Improving Liver Function Before Going Full Peat? Dealing With Abdominal Fat

[panda]

The past few years I had read a lot about nutrition. But just until this last month I'm coming around to the ideas of Raymound Peat.

I have read (obsessively) all I can, including this forum, and sometimes it's overwhelming, there are just too many variables to track.

I don't care much about gaining weight, if it improves my health, still, I do care some about gaining abdominal fat.
I started to follow a lot of Peat guidelines this last month, I'm 44yo, 5'11''. Last month I was 220 lbs and 40in, now I'm 230 and 42in.
I knew weight gain was coming, and I told myself I was going to reevaluate at 42in and here I am.

Gaining abdominal fat do concern me, and I started to read about what could I do about it, while being Peat.

I found this (below, please do read it) amazing, spectacular post by Haidut, which help me to understand and probably solve some of my issues?

Right now, I cut the aspirin and Niacinamide, and started taking around 10g of LE Super K (4 softgels daily), and drinking more caffeine (~300 mg), hoping to improve my liver function.

What do you think of the strategy? Any other advice?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation byproducts, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience, I think a number of chicken/egg question still remain.
Anybody care to comment?

 

[Brian]

Panda, 4 soft gels of LE Super K would be 4 mg of vitamin K1. I'm not sure that's such a good idea as K1 is involved in coagulation of the blood. I did the math once and 1 mg of K1 is equivalent to about the amount you would get in a little under a pound of spinach. Since you already bought the Super K, maybe a better approach to finishing up the bottle would be 1 super K and then some additional K2 M4 through a different supplement if you think you would like to try more for therapeutic purposes.

 

[nikotrope]

I've done the k2/caffeine combo for 2 weeks and I lost an inch for the first time in a year, and a year ago it was from severe calorie restriction.

I've started with 400mg caffeine and now can take 700-800mg per day. The caffeine naturally cut my calorie requirement from 3500-4000kcal to 2500-3000kcal I think because my liver is getting better and I can burn carbs instead of storing or wasting them.

I agree with Brian, you should only use K2 MK-4. I also had LE Super K but studies show too much K1 can be bad so I stopped.

I have been using peat ideas for a year and improved a few very important things in my health (temps, pulse and other stuff). I think the effects of k2/caffeine have been quick because I already felt better. It could take more time for someone who has just started.

 

[panda]

Thanks Brian and Nicotrope for the K1 warning. I'll buy some K2-MK4 (Any brand recommendation?)

May I ask you Nicotrope, what is/was your dosage of K2? Did you start the combo because of the abdominal fat? Did you do any other thing besides the caffeine/K2?

 

[jaa]

Thorne Liquid K2 gets recommended a lot.

 

[nikotrope]

Thanks Brian and Nicotrope for the K1 warning. I'll buy some K2-MK4 (Any brand recommendation?)

May I ask you Nicotrope, what is/was your dosage of K2? Did you start the combo because of the abdominal fat? Did you do any other thing besides the caffeine/K2?

I took a total of 15mg vitamin k2 divided in 3-6 doses through the day. I started the combo because I concluded that my ongoing symptoms were from liver problems (and the post from haidut you quoted reinforced my conclusions). Of course I wanted to lose the abdominal fat but I have fat because I have hormone problems and I have hormone problems because I have liver problems. So my goal was to fix my liver to fix my hormones to fix my fat. And it currently works so I am very happy.

I didn't stop aspirin and still lost weight, because I wanted to know if I could lose weight with aromatase inhibitors. And I did. Maybe it was just water and will continue to confirm it. I also have vitamin e sometimes but not regularly.

I also eat low-fat (10% of total calories) and switch back to a no starch diet of mainly milk 1.5%, orange juice and sugar. I can consume more calories this way and still lost weight. And I eat liver once a week for vitamin a.

 

[Spondive]

I write Peat about fatty liver and elevated enzymes and his reply was a raw carrot salad a day to reduce endotoxin burden on the liver. When I asked would a low fat diet work he said it may help

 

[Spondive]

I believe I have heard Peat is not fond of Choline but in the veterinarian literature choline chloride is added to the feed of animals while fattening them up which prevents serious fatty liver complications.

I have tried a lot of supplements and did before and after liver enzyme levels and choline chloride at 2000 mg a day my liver enzymes went from ALT 94 to 66 and AST went from 65 to 40 in a month.

 

[Spondive]

I am trying Thorne vitamin K2 and trying to add in more cups of coffee a day to see if that brings my liver enzymes down or reduce the size of my fatty liver.

 

[Spondive]

I know this has been mentioned before but Chris Masterjohn wrote this article...

http://blog.cholesterol-and-health.com/ ... te-to.html

Anyway I did 23 and Me and I have both defective genes for PEMT.. I have had a fatty liver since finding a fatty liver at age 18 and I am now 45. I don't know if there is validity to this. That would mean I have trouble converting methionine to choline and methionine would be shuttled to homocysteine instead

 

[narouz]

I write Peat about fatty liver and elevated enzymes and his reply was a raw carrot salad a day to reduce endotoxin burden on the liver. When I asked would a low fat diet work he said it may help

Interesting, Spondive. Thanks.
There's a place to put Peat responses to emails (or whatever).
I think it's called "Peat Repository" or something like that.
If you get a chance, you might put your Peat answer over there.

 

[visionofstrength]

The past few years I had read a lot about nutrition. But just until this last month I'm coming around to the ideas of Raymound Peat.

I have read (obsessively) all I can, including this forum, and sometimes it's overwhelming, there are just too many variables to track.

I don't care much about gaining weight, if it improves my health, still, I do care some about gaining abdominal fat.
I started to follow a lot of Peat guidelines this last month, I'm 44yo, 5'11''. Last month I was 220 lbs and 40in, now I'm 230 and 42in.
I knew weight gain was coming, and I told myself I was going to reevaluate at 42in and here I am.

Gaining abdominal fat do concern me, and I started to read about what could I do about it, while being Peat.

I found this (below, please do read it) amazing, spectacular post by Haidut, which help me to understand and probably solve some of my issues?

Right now, I cut the aspirin and Niacinamide, and started taking around 10g of LE Super K (4 softgels daily), and drinking more caffeine (~300 mg), hoping to improve my liver function.

What do you think of the strategy? Any other advice?

So, assuming one keeps a steady dietary supply of sucrose (or some other type of sugar), wouldn't the constant presence of glucose in the blood stream keep insulin chronically elevated too? I have read various, and often contradictory, statements from Peat about the whole blood sugar and insulin thing. Often, he says that it is important to always keep blood glucose up to keep cortisol at bay and metabolism high. Of course, this means insulin would be elevated chronically too. On insulin, Ray sometimes says it is a good hormone responsible for anabolism and keeping tumor growth under control. At other times he has said that elevated insulin is not a good thing. So, I am bit confused about the overall dietary guidelines. Should we try to keep blood sugar elevated all the time but at a certain stable (and reasonable) level, which would imply higher (but stable insulin), or should we do pulse feeds which would temporarily bring insulin up to shuttle the glucose to the muscles and then insulin goes down and the body runs on glycogen from the liver?
I suspect a number of people on the forum struggle with this issue as evidenced by several posts of rapid weight gain, elevated blood glucose and insulin on blood tests and worried doctors making recommendations to cut down on sugar, blood pressure rising in people who did not have blood pressure issues before, etc. Some of these things could be beneficial, but there was a post by one person who said her blood pressure went from 120/80 to 150/90 after adopting the higher sugar diet and after some back and forth with her doctor she decided to quit the Peat diet. Then she reported her blood pressure normalizing after reducing sugar intake. Btw, it is well known in the bodybuilding community that cutting carbs works just like diuretics. I am not an advocate of this, but wouldn't people prone to edema and having thyroid problems get their water-retention problems exacerbated if they increase sugar/carbs intake? I guess that would happen at least initially and the theory is that as their metabolism normalizes they should be able to better utilize glucose and then lose all the excess water. So, the million dollar question is how long does one have to re-feed higher carbs diet (and suppress fatty acid oxidation through the Randle effect) until their insulin sensitivity is restored?
Finally, there have been a number of reports on Peatarian and occasionally on this forum of people experiencing proteinuria (protein in the urine) when increasing sugar intake above 200g daily. If you are eating 80g+ of protein then you probably strive to eat at least as many carbs. Peat has said that this proteinuria is due to people burning PUFA, which makes albumin leak in the urine and show up on the tests but as far as I can tell, these people were actually burning fat before adopting the higher sugar diet and only experienced proteinuria after increasing sugar intake. Of course, they could have had this issue all along and only realized it after switching and measuring their urine but there are several reports of this so I doubt it's a random thing. Somebody also posted a study on thousands of university employees and those who consumes the most sugary drinks reported the highest incidence of proteinuria.
It would be nice if we can get some guidelines on this. Personally, I use caffeine to increase the utilization of sugar and don't really have issues with it, but in theory there should be a way to handle sugar from diet without relying on sugar burning aids like caffeine and/or thyroid. Thyroid does not seem to be a good option for me, and I have tried all kinds of supplementing schedules and dosages. As I have posted on other threads, my experience with sugar only improved after I took serious measures to "normalize" my liver function through caffeine and vitamin K2, BUT my liver enzymes were NORMAL according to the standard lab ranges. If the stats are true and over 80% of people over 30 have some degree of fatty liver, which is the real cause behind type II diabetes, then I think many people adopting the Peat diet will likely experience stress reduction through the lower cortisol, but may end up making their fatty liver worse, especially is supplementing niacinamide and aspirin. Such_Saturation and I posted about this in another thread.
So, my main point is that burning sugar is definitely preferable to burning fat based on both Peat's writings and all the studies I have seen about liver disease being caused by increased lipid peroxidation byproducts, and cirrhosis (in alcoholic rats) being easily and succesfully treated by feeding about 60g-70g of saturated fat like butter or coconut oil for a week, while the rats kept drinking alcohol at the same time! So, on the point of burning sugar I think the question is settled that it is preferable to burning fat.
However, the point is to actually BURN the sugar rather than simply feeding ourselves more of it. For people with sluggish livers, many of whom also take niacinamide and aspirin, this is likely to make the metabolism situation worse by fattening the liver even more, even though admittedly the fat synthesized will be saturated since it is made from sugar. But fatty liver will increase your estrogen no matter how saturated the fat is that you are synthesizing. So, fattening up the liver even more probably won't do much good for metabolism. Another suggestion from Peat would be to increase protein intake to at least 80g a day which should support liver function, lower estrogen and increase conversion of T4 into T3. However, that will likely also not work very well in people with sluggish and fatty livers since underperforming liver will convert a lot of that extra protein into ammonia. Even Peat is clear on this point in one of his articles where he says that "hyperammonemia can be caused by exhaustive exercise or hypothyroidism". This is also evidenced by a number of studies showing that people in their late 30s, 40s, and 50s experience chronic fatigue issues that are greatly helped by giving them ammonia-reducing agents like ornithine or sodium benzoate. And those people consume nowhere near the 80g of protein Peat recommends. So, if they are having ammonia issues imagine how would the people loading up on extra protein would feel.
Which brings us to the point that for many people over the age of 30, simply increasing sugar and/or protein will likely not solve the metabolic issues. Thus, the Peat diet, while the correct way to eat, may not be a solution to the issues of hypothyroidism, but rather a way to avoid the worse option of running on cortisol and adrenalin, which while energizing in the short run will ruin you in the longer run.
Considering the Barnes book "Hypoglycemia: It's not your brain, it's your liver", which I read, it seems that restoring optimal liver function is also a key to improving metabolism. Yes, thyroid function is important too, but I think Peat's recommendation on supplementing thyroid even in the presence of normal thyroid labs may cause issues for a number of people. Charlie, and at least 20 other people have posted on struggling with supplementing thyroid. If they take it, they develop teeth issues, skin issues, anxiety or some other unpleasant symptoms. If they don't take it, their digestion slows down to a crawl or they start getting hypothyroid symptoms like brain fog or muscle issues, etc.
So, if the stats are true and the evidence I have seen is legit, then eating according to the peat guidelines is a great strategy AFTER metabolism is fixed. But if 80% of people over 30 are having liver issues or some other problems with metabolism, then the diet will be certainly supportive, but likely not "curative". And for some people with particularly bad liver problems the situation may end up getting worse in a way due to even more fatty liver issues or higher ammonia levels. Just ask anybody over the age of 40 if they are having trouble maintaining (let alone building) muscle mass.
Then the question becomes, what will aid metabolic recovery, other than blindly supplementing thyroid even in the presence of normal thyroid labs? I guess the answer Peat will give is that one needs to wait at least 4 years and get rid of the PUFA before starting to see solid results. There is some solid evidence in favor of lower PUFA fixing metabolic issues. But I wonder if working on liver health or trying to build more muscle will also help while waiting out the PUFA detox period? Uncoupling agents are probably also key, but they should probably be other than aspirin since it may make fatty liver issues worse for many people if used in the doses needed for mitochondrial uncoupling. Finally, increasing CO2 production or intake somehow will also likely have a key role. Just throwing things out there that seem to be cardinal methods for improving metabolism.
Sorry about the long rant, I just felt like this deserves some attention since a number of threads pop on the forum asking the same questions and I have been thinking about this for some time. If someone knows about Peat's definitive opinion on this issue please share it. Maybe I missed it in his articles. IMHO, after reading pretty much all of his published stuff, reading people's testimonies/complaints, cross-referencing this with studies, and my own experience, I think a number of chicken/egg question still remain.
Anybody care to comment?

My sense is haidut was expressing himself in a long rant as he said. I've posted a comment for haidut, articulating at least in simple terms Peat's perspective on this, in the original thread here:
viewtopic.php?f=10&t=5525&p=67177#p67177

 

[BingDing]

That is a great testimonial about choline, Spondive. Choline irreversibly converts to betaine, which improves or prevents fatty liver. I've used betaine anhydrous for the last six months because I had qualms about using choline.

 

[Spondive]

How much Betaine do you take?

 

[Spondive]

I was also reluctant to take it, so I stopped for awhile and just started to take it again given that my liver enzymes came up again. I also have Betaine anhydrous which I take occasionally but seems to not have same effect but maybe I'm not taking high enough dose

 

[BingDing]

I've been taking 1/2 tsp/day, which is about 1.5g. But I haven't had liver labs since I started it. I did have homocysteine labs and that was down to the normal range, but still at the high end.

This paper has a lot of info on betaine, IIRC some studies used 15g/day with no ill effects.

 

[Spondive]

Good to know... I will add that along with Choline since it spares choline.. I like the idea better since it is a glycine molecule

 

[visionofstrength]

That is a great testimonial about choline, Spondive. Choline irreversibly converts to betaine, which improves or prevents fatty liver. I've used betaine anhydrous for the last six months because I had qualms about using choline.

Betaine and choline are described as methyl donors. Though conventional medical literature may curry to corporate interests as proproprietors of methyl donors, I think Peat is clear that reducing methylation from methyl donors is important:

Methionine and choline are the main dietary sources of methyl donors. Restriction of methionine has many protective effects, including increased average (42%) and maximum (44%) longevity in rats (Richie, et al., 1994). Restriction of methyl donors causes demethylation of DNA (Epner, 2001). The age accelerating effect of methionine might be related to disturbing the methylation balance, inappropriately suppressing cellular activity. Besides its effect on the methyl pool, methionine inhibits thyroid function and damages mitochondria.

If you need to treat fatty liver, Peat's answer is to stop fatty acid oxidation, which has systemic benefits in the liver and the body.

When free fatty acid levels are elevated, the metabolism of glucose to carbon dioxide becomes impaired, and glucose is rerouted to lactate instead.

I tried to write more about this in the post that I linked to above, in response to what haidut calls his long rant.

 

[Spondive]

I agree with you and Peat that is why I am reluctant to use choline and Betaine. I figured if my metabolism increases with the use of T3 and uncouplers I would require more choline etc. the choline seems to lower my liver enzymes whether that is healthy or not is a different story and whether it is liberating to much free fatty acids because of this could be detrimental

 

[Spondive]

Currently I am gradually increasing my caffeine intake with coffee and using 30 to 40 mg K2 by Thorne and these things are having some good effects particularly on like libido. I believe my liver is the biggest cause of my issues..low T etc. Overall doing these Peat recommended things has improved my health and well being.

I have been following Peat for 2 years now and it has been eye opening..wonderful stuff