Managing fatty infiltration

Fatty infiltration of the liver is known to cause varying degrees of liver dysfunction. How do you prevent or reverse it? What about fatty infiltration in other organs?

One place to start would be to consider the possible role of fructose. Some people on a Paleo diet exclude it, but many (most?) don’t.

Fructose is converted to fructose-1-phosphate in the liver, a process which can deplete the phosphate stores that normally would be used to create ATP, which is the body’s primary source of metabolic energy. A lack of ATP triggers the degradation of adenine, which produces uric acid, which can lead to gout — which is associated with metabolic syndrome. The fructose metabolites are then moved into fat storage, by increasing triglyceride levels in the blood. Fructose also increases insulin resistance.

As a result of the process above, fructose can then lead to fatty liver:

Consuming PUFAs and alcohol can also contribute to liver injury and inflammation:

I should mention that there’s a difference between eating low-carb and being in ketosis. When you’re in ketosis, the body is burning fat as a primary fuel, rather than glucose. Triglycerides are fats, and if you don’t burn them up, they tend to accumulate. Triglyceride levels can go from being high to normal within 72 hours of going into ketosis.

Based on the research I’ve done, it is perfectly safe to be in ketosis for a few months at a time, and probably even longer. However, alternating out once in a while is prudent — an expert I know advocates going out of ketosis twice a week or so, or maybe one week a month. In my case, making the transition isn’t particularly easy, so I do it less often (out 1 month of every 6 feels like it would be about right, although it’s more easily said than done).

A few interesting tidbits about ketosis: the brain’s adaptation to ketones starts on about day 3, but isn’t complete for about 2 weeks; I tend to feel a bit fuzzy during that adjustment period. After 2 weeks, though, the brain can derive 25% of its energy from ketones. The heart ejection fraction can increase by 30% within a few hours after an injection of ketones (helps with CHD). If you force cells to burn glucose, they turn cancerous relatively quickly; if you force them to use the same fuel they used in the fetal state (ketones), the cells tend to undifferentiate (stop being cancerous). Alkaline cancers, in particular, live on glucose; getting your blood glucose level down from 110 to 80 makes a huge difference in the cancer’s ability to grow.

Leptin resistance can also be a factor in the body’s use and accumulation of fat. Mold toxins can cause adverse effects on the leptin system, as well as aggravating insulin resistance. There’s a book called “Mold Warriors” that talks about this (redirects to Amazon):

This may include various forms of subclinical intestinal yeast overgrowth (meaning it can be a problem with no obvious symptoms). Everyone has yeast in their gut and on their skin; it’s a question of species and quantity, as well as the competitive balance with normal gut bacteria. Some fungal species, such as Candida rugosa, are resistant to certain antifungals, so just because you’ve been through a round of treatment doesn’t mean the problem has gone away. Sometimes, treatment just changes the balance around, and can even make you worse (always a good idea to supplement probiotics when taking antifungal meds).

In addition, prostaglandin E2 (PGE2) can inhibit lipolysis (breaking down fats). You may be able to check yourself to see if your PGE2 levels are a factor. A niacin flush can significantly lower your PGE2 level (as well as histamine). One way to do the test is to start by dissolving a 24 hr dose of regular niacin (not niacinamide or no-flush niacin) in 8 oz of water. Then, take a sip and wait about 30 to 40 minutes for a flush. Then take a larger sip, wait, flush and repeat. You may need to repeat again for a few days, with steadily increasing doses per day. When you’re done, the flushing should stop or nearly stop. After that, if PGE2 is a problem, you should be symptom-free for many hours. In general, the larger the flush, the higher your PGE2 levels.

Some people also have mitochondrial deficiencies. I have recently come to suspect that “subclinical” mitochondrial disease is much more widespread than is commonly accepted (particularly in brain-related illnesses, including schizophrenia, autism spectrum disorders and possibly epilepsy). This can also contribute to difficulties in effectively burning fat for fuel; you can run into a bottleneck of sorts. Experimenting with mitochondrial nutrients while in ketosis might help to both identify and treat some of those issues — for example, carnitine, medium chain triglycerides, NADH, Lipoic Acid, B1, B2, B3 (NADH precursor) as niacin vs. niacinamide, B5, CoQ10 (std vs. ubiquinone) and N-Acetyl-Cysteine. You can assess yourself to see if they’re helping by looking at your cognitive function (memory or something similar), strength, stamina, and/or body temperature.

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