“Should I take antifungal medication if I have a fatty liver?”
As a podiatrist, I often get patients who are reluctant to take oral antifungal medications because they were diagnosed with a fatty liver. So what is it?
What is Fatty Liver?
The liver is an important natural detoxifying organ but when healthy cells are replaced with fat cells, it will lead to inflammation, scarring (cirrhosis) and in end stages liver failure. Fatty liver may lead to heart disease, diabetes, cancer, dementia, and impacts the immune system and how our bodies metabolize food.
The 2 Main Types of Fatty Liver
Alcohol induced fatty liver disease means liver damage is caused by high consumption of alcohol. While there is no “healthy” amount of alcohol to consume (zero is best), there is a guideline of what is considered safe for adults: men less than 10 drinks a week, women less than 5 drinks a week.
Non-alcoholic fatty liver disease (NAFLD) is when too much fat is stored in the liver that is not caused by alcohol. The number one cause of liver disease in the U.S. is consuming large amounts of sugars. Other causes for NAFLD include obesity, a high-fat diet, and diabetes.
“How is fatty liver diagnosed and treated?”
The trouble with fatty liver is that symptoms are not obvious until much later or when labs are ordered. I often order liver enzymes (AST/ALT) before starting patients on oral antifungals and may occasionally catch an abnormal lab reading. I’d then offer lifestyle changes and rechecking the labs in a few months. I’d recommend that you follow up with your primary care doctor as well.
Symptoms of fatty liver may include
Fatigue
Pain in the abdomen in the upper right side
Unexplained weight loss
Weakness
Yellowing of the whites of the eye or skin (jaundice)
Your doctor may order additional labs, ultrasound and/or MRI to further investigate the cause of elevated liver enzymes.
Knowing what caused fatty liver will direct treatment so your doctor can help with this. If fatty liver is caused by alcohol consumption, then reducing or eliminating alcohol would be the first step. In someone who doesn’t consume alcohol but has fatty liver, your doctor will take a thorough medical history and address diet, exercise and other environmental factors that may contribute to fatty liver.
“Should I take antifungal medication if I have a fatty liver?”
Antifungal medications are detoxified by your liver so it is important to have a healthy liver to start with. Those with fatty liver or liver disease are more prone to drug-related side effects so always check with your doctor. There are many medications, not just oral antifungals, that are processed in your liver so it is important to weigh the risk and benefit with your doctor when using oral antifungals long term. Topical antifungals rarely affect the liver, so may be considered as an alternative for some conditions.
Last notes
It’s important to work with your doctor to improve the health of your liver, avoid chronic diseases and drug interactions. Your liver is a critical organ that doesn’t get enough attention for all that it does for us. Take advantage of the natural ways to support your liver with exercise, adopting a Mediterranean diet and decreasing environmental toxins such as pesticides in our foods. Here’s a resource of the foods with the highest concentration of pesticides to avoid. Opt for organic, locally and seasonally grown when possible. https://www.ewg.org/foodnews/dirty-dozen.php
Support your local farmer’s market at well.Maybe I’ll see you there https://santacruzfarmersmarket.org/
This article was inspired by The Doctor’s Farmacy Podcast, go check it out: https://podcasts.apple.com/us/podcast/the-doctors-farmacy-with-mark-hyman-m-d/id1382804627?i=1000624804843
