Re: RDs with Liver disease experience, help appreciated

[Guest guest]

Yikes,

Liver support?

What's with Vit D defiency? Assume other vit/min deficiency?

Omega 3 intake?

Silymarin?

LEAP may be a huge support for all. ..

What are his goals? Is he just wanting to get by?

Or willing to do whatever he can do to maintain ultimate health?

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist (CLT) and specialist in inflammation caused by

non-IgE food sensitivity - which causes IBS, migraine, fibromyalgia,

arthritis and more. Co-author of the Certified LEAP Therapist Training Course.

Your email is important to me. If you send me an important email, and I

don't respond in 2 business days, PLEASE give me a call. Some weeks, I get

buried in email and I do not mean to ignore your email.

In a message dated 5/28/2012 5:53:43 A.M. Mountain Daylight Time,

rd-usa writes:

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_RDs with Liver disease experience, help appreciated_

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_RDs with Liver disease experience, help appreciated _

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Posted by: " Lori Sullivan " _rdcooking@... _

(mailto:rdcooking@...?Subject=

Re:%20RDs%20with%20Liver%20disease%20experience,%20help%20appreciated)

_rdcooking _ (http://profiles.yahoo.com/rdcooking)

Sun May 27, 2012 9:32 am (PDT)

Hi

I need RDs who brains I can pick a bit.

66 yo male, DB

insulin and newly added metformin. s/p 3 months choleycystectomy, still

had radiating pain GI to chest then they did liver biopsy & Dx

Cirrhosis (stopped drinking 12 y ago)

Current Labs (from memory don't have his chart)

ALK Phosp above normal at ~215 Other Liver function tests WNL

Mg low, put on supplement by PCP

Alb. 3.3

Renal WNL, 9some variances/outliers in WBC/RBC low H/H)

About 40 pounds weight loss in past several months, 6'0 " 255. now.

Large belly, states no ascities or frank fluid retention noted. On B/P

meds which is under control.

AIC over 10

Fasting glucose 121

Vit D still low about 16 (was on 50,000 IU 1x wk for about 3 wks, then

had switched to D3 2000 IU/d). Not sure what Vit D level on previous

test was before they started supplementing.

Going to Hepatology center in 10 days.

I told them not to change any supplements yet. Just concentrate on

standard food, decrease saturated fats, decrease animal protein,

increase vegetables and whole grains and get b/s under control. Avoid

salt. Then see what hepatologist says ( and see if fish oil, vit D,

etc. are going to help/hurt/?)

Any insight is great! I haven't had cirrhosis patient in years and then

throw in diabetes.... I

THANKS

Regards,

Lori

Lori Sullivan

OneSourceNutrition

_Lori@onesourcenutriLori@one_ (mailto:Lori@...)

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[Guest guest]

Yikes,

Liver support?

What's with Vit D defiency? Assume other vit/min deficiency?

Omega 3 intake?

Silymarin?

LEAP may be a huge support for all. ..

What are his goals? Is he just wanting to get by?

Or willing to do whatever he can do to maintain ultimate health?

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Signet Diagnostic Corp.

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist (CLT) and specialist in inflammation caused by

non-IgE food sensitivity - which causes IBS, migraine, fibromyalgia,

arthritis and more. Co-author of the Certified LEAP Therapist Training Course.

Your email is important to me. If you send me an important email, and I

don't respond in 2 business days, PLEASE give me a call. Some weeks, I get

buried in email and I do not mean to ignore your email.

In a message dated 5/28/2012 5:53:43 A.M. Mountain Daylight Time,

rd-usa writes:

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_RDs with Liver disease experience, help appreciated_

(mip://0b74d0f8/default.html#1) From: Lori Sullivan

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_RDs with Liver disease experience, help appreciated _

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Posted by: " Lori Sullivan " _rdcooking@... _

(mailto:rdcooking@...?Subject=

Re:%20RDs%20with%20Liver%20disease%20experience,%20help%20appreciated)

_rdcooking _ (http://profiles.yahoo.com/rdcooking)

Sun May 27, 2012 9:32 am (PDT)

Hi

I need RDs who brains I can pick a bit.

66 yo male, DB

insulin and newly added metformin. s/p 3 months choleycystectomy, still

had radiating pain GI to chest then they did liver biopsy & Dx

Cirrhosis (stopped drinking 12 y ago)

Current Labs (from memory don't have his chart)

ALK Phosp above normal at ~215 Other Liver function tests WNL

Mg low, put on supplement by PCP

Alb. 3.3

Renal WNL, 9some variances/outliers in WBC/RBC low H/H)

About 40 pounds weight loss in past several months, 6'0 " 255. now.

Large belly, states no ascities or frank fluid retention noted. On B/P

meds which is under control.

AIC over 10

Fasting glucose 121

Vit D still low about 16 (was on 50,000 IU 1x wk for about 3 wks, then

had switched to D3 2000 IU/d). Not sure what Vit D level on previous

test was before they started supplementing.

Going to Hepatology center in 10 days.

I told them not to change any supplements yet. Just concentrate on

standard food, decrease saturated fats, decrease animal protein,

increase vegetables and whole grains and get b/s under control. Avoid

salt. Then see what hepatologist says ( and see if fish oil, vit D,

etc. are going to help/hurt/?)

Any insight is great! I haven't had cirrhosis patient in years and then

throw in diabetes.... I

THANKS

Regards,

Lori

Lori Sullivan

OneSourceNutrition

_Lori@onesourcenutriLori@one_ (mailto:Lori@...)

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[Guest guest]

Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

Cirrhosis without encephalopathy:

- Don't restrict protein (1-1.5g/kg/d)

-Administration of complex carbs (non refined ones)

- 30-35 Kcal/kg body weight/day

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation, calcium, zinc, magnesium

Cirrhosis with acute encephalopathy:

- Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of time

possible

- Use branched chain aminoacids (fresenius has oral supplements with those)

- Reindroduce the normal protein ingestion as soon as possible

- If nutritional support is needed use 35Kcal/day/kg at least

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

Cirrhosis with chronic encephalopathy:

- Moderate protein restricion (0.8-1.0g/kg/day)

- Oral supplement with branched chain aminoacids

- Prefer vegetable proteins

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation

Ómega-3 might be useful since reduces inflammation and liver fibrosis but some

authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

On personal experience, and based in some studies done in the decades of 70-80s

that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

Any other question feel free to post or mail me.

Catia Borges, nutricionista

Centro de Saúde Chaves 1

ARS Norte, Portugal

[Guest guest]

Thanks Catia

Appreciate the insight and your suggestions, which I have basically advised.

I want to have him try coconut oil..(pure source is available to me)......though

don't know if enough research to support it.

(He is diabetic).

________________________________

To: rd-usa

Sent: Wednesday, May 30, 2012 4:11 AM

Subject: Re: RDs with Liver disease experience, help appreciated

 

Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

Cirrhosis without encephalopathy:

- Don't restrict protein (1-1.5g/kg/d)

-Administration of complex carbs (non refined ones)

- 30-35 Kcal/kg body weight/day

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation, calcium, zinc, magnesium

Cirrhosis with acute encephalopathy:

- Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of time

possible

- Use branched chain aminoacids (fresenius has oral supplements with those)

- Reindroduce the normal protein ingestion as soon as possible

- If nutritional support is needed use 35Kcal/day/kg at least

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

Cirrhosis with chronic encephalopathy:

- Moderate protein restricion (0.8-1.0g/kg/day)

- Oral supplement with branched chain aminoacids

- Prefer vegetable proteins

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation

Ómega-3 might be useful since reduces inflammation and liver fibrosis but some

authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

On personal experience, and based in some studies done in the decades of 70-80s

that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

Any other question feel free to post or mail me.

Catia Borges, nutricionista

Centro de Saúde Chaves 1

ARS Norte, Portugal

[Guest guest]

Thanks Catia

Appreciate the insight and your suggestions, which I have basically advised.

I want to have him try coconut oil..(pure source is available to me)......though

don't know if enough research to support it.

(He is diabetic).

________________________________

To: rd-usa

Sent: Wednesday, May 30, 2012 4:11 AM

Subject: Re: RDs with Liver disease experience, help appreciated

 

Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

Cirrhosis without encephalopathy:

- Don't restrict protein (1-1.5g/kg/d)

-Administration of complex carbs (non refined ones)

- 30-35 Kcal/kg body weight/day

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation, calcium, zinc, magnesium

Cirrhosis with acute encephalopathy:

- Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of time

possible

- Use branched chain aminoacids (fresenius has oral supplements with those)

- Reindroduce the normal protein ingestion as soon as possible

- If nutritional support is needed use 35Kcal/day/kg at least

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

Cirrhosis with chronic encephalopathy:

- Moderate protein restricion (0.8-1.0g/kg/day)

- Oral supplement with branched chain aminoacids

- Prefer vegetable proteins

- Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

- Water restriction if there is hyponatremia

- Sodium restriciton with ascitis or edemas

- Polivitaminic supplementation

Ómega-3 might be useful since reduces inflammation and liver fibrosis but some

authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

On personal experience, and based in some studies done in the decades of 70-80s

that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

Any other question feel free to post or mail me.

Catia Borges, nutricionista

Centro de Saúde Chaves 1

ARS Norte, Portugal

[Guest guest]

Type 2 or type 1 DM?

How is his HgA1C? Why is he taking metformin together with insulin?

With metformin there is a high chance of vitamin B12 deficiency since it impairs

de production of intrinsic factor.

There is no research on coconut oil in these type of patients, but empirically

speaking it can have advantages.

If he has a bad glucose control I would suggest you try chromium supplements.

LLL courses of ESPEN have alot of info in the metabolic control of these

patients, liver disease and also DM, I suggest you do them. It is free you just

have to register online and they give formation credits.

Catia Borges

>

> Thanks Catia

> Appreciate the insight and your suggestions, which I have basically advised.

>

> I want to have him try coconut oil..(pure source is available to

me)......though don't know if enough research to support it.

> (He is diabetic).

>

>

>

> ________________________________

>

> To: rd-usa

> Sent: Wednesday, May 30, 2012 4:11 AM

> Subject: Re: RDs with Liver disease experience, help appreciated

>

>

>  

>

> Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

>

> Cirrhosis without encephalopathy:

> - Don't restrict protein (1-1.5g/kg/d)

> -Administration of complex carbs (non refined ones)

> - 30-35 Kcal/kg body weight/day

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation, calcium, zinc, magnesium

>

> Cirrhosis with acute encephalopathy:

> - Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of

time possible

> - Use branched chain aminoacids (fresenius has oral supplements with those)

> - Reindroduce the normal protein ingestion as soon as possible

> - If nutritional support is needed use 35Kcal/day/kg at least

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

>

> Cirrhosis with chronic encephalopathy:

> - Moderate protein restricion (0.8-1.0g/kg/day)

> - Oral supplement with branched chain aminoacids

> - Prefer vegetable proteins

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation

>

> Ã " mega-3 might be useful since reduces inflammation and liver fibrosis but

some authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

>

> Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

>

> On personal experience, and based in some studies done in the decades of

70-80s that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

>

> On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

>

> Any other question feel free to post or mail me.

>

> Catia Borges, nutricionista

> Centro de Saúde Chaves 1

> ARS Norte, Portugal

>

>

>

>

>

[Guest guest]

He is morbid obese, though about 50 pounds lost in past 8 mo, so not positive if

type 1 or 2, as many 2's will need insulin.

Yep, he's already on B12.

I don't recall if I know the A1C or not....awaiting the full liver workup.

Thanks I will try to look at ESPEN/ASPEN   (its been a long while since I had a

case list this....I see weight and eating disorders!).

I would worry about the chromium supplement with cirrhosis, actually adding in

any supplement with the liver not functioning that well.  Wouldn't that need to

be concern?

Thanks again, for the continued insight.

Lori Sullivan 

________________________________

To: rd-usa

Sent: Friday, June 1, 2012 4:23 AM

Subject: Re: RDs with Liver disease experience, help appreciated

 

Type 2 or type 1 DM?

How is his HgA1C? Why is he taking metformin together with insulin?

With metformin there is a high chance of vitamin B12 deficiency since it impairs

de production of intrinsic factor.

There is no research on coconut oil in these type of patients, but empirically

speaking it can have advantages.

If he has a bad glucose control I would suggest you try chromium supplements.

LLL courses of ESPEN have alot of info in the metabolic control of these

patients, liver disease and also DM, I suggest you do them. It is free you just

have to register online and they give formation credits.

Catia Borges

>

> Thanks Catia

> Appreciate the insight and your suggestions, which I have basically advised.

>

> I want to have him try coconut oil..(pure source is available to

me)......though don't know if enough research to support it.

> (He is diabetic).

>

>

>

> ________________________________

>

> To: rd-usa

> Sent: Wednesday, May 30, 2012 4:11 AM

> Subject: Re: RDs with Liver disease experience, help appreciated

>

>

>  

>

> Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

>

> Cirrhosis without encephalopathy:

> - Don't restrict protein (1-1.5g/kg/d)

> -Administration of complex carbs (non refined ones)

> - 30-35 Kcal/kg body weight/day

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation, calcium, zinc, magnesium

>

> Cirrhosis with acute encephalopathy:

> - Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of

time possible

> - Use branched chain aminoacids (fresenius has oral supplements with those)

> - Reindroduce the normal protein ingestion as soon as possible

> - If nutritional support is needed use 35Kcal/day/kg at least

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

>

> Cirrhosis with chronic encephalopathy:

> - Moderate protein restricion (0.8-1.0g/kg/day)

> - Oral supplement with branched chain aminoacids

> - Prefer vegetable proteins

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation

>

> Ã " mega-3 might be useful since reduces inflammation and liver fibrosis but

some authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

>

> Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

>

> On personal experience, and based in some studies done in the decades of

70-80s that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

>

> On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

>

> Any other question feel free to post or mail me.

>

> Catia Borges, nutricionista

> Centro de Saúde Chaves 1

> ARS Norte, Portugal

>

>

>

>

>

[Guest guest]

He is morbid obese, though about 50 pounds lost in past 8 mo, so not positive if

type 1 or 2, as many 2's will need insulin.

Yep, he's already on B12.

I don't recall if I know the A1C or not....awaiting the full liver workup.

Thanks I will try to look at ESPEN/ASPEN   (its been a long while since I had a

case list this....I see weight and eating disorders!).

I would worry about the chromium supplement with cirrhosis, actually adding in

any supplement with the liver not functioning that well.  Wouldn't that need to

be concern?

Thanks again, for the continued insight.

Lori Sullivan 

________________________________

To: rd-usa

Sent: Friday, June 1, 2012 4:23 AM

Subject: Re: RDs with Liver disease experience, help appreciated

 

Type 2 or type 1 DM?

How is his HgA1C? Why is he taking metformin together with insulin?

With metformin there is a high chance of vitamin B12 deficiency since it impairs

de production of intrinsic factor.

There is no research on coconut oil in these type of patients, but empirically

speaking it can have advantages.

If he has a bad glucose control I would suggest you try chromium supplements.

LLL courses of ESPEN have alot of info in the metabolic control of these

patients, liver disease and also DM, I suggest you do them. It is free you just

have to register online and they give formation credits.

Catia Borges

>

> Thanks Catia

> Appreciate the insight and your suggestions, which I have basically advised.

>

> I want to have him try coconut oil..(pure source is available to

me)......though don't know if enough research to support it.

> (He is diabetic).

>

>

>

> ________________________________

>

> To: rd-usa

> Sent: Wednesday, May 30, 2012 4:11 AM

> Subject: Re: RDs with Liver disease experience, help appreciated

>

>

>  

>

> Her is a resume of nutritional recommendations, there is alot of papers on it

just do a search on pubmed:

>

> Cirrhosis without encephalopathy:

> - Don't restrict protein (1-1.5g/kg/d)

> -Administration of complex carbs (non refined ones)

> - 30-35 Kcal/kg body weight/day

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation, calcium, zinc, magnesium

>

> Cirrhosis with acute encephalopathy:

> - Transitory restriction of proteins (0.8g/kg/day)for the lowest amount of

time possible

> - Use branched chain aminoacids (fresenius has oral supplements with those)

> - Reindroduce the normal protein ingestion as soon as possible

> - If nutritional support is needed use 35Kcal/day/kg at least

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

>

> Cirrhosis with chronic encephalopathy:

> - Moderate protein restricion (0.8-1.0g/kg/day)

> - Oral supplement with branched chain aminoacids

> - Prefer vegetable proteins

> - Frequent low volume meals (5-7/day),the night fast shouldn't be over 8h

> - Water restriction if there is hyponatremia

> - Sodium restriciton with ascitis or edemas

> - Polivitaminic supplementation

>

> Ã " mega-3 might be useful since reduces inflammation and liver fibrosis but

some authors discuss if it wouldn't increase the oxidative stress since

polyunsaturated fats are easily oxidised. Personally I recommend them together

with the ingestion of food high in AO content.

>

> Probiotic agents have been recommend by some authors as well and considering

their modulation of the gut flora and their role in reducing gut bacteria that

produce ammonia, also reduce fibrosis in NAFL I also recommend the use.

>

> On personal experience, and based in some studies done in the decades of

70-80s that never were done again (no idea why because they showed good results)

ketoacids also work very well in patients with chronic and acute encephalopathy

since they bind to the circulating ammonia. Used those in 2 patients that

entered in comma each 2 weeks and they remained stable until the liver

transplant.

>

> On the side note, but this should be for anyone, avoid food with high-fructose

corn syrup added and simple sugars also avoid trans fats.

>

> Any other question feel free to post or mail me.

>

> Catia Borges, nutricionista

> Centro de Saúde Chaves 1

> ARS Norte, Portugal

>

>

>

>

>

[Guest guest]

I would go for lowest dose ( 500ug, then recommended is 1000 ug), diabetes

increases the needs for chromium, and if he is morbidly obese his nutrient needs

are increased , don't forget the adipocites are metabolic active and consume

nutrients for their functions.

The insulin resitance targes usually muscle cells not adipocites so w/o proper

nourishment those get depleted but the adipocites don't.

[Guest guest]

I would go for lowest dose ( 500ug, then recommended is 1000 ug), diabetes

increases the needs for chromium, and if he is morbidly obese his nutrient needs

are increased , don't forget the adipocites are metabolic active and consume

nutrients for their functions.

The insulin resitance targes usually muscle cells not adipocites so w/o proper

nourishment those get depleted but the adipocites don't.

[Guest guest]

Hi All,

Happy Friday!

I have a thin 12 yo boy who has documented fatty liver,  elevated transaminases,

high triglycerides, sees Liver MD specialist who continue to look for genetics

etc as cause.

Diet was not terribly high in carbs.  Problem is that he is an athlete who plays

over 2 hours most days in high level aerobic sports.

Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

Suggestions?  

Thanks for any input you may have.

[Guest guest]

Was he tested for Celiac?

Sent from my iPhone

> Hi All,

>

> Happy Friday!

>

> I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

>

> Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

>

> Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

>

> Suggestions?

>

> Thanks for any input you may have.

>

>

>

>

[Guest guest]

Was he tested for Celiac?

Sent from my iPhone

> Hi All,

>

> Happy Friday!

>

> I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

>

> Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

>

> Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

>

> Suggestions?

>

> Thanks for any input you may have.

>

>

>

>

[Guest guest]

Was he tested for Celiac?

Sent from my iPhone

> Hi All,

>

> Happy Friday!

>

> I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

>

> Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

>

> Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

>

> Suggestions?

>

> Thanks for any input you may have.

>

>

>

>

[Guest guest]

We checked and he was negative. Thanks for the quick response.

Sent from my iPhone

> Was he tested for Celiac?

>

> Sent from my iPhone

>

>

>

> > Hi All,

> >

> > Happy Friday!

> >

> > I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

> >

> > Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

> >

> > Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

> >

> > Suggestions?

> >

> > Thanks for any input you may have.

> >

> >

> >

> >

[Guest guest]

We checked and he was negative. Thanks for the quick response.

Sent from my iPhone

> Was he tested for Celiac?

>

> Sent from my iPhone

>

>

>

> > Hi All,

> >

> > Happy Friday!

> >

> > I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

> >

> > Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

> >

> > Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

> >

> > Suggestions?

> >

> > Thanks for any input you may have.

> >

> >

> >

> >

[Guest guest]

We checked and he was negative. Thanks for the quick response.

Sent from my iPhone

> Was he tested for Celiac?

>

> Sent from my iPhone

>

>

>

> > Hi All,

> >

> > Happy Friday!

> >

> > I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to look

for genetics etc as cause.

> >

> > Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

> >

> > Have eliminated junk carbs, hfcs, etc. but looking for other suggestions or

resources.

> >

> > Suggestions?

> >

> > Thanks for any input you may have.

> >

> >

> >

> >

[Guest guest]

Agree to R/o celiac. Also, was hemochromatosis ruled out. Cannot rule out

with standard CBC.

Jan Patenaude, RD, CLT

Director of Medical Nutrition

Oxford Biomedical Technologies, Inc. (formerly Signet Diagnostic Corp.)

Telecommuting Nationwide

(Mountain Time)

Fax:

DineRight4@...

Certified LEAP Therapist (CLT) and specialist in inflammation caused by

non-IgE food sensitivity - which causes IBS, migraine, fibromyalgia,

arthritis and more. Co-author of the Certified LEAP Therapist Training Course

-inexpensive CPE for the RD and learn how to use the Mediator Release Test

(MRT)

and implement the LEAP Diet Protocol.

Your email is important to me. If you send me an important email, and I

don't respond in 2 business days, PLEASE give me a call. Some weeks, I get

buried in email and I do not mean to ignore your email.

In a message dated 7/7/2012 4:15:20 A.M. Mountain Daylight Time,

rd-usa writes:

_Re: RDs with Liver disease experience, help appreciated _

(http://groups.yahoo.com/group/rd-usa/message/28597;_ylc=X3oDMTJzMG5uMG92BF9TAzk\

3MzU5NzE1BGd

ycElkAzEwMDM1NTQ3BGdycHNwSWQDMTcwNTA2MTIwOQRtc2dJZAMyODU5NwRzZWMDZG1zZwRzbGs

Ddm1zZwRzdGltZQMxMzQxNjU2MTE2)

Fri Jul 6, 2012 3:07 am (PDT) . Posted by: _ " " cathydavis23 _

(mailto:cathydavis23@...?Subject=

Re:%20RDs%20with%20Liver%20disease%20experience,%20help%20appreciated)

Hi All,

Happy Friday!

I have a thin 12 yo boy who has documented fatty liver, elevated

transaminases, high triglycerides, sees Liver MD specialist who continue to

look

for genetics etc as cause.

Diet was not terribly high in carbs. Problem is that he is an athlete who

plays over 2 hours most days in high level aerobic sports.

Have eliminated junk carbs, hfcs, etc. but looking for other suggestions

or resources.

Suggestions?

Thanks for any input you may have.