Dr. Elizabeth Boham
Appearances
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So we want to really help focus the treatment plan on that individual patient. And I think that's what's so special about functional medicine is it's really looking for that underlying root cause for that underlying patient so that they can reach their optimal health. And we know that problems with the liver and fatty liver impact our immune system and how well we fight off infections.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
It impacts how we can digest food, metabolize food. It impacts our nutritional state in our body. So there's so many reasons why we really want to
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Fatty liver is when the liver cells, the cells in your liver are replaced with fat cells. So fatty liver just means that some of the cells in your liver have been replaced with fat cells. And so there's fat deposited within your liver. Why do we care? Because then that means your liver can't work as well because it doesn't have all those liver cells doing the job that the liver does, right?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Look deeper here.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So the liver really helps our body detoxify, metabolize chemicals from the environment, metabolize our own hormones, metabolize and get rid of toxins. And so we definitely don't want to have an under-functioning liver, that's for sure. And this is the prevalence of fatty liver disease.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
is is is it is it is really really high and unfortunately it's increasing um but about 90 million people in the u.s have fatty liver disease and so that's uh it's and it's increasing in this country it's increasing worldwide the amount of fatty liver we are seeing so um
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Yeah. So. I had a 50 year old gentleman who came in to see me and he was told by his primary doctor that his liver function tests, his ALT and AST were mildly elevated. And so he came in because he was frustrated with his weight. He wanted to lose some weight. He was about 25 pounds overweight.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We're seeing this huge rise in fatty liver, not only because of alcohol, but because of how high blood sugar, high levels of insulin, toxins like glyphosate and all the other toxins you mentioned, medications that people are taking, all are putting stress on our liver.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And he just mentioned to me that his doctor had said his liver function tests were a little elevated and that they were gonna be rechecking them in a few months.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so, you know, we really got a good detailed history from him and we got a sense of what he was what his diet was like and and and, you know, what his what his alcohol consumption was like, because, you know, that's one of the first things, of course, we think about with, you know, fatty liver or.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
or these elevated liver function tests were like, okay, how much alcohol is this person consuming? And what was interesting to me about him was he was pretty moderate in his alcohol consumption. He was having about two glasses of wine a night. And so not for a man, that kind of almost falls within what's considered moderation. So I was, um, you know, he was not a binge drinker.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
He was not overusing alcohol from the, from the criteria we were talking about earlier, but I think the amount of alcohol he was consuming in, in connection with his diet and probably his genetics and many other things like his microbiome that we've spoken about, you know, that altogether was really impacting these liver functions for him. And so, um,
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We noticed with his diet, it was not rich enough in vegetables, that's for sure. And really, that was probably the biggest thing I would say with his diet. It was just devoid of a lot of vegetables. And you were talking about some of the things, supplements we use for... helping the liver. You know, one of the things we think a lot about is sulforaphane, right?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Which comes from your cruciferous vegetables that helps and encourages the production of glutathione in the body. And so one of the things we really worked on with him is making sure he got some cruciferous vegetables every day, broccoli, cauliflower, cabbage, kale, Brussels sprouts, you know, really to help support, uh, the, uh, liver and help it heal. Essentially.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We also had him take a break from alcohol. You know, we said, you know, let's just pull away alcohol for a period of time, really help that liver heal. calm down and let it give us some time to heal. And as I was mentioning earlier, we really can see the liver function tests go down pretty quickly for some patients.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We can see if somebody did have fatty liver, you can watch it improve within a few weeks of cleaning up the diet and, and decreasing alcohol intake. So it's, it's, it can be, especially if it's not too far progressed, we can see changes pretty darn quickly. And so with him, we really focused on cruciferous vegetables, lots of the sulfurous vegetables like onions and garlic.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
We gave him turmeric, we gave him dandelion root to help his liver and gallbladder work better, lots of green leafy vegetables. we made sure he was eating enough protein. We know that protein is really important for the detoxification process in the body. We need to be eating enough protein to do that.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so we made sure he was getting enough and foods that were rich in fiber to bind toxins, things like the beans and legumes and nuts and seeds, ground flaxseed. And I did, I gave him some N-acetylcysteine, some NAC. I gave him some liposomal glutathione and milk thistle. We put him on a really good multi that had methylated B vitamins in it.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
I gave him a little bit of an extra methylated B vitamin and really focused on those nutrient dense foods so that he wasn't wasting his calories because he was 25 pounds overweight and we needed to cut back on that weight. So we really needed to pull away those foods that were not nutrient dense.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So things that are just people are eating way too much of that are getting into our diet that are not giving us all of the nutrients the body needs to work properly.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Yeah, I mean, within four months on the plan, his liver functions came down to totally normal. He lost 10 of those pounds, and then within a few more months, he lost another 10 pounds. And his fasting insulin came down to normal. His liver function tests, his – his markers of inflammation in the body improved. And then eventually, I've been seeing him for a while.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So at this point, he does have one or two glasses of wine a few days a week. He does drink some alcohol at this point. He never, as I said, he never had a problem with alcohol abuse or alcohol overuse disorder. It just was, he was drinking too much for his body. And so at this point in time, he's having a little bit of alcohol and doing okay with that.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And it's not causing a bump in those liver function tests or some problem with his weight or insulin resistance anymore. So he did really well.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Right. I mean, they can happen quickly. Fatty liver can develop quickly. They know that within two weeks of heavy drinking, having one and a half to two ounces of hard alcohol every day for two weeks, you can start to see signs of fatty liver, which is, you know, It can develop very quickly. What's great to also understand within a lot of this research is that it can resolve quickly.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So when somebody has fatty liver because of alcohol and you take them off of alcohol, that you can see resolution of fatty liver within four to six weeks. So that is interesting. It can progress, unfortunately, quickly if we're not taking care of ourselves. And then it also regresses when we start to make some shifts.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And as you were mentioning, we're seeing this huge rise in fatty liver, not only because of alcohol, but because of how high blood sugar, high levels of insulin, toxins like glyphosate and all the other toxins you mentioned. medications that people are taking all are putting stress on our liver and making it so then our liver can't do what it needs to do to detoxify.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So it becomes this vicious cycle of we're inundated with toxins that are impacting our liver, but then the liver can't work as well. And so then we can't get rid of the toxins that we're inundated with. So it becomes a vicious cycle of having issues with our detoxification system in our body.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And as we've spoken about before, the liver is such a critical organ within the body's natural ability to detoxify and handle all the toxins we're exposed to. Maybe we weren't put together to handle all of these toxins, unfortunately, that we're exposed to, but we do have this ability to handle toxins and we wanna take care of our body so we can handle the toxins that we are exposed to.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
And so it's really important that we take care of our liver. And so what's considered normal for alcohol intake? For men, it's less than 10 drinks And for women, it's less than five drinks a week. And so we know that problems with the liver can occur when we're drinking too much.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So we see problems when people are binge drinking or consuming more than 14 drinks a week for men or more than seven drinks a week for women. So I think it's important we also talk to our patients about what is moderation with alcohol? How do we take care of our liver, both from all aspects of nutrition and lifestyle?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
You know, one of the first ways we find out is with general blood work. So if you do a metabolic panel, comprehensive metabolic, a panel on a patient, and we look at these markers like the AST and the ALT, and if they're elevated, either high end of normal or elevated above the normal range, you know, that's something we really have to be thinking about is, is this fatty liver?
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Should we go on and do an ultrasound? of the liver to see if we are seeing some fat deposition in the liver. And so that's one of the ways we start to see it most frequently with our patients.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
I mean, one of the first things we do, right, is of course we get a good detailed history from our patients. and try to get a sense of what's going on for them. Get an understanding of their timeline of their health. And that can help us find out what may be driving health problems in that person.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
So if there is some concerns about fatty liver, you wanna get a sense of what their toxic load has been in their lifetime. What is their weight? What is their nutrition? What are they eating? And what is their microbiome like? And so we can really evaluate all of that. and get a sense of how best to help this patient, that individual patient improve.
The Dr. Hyman Show
Fatty Liver Is the New Smoking—And 90 Million Americans Have It
Because we know that for some people, it may be more focusing on toxic load. For somebody else, it may be focusing more on alcohol intake. For somebody else, it may be more they're eating way too many carbohydrates, refined sugars, soda, you know, coffee drinks, muffins, and not exercising enough, and that whole metabolic syndrome process.