DR MICHAEL MOSLEY: Why spidery writing could mean you've got liver disease 

2 months ago 19

Signs of serious liver problems include tiredness, confusion, itchy skin and, according to the British Liver Trust, ‘writing which becomes difficult, spidery and small’, writes Dr Michael Mosley, pictured

Large, the size of a rugby ball, rubbery and reddish-brown in colour, your liver is not a glamorous organ.

Yet it quietly gets on with performing at least 500 vital functions, including removing toxins from your blood and helping convert the food you eat into energy, and you certainly couldn’t live without it.

The bad news is that around one in three of us now has signs of fatty liver disease — which, as the name suggests, is the result of a build-up of fat which can lead to scarring and the liver becoming stiff and unable to function properly and, eventually, to liver failure. 

Even if you avoid this extreme, a damaged liver is bad for your health. And because so many of us treat our livers badly, liver disease is now a leading cause of premature death in the UK.

But it is a largely silent killer because most people don’t know they’re at risk until too late. 

Signs of serious liver problems include tiredness, confusion, itchy skin and, according to the British Liver Trust, ‘writing which becomes difficult, spidery and small’. Perhaps a sign that toxins are reaching the brain.

One bit of good news is that your liver has amazing powers of regeneration and a recent study from Sweden has shown that going on the 5:2 diet, something I’ve long advocated, is a safe and effective way to slim a fatty liver down and restore it to health.

Drinking too much alcohol used to be the main cause of liver failure, but these days it is more likely to be the result of non-alcoholic fatty liver disease (NAFLD) — and the high rates we have in the UK are mainly the result of our rapidly expanding waistlines.

This is because when we put on weight, the fat is not evenly distributed throughout our bodies.

You don’t, for example, develop fat feet or a fat forehead. Instead, surplus calories are stored in fat cells on your bottom, thighs, stomach, and under your skin. But beyond a certain point, your body runs out of ‘safe’ places to store the fat.

So, it begins to stuff some of that fat into your liver. Ideally, this should have almost no fat. If your liver is above 5 per cent fat, officially, you have a fatty liver.

A while ago, while making a documentary, I saw a young man, significantly overweight, whose liver was nearly 60 per cent fat.

One bit of good news is that your liver has amazing powers of regeneration and a recent study from Sweden has shown that going on the 5:2 diet, something I’ve long advocated, is a safe and effective way to slim a fatty liver down and restore it to health

As there are few signs of early fatty liver disease, the only way it can be detected reliably is with an ultrasound scan or a blood test, called a liver function test, which measures enzymes and proteins that build up in the blood when the liver is damaged. The young man in the documentary had no symptoms, and only found out he had a fatty liver with a scan.

You’re at greater risk of NAFLD if you are over 50, have a large waist, or smoke (there are chemicals in tobacco that are toxic to liver cells). It’s also more common in people who have type 2 diabetes, high blood pressure, high cholesterol or all three. But you can have none of these and still have fatty liver disease. Nine years ago, I had an MRI scan as part of a documentary I was making, and discovered my liver was streaked with fat.

Although, at the time, I didn’t look overweight, it turns out that I was a TOFI — thin on the outside, fat inside. The only sign that I was carrying too much internal fat was my 37in waist, which was relatively large for my height (I’m 5ft 11in) – my waist is now around 34in.

Ideally your waist should be less than half your height. The NHS recommend losing weight if your waist is 37in or more for men, and 31.5in or more for women.

Around that time I also discovered I had type 2 diabetes, and the two were almost certainly related. I put myself on the 5:2 diet (cutting my calorie intake to about 600 a day twice a week, then eating as normal on other days) and in a couple of months I shed nearly 20lb, and reversed both my fatty liver disease and type 2 diabetes.

So I wasn’t surprised by the results of a recent study from the world famous Karolinska Institute in Sweden on the 5:2 and fatty liver. 

The researchers randomly allocated patients with non-alcoholic fatty liver disease to the 5:2 diet, a low-carb high-fat (LCHF) diet, or were given general lifestyle advice from a hepatologist (a liver expert).

After 12 weeks, those on the 5:2 and the LCHF diets had not only lost an average of 16lb (7.4kg), three times as much weight as those following standard lifestyle advice, but there was a bigger fall in thier levels of liver fat.

The dropout rate was lowest in the 5:2 group, suggesting it was the easiest diet to stick to. It was also the only one of the three that led to significant improvements in cholesterol and liver stiffness, a measure of damage.

I suspect the reason the two dieting groups did better is because they lost more fat overall. As for liver stiffness, intermittent fasting has been shown to reduce inflammation, which may be key.

If you’re worried you might have a fatty liver, talk to your GP and perhaps have a blood test. If it turns out you do have problems then at least you now know what to do about it. Liver damage is reversible, but it is obviously better to start sooner rather than later.

Rinse after brushing your teeth? Most people (62 per cent) do, according to one poll.

Big mistake: if you do, you’re washing away the fluoride in your toothpaste. If you spit, then more of that fluoride will hang around, strengthening your tooth enamel. For similar reasons, using a mouthwash after brushing is also a no-no.

As for flossing, you should always do it before brushing, suggests a study by dentists in Iran. They found that the floss-then-brush approach not only removes more plaque but flossing after brushing, means the food, plaque, and bacteria you’ve released lingers in your mouth all night long.

I’ll soon be running, but cursing other runners under my breath! 

Spring is on its way and fair weather, runners across the country will be dusting off their trainers and reluctantly running again.

I say ‘reluctantly’ because many people, myself included, run because they feel they should, not because they enjoy it. And I am jealous of those who get a ‘high’ while doing it.

For years we’ve been told this is caused by endorphins, feel-good chemicals produced by your body that mimic the action of opioid drugs. In fact, while the high is real, it has nothing to do with endorphins, according to a new study from the University Medical Center in Hamburg, Germany.

The researchers took 63 runners who all claimed to experience the ‘high’, and gave them either an injection of naloxone, a drug that blocks the uptake of opioids, or a placebo jab.

After a 45-minute run, most of the runners still reported getting the high, which suggested it wasn’t the endorphins. It turned out it was due to a rise in endocannabinoids, chemicals that mimic the actions of cannabis (and are thought to play a role in mood).

A few years ago I did a similar experiment with Dr Saoirse O’Sullivan, a physiologist from Nottingham University, where we tested three runners and detected a 30 per cent rise in their endocannabinoid levels after exercise.

One, who suffers with depression, told me she self-medicates by running. As Dr O’Sullivan explained: ‘We’re mentally and physically healthier when we exercise, so having a reward system for exercise would seem like a good evolutionary thing.’

But we don’t all get the buzz. Tests show that my endocanna-binoid levels don’t rise after exercising. Nonetheless, because I believe in the health benefits, I continue to run, while cursing the happy runners who sprint past me.

Many people, myself included, run because they feel they should, not because they enjoy it. And I am jealous of those who get a ‘high’ while doing it [File photo]

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