Dear XXXXXXX,
Thank you for writing in to XXXXXXX
I am a medical specialist with additional degree in cardiology. I read your mail with diligence. You have not mentioned your height but weight 124 KG will mean severe obesity for any Indian woman. Coming to your ultrasonography of liver. It shows hepatomegaly and fatty liver.
Some fat in the liver is normal. But if fat makes up more than 5%-10% of the weight of your liver, you may have alcoholic or nonalcoholic liver disease. In some cases, these diseases can lead to serious complications.

Alcoholic Liver Disease (ALD)
It remains the most important cause and is due to abuse or overuse alcohol. Almost all of them -- 90%-100% -- develop fatty livers.

Fatty liver can occur after drinking moderate or large amounts of alcohol. It can even occur after a short period of heavy drinking (acute alcoholic liver disease).

Genetics or heredity (what is passed down from parent to child) plays a role in alcoholic liver disease in two ways: It may influence how much alcohol you consume and your likelihood of developing alcoholism. And, it may also affect levels of liver enzymes involved in the breakdown (metabolism) of alcohol.

Other factors that may influence your chances of developing alcoholic fatty liver disease include:

Hepatitis C (which can lead to liver inflammation)
An overload of iron
Obesity
Diet
Nonalcoholic fatty liver disease (NAFLD) This may be applicable to you as overuse or abuse of alcohol is uncommon in India.

Nonalcoholic fatty liver disease is now the most common cause of chronic liver disease in India. Some people with excess fat in the liver simply have what's called a fatty liver. Although this is not normal, it is not serious if it doesn't lead to inflammation or damage.

Others have what's called nonalcoholic steatohepatisis (NASH). Although it is similar to alcoholic liver disease, people with this type of fatty liver disease drink little or no alcohol. XXXXXXX can lead to permanent liver damage. The liver may enlarge and, over time, liver cells may be replaced by scar tissue. This is called cirrhosis. The liver can't work right and you may develop liver failure, liver cancer, and liver-related death. XXXXXXX is one of the leading causes of cirrhosis.

Both types of NAFLD are becoming more common. Up to 20% of adults may have either fatty liver or XXXXXXX And more than 6 million children have one of these conditions, which are most common in Asian and Hispanic children. Recent evidence indicates that NAFLD increases the risk of heart disease in children who are overweight or obese. You ought to know this issue.

Causes of Nonalcoholic Fatty Liver Disease (NAFLD)

The cause of nonalcoholic fatty liver disease is not clear. Certain factors tend to increase risk, but in some cases, no risk factors show up. However, NAFLD tends to run in families. It also shows up most often in people who are middle-aged and overweight or obese. These people often have high cholesterol or triglycerides and diabetes or prediabetes (insulin resistance), as well.

Other potential causes of fatty liver disease include:

Medications
Viral hepatitis
Autoimmune or inherited liver disease
Rapid weight loss
Malnutrition
Coming to causes of ovarian cysts.

Irregular menstrual cycles
Increased upper body fat distribution
Early menstruation (11 years or younger)
Infertility
Infertility treatment with gonadotropin medications
Hypothyroidism
Chemotherapy for breast cancer
Cigarette smoking also increases the risk of functional ovarian cysts.

It is unlikely for you to have two different diseases therefore, I assume obesity (to exclude hypothyroidism) as the cause of ultrasonographic findings.
You have to seriously take up this issue and get yourself examined by a medical specialist(MD Medicine) and Gynaecologist (MS in Obstetrics and Gynaecology). Such a combination of specialist you can find in any medical college of Chennai, where I assume you live. If you can afford then you can to Apollo Group of Hospitals. For a young person like you that is the best advice I can give. Please do not waste your time with going to indigenous form of therapist for you can cause yourself a serious harm. If there is any more question, I will be happy to answer.Good Luck.
With Best Wishes

Dr Anil Grover
MD(Internal Medicine),DM(Cardiology)
Cardiologist and Medical Specialist
WWW.WWWW.WW

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Thank you for writing back.
I have Ayurvedic doctors working for my hospital.
There is no standard Ayurvedic treatment for Morbid Obesity + Fatty Liver + Polycystic Ovarian Disease. If you ask which implies that it is not serious serious that would be wrong thinking. About mode of therapy, I can only give suggestions and following them up is upto you.

Regards

Anil Grover

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Dear XXXXXXX,

I did say either one of the Medical College in Chennai or Apollo Group of Hospitals; both specialists I mentioned are specialists with degrees in Allopathy. Furthermore, I did say that there is no protocol for the malady you are suffering in Ayurvedic.

You read rightly about cancer. If you read my first reply I said non alcoholic fatty liver is most common cause for cirrhosis. Cirrhosis further leads to cancer. Per se cirrhosis is a end stage disease. So, please do not take your disease lightly.

However, further tests are needed to evolve a treatment protocol for you:
1. As hypothyroidism can cause both cysts in ovary and obesity that needs to be excluded. How many other hormonal tests are needed will be known only after physical examination for example till you get Fasting Blood Sugar and glycated hemoglobin HbA1C Diabetes can not be excluded in you.

2. In general, those with Body Mass Index (can not be calculated without knowing your height) above 35 is called morbid obesity (taking height of a tall Indian woman you cross this) and one of the treatment option is Bariatric Surgery. Decision whether you will be a suitable person or not can not be taken without examination and tests in an Allopathic Hospital. For example your lipid profile can not be normal but it has to be tested first. Medical treatment of increased lipids or cholesterol
can be successfully done.

Good News is with the data supplied by you the disease in my opinion can be halted at this stage (that would be 'Cure' mentioned by you) without your developing cirrhosis or cancer. So, make an appointment with an MD (Medicine) or DM (Endocrinology) without wasting another week. Good Luck. If you have any other question please do not hesitate to ask.
Regards


Dr Anil Grover

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