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Can You Please Suggest Next Course Of Action Fatty Liver Grade 2 ?
Question: Hi, I was diagnosed with Fatty liver grade 2 in July 2023. I took medication (Hepamerz and Udiliv) for next two months after which my sgpt levels came down to 150 from 308. Then I had to move to another town for work and I stopped taking medicines for liver. Then again after two years, yesterday 25th August, I got my liver enzymes checked and saw sgpt and sgot elevated. I have started working out since last 2 weeks to tone down body fat. Can you pls have a look and suggest next course of action
Brief Answer:
Need more details
Detailed Answer:
Hello and welcome here,
Can you share more details about this condition?
- Have you taken any new medicines since last year?
- How is your diet and lifestyle? Any alcohol intake?
- Any symptoms of fever indigestion etc?
Please upload reports
Regards,
Dr Vaishalee
Need more details
Detailed Answer:
Hello and welcome here,
Can you share more details about this condition?
- Have you taken any new medicines since last year?
- How is your diet and lifestyle? Any alcohol intake?
- Any symptoms of fever indigestion etc?
Please upload reports
Regards,
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doc,
Pls find my answers below -
Can you share more details about this condition?
- Have you taken any new medicines since last year? Aside from my diabetic medicine (Glykind - M 1tab twice a day after meal), I took Itraconazole 200mg twice a day for approx 24 days for fungal infection. HBA1C as of last week is 7.3
- How is your diet and lifestyle? Any alcohol intake? No alcohol taken ever but life style has not been very good as I had to stay away from home due to work and survived on processed and packaged food. But now I'm back at my place and have started working out past 1 week now.
- Any symptoms of fever indigestion etc? No nothing as of now.
Please upload reports.... Looks like I cannot upload pdf somehow but I can uploads screenshots of my reports
Pls find my answers below -
Can you share more details about this condition?
- Have you taken any new medicines since last year? Aside from my diabetic medicine (Glykind - M 1tab twice a day after meal), I took Itraconazole 200mg twice a day for approx 24 days for fungal infection. HBA1C as of last week is 7.3
- How is your diet and lifestyle? Any alcohol intake? No alcohol taken ever but life style has not been very good as I had to stay away from home due to work and survived on processed and packaged food. But now I'm back at my place and have started working out past 1 week now.
- Any symptoms of fever indigestion etc? No nothing as of now.
Please upload reports.... Looks like I cannot upload pdf somehow but I can uploads screenshots of my reports
I tried compressing the file and looks like it uploaded just fine.
Brief Answer:
You need to revise the medicines
Detailed Answer:
Hi again
Thanks for sharing the details.
I have seen the reports also.
Your liver issue is not due to alcohol or infection. Your digestion is also normal.
Glykind-M contains gliclazide and metformin. I think this diabetes medicine especially gliclazide maybe cause of liver issue. Anyways metformin also needs to be taken with caution in liver problem.
Recently you took itraconazole and it may have exacerbated the liver issue. Since you have stopped taking it now, liver issue should recover in 3-4 weeks time. Meanwhile you need to drink cleaner water with TDS less than 30 and allow your body to recover. Avoid any medicine that can affect the liver.
You may resort to insulin and/or herbal medicines for now. Herbal medicines that can be effective are aloe vera (to be used occasionally), amla (can be used daily), karela, jamun . Tab Nishamalakki can be taken for diabetes. Also regular walks/exercise and dietary control.
If all this doesn't help, then go for more tests to find the cause. Treatment of the condition is treatment of the cause.
Regards,
Dr Vaishalee
You need to revise the medicines
Detailed Answer:
Hi again
Thanks for sharing the details.
I have seen the reports also.
Your liver issue is not due to alcohol or infection. Your digestion is also normal.
Glykind-M contains gliclazide and metformin. I think this diabetes medicine especially gliclazide maybe cause of liver issue. Anyways metformin also needs to be taken with caution in liver problem.
Recently you took itraconazole and it may have exacerbated the liver issue. Since you have stopped taking it now, liver issue should recover in 3-4 weeks time. Meanwhile you need to drink cleaner water with TDS less than 30 and allow your body to recover. Avoid any medicine that can affect the liver.
You may resort to insulin and/or herbal medicines for now. Herbal medicines that can be effective are aloe vera (to be used occasionally), amla (can be used daily), karela, jamun . Tab Nishamalakki can be taken for diabetes. Also regular walks/exercise and dietary control.
If all this doesn't help, then go for more tests to find the cause. Treatment of the condition is treatment of the cause.
Regards,
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doc
You mean I need to stop taking this combination - gliclazide and metformin ? I had no idea. Do I need to take only Tab Nishamalakki only or any allopathic medicine. Earlier I was taking Dapagliflozin (10mg) which caused me to have frequent urination and penile fungal infection...
Do you think these medication would have seriously elevated my enzymes to such a degree ? Do I need ultrasound or fibroscan ?
You mean I need to stop taking this combination - gliclazide and metformin ? I had no idea. Do I need to take only Tab Nishamalakki only or any allopathic medicine. Earlier I was taking Dapagliflozin (10mg) which caused me to have frequent urination and penile fungal infection...
Do you think these medication would have seriously elevated my enzymes to such a degree ? Do I need ultrasound or fibroscan ?
Brief Answer:
I would repeat liver function test regularly
Detailed Answer:
Hi
If this enzyme increase is due to itraconazole, then it should start decreasing by now. You may get this test done again to see the trend - increase, decease or same. If it is decreasing, then discontinue the above medicines and allow the liver to recover. Liver has good recovering capability.
If it is due to another cause then it won't decrease. Then we need to go for ultrasound etc to find the cause and extent of damage.
For diabetes, you may currently switch to herbs (nishamalaki) or insulin or both depending on sugar control. Talk to your doctor about dose of insulin instead of oral antidiabetics. Regarding Nishamalakki, you may start taking it 2-3 times a day . You may check blood glucose levels at home with a glucometer during the change of medicine.
Whether these medicines caused it or not, but they cannot be continued in the presence of active liver issue. When liver issue subsides, then we may re-consider metformin.
Regards
Dr Vaishalee
I would repeat liver function test regularly
Detailed Answer:
Hi
If this enzyme increase is due to itraconazole, then it should start decreasing by now. You may get this test done again to see the trend - increase, decease or same. If it is decreasing, then discontinue the above medicines and allow the liver to recover. Liver has good recovering capability.
If it is due to another cause then it won't decrease. Then we need to go for ultrasound etc to find the cause and extent of damage.
For diabetes, you may currently switch to herbs (nishamalaki) or insulin or both depending on sugar control. Talk to your doctor about dose of insulin instead of oral antidiabetics. Regarding Nishamalakki, you may start taking it 2-3 times a day . You may check blood glucose levels at home with a glucometer during the change of medicine.
Whether these medicines caused it or not, but they cannot be continued in the presence of active liver issue. When liver issue subsides, then we may re-consider metformin.
Regards
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks Doc, for the guidance. I'll get another LFT done by the end of this week and reach out again for any further questions.
Brief Answer:
Yes please
Detailed Answer:
Yes you may repeat the test and share the new reports with me
You can also raise diet request and our dieticians can share specific diets for your condition
Regards,
Dr Vaishalee
Yes please
Detailed Answer:
Yes you may repeat the test and share the new reports with me
You can also raise diet request and our dieticians can share specific diets for your condition
Regards,
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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