Get your liver healthy again
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Q: My doctor told me that my last blood test showed elevated liver enzymes and that I may have non-alcoholic fatty liver disease. What should my next steps be and how serious is it?
A: Non-alcoholic fatty liver disease, or NAFLD, is quite common in the United States. About 25 percent of adults have NAFLD – and about 20 percent of those people have a more advanced stage called NASH (non-alcoholic steatohepatitis), in which hepatitis causes inflammation and swelling. and even cirrhosis of the liver.
NAFLD is often associated with other health challenges – from obesity to insulin resistance and diabetes, to increased alcohol consumption and hypogonadism (that’s low testosterone levels) in men. They don’t say what the possible causes were in your case, but if you have any of these conditions, or have very high levels of LDL cholesterol or triglycerides in your blood, you are a candidate for NAFLD. However, there are times when someone has NAFLD without being obese or having metabolic syndrome.
In either case, the next steps are to make certain lifestyle and medical changes pronto, and do additional tests to confirm the diagnosis.
Increased physical activity; Improved diet (no foods with saturated fats, red or processed meat, or ultra-processed or sugary packaged foods) and taking prescribed medications to control blood sugar, blood pressure, and lipids can slow or even reverse the progression of NAFLD.
You may also need to reduce or give up your alcohol consumption even if you are not a problem drinker.
Next, you can do a scan – ultrasound, CT, or MRI, or a newer form of ultrasound called transient elastography – to assess the amount of fat in your liver and its stiffness. You can also ask your doctor to check your testosterone levels. A new study shows that in obese men with low testosterone levels and type 2 diabetes, testosterone therapy normalizes hormone levels and reduces NAFLD.
Whatever you do, don’t hesitate. Follow up, take steps to live healthier lives, and you will be able to protect your liver – and your life.
Q: I am a 64 year old female. Do I really have to have a mammogram every year, as my family doctor says?
Dee F., Austin
A: If you’re at moderate risk of developing breast cancer, the American Cancer Society says women ages 40 to 44 have the option to start a mammogram every year. Women aged 45 to 54 should have a mammogram every year. Women aged 55 and over can switch to a mammogram every two years or continue the annual mammogram. Screening should continue as long as the woman is in good health and is likely to be at least 10 years old.
Unfortunately, cancer screening is way below what it should be – and not just for breast cancer. A new study found that in 2018, only 66 percent of people ages 50 and older had colon cancer screenings; in women aged 45 and over, only 63 percent were screened for breast cancer; and in women aged 21 to 65, only 83 percent have been screened for cervical cancer.
This puts all women at risk for late diagnosis – and riskier recovery. This is especially true of two subgroups of women who have survived breast cancer, no matter how long. A new study in the journal Cancer shows that breast cancer, acute non-lymphocytic leukemia, ovarian cancer, and lung cancer are more likely to occur after HR-negative breast cancer than after HR-positive breast cancer. Women who were first diagnosed with breast cancer before the age of 50 also have a higher risk of developing cancer later than women who have breast cancer later.
Some good news when it comes to fighting cancer: The combination of a new cancer vaccine and an existing immunotherapy drug has shown in mice that the success rate of treating metastases increases from 20 percent to 75 percent, according to a study in Nature Communications. Stay tuned for clinical trials. And make sure you get all of the cancer screenings as your doctor recommends.
Contact Dr. Oz and Roizen on sharecare.com.
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