OpenHealth Q&A

It's understandable to feel concerned about your elevated liver enzymes, especially given your ongoing health conditions and recent surgery. Elevated liver enzymes, such as ALT and AST, can be influenced by various factors, including medications, diet, and underlying liver conditions. Here’s a structured response to help you reduce these enzyme levels and improve your overall liver health.

Main Points:

1. Focus on Diet and Weight Management.
2. Monitor and Adjust Medications with Care.
3. Implement Lifestyle Changes.

Explanation:

Elevated liver enzymes can indicate inflammation or damage in the liver. In your case, factors such as your medications (methotrexate and sulfasalazine), recent gallbladder removal, fatty liver disease, and insulin resistance may all contribute to these levels. Addressing your liver health through lifestyle modifications and careful management can help in reducing these elevated enzymes.

Next Steps:

1. Dietary Adjustments:

   • Reduce Intake of Simple Carbohydrates: Avoid sugary foods and drinks, white bread, and pastries to help manage insulin resistance.
   • Incorporate Healthy Fats: Opt for sources of omega-3 fatty acids like fish (salmon, mackerel), nuts, and seeds. These can improve liver health.
   • Increase Fiber Intake: Include whole grains, fruits, and vegetables to support weight management and liver function.
   • Limit Alcohol and Processed Foods: Alcohol can exacerbate liver conditions, while processed foods often contain unhealthy fats and sugars.

2. Weight Management:

   • If overweight, losing even a modest amount of weight (5-10%) can significantly affect liver enzyme levels and improve NAFLD.
   • Aim for gradual weight loss through a balanced diet and regular physical activity.

3. Physical Activity:

   • Engage in regular exercise, aiming for at least 150 minutes of moderate aerobic activity (like brisk walking) per week. This can help lower liver enzymes, improve insulin sensitivity, and promote overall health.

4. Medication Monitoring:

   • Consult your healthcare provider about the medications you're currently taking, as some (like methotrexate) can impact liver function. They may consider adjusting dosages or switching medications if necessary.

5. Regular Monitoring:

   • Continue to have your liver enzymes checked regularly and discuss any concerns with your healthcare provider, especially given your eligibility for biologic treatments.

By focusing on these areas, you can take proactive steps towards improving your liver health. Remember to be patient with your progress, as it may take time to see changes in your liver enzyme levels. It's understandable to feel pessimistic, but managing these factors can lead to positive outcomes. Stay committed to your health goals, and take care!