Managing Elevated Liver Function: Concerns and Dietary Strategies

Liver function indices are not decreasing significantly?

I am a carrier of hepatitis B, and recently my liver enzyme levels have risen to 185.
I have been taking Bixikang for a month, taking it before each meal, but my enzyme levels have only decreased by 10.
My doctor mentioned that I have moderate fatty liver, which is considered chronic inflammation.
I am concerned that after a month of medication, the reduction in enzyme levels is minimal (currently, I can only try to improve my diet; since I often eat out, I can only choose vegetables, consume white meat, and limit starches and desserts).
I would like to ask if incorporating some fat-reducing teas, such as hawthorn rose tea or hawthorn black plum tea, could negatively affect my liver function and cause my enzyme levels to rise instead of fall.
Additionally, my doctor informed me that due to regulations from the National Health Insurance Bureau, I need to continue taking Bixikang for three months before reassessing my condition.
However, I would like to know if I can switch medications or pay out of pocket for a different medication after one month of unsatisfactory results.

Yang Mie Mie, 40~49 year old female. Ask Date: 2023/09/13

Dr. Chen Shidian reply Gastroenterology and Hepatology

There are no liver-protective medications covered by health insurance available for exchange; if willing, you can pay out of pocket for hepatitis B antiviral medication for 3 years or more.
Regular food has no significant impact, but it is advisable to avoid traditional Chinese medicine.

Reply Date: 2023/09/13

More Info

Managing elevated liver function, especially for individuals with chronic conditions such as hepatitis B and fatty liver disease, requires a comprehensive approach that includes dietary modifications, lifestyle changes, and careful monitoring of medication. Your situation, where liver enzyme levels have only slightly decreased after a month of treatment, is understandably concerning. Here are some strategies and considerations to help manage your liver health effectively.

Dietary Strategies
1. Balanced Diet: Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins. Since you mentioned that you are already trying to eat more vegetables and lean meats, continue this practice. Aim for a variety of colors on your plate, which indicates a range of nutrients.

2. Limit Saturated Fats and Sugars: Reduce your intake of saturated fats found in red meats and full-fat dairy products, as well as sugars from sweets and sugary drinks. Instead, opt for healthy fats such as those found in avocados, nuts, and olive oil.

3. Hydration: Staying well-hydrated is crucial for liver health. Water is the best choice, but herbal teas can also be beneficial. However, be cautious with herbal teas like hawthorn and rose tea, as some herbal ingredients can interact with medications or affect liver function. Always consult with your healthcare provider before introducing new herbal remedies.

4. Portion Control: Since you are aiming to lose weight, controlling portion sizes is essential. Eating smaller, more frequent meals can help manage hunger and reduce the likelihood of overeating.

5. Avoid Alcohol: Given your liver condition, it is vital to abstain from alcohol entirely. Alcohol can exacerbate liver damage and hinder recovery.

Lifestyle Changes
1. Regular Exercise: Incorporating regular physical activity can help reduce liver fat and improve overall health. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, along with strength training exercises on two or more days a week.

2. Weight Management: Since you are aiming to lose weight, focus on gradual weight loss (1-2 pounds per week is considered safe). Rapid weight loss can actually worsen liver function, so a steady approach is best.

3. Sleep Hygiene: Ensure you are getting adequate sleep, as poor sleep can negatively impact liver health and overall well-being. Aim for 7-9 hours of quality sleep each night.

Medication Management
1. Follow-Up with Your Doctor: Since your liver enzyme levels have only decreased slightly, it is essential to maintain open communication with your healthcare provider. Discuss your concerns about the effectiveness of your current medication (比喜肝) and whether a change is warranted. Your doctor may suggest continuing the medication for the recommended duration before making any changes, but it is important to express your concerns.

2. Monitor for Side Effects: Be aware of any side effects from medications and report these to your doctor. If you experience adverse effects, your doctor may consider alternative treatments.

3. Regular Monitoring: Regular blood tests to monitor liver function are crucial. This will help assess the effectiveness of your treatment and make necessary adjustments.

Conclusion
Managing elevated liver function, particularly in the context of chronic hepatitis B and fatty liver disease, requires a multifaceted approach that includes dietary changes, lifestyle modifications, and careful medication management. While it can be frustrating to see only a slight decrease in liver enzyme levels after a month of treatment, it is important to remain patient and committed to your health plan. Always consult with your healthcare provider before making any significant changes to your diet or medication regimen. They can provide personalized advice based on your specific health needs and conditions.

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