| The
question and answer below highlights the Virtual Faculty at Jennifer
Jensen's Nutrition Power web site.
Question: Controlling
Liver Enzymes
My liver enzymes began
climbing about five months ago. (I had started a new drug cocktail.) I
began to panic, because the HIV specialist was getting very concerned and
wanted to switch my drugs yet again! In any case, I started the supplement
regimen suggested by your faculty and have been taking (among other things)
600 micrograms (mcg) of selenium daily. My liver enzymes are slowly normalizing
(YEAH!!!), however, I remember hearing somewhere that prolonged use of
selenium at anything above 200 mcg can be toxic. Any views on this would
be extremely helpful. I have been taking 600 mcg of selenium with the other
supplements like N-acetyl cysteine (NAC), Alpha Lipoic Acid etc., for about
two months now. (January, 2002)
Answer: Charlie
Smigelski, RD/N responds: It is nice to hear that good nutrition
does work!!! I think that 2 grams NAC and 100 mg or 200 mg of Alpha Lipoic
Acid are probably doing the most for your liver. You didn't mention L-glutamine,
but 5 to 10 grams per day of that would be good too.
Selenium at 600 mcg may
be a bit more than you need, though not toxic at that level, even over
time. I do recall speaking to Jennifer about this very subject. Unless
you are co-infected with a Hepatitis, besides HIV, I would drop back to
400 mcg per day of selenium, just to save $$ and pill burden.
Question #2: Fatty
Liver?
Is burning on the arch
of the foot ever a result of fatty liver? (July, 2001)
Answer: Charlie Smigelski,
RD/N responds: I have never heard of any fatty liver symptom expressed
in the arch of the foot. A medical literature review does not show any
case reports either.
The patient may have side
effects to anti-HIV drug therapy, which is both causing fatty liver problems,
and some neuropathies at the same time. A common symptom of neuropathy
is burning feeling in the whole foot, but not specifically the arch.
Question #3: Liver
Cirrhosis
What diet is appropriate
for a liver cirrhosis patient (alcohol) with heavy liver damage (70-80%)
with ascites and edema complications? (May, 2000)
Answer: Donna Tinnerello,
MS, RD, CD/N responds:
Cirrhosis and Diet
In liver cirrhosis normal
functional tissue is gradually destroyed and replaced by inactive fibrous
connective tissue (scar tissue). The liver is contracted and has lost most
of its function. The growth of abnormal tissue limits function by interfering
with blood flow through the liver.
One of the complications
of liver cirrhosis is ascites- this is the accumulation of fluids in the
abdominal area (peritoneal cavity). Ascites, because it causes pressure
on the chest cavity, can cause shortness of breath. It can also cause peritonitis,
a life threatening condition. Sodium restriction is critical - 2-4 grams/day.
That means not adding salt to your food or eating processed foods like
cold cuts, pickles, salted chips, etc. Unfortunately, diet therapy is not
enough for most patients, and pharmacological measures (e.g. water pills)
are usually necessary. If neither sodium restriction or water pills can
get rid of the fluid, a procedure called paracentesis is guaranteed to
work. This is extraction of the fluid by needle. It sounds painful, but
people feel so much better afterwards that they soon forget any pain involved
in this procedure.
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