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DR. EHTISHAM
DR. EHTISHAM, Doctor
Category: Medical
Satisfied Customers: 3057
Experience:  MBBS, FCPS
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Here is my situation: I have Chronic Hepatitis [viral] 'C'.

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Hello,
Here is my situation: I have Chronic Hepatitis [viral] 'C'.
Here is my question: Having this condition, restricts the liver's efficiency to metabolise substances such as nutrients [carbohydrates, proteins etc] and alcohol. I am told this is due to "Cellular Reserve". Can you please:
[a] Confirm this
and
[b] Explain exactly what "Cellular Reserve" is?
[c] Can you recommend any texts that are available for me to read further?
I thank you [in advance] for your knowledgeable advice.Kind regards,Stephen

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with your reply momentarily.

Thanks for the question

If the damage to liver by hepatitis is a moderate or severe one then an issue can occur with the metabolism of various nutrients

The liver plays a unique role in controlling carbohydrate metabolism by maintaining glucose concentrations in a normal range. This is achieved by a tightly regulated system of enzymes and kinases regulating either glucose breakdown or synthesis in hepatocytes.

Liver change amino acid in foods so that they can be used to produce energy, or make carbohydrates or fats.

Ammonia is a byproduct of protein metabolism and thus it can start to accumulate in blood if liver is damaged and give rise to toxic manifestation

This all occur if there is advanced damage to liver like in Cirrhosis

Usually these features are not seen in case if the liver is not having fibrosis or Cirrhosis

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072577/

https://www.ncbi.nlm.nih.gov/pubmed/17236121

Alcohol is also metabolized in liver so use of alcohol can further increase the risk of liver toxicity

I sincerely ***** ***** I have helped you,and that I have earned my 5-stars rating today.

Please remember to rate my service by selecting 5-stars at the top of the screen(rating me now does not close your question)

We can continue further till you are satisfied and you simply use the reply box to let me know

Thank you and regards

So in advanced liver disease there is risk of hypoglycemia or low blood sugar and toxic effect of ammonia on the brain causing encephalopathy

Please do let me know if you have any other question

Regards

Customer: replied 3 months ago.
Dear DR. EHTISHAM
Thank you for your prompt reply. So, as I understand it, having Hepatitis can restrict the Liver's ability to metabolise. I am told this is due to the Liver's "Reduced Cellular Reserve" or "Lack of Cellular Reserve", so can you confirm that: I have had fibrosis.
Also, can you actually define the terms: "Reduced Cellular Reserve" or "Lack of Cellular Reserve" for me [in easyly understood layman's terms?Thank you in advance again.Stephen

Dear *****.

Liver is composed of a number of cells called hepatocytes

Once there is a liver disease or injury there is damage to these cells

In some conditions like acute hepatitis the liver regenerate itself and there is no long term damage to the liver

In chronic hepatitis or any other chronic damage the liver regenerative capacity is lost

So this leads to a reduced or lack of cellular reserve and if this cellular reserve is completely lost signs of liver failure develop leading to defect in various synthetic and metabolic function of the liver

You can have an ultrasound and fibroscan to assess the exact status of liver and whether you have any features of cirrhosis or not

Synthetic function of liver can be checked with simple blood test called serum albumin and PT/APPT/INR level

Please do let me know if you have any other question

If done please leave a 5-stars feedback rating

Regards

DR. EHTISHAM and other Medical Specialists are ready to help you
Customer: replied 3 months ago.
Dear DR. EHTISHAM
Thank you for your prompt reply. So, as I understand it, having Hepatitis can restrict the Liver's ability to metabolise. I am told this is due to the Liver's "Reduced Cellular Reserve" or "Lack of Cellular Reserve", so can you confirm that: I have had fibrosis.
Also, can you actually define the terms: "Reduced Cellular Reserve" or "Lack of Cellular Reserve" for me [in easyly understood layman's terms?Thank you in advance again.Stephen

Dear *****.

Liver is composed of a number of cells called hepatocytes

Once there is a liver disease or injury there is damage to these cells

In some conditions like acute hepatitis the liver regenerate itself and there is no long term damage to the liver

In chronic hepatitis or any other chronic damage the liver regenerative capacity is lost

So this leads to a reduced or lack of cellular reserve and if this cellular reserve is completely lost signs of liver failure develop leading to defect in various synthetic and metabolic function of the liver

You can have an ultrasound and fibroscan to assess the exact status of liver and whether you have any features of cirrhosis or not

Synthetic function of liver can be checked with simple blood test called serum albumin and PT/APPT/INR level

Please do let me know if you have any other question

If done please leave a 5-stars feedback rating

Regards