What my doctor told me left me in absolute shock.
She had already told me that my gut microbiome was completely unrelated to my fibromyalgia, that I had confessed to eating “a lot of meat” when I had actually said “Most of what I eat is meat and vegetables,” and that she simultaneously wanted me to wear strong sunscreen every time the sun touched my skin and take a vitamin D supplement. Then she blurted out, with a straight face, “Cod liver oil doesn’t have vitamin D in it.“*
As I sat speechless, she drove the point home: “You take cod liver oil for fish oil, and you don’t need that. What you really need is a vitamin D supplement.”
That’s why, when a few seconds later she told me I was storing fat in my liver and might have NASH, I glazed over and tuned her out. Nothing but scare tactics to bully me into following her grossly outdated, politically driven conventional wisdom, I was sure.
Still, my total cholesterol was 300 and my liver enzymes were elevated, and I needed to understand why. The second return from Google search for “high cholesterol liver enzymes paleo” led me to, of all things, fatty liver. So although she was wrong to pin the blame solely on dietary fat, she was indeed onto something.
Not as bad as it seems
I panicked at first, but as I read about the condition, I saw my initial calm was justified. First, I probably just have NAFLD (simple fat accumulation), not NASH (inflammation). I definitely don’t have any of the scary signs of liver damage (jaundice, abdominal pain), and the doctor didn’t order any further tests. Even if I do have a bit of inflammation going on at this point, it’s fully reversible.
It’s good to know I’m already doing some things right. My consumption of PUFA, aside from the cod liver oil and a few nuts, is practically nil, and sugar and starch are moderate to low (although I have a weakness for white rice). I use coconut oil on a regular basis (see video above).
So if I’m not getting hammered on high fructose corn syrup and canola oil cocktails, what’s going on? For one, this could actually be a good sign. As the liver dumps the fat, it goes into the bloodstream, and cholesterol levels can spike. I started my bone broth breakfast hack (think Bulletproof coffee, with bone broth instead of coffee) a couple of months ago, which supplies the coconut oil and just might put me in extremely mild keto through the morning. Maybe it’s enough to help my liver run just a little better.
My gut flora is probably a factor. I have a history of aggressive IBS-D, and although it’s been in remission for over a decade, I’d be lucky if my gut bugs weren’t still out of whack. That, of course, affects my metabolism in myriad ways, including…
A simple nutrient deficiency
This one’s the biggie. According to Chris Masterjohn, choline deficiency is the primary driver of fatty liver disease. And considering that about 90% of the population doesn’t get enough, it’s a pretty safe bet I have this problem.
I was eating liver semi-regularly for a while, but it fell off my radar when my meat supplier left my farmers market, and I started buying from another vendor who frequently runs out. I’ve backed off on eggs, too, because I’ve been paranoid about the whites and intestinal permeability. During all that, I completely lost sight of my choline intake. That’s what I get for winging it without a plan.
Anyway, as soon as I figured out about the choline, I threw everything I could easily acquire at it–egg yolks, liver, choline bitartrate and inositol caps (the alpha GPC is on its way in the mail). Since then:
- The acne that has been steadily worsening cleared up by 90% immediately
- Same with my constant sinus drip
- I’ve been groping for words a lot less, even though I’ve been short on sleep
- My usual background muscle aches have been greatly relieved
- My eyes have been stinging less, and cleaning them with Ocusoft no longer stings
- It’s been easier to feel full after meals, and I have less cravings for fats
As I learn to hack this condition, I’ll keep you posted. Meanwhile, don’t repeat my mistake. Get yourself some liver, pastured eggs, and supplements, and make double sure you’re getting the choline you need.
*She was, actually, onto something here too. With many modern sources of cod liver oil, apparently, the deodorizing process strips out the vitamins. Some brands add them back in, some don’t. Her communication was still questionable, though.