Fatty Liver Update - Some Possible Good News

[leonardo]

A few months ago, I got a bit of a shock when after years of eating a Peat inspired diet, I was diagnosed with a fatty liver when I got an ultrasound of the abdomen and pelvis.

You can see the original thread here - viewtopic.php?f=56&t=4574

My liver was said to be 'mildly enlarged' and measured 14.8 cms. The impression was "Mild hepatomegaly with Grade 1 Fatty changes".

Today after four months of conscious effort, I got another ultrasound scan done.

This time, the doctor has written that the "liver is normal in size (12 cms) and shows diffuse fatty changes."

So it appears that my liver has actually reduced in size and there appears to be some improvement.

Before I move on to describing the things that I've done over the last several months, here are some disclaimers:

1. I got the tests done in two different places by two different doctors. So there may be differences because of equipment, reading error etc.

2. I don't know what exactly has caused the 'improvement' to my liver as I've not isolated the variables carefully.

Here's what I did:

1. Increased caffeine intake to about 4 cups a day.
2. Increased Vitamin E intake
3. Tried to increase protein intake (not able to reach target intake of 80 grams on most days ... but I'm at least hitting 60 to 70 grams on many days.)
4. Stopped taking aspirin (was regularly taking a baby aspirin earlier)
5. Reduced my sugar intake and my daily mega large cup of orange juice. I've not cut out the sugar but have just stopped going crazy with the quantities.
6. I've replaced fruit juices with eating fruit.
7. Read a free ebook by Matt Stone (it's called "Diet Recovery") and implemented 'resistant starches' in to my diet. This is basically boiling a potato and keeping it overnight in the fridge for consumption the next day. You can do the same with rice also. This has a nice side effect of really easy, well-formed stools.
8. Implemented the 'Peak 8 Protocol' as shown in this mercola video - http://fitness.mercola.com/sites/fitnes ... rview.aspx
9. Focused on improving my state of mind (more conscious about being grateful which in turn makes me calmer).
10. Cut back on the enormous quantities of cream, ghee, butter and red meat that I was consuming.
11. Was taking 1 Thyroid-s a day ... reduced it to .75 (1/2 in the morning and quarter in the evening)
12. Started taking choline regularly

Hope this helps somebody else out there.

Also, a special thanks to the Ray Peat forum community (PeaterPan, Wilfrid, Mittir, Such_Saturation, visionofstrength and others) for the extraordinary support and direction you guys gave me.

Thanks!

 

[sweetpeat]

Wow, that's great news! I've not been officially diagnosed with fatty liver, but had elevated liver enzymes back in the fall. I've been doing most of the things on your list, plus supplementing vitamin K. I hope to get some lab work done soon to see where things stand. I hope I get similar good results!

 

[SQu]

That's great news, well done and thanks for the update. Very encouraging!

 

[charlie]

Fantastic update!

 

[Dean]

congrats, Leonardo.

I'm curious about your difficulties with getting up to the 80 g protein mark. I had the same problem the first two times I tried Peating because I was trying to force feed myself milk. Have you thought about trying a good quality greek yogurt? I am having good success with Fage fat free. It is strained, so I don't have lactic acid issues from it (as long as I don't eat too much at one sitting). Much easier to get down one cup of that, than 3 cups of milk for the same amount of protein.

Also curious about what percentage of your protein comes in different parts of the day. As you probably know, Peat recommends getting as much of your protein earlier in the day as you can. Switching from milk to the yogurt has made it much easier for me to accomplish that and I have noticed a big difference in how I feel in terms of comfort and satiety compared to the previous times I "peated."

 

[jaa]

Congrats man!

 

[Peata]

Very good news. Congrats to you.

Looking over your list, I'm doing all but 5 out of the 12 things.

Thanks for giving us the update. Great job on improving your health.

 

[kineticz]

Am I missing something or is this not evidence against Peat? Or was it just that the quantities were wrong?

 

[leonardo]

I also need to add two more things:
1. About a week ago, I had an ear infection and took a full course of antibiotics.
2. When I asked the doctor who did the ultra sound today as to what may have contributed to the decrease in size, she said that the earlier larger measurement may have been caused because of an infection.

 

[leonardo]

congrats, Leonardo.

I'm curious about your difficulties with getting up to the 80 g protein mark. I had the same problem the first two times I tried Peating because I was trying to force feed myself milk. Have you thought about trying a good quality greek yogurt? I am having good success with Fage fat free. It is strained, so I don't have lactic acid issues from it (as long as I don't eat too much at one sitting). Much easier to get down one cup of that, than 3 cups of milk for the same amount of protein.

Also curious about what percentage of your protein comes in different parts of the day. As you probably know, Peat recommends getting as much of your protein earlier in the day as you can. Switching from milk to the yogurt has made it much easier for me to accomplish that and I have noticed a big difference in how I feel in terms of comfort and satiety compared to the previous times I "peated."

Dean, I do consume comfortable quantities of yogurt (or curd) and I usually mix it with the cold rice (for the resistant starches.) It's just that consuming larger quantities of protein requires more discipline (so much easier to carb out!)

Breakfast is usually a couple of eggs (and a small cup of orange juice).
Lunch includes some meat and gelatin (Great Lakes green box).
Dinner is usually curd + rice and some times some cottage cheese.

 

[leonardo]

Am I missing something or is this not evidence against Peat? Or was it just that the quantities were wrong?

I think Peat is definitely on to something. When I started out with Peat, (was coming off low carb + high fat diet), it gave me a great sense of well-being. It significantly increased my motivation.

However, I think I was doing too much with the fats and the sugar.

At present, what appears to work for me is:

1. High protein
2. High carbohydrate (mostly in the form of starches and sugar in moderation)
3. Moderate quantities of resistant starches (which turn in to butyric acid) - http://wholehealthsource.blogspot.in/20 ... er-of.html

And the Peak 8 style training also appears to be helping (looking leaner around the middle without actually losing weight.)

Now I'm not sure if the increased resistant starches is going to eventually increase my endotoxin load and cause an imbalance.

So I'll be restarting the carrot salads in order to prevent that situation.

Also, the intense exercise may trigger overtraining and stress hormones ... so I'm trying to listen to my body as much as I can.

 

[Dean]

Leonardo, thanks for your reply. Certainly don't want to dissuade you from what you feel is working for you. It would be interesting to see, though, how you would do with more protein earlier in the day. A couple of eggs isn't much protein, nor do I think Peat would think it is ideal with so few calories around the eggs.

But again, do what works for you, as long as it does.

 

[BobbyDukes]

A few months ago, I got a bit of a shock when after years of eating a Peat inspired diet, I was diagnosed with a fatty liver when I got an ultrasound of the abdomen and pelvis.

You can see the original thread here - viewtopic.php?f=56&t=4574

My liver was said to be 'mildly enlarged' and measured 14.8 cms. The impression was "Mild hepatomegaly with Grade 1 Fatty changes".

Today after four months of conscious effort, I got another ultrasound scan done.

This time, the doctor has written that the "liver is normal in size (12 cms) and shows diffuse fatty changes."

So it appears that my liver has actually reduced in size and there appears to be some improvement.

Before I move on to describing the things that I've done over the last several months, here are some disclaimers:

1. I got the tests done in two different places by two different doctors. So there may be differences because of equipment, reading error etc.

2. I don't know what exactly has caused the 'improvement' to my liver as I've not isolated the variables carefully.

Here's what I did:

1. Increased caffeine intake to about 4 cups a day.
2. Increased Vitamin E intake
3. Tried to increase protein intake (not able to reach target intake of 80 grams on most days ... but I'm at least hitting 60 to 70 grams on many days.)
4. Stopped taking aspirin (was regularly taking a baby aspirin earlier)
5. Reduced my sugar intake and my daily mega large cup of orange juice. I've not cut out the sugar but have just stopped going crazy with the quantities.
6. I've replaced fruit juices with eating fruit.
7. Read a free ebook by Matt Stone (it's called "Diet Recovery") and implemented 'resistant starches' in to my diet. This is basically boiling a potato and keeping it overnight in the fridge for consumption the next day. You can do the same with rice also. This has a nice side effect of really easy, well-formed stools.
8. Implemented the 'Peak 8 Protocol' as shown in this mercola video - http://fitness.mercola.com/sites/fitnes ... rview.aspx
9. Focused on improving my state of mind (more conscious about being grateful which in turn makes me calmer).
10. Cut back on the enormous quantities of cream, ghee, butter and red meat that I was consuming.
11. Was taking 1 Thyroid-s a day ... reduced it to .75 (1/2 in the morning and quarter in the evening)
12. Started taking choline regularly

Hope this helps somebody else out there.

Also, a special thanks to the Ray Peat forum community (PeaterPan, Wilfrid, Mittir, Such_Saturation, visionofstrength and others) for the extraordinary support and direction you guys gave me.

Thanks!

Sorry to digress away from your wonderful news (congrats, btw).

I know Peat doesn't advocate resistant starch (unless I am wrong), but I might try that potato thing you are talking about.

For me, the Peat approach has given me a constipation problem, which I am still trying to solve 1.5 years since starting. At the moment, I am reliant on cascara (which, to be honest, I would happily take for the rest of my life, because of its widespread benefits) but I also don't feel comfortable 'relying' on something, in order to go everyday. I guess my shot metabolism cannot handle all the milk, meat, cheese, etc. Fattier things go very slowly through my digestive tract, and my body seems to really struggle with expelling it. Skimmed milk doesn't seem to make any difference. Nibbling t3 each hour didn't do much. OJ does absolutely nothing, and never has that department. Adding salt to OJ may improve it somewhat. Salt in general, seems to help the most, but sometimes I will take a lot of it and it won't help at all, and all I'm left with is a mouth as dry as the sahara desert. Magnesium, also does nothing (although, I've only tried the Peat friendly forms). I honestly do miss the days when going was never an issue. An avocado, first thing in the morning always worked amazingly for regular BMs. I would usually blend it in a smoothie with a whole lemon and strawberries. Raw egg yolks too. Yep, that moved through me pretty quick, but probably contributed significantly to the amount of PUFA that I was eating each day. I have always been told that dairy causes constipation and is problematic, and I always believed it until I read more about Peat's views. Thing is, I could get to the end of this 4 year period, and I might still be struggling with dairy. When do you throw the towell in with it? Meat digests just fine and perhaps doesn't move through me quite as slow as dairy. But meat has a lot of nasties (anti thyroid AAs, very high iron and a few others). When I base my diet on meat, I feel like ***t. I feel good with a little meat (almost like I need it) but if I overdo it, my body doesn't feel good at all (it's always eaten with lots of broth high in gelatin).

Do you get any endotoxin repsonse from the resistant starch (cold potato)? Or is it generally out of you pretty quickly? I need something that's going to push this ***t through.

 

[RPDiciple]

in RP words, the best things he recommends for liver is this

Thyroid
caffeine
niacinamide
aspirin
sugar
enough protein
no fat/low fat
b1
carrot salad

reduce all endotoxin aka starch etc etc

 

[leonardo]

Sorry to digress away from your wonderful news (congrats, btw).

I know Peat doesn't advocate resistant starch (unless I am wrong), but I might try that potato thing you are talking about.

For me, the Peat approach has given me a constipation problem, which I am still trying to solve 1.5 years since starting. At the moment, I am reliant on cascara (which, to be honest, I would happily take for the rest of my life, because of its widespread benefits) but I also don't feel comfortable 'relying' on something, in order to go everyday. I guess my shot metabolism cannot handle all the milk, meat, cheese, etc. Fattier things go very slowly through my digestive tract, and my body seems to really struggle with expelling it. Skimmed milk doesn't seem to make any difference. Nibbling t3 each hour didn't do much. OJ does absolutely nothing, and never has that department. Adding salt to OJ may improve it somewhat. Salt in general, seems to help the most, but sometimes I will take a lot of it and it won't help at all, and all I'm left with is a mouth as dry as the sahara desert. Magnesium, also does nothing (although, I've only tried the Peat friendly forms). I honestly do miss the days when going was never an issue. An avocado, first thing in the morning always worked amazingly for regular BMs. I would usually blend it in a smoothie with a whole lemon and strawberries. Raw egg yolks too. Yep, that moved through me pretty quick, but probably contributed significantly to the amount of PUFA that I was eating each day. I have always been told that dairy causes constipation and is problematic, and I always believed it until I read more about Peat's views. Thing is, I could get to the end of this 4 year period, and I might still be struggling with dairy. When do you throw the towell in with it? Meat digests just fine and perhaps doesn't move through me quite as slow as dairy. But meat has a lot of nasties (anti thyroid AAs, very high iron and a few others). When I base my diet on meat, I feel like s***. I feel good with a little meat (almost like I need it) but if I overdo it, my body doesn't feel good at all (it's always eaten with lots of broth high in gelatin).

Do you get any endotoxin repsonse from the resistant starch (cold potato)? Or is it generally out of you pretty quickly? I need something that's going to push this s*** through.

Hi Bobby,

I'm not able to see any obvious endotoxin response. In fact, it seems to be really aiding my motions.

In Matt Stone's book he says, "A simple salad comprised of beans and potatoes dressed with some homemade dressing is a great, convenient staple to take to work or whatever. " and I've been doing something similar.

Good luck with your bug fixing!

 

[Henry]

I dont want to be a party pooper but ultrasounds are one of the most subjective measurements in medicine there are. They are exceedingly dependent on the operator, the device and how he grades and measures things. An operator just needs to choose a slighlty different position and there will be a big change in the measured diameter (you do the measurements by hand by drawing a line from one random point to the other).

Considering this, the second report essentially shows the same result of the first ultrasound (diffuse fatty changes). Unless you get an ultrasound from the first same sonographer (without telling him beforehand whether you changed anything for the good or the bad), who tells you that there are no fatty changes anymore and significantly reduced liver size, it is impossible to conclude that any of the supplements and interventions you did had any effect.

Notwithstanding, I really thank you for your effort in highlighting one of the problems that people struggle with trying this approach and suggestions how to alleviate it.

 

[narouz]

I just had a little question on the Matt Stone thing.
So you bake or boil a potato,
then you refrigerate it overnight
and eat it the next day.

Is that supposed to change the nutritional value of the potato?

 

[Dutchie]

I just had a little question on the Matt Stone thing.
So you bake or boil a potato,
then you refrigerate it overnight
and eat it the next day.

Is that supposed to change the nutritional value of the potato?

This method increases Resistant Starch which is supposed to help feed the good gutbacteria bc they turn it into butyrate if I'm not mistaking, I don't know if it changes the nutritional value.

 

[narouz]

I just had a little question on the Matt Stone thing.
So you bake or boil a potato,
then you refrigerate it overnight
and eat it the next day.

Is that supposed to change the nutritional value of the potato?

This method increases Resistant Starch which is supposed to help feed the good gutbacteria bc they turn it into butyrate if I'm not mistaking, I don't know if it changes the nutritional value.

Thanks, Dutchie.
from http://peatarian.com/32392/starches-and-butyric-acid

starches and butyric acid.

Matt Stone's first diet recovery book was free this week on amazon, so I downloaded it. I've never read his diet recovery books and didn't want to pay for them, so I thought I'd start here with the first one, as it was free.

Anyhoo, one of the differences I've noticed between Matt Stone and other Peat followers is that he's a big fan of starches for boosting metabolic rate. I was curious as to why and then in his first book he says this:

"Butyric acid actually facilitates the entry of T3, the active thyroid hormone, into the mitochondria where it does a sexy dance of sorts, excites the mitochondria, and makes it cheesily say something along the lines of “Is it hot in here or is it just me?” This is why when rodents are bombarded with butyric acid as in the study pointed out by Dr. Guyenet, they have a drop in appetite, a drop in cholesterol (I’ll explain this later), a drop in blood sugar, increased insulin sensitivity, an increase in physical activity, and a drop in body fat."

Aside from butter, the best way to get butyric acid flowing in the body is by eating starch. "Butyric acid is something we get primarily from the fermentation of fiber and resistant starch in the digestive tract." [Stone, Matt (2013-11-24). Diet Recovery: Restoring Hormonal Health, Metabolism, Mood, and Your Relationship with Food (p. 59). Archangel Ink. Kindle Edition.]

He lists these foods as being good sources for ramping up butyric acid: beans, legumes, whole grains (including corn), root veggies, plaintains, not overly ripe bananas, hi maize.

Anyhow, I would like to hear peoples' thoughts about starches. I haven't read much past this point in the book and I know that starches need to be cooked and accompanied with saturated fats for best digestion, but still - food for thought. The past few days I've been trying to eat more ripe bananas and some potatoes (which were so filling the thought of food was repulsive, but......) the result has been more energy. I feel more energized right after eating bananas and potatoes than grapes (although I love grapes).

In the past I used to eat a lot of squash and other starchy veggies and they always improved my digestion - maybe there is something to this and how it facilitates T3 and metabolism?

Additionally, uncooked starch has been a nightmare for me - undercooked potatoes & unripe bananas have caused massive nausea and sickness, so I'm specifically thinking of well cooked starches when I mention starches here.

The fiber in the foods seems to be the important co-factor.

EDIT: by the way, Matt's book is still available on Amazon for a couple more days, free of charge - in case any of you are interested. His sources are listed in the back. Cheers!

asked Dec 2, 2013 by Lindsay

 

[narouz]

more on this resistant starch & butyrate thing
from http://wholehealthsource.blogspot.de/2009/12/butyric-acid-ancient-controller-of.html

Monday, December 7, 2009
Butyric Acid: an Ancient Controller of Metabolism, Inflammation and Stress Resistance?
An Interesting Finding
Posted by Stephan Guyenet

Susceptible strains of rodents fed high-fat diets overeat, gain fat and become profoundly insulin resistant. Dr. Jianping Ye's group recently published a paper showing that the harmful metabolic effects of a high-fat diet (lard and soybean oil) on mice can be prevented, and even reversed, using a short-chain saturated fatty acid called butyric acid (hereafter, butyrate). Here's a graph of the percent body fat over time of the two groups:

The butyrate-fed mice remained lean and avoided metabolic problems. Butyrate increased their energy expenditure by increasing body heat production and modestly increasing physical activity. It also massively increased the function of their mitochondria, the tiny power plants of the cell.

Butyrate lowered their blood cholesterol by approximately 25 percent, and their triglycerides by nearly 50 percent. It lowered their fasting insulin by nearly 50 percent, and increased their insulin sensitivity by nearly 300 percent*. The investigators concluded:
Butyrate and its derivatives may have potential application in the prevention and treatment of metabolic syndrome in humans.
There's one caveat, however: the butyrate group at less food. Something about the butyrate treatment caused their food intake to decline after 3 weeks, dropping roughly 20% by 10 weeks. The investigators cleverly tried to hide this by normalizing food intake to body weight, making it look like the food intake of the comparison group was dropping as well (when actually it was staying the same as this group was gaining weight). This does cast some doubt on the health-promoting effects of high-dose butyrate.

I found this study thought-provoking, so I looked into butyrate further.

Butyrate Suppresses Inflammation in the Gut and Other Tissues

In most animals, the highest concentration of butyrate is found in the gut. That's because it's produced by intestinal bacteria from carbohydrate that the host cannot digest, such as cellulose and pectin. Indigestible carbohydrate is the main form of dietary fiber.

It turns out, butyrate has been around in the mammalian gut for so long that the lining of our large intestine has evolved to use it as its primary source of energy. It does more than just feed the bowel, however. It also has potent anti-inflammatory and anti-cancer effects. So much so, that investigators are using oral butyrate supplements and butyrate enemas to treat inflammatory bowel diseases such as Crohn's and ulcerative colitis. Some investigators are also suggesting that inflammatory bowel disorders may be caused or exacerbated by a deficiency of butyrate in the first place.

Butyrate, and other short-chain fatty acids produced by gut bacteria**, has a remarkable effect on intestinal permeability. In tissue culture and live rats, short-chain fatty acids cause a large and rapid decrease in intestinal permeability. Butyrate, or dietary fiber, prevents the loss of intestinal permeability in rat models of ulcerative colitis. This shows that short-chain fatty acids, including butyrate, play an important role in the maintenance of gut barrier integrity. Impaired gut barrier integrity is associated with many diseases, including fatty liver, heart failure and autoimmune diseases (thanks to Pedro Bastos for this information-- I'll be covering the topic in more detail later).

Butyrate's role doesn't end in the gut. It's absorbed into the circulation, and may exert effects on the rest of the body as well. In human blood immune cells, butyrate is potently anti-inflammatory***.

Butyrate Increases Resistance to Metabolic and Physical Stress

Certain types of fiber reduce atherosclerosis in animal models, and this effect may be due to butyrate production produced when the fiber is fermented. Fiber intake was associated with lower blood markers of inflammation in the Women's Health Initiative study, and has been repeatedly associated with lower heart attack risk and reduced progression of atherosclerosis in humans. Butyrate also sharply reduces the harmful effects of type 1 diabetes in rats, as does dietary fiber to a lesser extent.

Butyrate increases the function and survival of mice with certain neurodegenerative diseases. Polyglutamine diseases, which are the most common class of genetic neurodegenerative diseases, are delayed in mice treated with butyrate (1, 2, 3). Many of you have probably heard of Huntington's disease, which is the most common of the class. I did my thesis on a polyglutamine disease called SCA7, and this is the first suggestion I've seen that diet may be able to modify its course.

Yet another interesting finding in the first paper I discussed: mice treated with butyrate were more cold-resistant than the comparison group. When they were both placed in a cold room, body temperature dropped quite a bit in the comparison group, while it remained relatively stable in the butyrate group, despite the fact that the butyrate group was leaner****. This was due to increased heat production in the butyrate group.

Due to the potent effect butyrate has on a number of bodily processes, it may be a fundamental controller of metabolism, stress resistance and the immune system in mammals.

An Ancient Line of Communication Between Symbiotic Organisms

Why does butyrate have so much control over inflammation? Let's think about where it comes from. Bacteria in the gut produce it. It's a source of energy, so our bodies take it up readily. It's one of the main molecules that passes from the symbiotic (helpful) bacteria in the gut to the rest of the body. Could it be that the body receives butyrate as a signal that there's a thriving colony of symbiotic bacteria in the gut, inducing immune tolerance to them? The body may alter its immune response (inflammation) in order to permit a mutually beneficial relationship between itself and its symbionts.

Sources of Butyrate

There are two main ways to get butyrate and other short-chain fatty acids. The first is to eat fiber and let your intestinal bacteria do the rest. Whole plant foods such as sweet potatoes, properly prepared whole grains, beans, vegetables, fruit and nuts are good sources of fiber. Refined foods such as white flour, white rice and sugar are very low in fiber. Clinical trials have shown that increasing dietary fiber increases butyrate production, and decreasing fiber decreases it (free full text).

Butyrate also occurs in significant amounts in food. What foods contain butyrate? Hmm, I wonder where the name BUTYR-ate came from? Butter perhaps? Butter is 3-4 percent butyrate, the richest known source. But everyone knows butter is bad for you, right?

After thinking about it, I've decided that butyrate may have been a principal component of Dr. Weston Price's legendary butter oil. Price used this oil in conjunction with high-vitamin cod liver oil to heal tooth decay and a number of other ailments in his patients. The method he used to produce it would have concentrated fats with a low melting temperature, including butyrate, in addition to vitamin K2*****. Thus, the combination of high-vitamin cod liver oil and butter oil would have provided a potent cocktail of fat-soluble vitamins (A, D3, K2), omega-3 fatty acids and butyrate. It's no wonder it was so effective in his patients.


* According to insulin tolerance test.

** Acetate (acetic acid, the main acid in vinegar), propionate and butyrate are the primary three fatty acids produced by intestinal fermentation.

*** The lowest concentration used in this study, 30 micromolar, is probably higher than the concentration in peripheral serum under normal circumstances. Human serum butyrate is in the range of 4 micromolar in British adults, and 29 micromolar in the hepatic portal vein which brings fats from the digestive tract to the liver (ref). This would likely be at least two-fold higher in populations eating high-fiber diets.

**** Due to higher mitochondrial density in brown fat and more mitochondrial uncoupling.

***** Slow crystallization, which selectively concentrates triglycerides with a low melting point.

Posted by Stephan Guyenet at 8:00 PM