April 27, 2025 • 39 mins
Dr. Galati starts the program by discussing a New York Times article about 17 ways to cut your risk of stroke, dementia, and depression all at once. He also stresses how the common thread of obesity is the leading cause of so many metal health issues or disorders. Dr. Galati also has Dr. Mazen Noureddin join the show to talk about fatty liver disease, second level testing, and more.
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Episode Transcript
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Speaker 1 (00:01):
Initialize sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center. The lunch phrase.
Speaker 1 (00:09):
Everything looking alive.
Speaker 3 (00:16):
To you.
Speaker 2 (00:19):
This is Your Health First, the most beneficial health program
on radio with doctor Joe Bellotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Now here's your host, Doctor Joe Bellotti.
Speaker 1 (00:47):
Well THEOK good Sunday evening to everybody. Doctor Joe Galattiatoy's
great to have you join along for this hour of
Your Health First. We hear every Sunday between seven and
eight pm. Don't forget. If you want to follow along,
send me a message. Find out about all the other
health and wellness things that we do see other members
(01:09):
of my team. Go to doctor Joglotti dot com, doctor
Joeglotti dot com, d R J O E. G A
L A t I dot com. While you're there, Soner
for our newsletter. You could also send me a message
through the contact us tab. But all of our social
media and all of the health and wellness information that
(01:32):
we share with you is at the doctor Joglotti dot
com website and again for those that are regular listeners
to the program, my whole mission here, and it's rather simple.
It's to make you better consumers of healthcare, really make
you understand what is at hand here. And the program
(01:56):
is design. The information that we share with everybody is actionable,
meaning what you hear in the next minute or two
you can put into play immediately. It is not something
that is theoretical and we're waiting for new research to
come out. This is information that you could use right now,
(02:19):
and hopefully as you listen through the program, a light
goes off in your head to say, you know what,
I really really need to do a better job with
fill in the blank, something we talked about tonight. So
that is my goal. It's actionable. It's not some high
falutin theoretical kind of information that is just over everybody's head.
(02:44):
A little later in the program, doctor Masen Neuridine, he
is a hepatologist like me. He is a colleague, he
is a friend, he is a good guy. And doctor
Neuridine and I are going to be talking about what
I would say is public health enemy number one Numero uno,
(03:07):
fatty liver disease. You've heard me talk about it before.
We will still be talking about it. I'll stop talking
about it when we get it under control. But for
right now, it is absolutely not under control, and it
warrants your attention, your understanding, and the sharing of this information.
(03:28):
So stay tuned for doctor Norden. He'll be on in
just a little while. As they say. All right, So,
there was an article in the New York Times this
past week about seventeen ways to cut your risk of stroke, dementia,
and depression all at once. And you might say, wow,
(03:49):
seventeen ways to cut your risk all at once, doctor Galotti,
you must be fooling me. Well, no, not really. When
you really break it up, part these overlapping risk factors,
as I would say, are staring us right in the face.
(04:10):
They are staring us in the face. And really, what
we need to do, what you need to do, hint.
The actionable information is to look at yourself, look at
your family, look at your loved ones, look at Bob
in the cubicle next to you, if you feel like
helping him and identifying these different risk factors. So, and
(04:36):
by the way, I'm going to post this on the
Facebook page of doctor Joglotti dot com. All right, So,
the new research has identified these seventeen overlapping factors that
affect your risk for stroke, dementia, and late life depression.
I think that really is an unsung hero, suggesting that
(05:00):
really a number of these lifestyle changes could simultaneously lower
your risk for all three. Now, though they may appear unrelated,
So you say, stroke, dementia, depression, all right, maybe they're related.
Maybe not. People who have dementia or depression, or who
(05:21):
experience a stroke often end up having one or both
of the other conditions. So where there's smoke, there is fire.
Some of the risk factors common to the three brain
diseases include high blood pressure and diabetes. I mean, come on,
(05:41):
we've been talking about this for a long time. Research
suggests that at least sixty percent of stroke, forty percent
of dementia cases, and thirty five percent of late life
depression causes can be prevented or slowed by controlling the
risk factors. So let's get right to the box, because
you're sitting here saying, hey, I want some actionable information.
(06:07):
So the factors that protect against protect against brain disease. Okay,
low to moderate alcohol intake, now be careful there. Low
to moderate consuming one two three drinks a day had
a smaller benefit than consuming less than one drink a day.
(06:30):
So let me let me just say this again. In
this study, they're saying low to moderate alcohol intake may
protect you. But listen, consuming one to three drinks a
day had a smaller benefit than consuming less than one
a day. So come on, I don't know why they
(06:50):
don't come up and say less than one drink a day.
All right, so less alcohol is better. Keep in mind,
glass of wine, bottle of beer, shot a whiskey, any
distilled spirit. They're all the same, okay. Number two, these
are things that protect you against brain disease. Number two
(07:12):
cognitive activity, which really means regular engagement in mentally stimulating
tasks like reading or doing puzzles. So once you throw
in the towel and stop using your brain, your brain
sort of like melts away. So you want to stay
active now. Number three, Now this is no surprise, and
(07:37):
if you have not heard this from me, then you
may need a hearing test. A diet high in vegetables, fruit,
dairy fish, and nuts. This is pretty much the Mediterranean diet.
High diets and high end fruits and vegetables, dairy fish, nuts.
I'd probably throw in their legomes beans, I doubt they
(07:59):
would say, if you too many beans, you got dementia,
all right. Next, moderate or high level of physical activity,
And more and more and more research is showing if
you want to have life span, which means not only
you live long, say into your eighties or nineties, but
you're physically in good shape, it is moderate to high
(08:21):
level of physical activity. Walking your chihuahua around the court
or your cul de sac, to me, is not moderate
or high level physical activity. We're talking about rowing, ski machine, swimming,
riding a bike, running elliptical, doing some weight training, or
(08:48):
hit high intensity interval training where you're really going to
get your heart rate up. Now, you don't have to
do this seven days a week. If you do some
sort of exercise five or six days a week and
you do higher intensity twice a week with some weight training,
I think that would be fine. Next these are to
(09:10):
prevent brain damage. You have to have a sense of purpose.
All of us get to a point in our life
where we have led a good life, we have learned
a lot. You have to give back to society, get
back to your kids, your grandkids, your community, your church, whatever.
(09:33):
Don't think you're retiring. You just hide and watch wheel
of fortune all day. You have to have a sense
of purpose. But tie it into this is a large
social network. We are meant to be social, We are
meant to engage with one another. And so by going
out and having a large social network, you could do
(09:55):
neurologically active engagement within the social network. It will give
you a sense of purpose. You can do physical activity
with people as a group. You could eat together as
a group. A diet high in vegetables, fruits, dairy, fish, nuts,
(10:16):
and lagomes. Okay, and consume your low level of alcohol.
All right, So these are the factors to prevent a
prevent dementia, stroke and depression. Let's go over it real fast,
and we're going to take a break load to moderate
alcohol intake, though you have to be careful. It's like
(10:37):
less than one drink a day is best. Cognitive activity
meaning regular engagement in mentally stimulating tasks, read, puzzles, et cetera.
A diet high in vegetables, fruit daily, dairy fish, nuts, lagomes, monitor,
high level physical activity, a sense of purpose, and a
large social network. So doing all of these things is
(11:00):
not only going to keep your brain in check, but
it's going to keep your weight down your risk of
diabetes down, your risk of heart disease down, stronger bones.
All right, so all of these things we can't say,
I'm going to exercise to keep my brain healthy. Yes,
of course you will, but it's also to physiologically keep
(11:22):
you in check as well. All right, we're going to
take a quick break, Doctor Joe Glotti, this is your
Health First. Every Sunday evening between seven and eight pm,
we're here raising your health IQ, one listener at a time.
Stay tuned. I'll right back to you trying to raise
your health IQ, one listener at a time. You are
tuned into your health First.
Speaker 3 (11:44):
We hear.
Speaker 1 (11:46):
Every Sunday evening making you better consumers of health care.
And our goal is to keep you out of the
doctor's office, out of the key r Now, of course
we want you to go to the doctor force routine
health care checkups, but keeping you out for these chronic
(12:10):
diseases is the key. We are swamped literally for all
of us in healthcare, and I I would say it
doesn't matter what specialty you're in. So yes, internal medicine,
primary care. The lion's share of the patients that they
(12:31):
are seeing are patients that are overweight, they have high cholesterol,
they have diabetes or pre diabetes. They have cholesterol issues.
They're getting into kidney issues, orthopedic issues, they're getting into
mental health issues. And the common thread, the common thread
(12:53):
to all of these disorders is obesity. The food we're eating,
which is now becoming the norm in a sense, is
low quality food that is stripped of nutrients, stripped of fiber.
It is processed or ultra processed. And really, you have
(13:14):
to be honest with yourself, the food that a lot
of us are eating doesn't even look like food. You
can't even figure out where this came from. It's Frankenstein food.
But whether you are in that primary care realm obgyn, okay,
same thing. But then you look at the medical specialties
(13:37):
in gastrenurology, sort of diseases of the intestinal tract. You're
looking at complications from diabetes, complications from obesity. You're looking
at cardiology. Your typical modern day cardiology office is filled,
and I do mean filled with individuals that have carnary
(14:00):
artery disease, they have stens, they've had bypass surgery, they've
had some sort of arrhythmia. Atrial fibrillation is almost epidemic.
At this point, it's as common as having a cavity
in your tooth, or it might even be more common
than having a cavity because dental health has improved so
much over the last fifty years. But it is a
(14:23):
major problem. So you have to look at yourselves, yourself,
your spouses, your significant others, your children, your community. Okay,
and I like to say, look at your community. We're
talking about people that you work with, people that you
socialize with. You have to look at them and say,
(14:44):
the majority, like seventy five to eighty percent are all
at risk for underlying development of crinic disease. So when
you start talking about dementia and depression and stroke, which
we were talking about last segment, you see that it's
tied back to hypertension, being overweight, diabetes, excessive drinking, things
(15:09):
like that. So, in to continue what I was saying
last segment, getting your hypertension under control, getting your blood
pressure under control is probably one of the most important
things for you to do if you indeed want to
(15:31):
not have a stroke develop dementia. Okay, Now, the American
Heart Association a few years ago came back and said
the ideal blood sugars should be about one twenty over seventy,
so that top number should be about one twenty. It
had been one thirty one hundred and thirty millimeters of
(15:55):
mercury as the pressure, but again through research and clinical
co observation, one thirty may put you at risk, and
so the American heart wont to drive that blood pressure
even further. Now, I cannot tell you how many patients
I see with blood pressures in the one forties and
one fifties. And we'll now we're a liver practice, but
(16:20):
we have in my staff and my team, we have
created this holistic approach to all of our patients, even
in non liver or digestive related issues. They're sitting there
with a one forty, one fifty or high a blood
pressure and our first question is what's being done about this?
Does your primary care doctor know? And they will say, well, yeah,
(16:42):
they're watching this, well, watching it for what watching it
until you have a stroke and then they say, oh, hey,
you know what, we should have done something. This is
where you need to take action. And everybody tonight write
this down. If your blood pressure is not within the
one twenty to one thirty range, and you know it,
(17:03):
and it's documented. You need to call your doctor first
thing tomorrow morning, Monday morning and say my blood pressures up,
I needed to be checked out, or what are the
strategies to get it lower? Now, certainly the approach to
hypertension is multi stage. Yes, it is lifestyle. It is
(17:23):
cutting out the processed food, cutting out the sodium in
your diet, more fruits and vegetables. Yeah, but hey, didn't
I say that is important to reduce your chance of
stroke and dimension late onset depression. So yes, you want
to improve your your diet, less sweets, less fats, and
(17:44):
then it's exercise. Certainly, thirty to forty five minutes of
exercise every day is going to help with blood pressure,
but it's going to also help with weight loss. And
then if it is not critical and your blood pressure
is not coming down, that is when medical intervention is required. Okay,
(18:07):
And I know plenty of people that, yes, they come
to us on high blood pressure medicine, but with weight
loss and exercise, and we you know, we're fixing their
fatty liver. Which, by the way, doctor Mason Neuridine is
on hold and he'll be calling it in just a minute.
But so we're trying to treat the fatty liver disease.
The really the foundation of it is getting your weight
(18:31):
under control. Well, to get your weight on the control,
you have to eat better and exercise, eat smaller meals.
But the byproduct, the intended consequence of all this is
that your blood pressure is going to come down, your
blood sugars are going to straighten out, and your cholesterol
will probably improve. So all of this, and while this
(18:52):
is an article and it's posted on the Facebook page
seventeen ways to cut your risk of stroke dimension to
prey all at once, you can't look at it as
an isolated event. By treating all of these issues, you're
going to improve globally your metabolic health and reduce the
(19:14):
chance of these serious complications. All right, don't forget Doctor
Joegalotti dot com is our website. You could check out
all of our social media there. If you want to
send me a message, souner for our newsletter, it is
all there. So we're going to change gears in just
a minute after newswather traffic. Maybe here about what the
astros are doing this weekend. Go to doctor Joegalotti dot
(19:36):
com dotr mauzennuridine is coming up in just a moment,
and hope you had a great weekend. Yesterday Saturday was awesome, sunny,
it was warm, me and my family were at a wedding.
And then today Sunday a little overcast but certainly wonderful weather.
Hope you all were able to get outside. Stay tuned,
(19:57):
We'll be right back. All right, everybody, Welcome back, Doctor
Joe Galotti, your help. First you hear me Sunday between
seven and eight pm. And as I was saying early
on the program, doctor Mazen Neurdine a really an expert
liver specialist, a hepatologist, especially in the world of clinical
(20:18):
research and fatty liver disease. We're lucky that he is
a colleague of mine. He is a friend of mine
and a co collaborator, I could say, Mazen, if that's
if that's accurate.
Speaker 3 (20:29):
Indeed, an honor and privilege to be so to be
your friend.
Speaker 1 (20:32):
Chair, well, I'm really happy for that. Right here in Houston, Texas,
the world's greatest medical center. So you know, one one
disease that I talk a lot about on the radio
and certainly with my patients, and you of course talk
worldwide on fatty livid disease is fatty livid disease, And
(20:54):
for everybody listening tonight, give give your perspective on just
how big of a problem fatty liver disease is not
only in the United States, but on a global perspective.
Speaker 3 (21:08):
Yeah, it's actually much bigger than people think of. And
the reason why it's an asymptomatic disease. So you've talked
to your show multiple times about this disease as well
as the pandemic of type two diabetes and obesity. And
about sixty percent of type two diabetics have faty liver
and there'll be people more than that, but on average
(21:30):
you end up with thirty percent in the US and
more in South America and the Middle East, up to
forty percent with fatty liver disease in Texas. Actually, we
have studies that should it's about forty percent of people
they have fatty liver disease. Now, not all of them
is a problem because it started with just faten deliver.
(21:52):
But over time, if you get that inflammation and what
I call the inflammation gas on fire, leave the scarting
of deliver and evention CRUs is that we both see
a lot of patients with devastating complications.
Speaker 1 (22:05):
Yeah, now with the large percentage, and numbers have ranged
eighty to one hundred million, which is about a third
of America has fatty liver. Why don't you think the
public is more in tune with this health threat. There's
all kinds of things that people are worried about, but
fatty liver is almost tucked under the rug. What's your take?
Speaker 3 (22:27):
Yeah, multiple factors, Joe. I mean, a lot of people
are worried about the heart because it leap to heart attack,
understandably so a lot of people are worried about the
sea word cancer, understandably so. But when it comes to
fatty liver, people think that cross can come from alcohol
(22:47):
usually and there are no other causes, and they don't drink,
they're fine. But actually the most common cause of liver
disease is faty liver without drinking, and it's just associated
with type two diabetes and or being overweight and all that. Two.
It's asymptomatic, so people don't focus on it. Three A
(23:10):
lot of primary care and indochronologists we're not quite aware
of it until we started exploring it in the last
twenty years or so. And importantly, there were no medications
for it, and so people did not do anything other
than weight loss and exercise, which a lot of people
failed to do and which led to services. But now
(23:32):
things have changed. You know, we have treatment, we have
others coming. So the world has changed, and we need
to make sure people are screened for it, right, or
it's screened for it.
Speaker 1 (23:44):
Yeah, that's the key thing. And you know you mentioned
heart disease, cancer. You could add in there all the
concerns about diabetes, mental health issues, and you know, I
like to say that the liver does not have a
very good pr company behind it. It's not really advertised
as a sexy disease or sexy organ. I know you're
(24:07):
working hard, we're working hard together on this, but what
do you think people need to know about the liver
and why we need to elevate its relative importance higher
than what it is now.
Speaker 3 (24:23):
Yeah, I mean, the liver is the the factory that
do a lot of things right. It's you cannot live
without a healthy liver. It mutibolized, drug mutabilize multiple other things,
stock sins, it makes sugar, burns sugar, a lot of
(24:45):
really cool things. And there's only one liver and kidney people,
you don't go on on the analysis, but the liver,
if it gets sick, you you really need to you
really need to deliver transplant if it's too sick. So
liver is not painful, so people don't feel pain usually,
so they don't pay attention to the symptoms. And unfortunately,
(25:07):
if it gets ignored, like the seriousness does not present
until lately when people have like the yellow eyes, the gundice,
the fluid and the abdomen, which is what we call society. So,
I mean, you and I were talking this week about
how unfortunately a lot of people showing on our office
(25:29):
being told, hey, I had this for many, many years,
and no one did anything about it, and now doctor
Golotti or myself, can you help me. I'm like, well,
it's quite late, it's quite late over all to reverse it.
But the only option we have is trip transport, which
we do well. But you really don't want to get
to that level.
Speaker 1 (25:50):
Yeah, you know, I've always yeah, I've always said that
for many cases, not all cases, but getting to the
point of liver transplantation is almost a failure of intervention early,
and you know, we don't want to wait for that,
you know, really end stage. A lot of these things
we can intervene early. Now you've been mentioning certain risk
(26:11):
factors obesity and diabetes, but outline for everybody, the list
of risk factors that put you at risk for having
a fatty liver.
Speaker 3 (26:23):
Yeah, so fatty liver can be divided in general, you
get faty liver from alcohol or you get it from
non alcohol causes. So the alcohol, I'm gonna leave it
a little bit on the side because that's a different
topic for a different day. People should not drink heavily.
And what's considered a right amount of alcohol or the
maximum acceptable amount is seven drinks for a woman a
(26:47):
week and fourteen drink fourteen drink for a man a week. Now,
there are a lot of data arguing this is actually
even like a lot now they are data arguing drinking
even very little can affect your liver. So moving to
the other side, which is well when people are like,
I really don't drink, doc, Yeah, but you still can
get a liver disease, and there is factors are the following.
(27:09):
Type two diabetes is one of the elephants in the room,
followed by others such as obesity, high dyslipidemia which is
high abnormalpitanol cholesterol and all this so hypertension and in
general insulin resistant. Now, if you have type two diabetes
(27:30):
or two other risk factors, it's mandated for the primary
care to be asking for screening. There are other risk
factors that are not as noticed. But for instance, family
history of cirrusis from fatly liver PCOS, polycystic ovary syndrome,
and some thyroid isshes as well. But the big three
(27:52):
is well, a lot of people have the type two diabetes, obesity,
high coaster, and high blood pressure.
Speaker 1 (27:58):
Yeah, so now the channel lenges. You've put this out
there and there are people sitting listening to this and
they say, you know what, I am overweight, and I've
been told I have just you know, sort of a
touch of diabete is not quite sure, and they have
high blood pressure, but my doctor has not said anything.
(28:21):
So I like my doctor, and I try to follow instructions,
but you know, as we both know, that may not
be enough. So how do you encourage those listening tonight
today to take somewhat of a bold move and stand
(28:42):
up for themselves and communicate back with their doctor, their
treatment team to say, I really believe I need to
be screened or tested further. What advice do you give?
All right, if.
Speaker 3 (28:58):
Everyone is ready, either grab a paper or pen or
your phone iPhone. It's actually easy. I want to Joe,
you have been advocating for this for some time now
and many other hepatologist. It's I want you to go
to Google and look at something called FIP four. If
I be four, and you can do even FIP four calculator,
(29:21):
and there will be four things being pulled out your age,
your livery numbers ALT and a SD and your plate
it which is a blood test number, and you can
plug in the numbers in actually will tell you what's
going on. Any number more than one point three you
will need further attention and further testing. So the one
(29:45):
point three and above not less is one point three,
you're fine and you can repeat that on early basis
if you have these risk factors, and simply you can
just go to your doctor. And I saw a patient
earlier and they're pulling the labs on their their iPhone now,
so you can just plug it in and ask and
(30:08):
you can tell your doctor. I've heard this these liver
experts on the radio and doctor Glotti's shoe and my
foot four is high, doc, and can you can you
refer me? So I wish we could have a billboard saying,
look at your liver if you you have type two
diabetes or these Striss factors, know your FIP for score.
(30:30):
So the project for for for Texas. Yeah, no, it
really is.
Speaker 1 (30:34):
And and I believe that one of the things we
try to do is for people to know their lambs,
to know that, you know, when we talk to patients.
And I would say patients are getting a lot better
because they have access on their phone and patient portals
and et cetera. But to really know your liver numbers
(30:55):
and have access to be able to pull these numbers
into the calculator. All right, final segment of this week's
Your Health First coming up. I'm doctor Joe Glotti. Don't
forget doctor Joeglotti dot com. We're talking with doctor masen Neurindane,
a worlds expert on patty liver disease. Stay tuned. Final
segment coming up. Now, you certainly talk a lot about
(31:20):
other testing, ultrasounds or something called fiber san certain kinds
of MRIs. Explain how these additional tools sort of the
second level testing fits in with patty liver.
Speaker 3 (31:36):
Yeah, so thanks for bringing that up, Joe. So after
the fifth four you pulled it on your like, let's
say you pulled it on your phone or on Google calculator.
If it's more than one point three and you actually
ask you really important questions. A lot of people say,
oh my god, if I go to the doctor, they
might deliver biap scene. Most of the time, actually more
(31:58):
than ninety five percent of the time, we don't do
verbibs or ninety percent of the time. They are additional testing.
Now technology has evolved. They are what we call it
point of care, which is a machine sitting in your office,
in my office, in multiple offices and without doing liver
biomecy and can tell how much fat you have in
deliver and how much cars you have in deliver. And
(32:20):
we also have like more sophisticated MRI machines. Water faces
tell me, well, but I had MRI doc last week. No,
they are more sophisticated MRI machine where they kind of
place a pillow on your liver and it sits there
nicely softly and like vibrates a little bit and measure
how stiff is your liver. So the world really has
(32:42):
changed in a non invasive way that takes us very
close to the truth and what's happened in your liver
without a doubt.
Speaker 1 (32:50):
Yes, Now, the complications you mentioned, you know soorrhosis, and
most people think sorosis is related to being an alcoholic
or a heavy alcohol user. But the reality is in
a subset of patients with fatty liver, we are going
to see soorosis. So explain that process. Who you think
(33:13):
might be more at risk for getting cerosis compared to
the average patient with fatty liver.
Speaker 3 (33:22):
Yeah, So the time plays a big role. So the
longer you have fatty liver disease, the more like you
had that gas on fire, the inflammation and then eventually
scarring and they get ignored. The scars, scarscrs and complete
scarring of the liver is what we call cerosis, and
then you start having complications from it.
Speaker 1 (33:43):
And the heavier.
Speaker 3 (33:45):
The patient is, the more metabolic Russ factors. If you
have a patient with type two diabetes BMIO forty have
cholesterol problem, high blood pressure, certain groups such as Hispanics
that they have the disease for twenty years or so,
they likely have a like, they're highly likely to have
(34:08):
faty liver, they're highly likely to have is corning, and
they could be very close to crosis. So it's metabolic
dis factors as well as time. For sure, there are
genetics components, other components. So the combination of genetics, metabolic, time,
and age all that player role into that progrestion to cerrosis.
Speaker 1 (34:31):
You know. Another thing is that so many patients want
to try and heal their liver naturally. Now, in a moment,
we'll get into some of the new therapies that you
are spearheading. But people say, I want to take milk thistle,
I want to take a liver clanse, I want to
you know, do celeryjuicing, things like that. What do you
(34:54):
say to them? What do you say to your patients
when they have faty liver and maybe it's not quite
at the level of cirrhosis, but it certainly is showing
a bit of a wicked hand where they're at risk
for cirrhosis and damage. How do you approach those questions
when they want to try a more natural approach.
Speaker 3 (35:18):
Well, let me start with this. If the fip for
is more than one point three, please seek and advise
with a specialist, because you don't want to just start
doing supplements and juicing and stuff like this and miss
the progression. And a lot of us, you know, life
(35:39):
is busy. Years goes on sometimes without paying attention, and
then people progress and they're like, oh, oops, it has
been three four years already. I thought it was just
last year. So seek attention the supplements in general, Like
let me talk about nuk fistle for instance. I don't
think it will hurt, but there was a study or
two that should It doesn't really help much with the
(36:02):
fatty liver and the scarting from it. There. As you
know and I know, and we have seen over and
over some supplements and some things out there can can
damage the liver and hurt it. And we transplanted people
of what we call it toxicity, liver toxicity from supplementation.
So that's that's the thing that we have to be
(36:23):
careful for. Uh, there are things that could be helpful.
You and I love coffee, and all liver doctors love coffee,
and if some people that they don't, they cannot have it,
like people with the regular heartbeats or rhythmias, heartburns. But
in general, we say, drink coffee, but a lot of
(36:45):
time I emphasize if you have a lot of scarring,
coffee will not do the job by itself, So drink
your coffee. If visit your liver doctor and that yeah.
Speaker 1 (36:54):
We should set up a coffee bar in our office.
Speaker 3 (36:56):
That's I know, right, I know.
Speaker 1 (36:59):
So the last thing and for everybody just maybe tuning
in doctor mars and Neurdine is a world renowned liver
expert and researcher. The pipeline of new therapies that are
on the horizon, some are like within reach, others are
just a little bit further out there. Where are we
and what's the encouragement that you have for everybody?
Speaker 3 (37:20):
Oh, there's a huge pipeline, Joe. We already have a
drug approved out there as minerm so a lot of
so if you heard that you cannot do anything for
fatty liver, we actually do things for fatty liver. Now
there are other medications coming in the pipeline, including that
(37:42):
those that induce weight loss, the GLP ones and others.
But we also we have this European meeting that Joe
and I were going to the European Meeting for liver
disease happening next month or so, and they will be
breaking news data on patients that reverse their crusis by
one stage five ruses. So this soros is regressed and
(38:05):
that is a drug call FGF twenty one. But the
bottom line is that we have drugs for fatty liver.
We don't have anything for crosis now, but the clinical
trials are offering huge options and those are actually progressing.
Is a huge pipeline. They're available in many any in
many sides of the country, including Houston, Texas, like your center, Joe.
Speaker 1 (38:30):
And I should say, and I'll post this online to
get in touch with doctor maz and Neurdine Euston Liver Institute,
Houstonliver Institute dot com Mason in the final thirty seconds here,
we've we've really covered a lot. I would say the
one take home message for everybody tonight with regard to
(38:52):
fatty liver, what would what would that.
Speaker 3 (38:54):
Be listening to your show because you tell people how
to get healthy, lose you weight, and eat and eat well.
But if you have risk factors, know what's your fit
for more than one point three see can advise I
have options, we have treatments, and we can we can
help you, but just don't don't ignore it. Know your risk.
Speaker 1 (39:16):
Exactly all right, Doctor Maza Nourdine, thank you, Thank you
a wealth of information for everybody tonight.
Speaker 3 (39:23):
And thank you Joe for this awesome show. I listened
to it often and I know many doctors and patient
listen to it, so keep it up, my friend.
Speaker 1 (39:31):
Absolutely, Thanks Masa, thank you Joe.
Speaker 2 (39:34):
You've been listening to Your Health First with doctor Joe Blotti.
For more information on this program or the content of
this program, go to your Health First dot com.
Initialize sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center. The lunch phrase.
Speaker 1 (00:09):
Everything looking alive.
Speaker 3 (00:16):
To you.
Speaker 2 (00:19):
This is Your Health First, the most beneficial health program
on radio with doctor Joe Bellotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Now here's your host, Doctor Joe Bellotti.
Speaker 1 (00:47):
Well THEOK good Sunday evening to everybody. Doctor Joe Galattiatoy's
great to have you join along for this hour of
Your Health First. We hear every Sunday between seven and
eight pm. Don't forget. If you want to follow along,
send me a message. Find out about all the other
health and wellness things that we do see other members
(01:09):
of my team. Go to doctor Joglotti dot com, doctor
Joeglotti dot com, d R J O E. G A
L A t I dot com. While you're there, Soner
for our newsletter. You could also send me a message
through the contact us tab. But all of our social
media and all of the health and wellness information that
(01:32):
we share with you is at the doctor Joglotti dot
com website and again for those that are regular listeners
to the program, my whole mission here, and it's rather simple.
It's to make you better consumers of healthcare, really make
you understand what is at hand here. And the program
(01:56):
is design. The information that we share with everybody is actionable,
meaning what you hear in the next minute or two
you can put into play immediately. It is not something
that is theoretical and we're waiting for new research to
come out. This is information that you could use right now,
(02:19):
and hopefully as you listen through the program, a light
goes off in your head to say, you know what,
I really really need to do a better job with
fill in the blank, something we talked about tonight. So
that is my goal. It's actionable. It's not some high
falutin theoretical kind of information that is just over everybody's head.
(02:44):
A little later in the program, doctor Masen Neuridine, he
is a hepatologist like me. He is a colleague, he
is a friend, he is a good guy. And doctor
Neuridine and I are going to be talking about what
I would say is public health enemy number one Numero uno,
(03:07):
fatty liver disease. You've heard me talk about it before.
We will still be talking about it. I'll stop talking
about it when we get it under control. But for
right now, it is absolutely not under control, and it
warrants your attention, your understanding, and the sharing of this information.
(03:28):
So stay tuned for doctor Norden. He'll be on in
just a little while. As they say. All right, So,
there was an article in the New York Times this
past week about seventeen ways to cut your risk of stroke, dementia,
and depression all at once. And you might say, wow,
(03:49):
seventeen ways to cut your risk all at once, doctor Galotti,
you must be fooling me. Well, no, not really. When
you really break it up, part these overlapping risk factors,
as I would say, are staring us right in the face.
(04:10):
They are staring us in the face. And really, what
we need to do, what you need to do, hint.
The actionable information is to look at yourself, look at
your family, look at your loved ones, look at Bob
in the cubicle next to you, if you feel like
helping him and identifying these different risk factors. So, and
(04:36):
by the way, I'm going to post this on the
Facebook page of doctor Joglotti dot com. All right, So,
the new research has identified these seventeen overlapping factors that
affect your risk for stroke, dementia, and late life depression.
I think that really is an unsung hero, suggesting that
(05:00):
really a number of these lifestyle changes could simultaneously lower
your risk for all three. Now, though they may appear unrelated,
So you say, stroke, dementia, depression, all right, maybe they're related.
Maybe not. People who have dementia or depression, or who
(05:21):
experience a stroke often end up having one or both
of the other conditions. So where there's smoke, there is fire.
Some of the risk factors common to the three brain
diseases include high blood pressure and diabetes. I mean, come on,
(05:41):
we've been talking about this for a long time. Research
suggests that at least sixty percent of stroke, forty percent
of dementia cases, and thirty five percent of late life
depression causes can be prevented or slowed by controlling the
risk factors. So let's get right to the box, because
you're sitting here saying, hey, I want some actionable information.
(06:07):
So the factors that protect against protect against brain disease. Okay,
low to moderate alcohol intake, now be careful there. Low
to moderate consuming one two three drinks a day had
a smaller benefit than consuming less than one drink a day.
(06:30):
So let me let me just say this again. In
this study, they're saying low to moderate alcohol intake may
protect you. But listen, consuming one to three drinks a
day had a smaller benefit than consuming less than one
a day. So come on, I don't know why they
(06:50):
don't come up and say less than one drink a day.
All right, so less alcohol is better. Keep in mind,
glass of wine, bottle of beer, shot a whiskey, any
distilled spirit. They're all the same, okay. Number two, these
are things that protect you against brain disease. Number two
(07:12):
cognitive activity, which really means regular engagement in mentally stimulating
tasks like reading or doing puzzles. So once you throw
in the towel and stop using your brain, your brain
sort of like melts away. So you want to stay
active now. Number three, Now this is no surprise, and
(07:37):
if you have not heard this from me, then you
may need a hearing test. A diet high in vegetables, fruit,
dairy fish, and nuts. This is pretty much the Mediterranean diet.
High diets and high end fruits and vegetables, dairy fish, nuts.
I'd probably throw in their legomes beans, I doubt they
(07:59):
would say, if you too many beans, you got dementia,
all right. Next, moderate or high level of physical activity,
And more and more and more research is showing if
you want to have life span, which means not only
you live long, say into your eighties or nineties, but
you're physically in good shape, it is moderate to high
(08:21):
level of physical activity. Walking your chihuahua around the court
or your cul de sac, to me, is not moderate
or high level physical activity. We're talking about rowing, ski machine, swimming,
riding a bike, running elliptical, doing some weight training, or
(08:48):
hit high intensity interval training where you're really going to
get your heart rate up. Now, you don't have to
do this seven days a week. If you do some
sort of exercise five or six days a week and
you do higher intensity twice a week with some weight training,
I think that would be fine. Next these are to
(09:10):
prevent brain damage. You have to have a sense of purpose.
All of us get to a point in our life
where we have led a good life, we have learned
a lot. You have to give back to society, get
back to your kids, your grandkids, your community, your church, whatever.
(09:33):
Don't think you're retiring. You just hide and watch wheel
of fortune all day. You have to have a sense
of purpose. But tie it into this is a large
social network. We are meant to be social, We are
meant to engage with one another. And so by going
out and having a large social network, you could do
(09:55):
neurologically active engagement within the social network. It will give
you a sense of purpose. You can do physical activity
with people as a group. You could eat together as
a group. A diet high in vegetables, fruits, dairy, fish, nuts,
(10:16):
and lagomes. Okay, and consume your low level of alcohol.
All right, So these are the factors to prevent a
prevent dementia, stroke and depression. Let's go over it real fast,
and we're going to take a break load to moderate
alcohol intake, though you have to be careful. It's like
(10:37):
less than one drink a day is best. Cognitive activity
meaning regular engagement in mentally stimulating tasks, read, puzzles, et cetera.
A diet high in vegetables, fruit daily, dairy fish, nuts, lagomes, monitor,
high level physical activity, a sense of purpose, and a
large social network. So doing all of these things is
(11:00):
not only going to keep your brain in check, but
it's going to keep your weight down your risk of
diabetes down, your risk of heart disease down, stronger bones.
All right, so all of these things we can't say,
I'm going to exercise to keep my brain healthy. Yes,
of course you will, but it's also to physiologically keep
(11:22):
you in check as well. All right, we're going to
take a quick break, Doctor Joe Glotti, this is your
Health First. Every Sunday evening between seven and eight pm,
we're here raising your health IQ, one listener at a time.
Stay tuned. I'll right back to you trying to raise
your health IQ, one listener at a time. You are
tuned into your health First.
Speaker 3 (11:44):
We hear.
Speaker 1 (11:46):
Every Sunday evening making you better consumers of health care.
And our goal is to keep you out of the
doctor's office, out of the key r Now, of course
we want you to go to the doctor force routine
health care checkups, but keeping you out for these chronic
(12:10):
diseases is the key. We are swamped literally for all
of us in healthcare, and I I would say it
doesn't matter what specialty you're in. So yes, internal medicine,
primary care. The lion's share of the patients that they
(12:31):
are seeing are patients that are overweight, they have high cholesterol,
they have diabetes or pre diabetes. They have cholesterol issues.
They're getting into kidney issues, orthopedic issues, they're getting into
mental health issues. And the common thread, the common thread
(12:53):
to all of these disorders is obesity. The food we're eating,
which is now becoming the norm in a sense, is
low quality food that is stripped of nutrients, stripped of fiber.
It is processed or ultra processed. And really, you have
(13:14):
to be honest with yourself, the food that a lot
of us are eating doesn't even look like food. You
can't even figure out where this came from. It's Frankenstein food.
But whether you are in that primary care realm obgyn, okay,
same thing. But then you look at the medical specialties
(13:37):
in gastrenurology, sort of diseases of the intestinal tract. You're
looking at complications from diabetes, complications from obesity. You're looking
at cardiology. Your typical modern day cardiology office is filled,
and I do mean filled with individuals that have carnary
(14:00):
artery disease, they have stens, they've had bypass surgery, they've
had some sort of arrhythmia. Atrial fibrillation is almost epidemic.
At this point, it's as common as having a cavity
in your tooth, or it might even be more common
than having a cavity because dental health has improved so
much over the last fifty years. But it is a
(14:23):
major problem. So you have to look at yourselves, yourself,
your spouses, your significant others, your children, your community. Okay,
and I like to say, look at your community. We're
talking about people that you work with, people that you
socialize with. You have to look at them and say,
(14:44):
the majority, like seventy five to eighty percent are all
at risk for underlying development of crinic disease. So when
you start talking about dementia and depression and stroke, which
we were talking about last segment, you see that it's
tied back to hypertension, being overweight, diabetes, excessive drinking, things
(15:09):
like that. So, in to continue what I was saying
last segment, getting your hypertension under control, getting your blood
pressure under control is probably one of the most important
things for you to do if you indeed want to
(15:31):
not have a stroke develop dementia. Okay, Now, the American
Heart Association a few years ago came back and said
the ideal blood sugars should be about one twenty over seventy,
so that top number should be about one twenty. It
had been one thirty one hundred and thirty millimeters of
(15:55):
mercury as the pressure, but again through research and clinical
co observation, one thirty may put you at risk, and
so the American heart wont to drive that blood pressure
even further. Now, I cannot tell you how many patients
I see with blood pressures in the one forties and
one fifties. And we'll now we're a liver practice, but
(16:20):
we have in my staff and my team, we have
created this holistic approach to all of our patients, even
in non liver or digestive related issues. They're sitting there
with a one forty, one fifty or high a blood
pressure and our first question is what's being done about this?
Does your primary care doctor know? And they will say, well, yeah,
(16:42):
they're watching this, well, watching it for what watching it
until you have a stroke and then they say, oh, hey,
you know what, we should have done something. This is
where you need to take action. And everybody tonight write
this down. If your blood pressure is not within the
one twenty to one thirty range, and you know it,
(17:03):
and it's documented. You need to call your doctor first
thing tomorrow morning, Monday morning and say my blood pressures up,
I needed to be checked out, or what are the
strategies to get it lower? Now, certainly the approach to
hypertension is multi stage. Yes, it is lifestyle. It is
(17:23):
cutting out the processed food, cutting out the sodium in
your diet, more fruits and vegetables. Yeah, but hey, didn't
I say that is important to reduce your chance of
stroke and dimension late onset depression. So yes, you want
to improve your your diet, less sweets, less fats, and
(17:44):
then it's exercise. Certainly, thirty to forty five minutes of
exercise every day is going to help with blood pressure,
but it's going to also help with weight loss. And
then if it is not critical and your blood pressure
is not coming down, that is when medical intervention is required. Okay,
(18:07):
And I know plenty of people that, yes, they come
to us on high blood pressure medicine, but with weight
loss and exercise, and we you know, we're fixing their
fatty liver. Which, by the way, doctor Mason Neuridine is
on hold and he'll be calling it in just a minute.
But so we're trying to treat the fatty liver disease.
The really the foundation of it is getting your weight
(18:31):
under control. Well, to get your weight on the control,
you have to eat better and exercise, eat smaller meals.
But the byproduct, the intended consequence of all this is
that your blood pressure is going to come down, your
blood sugars are going to straighten out, and your cholesterol
will probably improve. So all of this, and while this
(18:52):
is an article and it's posted on the Facebook page
seventeen ways to cut your risk of stroke dimension to
prey all at once, you can't look at it as
an isolated event. By treating all of these issues, you're
going to improve globally your metabolic health and reduce the
(19:14):
chance of these serious complications. All right, don't forget Doctor
Joegalotti dot com is our website. You could check out
all of our social media there. If you want to
send me a message, souner for our newsletter, it is
all there. So we're going to change gears in just
a minute after newswather traffic. Maybe here about what the
astros are doing this weekend. Go to doctor Joegalotti dot
(19:36):
com dotr mauzennuridine is coming up in just a moment,
and hope you had a great weekend. Yesterday Saturday was awesome, sunny,
it was warm, me and my family were at a wedding.
And then today Sunday a little overcast but certainly wonderful weather.
Hope you all were able to get outside. Stay tuned,
(19:57):
We'll be right back. All right, everybody, Welcome back, Doctor
Joe Galotti, your help. First you hear me Sunday between
seven and eight pm. And as I was saying early
on the program, doctor Mazen Neurdine a really an expert
liver specialist, a hepatologist, especially in the world of clinical
(20:18):
research and fatty liver disease. We're lucky that he is
a colleague of mine. He is a friend of mine
and a co collaborator, I could say, Mazen, if that's
if that's accurate.
Speaker 3 (20:29):
Indeed, an honor and privilege to be so to be
your friend.
Speaker 1 (20:32):
Chair, well, I'm really happy for that. Right here in Houston, Texas,
the world's greatest medical center. So you know, one one
disease that I talk a lot about on the radio
and certainly with my patients, and you of course talk
worldwide on fatty livid disease is fatty livid disease, And
(20:54):
for everybody listening tonight, give give your perspective on just
how big of a problem fatty liver disease is not
only in the United States, but on a global perspective.
Speaker 3 (21:08):
Yeah, it's actually much bigger than people think of. And
the reason why it's an asymptomatic disease. So you've talked
to your show multiple times about this disease as well
as the pandemic of type two diabetes and obesity. And
about sixty percent of type two diabetics have faty liver
and there'll be people more than that, but on average
(21:30):
you end up with thirty percent in the US and
more in South America and the Middle East, up to
forty percent with fatty liver disease in Texas. Actually, we
have studies that should it's about forty percent of people
they have fatty liver disease. Now, not all of them
is a problem because it started with just faten deliver.
(21:52):
But over time, if you get that inflammation and what
I call the inflammation gas on fire, leave the scarting
of deliver and evention CRUs is that we both see
a lot of patients with devastating complications.
Speaker 1 (22:05):
Yeah, now with the large percentage, and numbers have ranged
eighty to one hundred million, which is about a third
of America has fatty liver. Why don't you think the
public is more in tune with this health threat. There's
all kinds of things that people are worried about, but
fatty liver is almost tucked under the rug. What's your take?
Speaker 3 (22:27):
Yeah, multiple factors, Joe. I mean, a lot of people
are worried about the heart because it leap to heart attack,
understandably so a lot of people are worried about the
sea word cancer, understandably so. But when it comes to
fatty liver, people think that cross can come from alcohol
(22:47):
usually and there are no other causes, and they don't drink,
they're fine. But actually the most common cause of liver
disease is faty liver without drinking, and it's just associated
with type two diabetes and or being overweight and all that. Two.
It's asymptomatic, so people don't focus on it. Three A
(23:10):
lot of primary care and indochronologists we're not quite aware
of it until we started exploring it in the last
twenty years or so. And importantly, there were no medications
for it, and so people did not do anything other
than weight loss and exercise, which a lot of people
failed to do and which led to services. But now
(23:32):
things have changed. You know, we have treatment, we have
others coming. So the world has changed, and we need
to make sure people are screened for it, right, or
it's screened for it.
Speaker 1 (23:44):
Yeah, that's the key thing. And you know you mentioned
heart disease, cancer. You could add in there all the
concerns about diabetes, mental health issues, and you know, I
like to say that the liver does not have a
very good pr company behind it. It's not really advertised
as a sexy disease or sexy organ. I know you're
(24:07):
working hard, we're working hard together on this, but what
do you think people need to know about the liver
and why we need to elevate its relative importance higher
than what it is now.
Speaker 3 (24:23):
Yeah, I mean, the liver is the the factory that
do a lot of things right. It's you cannot live
without a healthy liver. It mutibolized, drug mutabilize multiple other things,
stock sins, it makes sugar, burns sugar, a lot of
(24:45):
really cool things. And there's only one liver and kidney people,
you don't go on on the analysis, but the liver,
if it gets sick, you you really need to you
really need to deliver transplant if it's too sick. So
liver is not painful, so people don't feel pain usually,
so they don't pay attention to the symptoms. And unfortunately,
(25:07):
if it gets ignored, like the seriousness does not present
until lately when people have like the yellow eyes, the gundice,
the fluid and the abdomen, which is what we call society. So,
I mean, you and I were talking this week about
how unfortunately a lot of people showing on our office
(25:29):
being told, hey, I had this for many, many years,
and no one did anything about it, and now doctor
Golotti or myself, can you help me. I'm like, well,
it's quite late, it's quite late over all to reverse it.
But the only option we have is trip transport, which
we do well. But you really don't want to get
to that level.
Speaker 1 (25:50):
Yeah, you know, I've always yeah, I've always said that
for many cases, not all cases, but getting to the
point of liver transplantation is almost a failure of intervention early,
and you know, we don't want to wait for that,
you know, really end stage. A lot of these things
we can intervene early. Now you've been mentioning certain risk
(26:11):
factors obesity and diabetes, but outline for everybody, the list
of risk factors that put you at risk for having
a fatty liver.
Speaker 3 (26:23):
Yeah, so fatty liver can be divided in general, you
get faty liver from alcohol or you get it from
non alcohol causes. So the alcohol, I'm gonna leave it
a little bit on the side because that's a different
topic for a different day. People should not drink heavily.
And what's considered a right amount of alcohol or the
maximum acceptable amount is seven drinks for a woman a
(26:47):
week and fourteen drink fourteen drink for a man a week. Now,
there are a lot of data arguing this is actually
even like a lot now they are data arguing drinking
even very little can affect your liver. So moving to
the other side, which is well when people are like,
I really don't drink, doc, Yeah, but you still can
get a liver disease, and there is factors are the following.
(27:09):
Type two diabetes is one of the elephants in the room,
followed by others such as obesity, high dyslipidemia which is
high abnormalpitanol cholesterol and all this so hypertension and in
general insulin resistant. Now, if you have type two diabetes
(27:30):
or two other risk factors, it's mandated for the primary
care to be asking for screening. There are other risk
factors that are not as noticed. But for instance, family
history of cirrusis from fatly liver PCOS, polycystic ovary syndrome,
and some thyroid isshes as well. But the big three
(27:52):
is well, a lot of people have the type two diabetes, obesity,
high coaster, and high blood pressure.
Speaker 1 (27:58):
Yeah, so now the channel lenges. You've put this out
there and there are people sitting listening to this and
they say, you know what, I am overweight, and I've
been told I have just you know, sort of a
touch of diabete is not quite sure, and they have
high blood pressure, but my doctor has not said anything.
(28:21):
So I like my doctor, and I try to follow instructions,
but you know, as we both know, that may not
be enough. So how do you encourage those listening tonight
today to take somewhat of a bold move and stand
(28:42):
up for themselves and communicate back with their doctor, their
treatment team to say, I really believe I need to
be screened or tested further. What advice do you give?
All right, if.
Speaker 3 (28:58):
Everyone is ready, either grab a paper or pen or
your phone iPhone. It's actually easy. I want to Joe,
you have been advocating for this for some time now
and many other hepatologist. It's I want you to go
to Google and look at something called FIP four. If
I be four, and you can do even FIP four calculator,
(29:21):
and there will be four things being pulled out your age,
your livery numbers ALT and a SD and your plate
it which is a blood test number, and you can
plug in the numbers in actually will tell you what's
going on. Any number more than one point three you
will need further attention and further testing. So the one
(29:45):
point three and above not less is one point three,
you're fine and you can repeat that on early basis
if you have these risk factors, and simply you can
just go to your doctor. And I saw a patient
earlier and they're pulling the labs on their their iPhone now,
so you can just plug it in and ask and
(30:08):
you can tell your doctor. I've heard this these liver
experts on the radio and doctor Glotti's shoe and my
foot four is high, doc, and can you can you
refer me? So I wish we could have a billboard saying,
look at your liver if you you have type two
diabetes or these Striss factors, know your FIP for score.
(30:30):
So the project for for for Texas. Yeah, no, it
really is.
Speaker 1 (30:34):
And and I believe that one of the things we
try to do is for people to know their lambs,
to know that, you know, when we talk to patients.
And I would say patients are getting a lot better
because they have access on their phone and patient portals
and et cetera. But to really know your liver numbers
(30:55):
and have access to be able to pull these numbers
into the calculator. All right, final segment of this week's
Your Health First coming up. I'm doctor Joe Glotti. Don't
forget doctor Joeglotti dot com. We're talking with doctor masen Neurindane,
a worlds expert on patty liver disease. Stay tuned. Final
segment coming up. Now, you certainly talk a lot about
(31:20):
other testing, ultrasounds or something called fiber san certain kinds
of MRIs. Explain how these additional tools sort of the
second level testing fits in with patty liver.
Speaker 3 (31:36):
Yeah, so thanks for bringing that up, Joe. So after
the fifth four you pulled it on your like, let's
say you pulled it on your phone or on Google calculator.
If it's more than one point three and you actually
ask you really important questions. A lot of people say,
oh my god, if I go to the doctor, they
might deliver biap scene. Most of the time, actually more
(31:58):
than ninety five percent of the time, we don't do
verbibs or ninety percent of the time. They are additional testing.
Now technology has evolved. They are what we call it
point of care, which is a machine sitting in your office,
in my office, in multiple offices and without doing liver
biomecy and can tell how much fat you have in
deliver and how much cars you have in deliver. And
(32:20):
we also have like more sophisticated MRI machines. Water faces
tell me, well, but I had MRI doc last week. No,
they are more sophisticated MRI machine where they kind of
place a pillow on your liver and it sits there
nicely softly and like vibrates a little bit and measure
how stiff is your liver. So the world really has
(32:42):
changed in a non invasive way that takes us very
close to the truth and what's happened in your liver
without a doubt.
Speaker 1 (32:50):
Yes, Now, the complications you mentioned, you know soorrhosis, and
most people think sorosis is related to being an alcoholic
or a heavy alcohol user. But the reality is in
a subset of patients with fatty liver, we are going
to see soorosis. So explain that process. Who you think
(33:13):
might be more at risk for getting cerosis compared to
the average patient with fatty liver.
Speaker 3 (33:22):
Yeah, So the time plays a big role. So the
longer you have fatty liver disease, the more like you
had that gas on fire, the inflammation and then eventually
scarring and they get ignored. The scars, scarscrs and complete
scarring of the liver is what we call cerosis, and
then you start having complications from it.
Speaker 1 (33:43):
And the heavier.
Speaker 3 (33:45):
The patient is, the more metabolic Russ factors. If you
have a patient with type two diabetes BMIO forty have
cholesterol problem, high blood pressure, certain groups such as Hispanics
that they have the disease for twenty years or so,
they likely have a like, they're highly likely to have
(34:08):
faty liver, they're highly likely to have is corning, and
they could be very close to crosis. So it's metabolic
dis factors as well as time. For sure, there are
genetics components, other components. So the combination of genetics, metabolic, time,
and age all that player role into that progrestion to cerrosis.
Speaker 1 (34:31):
You know. Another thing is that so many patients want
to try and heal their liver naturally. Now, in a moment,
we'll get into some of the new therapies that you
are spearheading. But people say, I want to take milk thistle,
I want to take a liver clanse, I want to
you know, do celeryjuicing, things like that. What do you
(34:54):
say to them? What do you say to your patients
when they have faty liver and maybe it's not quite
at the level of cirrhosis, but it certainly is showing
a bit of a wicked hand where they're at risk
for cirrhosis and damage. How do you approach those questions
when they want to try a more natural approach.
Speaker 3 (35:18):
Well, let me start with this. If the fip for
is more than one point three, please seek and advise
with a specialist, because you don't want to just start
doing supplements and juicing and stuff like this and miss
the progression. And a lot of us, you know, life
(35:39):
is busy. Years goes on sometimes without paying attention, and
then people progress and they're like, oh, oops, it has
been three four years already. I thought it was just
last year. So seek attention the supplements in general, Like
let me talk about nuk fistle for instance. I don't
think it will hurt, but there was a study or
two that should It doesn't really help much with the
(36:02):
fatty liver and the scarting from it. There. As you
know and I know, and we have seen over and
over some supplements and some things out there can can
damage the liver and hurt it. And we transplanted people
of what we call it toxicity, liver toxicity from supplementation.
So that's that's the thing that we have to be
(36:23):
careful for. Uh, there are things that could be helpful.
You and I love coffee, and all liver doctors love coffee,
and if some people that they don't, they cannot have it,
like people with the regular heartbeats or rhythmias, heartburns. But
in general, we say, drink coffee, but a lot of
(36:45):
time I emphasize if you have a lot of scarring,
coffee will not do the job by itself, So drink
your coffee. If visit your liver doctor and that yeah.
Speaker 1 (36:54):
We should set up a coffee bar in our office.
Speaker 3 (36:56):
That's I know, right, I know.
Speaker 1 (36:59):
So the last thing and for everybody just maybe tuning
in doctor mars and Neurdine is a world renowned liver
expert and researcher. The pipeline of new therapies that are
on the horizon, some are like within reach, others are
just a little bit further out there. Where are we
and what's the encouragement that you have for everybody?
Speaker 3 (37:20):
Oh, there's a huge pipeline, Joe. We already have a
drug approved out there as minerm so a lot of
so if you heard that you cannot do anything for
fatty liver, we actually do things for fatty liver. Now
there are other medications coming in the pipeline, including that
(37:42):
those that induce weight loss, the GLP ones and others.
But we also we have this European meeting that Joe
and I were going to the European Meeting for liver
disease happening next month or so, and they will be
breaking news data on patients that reverse their crusis by
one stage five ruses. So this soros is regressed and
(38:05):
that is a drug call FGF twenty one. But the
bottom line is that we have drugs for fatty liver.
We don't have anything for crosis now, but the clinical
trials are offering huge options and those are actually progressing.
Is a huge pipeline. They're available in many any in
many sides of the country, including Houston, Texas, like your center, Joe.
Speaker 1 (38:30):
And I should say, and I'll post this online to
get in touch with doctor maz and Neurdine Euston Liver Institute,
Houstonliver Institute dot com Mason in the final thirty seconds here,
we've we've really covered a lot. I would say the
one take home message for everybody tonight with regard to
(38:52):
fatty liver, what would what would that.
Speaker 3 (38:54):
Be listening to your show because you tell people how
to get healthy, lose you weight, and eat and eat well.
But if you have risk factors, know what's your fit
for more than one point three see can advise I
have options, we have treatments, and we can we can
help you, but just don't don't ignore it. Know your risk.
Speaker 1 (39:16):
Exactly all right, Doctor Maza Nourdine, thank you, Thank you
a wealth of information for everybody tonight.
Speaker 3 (39:23):
And thank you Joe for this awesome show. I listened
to it often and I know many doctors and patient
listen to it, so keep it up, my friend.
Speaker 1 (39:31):
Absolutely, Thanks Masa, thank you Joe.
Speaker 2 (39:34):
You've been listening to Your Health First with doctor Joe Blotti.
For more information on this program or the content of
this program, go to your Health First dot com.
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