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About Lyn Patrick, ND
Dr. Lyn Patrick ND graduated from Bastyr University in 1984 and has been in private practice in Colorado and Arizona for 25 years. She is past Contributing Editor for Alternative Medicine Reviews and has lectured internationally in the areas of fatty liver disease, cardiometabolic syndrome, environmental medicine and metal chelation. She is currently a Medical Director for Progressive Medical Education, an online provider of continuing medical education and a FacultyMember of the ACAM Chelation Advanced Providers Course. She is currently President of the Naturopathic Academy of Environmental Medicine, a specialty organization open to all licensed healthcare providers, that provides education and community resources to clinicians who encorporate toxicant exposure and treatment in their practices. She has also been a Founding Collaborator for the Environmental Health Symposium. When not working, she enjoys kayaking, biking and backpacking the mountains, rivers, lakes, and canyons of her home in Durango, Colorado.
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Environmental Health Symposium 2018
Read the Show Notes
01:57 Dr. Patrick’s Journey: She used to be an HIV/AIDS doctor. When the effective anti-HIV drugs were implemented in the 1990, the recipients began getting strange liver abnormalities, lipodystrophy, also known as fatty liver. About half of us infected with hepatitis C have fatty liver. As of 2015, about 25% of all Americans have fatty liver disease. Ten to 13 percent of all children have evidence of fatty liver.
03:14 What Causes Fatty Liver? Contenders for causes are high fructose corn syrup, toxicant exposure, diet/lifestyle and gut disorders. High fructose, from high fructose corn syrup and/or fruit, of about 50 grams per day, causes endotoxemia from dysbiosis in the gut, effecting the liver and causing systemic inflammation. Those of us between 13 and 30 consume an average of 60 to 70 grams per day of fructose.
05:15 The Two Hit Hypothesis: The first hit is fat in the liver. The liver starts importing and storing triglycerides, primarily from sugar, fructose, glucose and high carbs. The second hit comes from a free radical cascade without antioxidants to balance this assault. Free radicals can come from toxicants absorbed into the bloodstream, like PCBs from farmed salmon, and PBA from thermal receipts, water bottles or from our water supply. The second hit causes scaring in the liver, causing cirrhosis and primary liver cancer.
08:43 Endocrine Impact of BPA: Exposure to BPAs cause high levels of free radicals and effect our endocrine system. Adipose tissue, our fat, is an endocrine organ. BPA suppresses the hormone adiponectin, which is important in normal liver function and normal insulin sensitivity. It is deficient in diabetics and in those of us with fatty liver disease. BPA prevents the adipose cells from making adiponectin. The lack of adiponectin leads to increases in leptin, leptin resistance, obesity, and insulin resistance. There are a lot of skinny people who have fatty liver syndrome.
10:51 It Starts With Adipose Tissue: Fatty liver used to be blamed on the liver. However, the liver receives signals from the adipose tissue telling it to stop making glucose and stop storing triglycerides. Brown fat, the visceral fat around our organs and under our skin, is metabolically active fat.
11:43 Endocrine System: Men with low testosterone are more at risk for fatty liver syndrome. When testosterone levels are replaced, fatty liver regresses. Testosterone is a master signaler in both men and women. It helps the brain function and normalizes cardiovascular function. Those of us who are hypothyroid are at equal risk with those with low testosterone. When the endocrine system is lacking in hormonal production it can play a big role in fatty liver.
13:29 Fatty Liver Interventions: There are no FDA approved drugs for treating fatty liver. Pharmaceutical signaling agents are in the pipeline. Resistance training improves insulin signaling, which is helpful for fatty liver.
14:59 Mitochondria and Your Liver: There are more mitochondria in the liver than anywhere else, due to its many labor intensive jobs. Mitochondrial toxicity is a huge problem. For mitochondria to make energy (ATP), they make a lot of free radicals. Usually, the liver contains high levels of master antioxidants superoxide dismutase, catalase and glutathione peroxidase. In fatty liver disease, these enzymes are tanked. This leads to low functioning mitochondria and mitochondrial toxicity, impacting liver function and repair.
17:10 Upregulating Master Antioxidants: Anything that can be done to increase insulin sensitivity and decrease insulin resistance will help minimize both hits of fatty liver disease. A phytonutrient/polyphenol rich diet can help. Research in other countries is focusing on combinations for polyphenolic compounds to repair and prevent liver damage. The interventions of diet and exercise are the only accepted reparative interventions for fatty liver disease. Significant weight loss has been found to reverse fatty liver and the progressed form, called NASH, which leads to cirrhosis and liver cancer.
19:28 Keto-Adapted Diet and Fatty Liver Disease: There have been 475 studies on using probiotics for fatty liver disease. The minute that you decrease insulin stimulation, you lower insulin levels in the liver and reverse the process. It is the elevated levels of insulin in the liver that drive the process of triglyceride storage and gluconeogenesis. Keto-adapted diet has been effective in obese patients. Ketogenic diet is about eating 70% fat, 15% protein and less than 20 grams of carbs. There is no evidence that this is a long term (more than about 3 months) safe protocol in fatty liver disease. However, it is an effective early intervention. This is shown on liver biopsies. People with a BMI over 40 have fatty liver disease that has progressed to the dangerous form of NASH.
23:00 High Fructose Corn Syrup: It is an addictive alcohol. The research is clear that high fructose corn syrup causes hypertriglyceridemia in the liver and the rest of the body. Mercury has been found in significant amounts in high fructose corn syrup, contaminated during processing. It causes insulin resistance. A ketogenic or keto-adapted diet increases insulin sensitivity and takes away toxins that your liver cannot handle.
25:56 The Need for Antioxidants: In pediatric NASH, 800 to 1000 vitamin E can reverse liver damage. High levels 8 hydroxydeoxyguanosine and other markers of oxidant damage are seen with fatty liver disease. Probiotics improve liver function. Eating organic food is necessary to prevent further exposure to glyphosate, GMOs and other gut inflaming chemicals, which promote endotoxemia. The FDA says that we have increasingly higher levels of DDT in our food supply. DDT is used around the world.
31:26 Alcohol Consumption: Non-alcoholic fatty liver disease is defined as consuming fewer than 21 drinks in men and fewer than 14 drinks a week in women. Much lower levels of alcohol consumption contribute to gut dysbiosis and endotoxemia, and thus fatty liver. Dr. Patrick recommends that her patients avoid all alcohol. Alcohol is a metabolic toxin.
33:23 Saturated Fat and Endotoxemia: Saturated fat (GMO soy oil, GMO canola oil and non-organic meat sources), alcohol and fructose are the perfect storm of endotoxemia in the gut. Tallow, lard and GMO soy oil are used in mouse studies which profess that high fat diets are bad for fatty liver. Let’s look at studies where mice are given clean fats. Studies show that giving DHA and EPA is reparative in fatty liver disease and increases adiponectin.
37:26 Supplements that Help: There is good animal data on melatonin, an immune modulator. Long term use of melatonin should not suppress pineal production of melatonin. Melatonin also improves the ability of DMSA to chelate lead out of the body. Eat a rich of a polyphenol rich diet without increasing glucose and carb intake. Elderberry and black raspberry extracts provide significant polyphenols with a gram or 2 of glucose. Polyphenols negate dysbiosis and endotoxemia, most likely by supporting the production of good mucin layers in the gut and support the production of good bacteria there. Dr. Patrick recommends 1000 IU of a good vitamin E complex. It works at the gene level to prevent fibrogenesis in liver cells.
47:36 Parting Thoughts: Liver transplants cannot answer the need of 3 million Americans who are progressed patients with NASH today. NASH patients do not need to progress to cirrhosis and liver cancer.