So I had my yearly physical last week, replete with all the labs that are required of men in their 40s. This included a fasting lipid panel, hemoglobin, fasting blood sugar and a liver enzyme known as alanine aminotransferase, ALT for short. The good news is that pretty much everything came back within normal limits. My fasting blood sugar is normal, but higher than I would like it to be, and all my cholesterol markers are well within the normal range. Statins really turned that around for me after years of false starts with diet and exercise. ALT gets checked because in some cases, statins can cause liver damage as can Effexor, the med that I use to chronically manage my anxiety. Sadly, my ALT came back mildly elevated. The reference range for ALT is 12-78 units/L. Mine is 93 units/L.
The last time I had it checked was in January of 2014, prior to starting on Lipitor, is was 92 units/L. The doctor ran a full hepatic panel at the time and it was the only liver enzyme even remotely out of whack. Because it was still elevated two years later, he ran another hepatic panel and my AST (aspartate aminotransferase) is one point over the normal range.
Those of you that know me know that while I waited for the results of the hepatic panel yesterday, I was convinced that I had one of two things – hepatitis or liver cancer. Even though I joked about it being from too many jumbo margaritas, the little anxious voice in the back of my head wouldn’t shut off no matter how many logical conclusions I gave it. One of my strategies for dealing with those kinds of anxious thoughts is to say them out loud to other people, just so that I can hear myself say them and realize just how silly they sound. It worked for the most part.
So with the latest results, the doctor is going to run some hepatitis labs (unlikely to be that as I’ve been vaccinated against Hep B and I really don’t have any risk factors for hepatitis) as well as get an ultrasound of my liver. He is suspecting that what he’ll find is what’s known as fatty liver. It’s not an uncommon diagnosis, and that’s something for which I definitely have some risk factors. I’m overweight (not by much, but my BMI is 30.7 which is technically obese.) I also think that my fasting blood glucose, while normal, is still concerning, which can also lead to fatty liver disease. I do drink alcohol, but not to excess and alcoholic fatty liver disease would show up with an AST about double what my ALT is, so I’m pretty sure it’s not that. Regardless, cutting back on alcohol never hurt anyone, so I’ll probably be doing that. Heidi said that we need to stop having Bota Boxes around because I can’t say no to the Bota Box, but I guess that’s just a good chance for me to try to practice my will power.
Ultimately, I think the culprit is sugar. Fructose is currently public enemy number one as far as diets go. I think the data is really there to support it. There’s lots of stuff online that you can read about the deleterious effects of fructose on the human body, but the bottom line is that your liver is the only organ in your body that can metabolize it. Give it too much and it acts like alcohol and can damage your liver. Could this be the problem? Hard to say because I also found a meta-analysis that demonstrated that excessive calorie consumption and not fructose specifically, was more likely to cause non-alcoholic fatty liver disease. But meta-analyses are not how we make recommendations and I couldn’t read the entire study so your mileage may vary.
So I guess I’m not dead yet, like the some of the plague victims in Monty Python & The Holy Grail. But that’s not an excuse. I guess I get to try again at tracking calories and increasing activity. It was something I was going to do here very soon anyway. I guess now I just have a good reason to do it.