Fatty Liver and High Cholesterol

Nutrition Q&A [Moderated]
1

Hi Doc. I am a 40 year old male and weigh 150 lbs. I did the SSLP for approximately 3 months (from April to June of this year) and am currently on The Bridge. I gained a total of 3 lbs during the SSLP. I did not do GOMAD, but did consume a scoop of WPI and 5mg of Creatine on workout days (3x per week). Around 5 years ago I discovered that I had a fatty liver. I went on a diet (basically just cutting down on portion size and jogged for a bit and brought my liver indicators back into a normal range. Eventually I stopped controlling my portion size and during the first month of the SSLP discovered that my liver indicators are back up. Highlights of my blood test results are as follows:
ALT = 61
AST = 21
ALK Phos = 112
Total cholesterol = 219
HDL = 53
LDL (calculated) = 143
LDL (direct) = 149
Triglycerides = 117
A1c = 5.6
Glucose = 98 (family history of type II diabetes)

During The Bridge, my doctor’s nurse practitioner recommended that I avoid protein shakes because of my fatty liver. Out of an abundance of caution I stopped the WPI and Creatine.

I am worried that: 1. I am not consuming enough protein (I don’t even know how much I should be consuming),
2. the fatty foods that I am continuing to consume are not helping my fatty liver or high total cholesterol, and
3. I won’t be able to achieve gainzZz without increasing my calories, but I don’t know how to increase my calories in healthy way that doesn’t worsen my fatty liver or cholesterol. Any advice would be greatly appreciated.

2

Frosty,

Lot of potential issues here:

  1. How did you get diagnosed with fatty liver? Did you have a liver biopsy?
  2. Your liver enzymes may be reflective of exercise related muscle damage. A normal GGT, for example, would be helpful.
  3. Your cholesterol could use some work, but I don’t know what your height, waist, medical history, and what activity you’re doing now in addition to the bridge, but I’d recommend doing the GPP in this case. Not sure on additional rec’s for you specifically.
  4. Your glucose is normal
  5. One scoop of whey a day isn’t doing anything in relationship to liver function or disease
  6. I don’t know if you should gain weight right now.
  7. I don’t know what to tell you about protein intake because I don’t know what you’re eating right now.

I think specific management of this issue is likely consult territory, you know?

3

Thanks for the detailed response. My follow-up responses follow:

  1. Based on blood labs only. Nurse Practitioner recommended and ultrasound which I haven’t scheduled yet. Will do so soon. Would an ultrasound help or is a biopsy necessary for an accurate diagnosis?

  2. Although possible, I doubt it because the last time I had elevated liver indicators, I was leading a sedentary lifestyle.

  3. 6 ft tall. 34” waisted at belly button (surprising to me because I wear 32” pants). Underweight my entire life. Generally healthy. Only been doing The Bridge. Will go for an occasional jog (once every 2-3 weeks) for 3-4 miles.

Would be happy to do a consult. Do I have to fill out an application?

4

Frosty,

  1. Labs nor ultrasound are enough, though some clinicians may use repeated labs and imaging to diagnos it.

  2. It’s possible, but I can’t comment from here. Could also have one of a myriad of diseases or lab issues causing it too.

  3. Yep, cholesterol still may need some adjustment. I’d have you contact us through support@barbellmedicine.com