Curious on the potential paths here
My unscientific guess is no, fatty liver seems almost entirely an issue of either alcohol or fructose consumption (or both). It appears to have nothing to do with eating fat, as far as I know.
(As I say, unscientific. I’m looking forward to seeing who agrees with my guess, please don’t take my word on this!)
I have run into basically two schools of thought on fatty liver. KM mentions alcohol and fructose, which I think of as the “what happens in the liver stays in the liver” theory, based on the similar metabolic pathways for these that are distinctively limited to that location, and which result in de novo lipogenesis with sufficient quantities of substrate. The other is what I’ve heard called the “bathtub” theory: that we each have an individual capacity for storing fat subcutaneously, which is analogized to a bathtub, and only when that bathtub overflows does so-called ectopic fat begin to accumulate elsewhere, including the liver. I find the latter to be a little more plausible. The liver is brilliant at scavenging, transforming, and distributing stuff, including fat, so just because alcohol and fructose cause fat to be made in the liver shouldn’t mean that is forced to live there. In addition, although I don’t have citations on hand, I’m sure I’ve seen a study or studies showing that with weight loss, liver fat is the first to go, followed closely by other ectopic fat. I assume (but can’t remember for sure) that this is not something that only happens when the weight loss stems from avoiding alcohol and fructose. You might say that the overflow gets mopped up before the bathtub itself starts to empty in a big way. This theory seems to me to be better at explaining why some people (those with small bathtubs) can develop metabolic syndrome, including T2D, even when they don’t look fat. I’ve heard several doctors who treat lots of patients of east Asian and south Asian ancestry remark on the frequency of this skinny-fat phenotype in those populations. Whichever theory is true, it is difficult to see why MCT would contribute to the problem of fatty liver.
And yet my liver scan most recently showed that it was fatty. I have no baseline, but I’m ketogenic for 10 years and carnivore for 4. I’m not perfect and had a 2-year break in the 10 years, but that was 8 years ago itself. I do eat a lot of MCTs though.
See my post above though. How would my liver be fatty
Even back around 2010 when I was my heaviest at 290, I didn’t have a high insulin levels, nor did I have fatty liver, or even a high blood sugar level. And my triglycerides over HDL was less than 2. I am now down to 189 and my triglycerides over HDL is less than one. I do i take a lot of coconut oil, olive oil, butter etc. my lab results are still great and of course better than it was back then. I am off all prescription drugs and my doctors are amazed at my progress due to my diet and age.
Interesting question. I don’t know.
How do your triglycerides usually look? I’ve seen stuff show that aside from Insulin resistance causing it for many, that trigs can as well. Fructose is always ignored although we know that’s in the mix, but really wouldn’t apply to a Keto’r or Carni.
How much is “lots”? I resolved fatty liver while going through periods of a few months at a time on and off using varying amounts of MCT oil up to 1/4 cup a day. My strength and endurance has been better when taking it in the context of having SBMA a genetic neuromuscular disease. I’ve not had regain of visceral fat taking 1 to 2 tablespoons daily for a couple years but my BMI is 18.0 and I have gained a little muscle while my BMI was 25.5 when I had fatty liver. It would not surprise me if one got fatter while consuming MCT that it could contribute to gaining visceral fat including of the liver too.
Report said hepatic steatosis, which is fatty liver. After this long of keto, I’d not expect it
Right, but how are your Trigs? Or realistically Cholesterol as an average?
Cholesterol always high, but trigs were normal before—haven’t checked in a while. Last test was like a year ago. Trigs were like 70 and HDL was like like 60 then. Ldl was like 300
70’s not terrible, sure you’re already aware of all the studies linking high Cholesterol and fatty liver. Many Keto’rs discredit them because of how keto (usually) works when it comes to that, and that most of those people diets are both high fat (and) high sugar, as many of the studies actually do state, but even with that being the case, don’t mean it’s all wrong either. There’s also one linking LDL (sdLDL usually) to it as well, not sure if you’ve ever gotten a breakdown or not.
I’ve never signed on for the ignoring the cholesterol thing, I take it all in context and mainly worry about sdLDL, but don’t let it run stupid either, or ignore half of it just because a ratio is good. Not sure where you are there, but being Keto for that long and then Carni, clearly you’ve got to start tweaking something. Not sure where you stand on how you’ll fix things, I’m very much an anti-aging bio-hackery crazy person, not too much I won’t do/try. But most people aren’t. That said, you CAN drop cholesterol very quickly and fix numbers if you decide to come over to crazy town.
I did it a while ago, it’s always been fine since then, never went back to being crap. Made a post about it a while ago with the NMR Attached.
I’m wondering if it’s from extreme stress. Between worrying when my employer will tel me to move to Seattle or resign, constant insane pressures at home with managing a multigenerational household with 2 grandparents from different sides, and all the pressures I always had, maybe I am just eating too much with too much cortisol.
That’s my hunch.
Fatty liver disease is the result of a process called de novo lipogenesis. The fat produced is the result of the breakdown of ethyl alcohol, fructose, or branched-chain amino acids by the pathway that handles them, when that pathway gets overloaded. Some small quantity of fat gets exported, but the fat that remains causes fatty liver disease, steatohepatitis, cirrhosis, and eventually liver failure.
The good news is that the liver is a hardy organ and can quickly recover from fatty liver disease or steatosis, once the overload of those three substances stops. My understanding is that the liver can eventually recover even from cirrhosis, if it’s not too advanced, but I may be wrong.
So can lots of MCT oil cause fatty liver disease? No. But it can cause diarrhoea. Remember that the fact that a little of something can be good does not mean that more is even better.
I doubt that MCTs are causing fatty liver, although it’s unclear as to what “a lot” means. (Regardless, I’m left wondering why you’re supplementing with MCT in the first place?)
More importantly: Yes, stress certainly takes its toll in many ways.
With everything going on in your life as you’ve described, you’d be well-advised to find ways to worry less about the stuff that’s out of your control and to focus only on what you can actually change. Yes, far easier said than done.
Since I consume none of those, how do I have the disease
If you are a high-protein consuming carnivore, then you are eating plenty of branched-chain amino acids. Somewhere I read that fatty liver can come from too much carbs or protein. I don’t know how much protein might be too much though.
Much easier said than done, as I balance the doctor visits that determine whether I need a heart transplant (I don’t), cardiac surgery for artificial artery and valve (still don’t need yet) with those for hernia surgery (need now).