Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

New hope for fatty liver in overweight, its natural too: L-carnitine

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L-carnitine and fatty liver (NASH, NAFLD) 

By A. Minocha MD, author: Guide to Alternative Medicine and the Digestive System

Nonalcoholic steatohepatitis (NASH) or nonalcoholic fatty liver disease also known as fatty liver is a growing menace especially with the increase in prevalence of metabolic syndrome and obesity. There is paucity of treatments for effective treatment for NAH or fatty liver and many of these patients go on to liver cirrhosis and need liver transplantation. By the way, aA recent study published in the New England Journal of Medicine showed vitamin E to be of benefit.   

Mechanism of action:  L-carnitine adminsteration can affect  multiple metabolic pathways resulting in modifications of lipid profile, and altered glucose metabolism, oxidative stress, and inflammatory reaction. 

 

Authors and study design:  Malaguarnera et al. from the University of Catania, Italy conducted a randomized controlled trial to examine the role of L-carnitine supplementation on reversing the severity of NASH or fatty liver. 

 

Study: Subjects received 1-g L-carnitine tablet after breakfast plus diet and one 1 g tablet after dinner plus diet for 24 weeks or diet alone. Liver tests, as well as levels of  lipids, profile, fasting plasma glucose, C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, were measured. Histological scores on liver biopsy specimens were also compared.   

 

Study results: As compared to the controls, patients in treatment group demonstrated superior results on aspartate aminotransferase (AST),  alanine aminotransferase (ALT), gamma-glutamyl-transpeptidase (gamma-GT) , total cholesterol,  low-density lipoprotein (LDL) as well as  high-density lipoprotein, triglycerides (P=0.000), fasting glucose,  C-reactive protein (CRP) and tumor necrosis factor-alpha ( TNF-alpha) levels. This was accompanied by a significant improvement in histology scores on liver biopsy.   

Conclusions: L-carnitine administration helps  reduce inflammatory activity as manifested by effect on TNF-alpha and CRP, along with  improvements in liver function, metabolic functions, better lipid profile along with improved liver histology architecture.

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Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Helicobacter pylori and migraine headache

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By A. Minocha MD, author: Guide to Alternative Medicine and the Digestive System

Helicobacter pylori infection has been implicated in numerous disorders including vasomotor dysfunction in patients with Raynaud's and cardiovascular disease and may be an uncommon or uusual cause of migraine.

Studies by Hong and colleagues demonstrated that eradication of Helicobacter pylori reduces intensity, duration, and frequency of episodes migraine in patients with Hepatitis B related liver cirrhosis. The authors speculated that H. pylori antigens cause intermittent vasospasm of arterioles thus leading to migraine-type attack and the reduction of these vasoactive substances upon eradication provides protection against migraine attacks.

Gasbarrini and colleagues showed that H. pylori is found in 40% of patients with migraine which is similar to controls. However, among infected subjects, a significantly higher prevalence of the more virulent CagA-positive strains was seen among those complaining of migraine with aura as compared to those suffering from migraine without aura (41% vs. 19%, P<0.01) and with controls (41% vs. 17%, P<0.01).

 Yiannopoulou and colleagues argue that H. pylori infection is a probable independent environmental risk factor for migraine without aura, especially in patients that are not genetically or hormonally susceptible to migraine.

Of note, H. pylori has been implicated in numerous non-gastrointestinal disorders. However, the causal relationship has been difficult to establish in most cases.

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 Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Alcohol beverages and body weight

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Want to lose weight? I will drink to that!

By A. Minocha MD, author: Guide to Alternative Medicine and the Digestive System

According to Dennis and colleagues, evidence indicates that increased intake of water and other energy-free beverages may help you accomplish your goal of weight management. Although calorie-dense beverages acutely increase caloric consumption, jury is still out on their long term impact on body weight.

Some people avoid alcohol in order to avoid the calories that come with it. Now comes a study debunking this myth about alcohol and weight gain, at least to a limit.

Women who drink moderate amounts of alcohol are unlikely to gain as much weight in midlife as compared to women who abstain from alcohol. Investigators at Brigham and Women’s Hospital in Boston based their conclusions on analysis of data from 19,220 women enrolled in a long-standing Study. Comparison with women who do not drink revealed that those who imbibed 1.5 to 3 alcoholic drinks daily had a significantly reduced risk of becoming overweight or obese.

This study should not be interpreted as a blank check for the nearest bottle. While moderate drinking is good for heart as well, its risks for health otherwise would not be forgotten, e.g. liver, cancer etc. And of course it has potential to affect social life so drink responsibly! Because of biological differences, the generally acceptable healthy limit for women is one drink per day as compared to two drinks per day for men.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Hepatitis C: pot of coffee or just pot?

Treatment for hepatitis C is frequently accompanied by numerous side effects and patients try various kinds of modalities to counteract them.

Researchers from University of California recently presented preliminary data on the effect of coffee and marijuana on the liver in patients with hepatitis C. This presentation was part of the annual AASLD meeting (2006).

Dr. Ishida and colleagues studied HCV infected patients and correlated their coffee, alcohol and marijuana use with liver tests.

These investigators found that while cannabis is harmful in hepatitis C (HCV) infected patients, drinking three cups of coffee a day actually protects liver. The protective effect is thought to be due to the antioxidant properties. Alcohol is also harmful, although not as much as the pot is!

Do you or someone you know has hepatitis C. What was your experience with the treatment? What did you do to combat side-effects if any?

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Hepatitis C: another indication for marijuana?

Marijuana has been touted in past for a variety of reasons including its potential use in cancer patients. Now comes a study documenting its benefits for treatment of hepatitis C.

Dr. Sylvestre and colleagues from the University of California in San Francisco studied the effect of symptomatic relief provided by concomitant cannabis use and the outcome of treatment of hepatitis C. They published their findings in the European Journal of Gastroenterology and Hepatology.

It was a prospective observational study of standard interferon and ribavirin treatment in 71 recovering substance users, of whom 22 used cannabis.

These investigators found that fewer of cannabis users discontinued therapy (5% versus 33%). On the other hand, cannabis users had a much higher sustained virological response (54% versus 18%).

The authors concluded that modest cannabis use promotes adherence to therapy leading to better symptomatic and virological response.

What are your thoughts about medicinal use of marijuana? Have you tried it for recreational use? What are your thoughts on laws regulating its use especially for terminally ill cancer patients?

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger