Brief Answer: No cause of concern. Precautions need to be taken Detailed Answer: Hi there, Thanks for your query. There is no reason to be unduly concerned due to fatty liver with elevated SGPT enzymes. Anti-hypertensive drugs, when used for a long time, do tend to cause mild liver enzyme abnormalities. However, certain precautions need to be taken to restore the liver functions :- 1. If overweight, reduce your body weight to ideal level (BMI < 25). 2. Stop alcohol, if you take it. 3. Take low fat, high protein diet. 4. Regular physical exercises to burn out excess fat. 5. Get certain tests, such as, Lipid profile (to detect high lipid levels in blood), Blood sugar (to detect diabetes, if any), Blood Insulin levels (to detect Insulin resistance), Thyroid Hormone levels (to detect thyroid disorder) and vitamin D levels done. If lipids are high in blood, lipid lowering drugs should be taken to lower blood lipid levels. 6. Supplements containing Omega-3 Fatty acids and certain amino-acids, particularly, L-ornithine and L-aspartate will be of great help in treating fatty liver. 7. Strict control of Blood Pressure. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Dr. Rakesh Karanwal

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Brief Answer: Information solicited is given below. Detailed Answer: Dear Mr. XXXXXXX The answer was given ONLY after seeing your lab reports. Your Triglyceride level is high and should be brought down to <100mg% in the presence of Fatty Liver. Bringing down cholesterol and LDL levels FURTHER, too will help in regressing fatty liver. The other investigations advised were Blood Insulin levels (to detect Insulin resistance), Thyroid Hormone levels (to detect thyroid disorder) and vitamin D levels done. These tests have a relevance to Fatty Liver. You were advised to stop tea, coffee, carbonated drinks/soft-drinks as they aggravate duodenal ulcer. Perhaps, occasional alcohol intake is unlikely to cause fatty liver in normal people, EXCEPT for some whose liver tends to be oversensitive to alcohol insult. Both : TELMA and PANTOPRAZOLE elevate liver enzymes (including SGPT- which is more specific than SGOT). For that reason, You were advised not to worry about elevated SGPT: the levels will revert back to normal once these drugs are stopped. Several factors (alcohol, drugs, past history of jaundice)- which cause deranged liver functions- are simultaneously into play, their effect becomes synergistic. Elimination of these factors, help in regression of fatty liver. Add an antioxidant, such as, Vit E to the supplements listed above. The new information provided regarding history of two episodes in the past, leads to added possibility of an ongoing hepatitis, most likely Chronic Persistent Hepatitis. You should therefore, undergo blood test for circulating antibodies against Hepatitis A, C, D and E along with Australia antigen. Absence of antibodies against all hepatitis viruses will exclude ongoing hepatitis. NON-ALCOHOLIC FATTY LIVER is of two types : a LESS severe NAFLD and MORE severe XXXXXXX (Non-Alcoholic Steato-Hepatitis). So, NAFLD is not a severe disease, provided you take precautions listed above. Further investigations required have already been enumerated above. You may consult your doctor and apprise my opinion to him. He knows what further actions should be taken. Dr. Rakesh Karanwal

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