Treating Non-Alcoholic Fatty Liver Disease in Siddha Medicine

Fatty liver disease (specifically Non-Alcoholic Fatty Liver Disease (NAFLD), is highly prevalent in Singapore, affecting up to 40% of the adult population, significantly higher than the global average of roughly 25%.

The age group that is at high risk are those in their 40s, especially when the individual has other co-morbidities such as diabetes mellitus and hypertension. Recently, clinicians are seeing more patients from younger age group, as young as teenagers and those in their 20s, and typically these patients also suffer from obesity.

Source: https://www.its-nutriscience.com/health-topics/the-hidden-dangers-of-excess-fat-non-alcoholic-fatty-liver-disease-nafld-2/

The biggest culprit to the development of this disease is poor lifestyle and dietary habits such as,

1. Eating foods high in saturated food

2. Eating at random timings throughout the day instead of having 2 or 3 wholesome an nutritious meals

3. Snacking or binge-eating late at night

4. Not including sufficient protein and fibre into one's diet and primarily consuming carbohydrates in every meal

5. Consuming sugary beverages very often

6. A sedentary lifestyle; not having enough movement throughout the day.

7. Chronic mental stress

8. Poor quality of sleep & chronic sleep deprivation

9. Alcohol addiction/consuming alcohol frequently

10. Lack of management of pre-existing conditions like diabetes or hypertension through medications

11. The mindset that obesity or being overweight is just a "body type" that society needs to accept.

Source: https://m.economictimes.com/magazines/panache/sedentary-lifestyle-poor-eating-habits-led-to-a-spike-in-obesity-cases-in-india/articleshow/87995165.cms

Perhaps you've let go of your health and now you have been diagnosed with fatty liver. Your doctor does some blood work & puts you through a fibroscan, and you get back the results. How can one interpret the results & perhaps expect to see?

• Complete blood count:

  • If you have been following a poor diet & have malabsorption issues, you may expect to see a low haemoglobin level

  • If one progresses into liver fibrosis, platelet levels may start to drop.

• Liver Function Test results:

  • Liver enzyme like ALT, AST & GGT would likely be elevated; indicating liver cell damage.

  • ALT levels being higher than AST is a classic finding in Non-Alcoholic Fatty Liver.

• Lipid profile:

  • Triglycerides, Total cholesterol & LDL (Low-Density Lipoprotein) would most likely be elevated

  • HDL (High-Density Lipoprotein) would be lower that the normal range

• Liver Biopsy:

  Based on the severity, these are the following grades which may be conclude based on the specific findings:

  • Type 1: fatty liver alone; macro-vesicular steatosis

  • Type 2: fatty accumulation and lobular inflammation

  • Type 3: fat accumulation and ballooning degeneration

  • Type 4: fat accumulation, ballooning degeneration, and either Mallory hyaline or fibrosis.

    
    

    Type 3 and Type 4 are NASH (Non-Alcoholic Steato-hepatitis) by definition.

    
    

• Inflammatory markers:

  • ESR & CRP can be expected to be elevated

    
    

• Fibroscan:

  • This is an important imaging technique that is used to determine the extent of fibrosis & fat accumulation in the liver. This is how the result are interpreted:

    

  Based on the CAP & Liver stiffness measurement, the extent of liver damage is determined.

Management of Fatty Liver in Siddha Medicine

Lifestyle modifications & dietary regulation is absolutely essential, and an integral part in Siddha Medicine treatment protocols. We provide our patients with a customised dietary regimen to follow while on medication. Moreover, we guide patients to adopt a healthier dietary habit to follow for the rest of their lives.

Medicines & approach to treating fatty liver:

• Management of co-morbidities such as diabetes and hypertension is essential through medications

  • In siddha medicine, we give medications such as Madhumega choranaam for diabetes & Venthamaraiyathi chooranam for hypertension.

• Body recomposition is prioritised (Gaining lean muscle mass & decreasing body fat percentage) through strength training & cardio exercises.

  • We design exercise regimes for our patients based on their state of health, their strength & endurance.

• Medicines like Nathaichoori chooranam, drakshathi kashayam, karisalai karpam & keezhanelli chooranam are given for patients with fatty liver.

The choice of medication, dietary guideline & exercise regime is customised according to each patient's personal needs, based on their severity of the condition and presence of co-morbidities.