Dr. Bob Rountree discusses Non-Alcoholic Fatty Liver Disease (NAFLD) with Dr. Ben Weitz.

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Podcast Highlights

0:53  Non-alcoholic Fatty Liver Disease is the leading cause of liver disease in the US, even though many people have not heard of this condition.  75% of patients who are overweight have this condition, which consists of an accumulation of fat in the liver. Nonalcoholic fatty liver disease, NAFLD, is an asymptomatic condition, but it can progress to non-alcoholic steatohepatitis which can lead to fibrosis, cirrhosis, liver cancer and liver transplantation. Dr. Rountree described it as a tsunami that no one’s paying attention to.  Technically, the definition is when 5% of your liver tissue is replaced with fat.  What is usually seen first is that one of the liver enzymes (AST, ALT, or GGT) is mildly elevated on a blood test.

8:25  It’s not just that the liver stores fat, but it produces new fat.  We know how to create fatty liver, which is when we produce fois gras.  We do this by force feeding the goose or duck grains, which is turned into fat by the liver. It’s eating sugar and carbs and esp. high fructose corn syrup, that turn on genes in the liver that cause fatty liver and not eating fat that causes this. Big Pharma is investing billions of dollars trying to develop drugs to reverse the progressive form of fatty liver, known as Non-Alcoholic Steatic Hepatitis (NASH). Technically speaking, fatty liver doesn’t hurt you, but a percentage of people with fatty liver will develop fibrosis because the inflammatory pathways have been turned on–an auto-inflammatory process. If you lay down enough scar tissue, eventually you end up with cirrhosis or possibly liver cancer.  It is expected that within the next 5-10 years, NASH will be the number one cause for liver transplants.

13:20  Studies show that when you track patients with fatty liver, they have much a higher incidence of mortality from other diseases. [Here is a good review paper on this topic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397356/?fbclid=IwAR19ujpU2qfD7mFaV-bAM96oN_SNZRoHiXb1BU3AbRM7xE4BLUmPUl-RW0g] The number one marker for this is C-reactive protein (HsCRP) and you start to worry especially when it is above 3. We also know that gum disease, like the existence of a bacteria known as Porphyromonas gingivalis in the gums, increases this risk.  Also dysbiosis of the gut increases inflammation and leads to fatty liver. 

15:56  We diagnose fatty liver first by measuring liver enzymes on a blood test, esp. ALT, AST, and GGT.  ALT and AST are called transaminases because they move amino acids around–they’re part of the digestion process.  Dr. Rountree feels that GGT, (Gamma-glutamyl transpeptidase), is a more sensitive test, though it is often not tested. GGT is an enzyme involved with glutathione metabolism.  But when you discover that these enzymes are elevated, you must first make sure that they don’t have a virus, that they haven’t taken too much Tylenol, or have some other toxic exposure.  After ruling these out, if you are suspecting Fatty Liver, then you should order an ultrasound.  A biopsy would be more definitive, but nobody wants to have this procedure done.

19:37  Elevated triglycerides indicate a condition we call Metabolic Syndrome, which Dr. Rountree believes is an intersection between several different biochemical pathways that have gone awry, and at the core is a person who’s over-producing triglycerides.

Dr. Al Danenberg talks about his Journey with Cancer with Dr. Ben Weitz.

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Podcast Highlights

3:20  Dr. Danenberg explained that he’s 71 years old and he has been a practicing periodontist for 44 years.  He wasn’t always a really healthy guy, but about 6 years ago he became primal (paleo) in his nutrition and lifestyle and dropped 30 lbs.  He was able to get off all of his medications and he was feeling great and was speaking at conferences about the paleo, primal lifestyle.  He was doing a seminar at a dental group in April 2018 and he was walking through the Atlanta airport and was carrying a heavy bag and felt some pain in his shoulder. Then he started to get some back pain and then he started to get a lot of pain in his chest and rib cage area. He though his pains would just go away but then in September 2018 he went to see his primary care MD and he had some blood work and everything was normal except he had an elevated CRP (3.5 or 4 instead of his normal 0.5).  Then he had an MRI and his doctor told him that he probably had either Lymphoma, Leukemia, or Multiple Myeloma. And there was a soft tissue mass next to his spine, two broken ribs, a cracked vertebra, and a cracked pelvis. He saw an oncologist and on September 19th, 2018 he was diagnosed with IgA Kappa Light chain Multiple Myeloma, which is a very aggressive form of cancer. The radiologist told him he had multiple lytic lesions throughout his entire spine, his ribs, and his pelvis. His bone is literally dissolving away, since the malignant plasma cells are creating a cytokine reaction and Interleukin 6 is destroying the bone. His oncologist recommended that he do a cocktail of chemotherapy and IV bisphosphonates to strengthen the bone and some focused radiation to his sternum for the severe pain he had there.  At some point, a bone marrow transplant would also be recommended, but the oncologist explained that this is not a curable disease. The oncologist explained that he would do better for a little bit but then the Multiple Myeloma would retake over and eventually he would die from the complications of the Multiple Myeloma.  This oncologist also told Dr. Dananberg that if he did not follow this course of treatment, that he would be dead in 3 to 6 months.

Dr. Danenberg decided that since it was almost certain that he would die from this disease, that he didn’t want to put himself through this chemotherapy that would tremendously decrease his quality of life and his family would have to deal with this dread for an extended period of time till he died.  He also didn’t want his wife to be saddled with 100s of thousands of dollars of medical bills after he was dead. He did agree to do some focused radiation to his sternum, which did decrease the sharp pain he was having there.  He decided to follow an integrative, alternative plan using diet and nutritional supplements and so far he feels great and has a good quality of life.  He feels his natural plan is starting to work but he understands that he could die next week.

12:40  Dr. Danenberg addressed the question of why he might have developed this cancer when he was leading such a healthy lifestyle.  He pointed out that when he went to dental school 45 years ago he was exposed to a lot of ionizing radiation from all the x-ray machines and being in the dental office all days for six years. Some research does show that dentists have a higher incidence of multiple myeloma. The other factor is that he was trained, like most dentists are, to put in mercury fillings. when Dr. Danenberg went to school they used to take the liquid mercury and mix it with some powder to make an amalgam.