Proteins and Liver Disease

Hi everyone, there is so much confusion about liver disease and protein that I wanted to help everyone understand how it all works. It's very complicated I know. If you can just imagine that the body as a whole is like a computer-full of data all coming from various places. Overall it functions very well when the data is entered correctly. However; when there is an input data error or problem the computer no longer functions the way it was supposed to. So, like the computer your body works the same way. This little exerpt is only a small fraction of the input that makes our bodies work properly and again it is just a synopsis (a quick one at that) of what protein is, why we need it, and what happens if there is a glitch in the body or input data. Finally, how the body reacts. Liver disease is the input data that is flawed or in error. So here goes............. Protein is an essential part of our diet and helps the body, grow tissue, regulate hormones, control metabolism, repair muscle, and defend against illness. The human body has to have protein to survive. Proteins are made from lots of amino acids that cluster together and convert to protein. Amino acids are made of carbon, nitrogen, hydrogen, and oxygen atoms, and are the building blocks of the human body These different proteins are dispersed to perform different functions in the body. Since the body can’t store protein it has to be replenished daily. There are several natural proteins in our blood but others have to come from dietary sources. The amino acids that are not used up as proteins (because we can’t store it) are converted into urea. Urea is broken down protein made in the liver and sent to the kidneys to be excreted as urine (urea is toxic and must be excreted as waste). The Dr can measure urea by doing a blood test called a BUN. It stands for Blood Urea Nitrogen. Remember that the amino acids are made of many things including nitrogen which is measurable. It is one of the kidney function tests Dr’s do. When the body can’t remove the urea from the blood the BUN level is high. Liver Disease is one of the causes for a low BUN levels as well as the cause of elevated BUN levels. When urea isn’t excreted it builds up to toxic levels causing elevated ammonia levels. The elevated ammonia levels then causes confusion etc. (THAT’S A WHOLE OTHER STORY) This is all like a vicious cycle when patients have liver disease. One thing leads to another. Too much protein and the sick liver can’t process it properly and the urea builds up which causes the ammonia levels to rise. As a result the kidneys can’t spill either one so now the kidneys are affected too. Too little protein and the body hunts for it. It‘s like robbing Peter to pay Paul. Since we have to have protein to survive the body reacts when we don’t have enough. It actually will take protein from other places. Instead of the protein going to their destinations for use in the body the brain steals it from the muscles, tendons, bones and other organs to keep it in the bloodstream. Thus; there is muscle wasting, muscle cramps, profound fatigue, and many other undesirable effects. It is a constant battle to maintain adequate levels of protein and yet not over or under do them.  SHELLY

Boy Cary, that is a tough one. First there are normal’s for people of good health. As far as I know it is based on body weight. But   another method of calculation is 10-15% of caloric intake should be dietary protein. When liver disease is involved it becomes really difficult to know. There are various types of liver disease and various stages so it is almost impossible for me to answer your question. Since encephalopathy occurs so frequently with liver disease the protein influences the degree or severity of the encephalopathy. That would be a question you would have to ask your heptologist. I would be lying if I said I knew the answer. It is too variable. I’m sorry I just can’t even guess. The standards for normal change quite a bit so evaluating protein in a person with an abnormal liver is just too individualized.   Shelly

Cary, It sounds like you are really watching what and how you eat. Diet is so important to remain well and healthy. Good for you........as far as the amount of protein you chose to eat again it sounds like you are doing well. Good luck.
Hugs
Shelly

JoAnn, thank you for the comment about my mom. It has been so hard losing her. As far as the protein issue as I said earlier it is really complicated but at some level we can all have a basic understanding of what, why and how they work. The muscle wasting is so unfortuante and it seems so unfair doesn't it? We went thru it all with my mom so I know how disheartening it is. I still propose that all end stage liver patients should be on appetite stimulants. I have argued for the wider use for a long time. If the patient is not eating it stands to reason they will have a starvation condition, If they are eating but not enough to promote healing then again we have the decreased protein issue with muscle wasting. Why not just Rx it automatically? I'll never know (however I do have my own opinions on that which I will not share with others). I would ask the Dr for it immediately. Within a few days of taking it you will see an increase in his appetite. He can then get some strength built back up at least. I'm rattling I know. I'll shut up on that for now.

 Hugs, Shelly

JoAnn, the question you asked is multi faceted. Muscle mass can be rebuilt but it is difficult if the patient doesn't have energy. When he is eating moe and regains some strength it is possible that he can do some minimal leg strengthing exercises. Then possibly short walks, and on and on. It is frustrating, painful, and slow to see results. The outcome depends on many factors including his desire.First lets get him eating better.

 Hugs Shelly

In a broad overview of diet, I try to eat roughly a 50/50 combination of the two food groups: 1. fats and proteins, and 2. carbohydrates in every meal. Too many carbs in a meal leads to blood sugar problems associated with hep c. Too much bad fat is bad in a number of ways. Sometimes for me protein and fats will kill my sugar cravings. A brilliant athletic trainer that I follow (Paul Chek) believes that the proper combination of the two food groups maximizes the metabolism to burn the fuel more completely and efficiently.

But probably the most important thing for me is not to eat to excess. My goal is too eat only as much as my body will metabolise without going into storage mode. That means small meals of the proper proportions and fairly often through the day. I believe that any excess will benefit the virus instead of me.

When I eat this way I feel great. But when I eat poorly it can really get to me. Being on a clean diet makes your body a lot more sensitive, and that isn't necessarily always pleasant when you indulge.

In the middle of a crisis it is hard to concentrate on food, but it is an important thing to focus on, because bad or deficient nutrition can make an acute situation worse.

Yes, I agree. Deficient nutrition is worse than too much, even for a non-acute patient. I know many (most) cancer deaths are from malnutrition because the patients can't tolerate food in the end stage. I imagine Hepatitis patients are similar in the end stages. It is heart-wrenching.

Luckydog

You are correct Hep93, in the end stages the patient should eat whatever they want to eat. That is my personal opinion. To me it doesn't matter just so that they get some nutrition because they have little appetite. Megace is a medication that is given to increase appetite and works quite well. The goal being to get the patient to get enough nutrition to prevent starvation. Dr's may disagree but I feel anything is better than nothing. If the patient has just a short time left I let them eat whatever they want, not just for nutritional value but what little pleasure it may bring them.

You picked a very old post to reply to. Our rules do not allow "advertising." Therefore your post has been deleted.

Junior, you responded to a very old thread. I haven't seen Shelley around here for quite awhile. I can tell you that I've never known anyone to post about this symptom before.

I suggest that you start your own thread (click on New Topic instead of Reply), and you can explain your symptoms. You will get more replies that way.

Hugs,
Connie