Friday, December 4, 2009

Hail Coffee! Saviour of my Day

I’ve been feeling rather low and grumpy today, thanks to next to no sleep last night – new side-effect, muscle cramps in feet and ankles keeping me awake – and very low levels of energy and brain power. Plus my credit card got eaten up by an ATM because I typed in my PIN wrongly!

Craving a coffee to wake my brain, I thought I’d better check out the bad news on coffee drinking and liver function. Drinking alcohol stresses the liver (not that I’ve had any for over three weeks); guaranteed coffee will do the same, right? Wrong! I found a Medscape article describing various recent clinical studies that show drinking up to four cups of coffee a day can actually improve liver function!

This is great news, as yet another of prednisone’s annoying, possibly dangerous, side-effects is the risk of liver inflammation, which can be recognised by an increase in the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

According to this information on liver function tests, ALT and AST are enzymes located in liver cells that leak out and make their way into the general circulation when liver cells are injured. The ALT is thought to be a more specific indicator of liver inflammation, since the AST may be elevated in diseases of other organs such as the heart or muscle. ALT and AST are often used to monitor the course of chronic hepatitis and the response to treatments, such as prednisone and interferon.

As well as other liver enzymes, the study by Tanaka et al quoted in the Medscape article also investigated the potential relationship between coffee consumption and ALT and AST. Once again, coffee intake was significantly related to decreased serum concentrations of both enzymes. While it’s not yet known which compound is doing the good work, something in coffee is protecting the liver cells.

Skinny bones and Not Enough Vitamin D

As well as being short – 5 foot 3 inches “in the old language”, I have very fine bones. I used to think they were elegant, and a sign of noble breeding, blue blood(!). Now, I look at them as fragile, and potentially hazardous. I already have a history of broken toes, and a family history of osteoarthritis and osteoporosis among my older female relatives.

Knowing that the steroids can lead to bone thinning and reduced calcium absorption, I discussed calcium supplementation with my GP. She sent me off for another blood test – this time to check my Vitamin D levels. Another curse of being a woman over 60 is that we can’t make as much Vitamin D through the action of sun on our skin as we used to, no matter how much of a lizard I am, and how rarely I wear sunscreen or long sleeves.

Vitamin D is converted from cholesterol in the blood by sunlight and helps increase calcium absorption in the intestine, which builds stronger bones. Australians should be able to receive about 90 per cent of their intake from sunlight production. Experts are now warning older people not to do so much of the ‘slip, slop, slap’, sun protection routine of sunscreen, shirts and hats.

I’m not sure if it’s just us older women who lose the Vitamin D making ability or older men as well, but anecdotally, more women suffer hip fractures from osteoporosis than men.

So, the blood Vitamin D results are back, and yes, I have only 50 per cent of the serum levels that I should have. I’m now taking a calcium supplement fortified with Vitamin D.

Chinese Herbal Medicines

I’ve made contact with a local GP who practises both western medicine and TCM and has treated at least one other patient with ITP. Unfortunately, she can’t see me for another couple of weeks.
I’m hoping to be put on a course of TCM herbal remedies to help strengthen the liver, increase absorption of calcium from my diet, improve my Vitamin D making abilities, stop the muscle cramps, shrink my face, unblur my eyes and give me a good night’s sleep.

In the meantime, I’m off to make myself a pot of coffee!


  1. Thanks for helping me make sense of a maddening situation. I am in Canada. The lengths we have to go for support.

  2. Hi Ramona, Glad to be of some help. Other than my doctor, I had no informed support, and like most of my family and friends, had never even heard of ITP when diagnosed, even though I was a medical and science reporter. It is maddening, & there's so many unknowns!

    I hope you find some useful information on this blog, and some encouragementfrom knowing you're not the only one.

    best wishes, Portia