DEAR DR. ROACH: I have been suffering from fatty liver for the past 10 years. Is there any medication to reverse it? — A.A.
ANSWER: Fatty liver is a very common finding that refers to the accumulation of excess fat in the liver cells.
The most common cause, in people who do not drink excess alcohol, is being overweight, which eventually leads to insulin resistance and many other metabolic abnormalities. This includes changes in the cholesterol levels and elevations in blood pressure.
Although you asked about medication treatment, the primary treatment for people who are overweight with fatty liver is losing weight.
Ideally, this is accomplished through healthy dietary changes and increased exercise; however, bariatric surgery is worth considering in people who continue to have fatty liver despite their best efforts on diet and exercise.
Fatty liver should not be taken lightly. It may progress to inflammation of the liver (steatohepatitis, from “steat-”, meaning “fat” in Greek), fibrosis and eventually cirrhosis of the liver.
Drug therapy is more often used to help the underlying and accompanying conditions than it is for treatment of the fatty liver itself.
Treatment of diabetes (if present), high blood pressure and high cholesterol are often of benefit in reducing not only liver disease risk, but also risk of heart attack and stroke. Weight-loss medications are prescribed by some weight management experts.
For people who have fatty liver without diabetes, the use of vitamin E appears to be of modest benefit, although there are conflicting data. Vitamin E should not be used in people with diabetes for the treatment of fatty liver.
Most experts will not use vitamin E in men with a personal history or strong family history of prostate cancer, since a large trial showed vitamin E increased the risk of prostate cancer about 17%.
DEAR DR. ROACH: I read your response to the guy with itching ears in a recent column.
I have that problem from wearing hearing aids. The itching is near the surface. I asked a pharmacist what to use, and he recommended 1% hydrocortisone on a cotton swab. This solved my problem, and I have used it for years. — D.C.
ANSWER: I appreciate your writing. Hydrocortisone is an effective but nonspecific treatment for itching on the skin. In the case of hearing aids, it may be that your skin is having a slight reaction to the material of the hearing aid.
Many people get itching ears without hearing aids. In this case, occasionally treating the symptoms with hydrocortisone is reasonable. If it doesn’t work, the ear canal needs an exam. Eczema is a common problem in the ear canal.
I am also cautious about using cotton swabs in the ears.
For applying medicine near the outside of the canal, a swab should be safe, but you should be very careful with any instrument inserted into the ear, as careless swabbing can perforate the eardrum.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
ARIES (March 21-April 19)
Security and cash flow issues are highlighted today. Much can be accomplished if you combine your analytical ability and forethought with the actions you initiate at this time. An old love can return. Children are a source of concern. Tonight: Venture into unfamiliar territory.
TAURUS (April 20-May 20)
Friends offer challenges and stimulating ideas. But for the most part, you will feel the urge to keep a low profile. Secretive. There is much you would prefer not to reveal. Solutions to difficult financial situations are in the wind. Tonight: Your life moves forward.
GEMINI (May 21-June 20)
Endings and beginnings must be balanced. Be alert to new trends in your professional sector. Networking leads to opportunity, and friends can truly be a blessing. A friend suggests charitable projects. Tonight: A new state of mind and new interests.
CANCER (June 21-July 22)
Social contacts impact your credibility. Elements of fate and fantasy affect your career today. Expressing imaginative ideas assures success. If you have always wanted to enroll in classes or write, now is the time. Tonight: You will be drawn toward altruistic interests.
LEO (July 23-Aug. 22)
A friendship with a foreign-born or very intellectual friend might lead to romance. You decide, attached Leo. You have greater vitality and clarity of thought. Enjoy this time of progress and accomplishment. Ignore the romance. Tonight: You have better fish to fry.
VIRGO (Aug. 23-Sept. 22)
Be patient if negotiating a pay raise. Employ humor and perspective. This helps you win your case. Be wary of advice that contradicts your better judgement regarding money. A friend gets in touch after three years out of the blue. Tonight: A Gemini is involved.
LIBRA (Sept. 23-Oct. 22)
One whom you cherish celebrates a success. Graciously allow them to take center stage. Write a wish list of desires you would like to manifest. An old hurdle is overcome. Diplomacy is essential in your delicate negotiations. Tonight: Use care in making promises.
SCORPIO (Oct. 23-Nov. 21)
Health and fitness factors surface today. It is the perfect time to transform any negative habits. Try to schedule some body work. Massage, shiatsu, lymphatic drainage, whatever you need most. Schedule it today. Tonight: Take the night off for yourself.
SAGITTARIUS (Nov. 22-Dec. 21)
An old love might return. Children are a source of both joy and concern. Invitations come to travel and visit — the first time since the quarantine began. Planning a party for co-workers is a great option for making the best of today’s benevolent influence. Tonight: Celebrate.
CAPRICORN (Dec. 22-Jan 19)
Family members offer ideas about interior decorating, family travel and household dynamics. It immediately brings residence and family issues to the fore. The structure of your family life is in flux. Tonight: Gracefully accept the fact that family ties change as time passes.
AQUARIUS (Jan. 20-Feb. 18)
A vehicle might need servicing or replacement. Be aware of events in your neighborhood that affect you. Stay on top of home repairs and security. A sense of purpose guides you toward worthwhile goals. Tonight: Exercise provides the perfect release.
PISCES (Feb. 19-March 20)
New strategies are worth examining. Partnerships are active. An associate has ideas about business and security needs. Enjoy candlelight during social situations that involve business negotiations. Attitudes about long-term goals are changing. Tonight: Your feelings about several friendships are in flux.
For entertainment purposes only.