and an aspirin a day as a result of some stents put in 10 years ago.

 

 

 

PM Sent

[eezergood]

Again, only going off what you have said here & i would have also asked about your body composition - I would say the fatty liver is a direct result of (I assume) the years of being diabetic. Insulin resistance & external insulin would be my first go to explanation.

As for reducing this, High Omega 3 foods - good beef, fish etc..... plus your standard greens etc..... Natural oils for cooking and see how you go for a few weeks. I would experiment with certain foods to see how they spike your bloods. 

 

Finally keep a detailed food diary, actually weigh out the stuff as most people are terrible at guessing, then see if you have any surprises after a few weeks.

[ThailandRyan]

4 hours ago, eezergood said:

Again, only going off what you have said here & i would have also asked about your body composition - I would say the fatty liver is a direct result of (I assume) the years of being diabetic. Insulin resistance & external insulin would be my first go to explanation.

As for reducing this, High Omega 3 foods - good beef, fish etc..... plus your standard greens etc..... Natural oils for cooking and see how you go for a few weeks. I would experiment with certain foods to see how they spike your bloods. 

 

Finally keep a detailed food diary, actually weigh out the stuff as most people are terrible at guessing, then see if you have any surprises after a few weeks.

BMI 27%, weight now at 96 kg, 181 cm tall. A1C of 5.8, blood sugars in a good range, eat salads, chicken, fish, black coffee, lots of fresh fruit, only eat eggs twice a week, and cook ground pork and ground chicken for adding protein to my vegetable broth soups and to make my own spring rolls with veggies and shrimp. My caloric intake is at 1100 calories a day, slow metabolism, and a few other minor medical issues. Run between 35 and 40 km each week.  My daily food diary is given to my endocrinologist every 3 months when I see him along with the downloads of my glucose meter.  Hereditary issues, since I only drink red wine once or twice a week, and its only a glass. Doc wants me at 80 kg, which will make me look like a skeleton.

[BritManToo]

On 9/1/2020 at 9:17 AM, ThailandRyan said:

Initial weight was 98 kg, with a height of 180.7 cm.  The blood pressure was a lovely 117/70 with a pulse of 66. 

You're 25Kg overweight, doctor is right you need to get below 80Kg

Eat less and exercise more.

Cut down on fruit and eggs, neither are good for weight loss.

Avoid all fizzy drinks and Thai bread.

 

I was nearly your weight at age 55 (182cm), and am now around 76Kg age 65.

If you continue to carry that much extra weight you can expect hip/knee/back problems at the very least.

Not surprised the bicycle hurt your back, you're too big to cycle.

[ThailandRyan]

1 hour ago, BritManToo said:

You're 25Kg overweight, doctor is right you need to get below 80Kg

Eat less and exercise more.

Cut down on fruit and eggs, neither are good for weight loss.

Avoid all fizzy drinks and Thai bread.

 

I was nearly your weight at age 55 (182cm), and am now around 76Kg age 65.

If you continue to carry that much extra weight you can expect hip/knee/back problems at the very least.

Not surprised the bicycle hurt your back, you're too big to cycle.

Thanks Brit, I am aware I am overweight.  I do not eat bread, no fizzy drinks either, Triple neck fusion, as well as a back fusion are reasons for my aches and pains, I lift weights moderately and run as I said between 35 and 40 km a week.  So far this year I am at 1100 KM and the goal is to break 1500 Km by years end.  I also walk everyday when not reviewing my companies final paperwork as I completely mothball it.  Thanks for the advice I will do as needed to get the weight off.  Being a diabetic is also a major issue, and it is entirely my fault from being overweight and eating carelessly many years ago.  Played College Football, Threw the Shot put and Discus, as well as fought MMA, while training Muay Thai, but always at the heavy weight division.  Lowest I have ever been weight wise was 94 KG.  Need to get this fatty liver taken care of before it takes care of me.  Keep safe.

[BigStar]

On 9/1/2020 at 9:17 AM, ThailandRyan said:

Doctors all want me to get down to 80kg of weight, which for my size as a former Track and field athlete throwing the hammer, shot put and discus, would make me look like a scarecrow.

Docs are right, you're fat and now you've have got all comfortable with it. Try to get out of denial and do what you need to do. BMI's too high, triglycerides too.

 

Diet's the way to go. Find one that works for you and that you can stick to. Look into various forms of intermittent fasting. 

[DUS]

I did the same checkup a couple of months ago and have also been diagnosed with a fatty liver and some other areas showed elevated levels (cholesterol, etc). Weight was 82.5kg with me being 180cm tall.

 

Was told to reduce weight by 5-10% and significantly reduce my intake of carbs in my diet, which the doctor claimed, would be a key contributing factor for the fatty liver. My level of alcohol intake alone at least, the doc said, couldn´t (fully) explain the fat visible in the scan. 

 

Anyways, what I wanted to actually ask you: given all the tests you did, I would expect you also got the info on your body fat in %. What was the result? I´m just curious, since while I knew I was categorised as overweight based on my BMI, I was genuinely & unpleasantly surprised that my body fat percentage put me in the "obese" category. Ouch! :-))))

 

Also, there are those people who are "skinny fat". 

[eezergood]

On 10/5/2020 at 5:42 PM, ThailandRyan said:

BMI 27%, weight now at 96 kg, 181 cm tall. A1C of 5.8, blood sugars in a good range, eat salads, chicken, fish, black coffee, lots of fresh fruit, only eat eggs twice a week, and cook ground pork and ground chicken for adding protein to my vegetable broth soups and to make my own spring rolls with veggies and shrimp. My caloric intake is at 1100 calories a day, slow metabolism, and a few other minor medical issues. Run between 35 and 40 km each week.  My daily food diary is given to my endocrinologist every 3 months when I see him along with the downloads of my glucose meter.  Hereditary issues, since I only drink red wine once or twice a week, and its only a glass. Doc wants me at 80 kg, which will make me look like a skeleton.

1100 cals a day with those figures, you would be dropping weight...... you cant cheat the laws of thermodynamics. 

Lets assume you are right, change EVERYTHING and have a day or 2 of eating as you please and then back to your "1100" cals and see the results

[ThailandRyan]

3 minutes ago, eezergood said:

1100 cals a day with those figures, you would be dropping weight...... you cant cheat the laws of thermodynamics. 

Lets assume you are right, change EVERYTHING and have a day or 2 of eating as you please and then back to your "1100" cals and see the results

I do agree, however, my body holds onto the weight.  My endocrinologist Doctor changed one of my Diabetic meds 2 weeks ago, and in the last 2 weeks I am down 3 kg.  Still eating the same. He has me scheduled to visit with a dietician to go over everything.  I think I need to change up the diet and maybe try to do Keto, just do not want my blood sugars to bottom out.

[eezergood]

1 minute ago, ThailandRyan said:

I do agree, however, my body holds onto the weight.  My endocrinologist Doctor changed one of my Diabetic meds 2 weeks ago, and in the last 2 weeks I am down 3 kg.  Still eating the same. He has me scheduled to visit with a dietician to go over everything.  I think I need to change up the diet and maybe try to do Keto, just do not want my blood sugars to bottom out.

can you send me a typical day of eating 

[Jillie Norman]

On 10/6/2020 at 7:54 PM, BigStar said:

Find one that works for you and that you can stick to. 

 

This is true as some diets are effective to some but not to others. Try everything until you find the one that suits you.