After weight-loss surgery, some patients may experience a transient elevation in liver function tests that resolves over time. We have previously reported on this. IT is essential to distinguish between the Duodenal switch and the SIPS/SADI procedure, where some patients are led to believe they are identical. These procedures differ physiologically, and their weight loss and metabolic behaviours vary significantly.

Other than the stress of the weight loss, obesity, and comorbidities of obesity, there may be other anatomical post-surgical causes for elevated liver function test. This has also been discussed extensively.

A recent literature review supports the protective effects of vitamin D supplementation.

Effects of vitamin D supplementation on the glycaemic indices, lipid profile, and liver function tests in patients with cirrhosis: a double-­ blind randomised controlled trial

Low serum 25-hydroxyvitamin D levels are associated with liver injury markers in the US adult population

Exploring the Correlation Between Vitamin D Level and Serological Markers in Liver Diseases: Insights from a Cross-Sectional Study

Elevated liver enzymes may be caused by many factors, including nutritional deficiencies, excessive supplementation (turmeric), medications, alcohol, adhesions causing partial bowel obstruction, and increased enterohepatic bile reabsorption . I would be very cautious about associating vitamin D supplementation with elevated liver function test results, even if the vitamin D level is in the very high normal range, regardless of the  daily dose (much less frequent with injectable).

Vitamin D, as a fat-soluble vitamin, however, protects the liver and improves liver function test even in very high serum level . In rare cases, prolonged, elevated vitamin D levels may strain the liver. In Fact, the association of the vitamin D level and liver disease, including cirrhosis, leads to hepatocellular carcinoma (HCC) and dea h. Vitamin D protects the liver from HCC but cannot reduce the risk of cirrhosis.

Cheers! Let’s take a minute to look at alcohol metabolism. It’s that time of year when it seems we are going from one Holiday or Christmas party to another, and then we get together with the family and have a little more alcohol. The following diagram shows how alcohol metabolism takes place.

Alcohol is a caloric intake, and we all need to keep close tabs on it. Alcohol is very easily metabolized and the calories add up quickly.  Every stage of alcohol processing in the liver involves the extraction of calories and free radicals, which are toxins. Excess calories not used in bodily functions can be stored as fat mass. Alcohol can be a  roadblock in weight loss. Those drinks add up!

Here is a short video as a reminder while everyone waits to get ready for the next party.

Happy holidays.

A newsletter post from 2004 regarding the effects of alcohol and weight loss surgery. 

We should be aware that being physically active is part of being healthy. Health is a combination of being physically active, having a healthy diet are all parts of the variables that contribute to our physical and mental well-being long-term.

The restrictions and the stressors caused by COVID-19 have resulted in our inability to maintain a healthy diet and be physically active. However, we must be vigilant with maintain our activity levels to combat health issues.

It is timely that the British Medical Journal has just published an entire issue regarding the significance of activity and our health as individuals and public health worldwide.

There are a few articles that are outlined here.

Ekelund et al. Reviewed published articles and correlated the activity level and mortality. They Concluded, “Higher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.”