*Results may vary. The information in this site is NOT to be construed as medical advice. Cirrhosis of the liver is a serious condition and if you have it, you should see a doctor. I am not a doctor and am not able to dispense medical advice. My husband saw a doctor (many of them) and they were able to do things for him that I could not. However, they were unable to recommend alternative treatments, and in MY OPINION they were VERY beneficial to my husband, so I am providing some of that information here. My husband and I tried all of these alternative therapies at our own risk, and if you try them you will be doing the same. At your own risk. No promises are made in this blog. I am not saying there is a cure for cirrhosis or any other condition. However, I believe most people can get well, like my husband did. My husband is alive, happy, productive, functional and has his energy back. He no longer worries about having to go on disability or getting a $577,000 liver transplant. Cirrhosis is a serious condition. He is currently in the fibrosis stage (Stage 2 liver disease), which is still serious. I cannot guarantee you will have the same results. I just want you to know about what worked well for my husband. I hope you will share what you learned with others, and share your story with us as well. This blog was made for YOU! Thanks for visiting!

Sunday, October 20, 2019

DDP Yoga - You guys have to watch this!

I am thanking God for the insomnia that woke me up around 4:30 AM today.  In my semi-groggy state, I wound up clicking on a YouTube video that had this as the "streaming ad" commercial. I feel really grateful to have been able to see it, so that I could put it on this blog. 

Exercise is really helpful for people with cirrhosis, but it's really hard to find something that's safe, low impact, that builds strength and muscle tone, that you'll want to actually stick to, when you feel like you have little to no energy - OR motivation! But this video I saw, shows a really great way that people could do just that, and I can't help thinking DDP (Diamond Dallas Page) is the kind of guy who'd be able to "connect with" a LOT of people with cirrhosis. He knows what it's like to be down and out. Many pro wrestlers turn to drugs and alcohol, later in their lives. DDP has a lot of friends who've died, but he found a way to rise above all that, and inspire his friends to get healthy again.

I do have to put the disclaimer here, that you are supposed to check with your doctor before beginning any type of exercise routine, but you really can't get any more "low impact" than yoga! And he combines it with his own rehabilitation techniques he was given, when he broke his back, so you can get a LOT of value from one of his programs.

People with cirrhosis get the message over and over again, that cirrhosis and scar tissue cannot be reversed (but we refused to believe it, and we're glad we did).  This video I saw at 4:30 am (below), really spoke to me, because, here's a guy who was told over and over by doctors, that he'd never walk again. He's a military veteran, who severely damaged his back after jumping out of planes, so many time that it caused (what seemed like) permanent damage to his back. Due to his injuries, he couldn't walk without forearm crutches, and often had to use a wheelchair.  He kept on gaining more and more weight, and his health was getting worse and worse. The doctors led him to believe that this was the low quality of life he just had to accept.

But one day, he managed to find DDP's videos on the internet - and they changed his life (I won't give away the details, you just have to watch it). This is such an inspiring video, it made me teary eyed. Heck, it even made Joe Rogan cry (you can see the video, further down the page).

Yoga is something that could be great for people with cirrhosis, because it is very low impact, and it builds strength and muscle tone, which can be important in increasing albumin, which can help you to reduce ascites and edema. Without enough albumin, fluid can leak all over your body, instead of staying inside the veins, where it should be. More and more articles like this one show that building muscle is important for longevity.

I have never done Yoga, partly because I've never gotten around to it, but also because to be honest, I've developed some associations to it, that don't fit in with how I see myself. When I think of yoga, I can't help thinking about the rich upper class women who live around me, who seem to "represent" yoga, as they parade around in their yoga pants, cart around their yoga mats, and shop at LuluLemon, while a nanny watches their kids. Yoga seemed to have turned into an elite activity for the rich and wealthy.  Yeah, I know, I've been making judgments, and I shouldn't knock it until I try it (nor should I knock these rich ladies who can afford nannies and yoga classes). I do realize that Yoga didn't start off that way, and just because certain types of people tend to gravitate towards it, that doesn't mean it couldn't be good for the rest of us, even if we don't fit in with the majority.

What I love about DDP, is that he changes the whole "vibe" of yoga. For most of my life, I've been pretty averse to working out, NOT because I am opposed to exercise, but I just don't like all the hype that goes along with it. It's like a whole lifestyle thing, that's designed for rich and famous people who can afford to work out (yeah, again, I know, this could be a story I've come to make up in my head... what better excuse for not working out). But still... it was an obstacle my brain set up. 

Well, DDP is all about removing obstacles, so that people can heal their bodies, and gain strength through fitness. He has a special gift for helping people who are really down and out, and feel like they've hit rock bottom. The program reminds me of the Phoenix gym I posted a video about, on this page, a few years ago.

This is the extended version of the video, if anyone cares to see it.

Here's the video with Joe Rogan...

Here's another really inspirational testimonial. The thing I love about this video is, this man GAINED 3 pounds when he first started, but he didn't let it get him down, and he kept on going. SO many people look for an immediate payoff, and when they don't see it (or they slide backwards), they give up. But you really need to have tenacity, and this guy has it.  Check this out: 

Another great story:

Here's a video about how DDP lifted up his former mentor, wrestler Jake the Snake.

Another testimonial...

And here's one more I had to share, because my husband used to really suffer from back pain.

This guy really felt like the documentary, "The Resurrection of Jake the Snake" could have saved his life. Will post a link for the video trailer, below this one.

This is the Amazon link you can click, to watch the trailer for The Resurrection of Jake the Snake. For some reason, at the moment, this full video doesn't seem to be available, but I am hoping this is just temporary, and maybe it will be available again in the future.


You can also see the video trailer, here:

Here are some of DDP's videos on Amazon, and there will be a link for his website and YouTube channel at the bottom of the page.

WWE: Diamond Dallas Page: Positively Living!

Positively Unstoppable: The Art of Owning It

Get the app, here: 

Positively Page: The Diamond Dallas Page Journey

DDP recommends using a heart rate monitor. 
Here are some affordable Heart rate monitors that have really good reviews on Amazon:

LETSCOM Fitness Tracker HR, Activity Tracker Watch with Heart Rate Monitor, Waterproof Smart Fitness Band with Step Counter, Calorie Counter, Pedometer Watch for Kids Women and Men

Letsfit Fitness Tracker HR, Activity Tracker Watch with Heart Rate Monitor, IP67 Water Resistant Smart Bracelet with Calorie Counter Pedometer Watch for Kids Women Men

 And this one has about 170 reviews, with a 5 star average:

Letsfit Smart Watch, Fitness Tracker with Heart Rate Monitor, Activity Tracker with 1.3" Touch Screen, IP68 Waterproof Pedometer Smartwatch with Sleep Monitor, Step Counter for Kids, Women and Men


And this one just has five 5-star reviews, as of this writing, but I'm posting it here because I think it looks cool: 

Honor Band 5 Smart Bracelet Watch Faces Smart Fitness Timer Intelligent Sleep Data Real-Time Heart Rate Monitoring 5ATM Waterproof Swim Stroke Recognition BT 4.2 Wristwatch

I like this yoga mat because it's inexpensive, extra thick, and has good reviews:
AmazonBasics Extra Thick Exercise Yoga Gym Floor Mat with Carrying Strap - 74 x 24 x .5 Inches, Blue\


You can see more of DDP's videos, and subscribe to his channel on YouTube, by clicking HERE.
You can see his website (and order his workout videos) by clicking HERE.

Hope he will inspire some of you to rebuild your strength. I know he certainly inspired me, and I'm going to see if I can get my husband to do some of his yoga videos with me : ).


When you see commercials for Pharmaceuticals.... remember this

Think about how many times you've seen some sort of pharmaceutical commercial like this one, below. It's amazing how much trust can be built with the right mood music, the right words, and the right actors (which will inevitably include some "doctor" in a white coat... is this how we got the term "doctored up")? 

Watching these commercials below, you get the feeling that this drug is safe to take. Or, should I say, we've just gotten used to thinking it's normal to hear commercials with serious side effects, and thinking it's ok to take the stuff.  Is there anything about these commercials that makes this drug appear to be LESS safe than any of the other pharmaceuticals being advertised on television, right now?  Further down the page, you'll see what Xarelto has been shown to cause (and a YouTube commercial for a lawsuit against the manufacturer).

How did we get so numb, as a society, so that we think it's somehow OK to take any drug that says THIS in the commercials:

Don't stop taking Xarelto without talking to your doctor, as this may increase your risk of stroke, while taking a spinal injection increases the risk of blood clots, which may cause paralysis, the inability to move. You may bruise more easily, or take longer for bleeding to stop. Xarelto can cause serious, and in rare cases, fatal bleeding. It may increase your risk of bleeding if you take certain medicines. Get help right away for unexpected bleeding or unusual bruising. Do not take Xarelto if you have an artificial heart valve, or abnormal bleeding. Before starting, tell your doctor about all planned medical or dental procedures, and any kidney or liver problems. Be sure you're doing all you can, to help protect yourself from a stroke. Ask your doctor if it's time for Xarelto."

In case you're not already aware of this.... when you hear "please tell your doctor if you have kidney or liver problems," that typically means it can cause kidney or liver damage. If you're healthy, you can probably handle a certain amount of kidney or liver damage and be ok. But if you're not healthy (which most people probably aren't, if they're considering taking this drug in the first place), then there's probably a good chance your liver and kidneys won't be able to handle it, in the long term! You may not even be aware of whether or not you have kidney or liver damage, so the side effects could take you by surprise. And, if you're thinking of taking a drug like this, for the short term, keep in mind what'll happen once you STOP taking it. As it said in the commercial: 

Don't stop taking Xarelto without talking to your doctor, as this may increase your risk of stroke


Now, check out what this lawyer has to say about Xarelto. This is just one example of many, many drugs that wind up turning into a huge lawsuit.  


This same lawyer also has something to say about Proton Pump inhibitors. In case you haven't seen my posts (or should I say rants) about PPI's like Nexium, Prilosec, Prevacid (and in cirrhosis patients, Pantroprazole or Omeprazole), just keep reading my blog.

There are so many times when I hear some commercial on TV, and then they get to the side effects and talk about how bad they are, and I always think the same thing: Why in the f*** would someone take that????  OK yes I know, obviously the answer is, because they are trying to get rid of whatever that other problem is, that they have. But you really have to consider how it will affect your health in the long term. This is why I'm such a huge fan of alternative healing, although, in my opinion, it should be called NORMAL healing, and pharmaceutical drugs should be considered "the alternative."

Wednesday, September 11, 2019

A post for anyone who's healing from the loss of a loved one

I've been wanting to make this post for a while. I've spoken to enough people who've had loved ones who died from cirrhosis, and music has always helped me to get through the loss of a loved one. I've lost all my Grandparents, my father, and a few pets that were so much like family, I still miss them to this day. 

It's been an emotional journey, the last few years, to speak to so many people with cirrhosis. When I hear that someone has passed away, my heart hurts, and I feel like I'm going through the loss of my own loved one all over again. My friend Jane passed away at age 78, around this time, last year, and the fall weather and so many other things are reminding me of her. It's been hard, and I've been popping Sam-e and Vitamin D and trying to do what I can to keep from falling into a terrible depression. Some of these songs made me start to cry all over again. But I do think it's therapeutic to allow ourselves to cry and bring some of that pain and loss to the surface sometimes, so that we can release it and move forward.

I wanted to share some of the songs that have helped me to heal from the loss of my own loved ones. I also put some of them in a playlist... if you'd like to listen to some of them, just CLICK HERE.

This one by Carrie Underwood is, in my opinion, the most beautiful one on the list, because it is so uplifting, and it makes me hopeful that I really might get to be able too see my loved ones again, one day.

I have to warn you, this video below is a real tearjerker. But it also might be the most touching video I've ever seen, regarding the loss of a loved one. I remember showing this video to one of my best friends on my cell phone. We were both bawling our eyes out, as we had both lost our fathers, and we both knew what it was like to want to do everything we could, to save them. It's really hard to let someone go, when they are in a hospital, and this video addresses that... but in a beautiful way. 

Love this song.

I lost my Dad in 2001, and this song was still being played on the radio a lot. At the time, I had no idea what it was about. It was only years after my Dad's passing, that I learned this song was about Pat Monahan losing his mother to cancer. It took on a whole new meaning, and now, every time I hear it, I think of my Dad and my friend Jane.  Really, really beautifully written song. Further down the page, I also included their performance of this at the Grammy's.

I love how Pat Monahan says, in this inteview: "The best thing we can do by loss of love is, find ourselves through it."

I'm embarrassed to admit this, but... like I said earlier, I didn't know what this song was about, when I saw this peformed live at the Grammy's. I just remember thinking, wow. This was a really big performance for a small club band from San Francisco. But boy, did they deserve it. This is such a beautifully written song, I'm giving Pat Monahan a virtual hug to say thank you for writing it.

It just occurred to me, right after I posted this video, that today is 9/11. It really was just a coincidence that today is the day I finally got around to posting this (I'd wanted to make it for a few weeks). I had included Enya's "Only Time" on my youtube playlist of song to help a person heal from loss, but I'm including it here also. My Dad passed away the month after 9/11, and it seemed like this song was being played nonstop on the radio. I'm not from a lovey dovey family where people say "I love you." Like, ever. But a few days after 9/11, I called my Dad and got his answering machine, and at the end of my message, I said, "I love you." And after he passed away, I was going through his answering machine, and I saw that he had saved my message, and it warmed my heart. I still talk to him on occasion, and I talk to Jane, too. They were best friends, and they were both good people, and I can feel that their presence is still with me, and I know they both helped to make me a better person. I think it's not about how long we're alive, but the people we leave a positive impact on, while we're here.

Charlie Puth is a great songwiter, and this is a great tribute song.


Sarah Mclachlan is always a good way to make tears flow.

This song isn't necessarily about loss, but I've included it because I like sharing this with the people who have worked tirelessly to save others. I know that most of the people who read this are caretakers, and people who are trying (or have tried) to save their loved ones. This is a beautiful song.

When I lost my favorite cat of all time, a few years ago, I was devastated. It left a big hole in my heart. I actually got him from Jane, and he was so great, in so many ways, I still miss him to this day. He was like my big baby, and when he passed away, I listened to this song a lot. It made me cry, and just hearing this song makes me cry, to this day. But it's beautiful, so I'm sharing it here.

Beautiful song, period.

I never listened to these lyrics until today. I found this song embedded on a different playlist someone else had created - a bunch of beautiful songs about loss, and this one was on there. Now I will appreciate it even more, next time I hear it.


Beautiful tribute by Eric Clapton, to his son.

Pink is such a beautifully emotive singer. This was also on that playlist I mentioned, earlier.

When Jane passed away last year, my sisters and I had to go to her house and sort through her belongings. I listened to the radio a lot, and during that time, this was being played a lot. One day, I saw the video, and started bawling. It made me think about the pets and people who've brought joy into my life. We want it to be forever, but really, we are all just part of a big life cycle, and the best we can do is to bring happiness to others, while we're here. This is a beautiful song and video.

And lastly... this song is not about death, but it's a song that reminds me of my Dad, because he liked John Denver's music, and at his memorial service, we hired a guitar player who sang this song. Now, it always reminds me of my Dad. We can't keep our loved ones forever, but we can always keep the beautiful memories we have of them, and we can keep them in our hearts forever. 

I also want to point out that John Denver is a good example of someone who died too young, but he spent his life creating music and bringing joy to others. Even though John Denver is long gone, we can always keep him alive in our hearts, through his music. We're all making our mark in some small way. My father didn't realize that when he had me, I'd end up writing a blog about cirrhosis (he always encouraged me to be a writer, but probably didn't predict it would be in this form). Sometimes we just don't know what kind of imprint we're going to make on this earth, but we can all become better people, thanks to the experiences we've had, and the people who've been good to us.  I like to think we're all here to just keep paying it forward.

To anyone who has lost a loved one, through cirrhosis or any other disease, I hope you will be able to heal, and also to keep their spirit in your heart, as you move through life. And if it is possible, I hope that we will all be able to see our loved ones again, someday.



Saturday, July 27, 2019

The Critical Importance of Vitamin D3 - Especially for someone with Cirrhosis!

I recently did some more research on Vitamin D3, and found a study that showed that supplementation in patients with NAFLD, using 20,000 IU per day for one week (then weekly, thereafter), brought the patients' levels to a normal range! I learned quite a bit about Vitamin D3 recently, and wanted to share it with you guys in case it might help, any.  
Of course, I am not a doctor, and cannot give medical advice, but I still thought this was worth sharing, and I encourage you to do your own research : ). 
 In my opinion, WAAAY too many people are just plain scared to take too much Vitamin D3, because somewhere along the way, we heard it's a fat soluble vitamin we have to "watch out for." But I think sooo many of us just don't get nearly enough. 

I was vitamin D3 deficient in my 20s and 30s, until I discovered how much a lack of D3 was contributing to depression and back pain. I decided to take 10,000  IU after reading that Dr. Andrew Weil said it's considered safe to take up to 10,000 IU. I can tell you I have a friend who was taking 25,000 to even 50,000 IU per day. She was getting her blood monitored, though, but it really seemed to be helping her. I've never had my blood monitored, and on occasion have taken up to 25,000 IU with ZERO side effects, but that doesn't mean it'd be safe for you also. You should be under a doctor's care. You know the drill. 
Please read what Dr. Weil says about Vitamin D3:

He says:

Are There Any Risks Associated With Too Much Vitamin D?

No adverse effects have been seen with supplemental vitamin D intakes up to 10,000 IU daily. Exposing the face and hands to roughly 10 minutes of direct sunlight daily is also quite safe and a good way to boost vitamin D; for some tips on general sun safety, read the DrWeil.com Q&A: “No Fun in the Sun.”

So what is a Normal Level of Vitamin D, anyway?

It's helpful to know what is considered a "normal" vitamin D range, in a blood test (I didn't know what a normal range was, myself, till I just looked it up):
What is the normal range for vitamin D in a blood test?
This guideline recommends a minimum vitamin D level of 20 ng/mL, but to guarantee sufficiency they recommend between 30 and 50 ng/mL for both children and adults.Jan 10, 2018
When a person has cirrhosis they become soooooo vitamin D3 deficient! I just get this feeling that Vitamin D3 is one of those supplements that gets sucked up like a sponge, by a person who has cirrhosis, because their bodies are crying out for more nutrition.

Check out this study of patients with NAFLD (non alcoholic fatty liver disease), which shows... participants in a study, who took 20,000 IU per day (then 20,000 IU per week, for 6 months) were able to bring their Vitamin D3 levels up to 34.7 ng/ml, which is considered an average range!  

Please note, I am not an expert on vitamin D3, but like I said, it can attest it worked like a miracle for my own back pain. Please be sure to do your own research, and make sure if you take more than 10,000 IU, you are getting your vitamin D3 levels checked.

Recent clinical trial discovers vitamin D supplementation may improve non-alcoholic fatty liver disease

Posted on: July 11, 2016   by  Amber Tovey
A recent clinical trial found that vitamin D supplementation reduced liver fat infiltration among patients with non-alcoholic fatty liver disease.
Non-alcoholic fatty liver disease (NAFLD) is the accumulation of fat in the liver unrelated to excessive alcohol consumption. The cause of NALFD is multifactorial, resulting from both genetic and environmental factors.
NAFLD is common, with a prevalence of 25-45% in Western countries. The majority of individuals with NAFLD do not experience signs, symptoms or complications. However, in some, NAFLD can progress to liver cancer or liver failure.
Researchers became interested in the role that vitamin D plays in NAFLD due to the presence of vitamin D receptors in the liver. Furthermore, research shows that vitamin D deficiency is linked to greater severity of NAFLD.
Recently, researchers aimed to determine the effects of vitamin D supplementation in NAFLD patients who were considered vitamin D deficient (< 20 ng/ml). A total of 40 patients from an outpatient liver clinic fit the criteria, and thus, were included in the study. The researchers quantified the severity of NAFLD by measuring controlled attenuation parameter (CAP), a marker used to assess liver fat content. Higher values signify greater liver fat content.
The study lasted six months. During the first week, all patients were instructed to supplement with 20,000 IU vitamin D3 daily. This dosage was followed by 20,000 IU vitamin D taken on a weekly basis for the remainder of the six months. The researchers performed follow ups after four weeks, and at three and six months. Here is what they found:
  • Average vitamin D status at baseline was 11.8 ng/ml.
  • Following six months of supplementation, average vitamin D levels significantly increased to 34.7 ng/ml (p < 0.0001).
  • CAP decreased significantly from baseline (330 vs 307 dB/m) during supplementation (P = 0.007).
  • An average CAP reduction relative to baseline was observed at four weeks, three and six months.
The researchers concluded,
“The degree of hepatic steatosis significantly improved after only four weeks of vitamin D replacement therapy in the absence of concomitant weight loss in this six-month supplementation study. Hepatic steatosis, as assessed by CAP, is a dynamic process, which appears to be modulated by interventions such as vitamin D substitution.”
The study suggests that patients who are affected with NAFLD should supplement with vitamin D to reduce liver fat content. As a clinical trial, the study design was relatively strong. However, the study lacked a control group, leaving room for placebo effect to possibly skew the results. The researchers called for controlled trials to further assess the possibility of managing NAFLD with vitamin D.

 And there's this study:


Home » Harvard Health Blog » Vitamin D: What’s the “right” level? - Harvard Health Blog

Vitamin D: What’s the “right” level?

POSTED DECEMBER 19, 2016, 9:30 AM , UPDATED OCTOBER 26, 2018, 8:55 AM
Monique Tello, MD, MPH

Contributing Editor
Many of my patients who come into the office for their physical exams ask to have their vitamin D levels checked. They may have a family member with osteoporosis, or perhaps they have had bone thinning themselves. Mostly, they want to know that they’re doing everything they can to keep their bones strong. Vitamin D is critical for healthy bones. But when we check that blood level, how to act on the result is the subject of great controversy in medical-research land.

Pinpointing a “healthy” vitamin D level is tricky

So, what is the current cutoff value at which people are considered “low,” and thus at risk for developing bone thinning and having fractures? (We are talking about the blood level of 25-hydroxy-vitamin D, which is usually measured in nanograms per milliliter.) Ah. This is where there is a lot of argument.
In 2010, the venerable Institute of Medicine (IOM) issued a report based on lengthy examination of data by a group of experts. To sum up, they estimated that a vitamin D level of 20 ng/mL or higher was adequate for good bone health, and subsequently a level below 20 was considered a vitamin D deficiency.
In my practice, and in most, it is not uncommon to see a vitamin D level less than 20. When that happens, we tell the patient that they are deficient and recommend fairly aggressive replenishment, as well as ongoing supplementation. The majority of folks have a level between 20 and 40, in my experience, and this is corroborated by the IOM’s findings in that 2010 report.
But in 2011, the respected Endocrine Society issued a report urging a much, much higher minimum blood level of vitamin D. At that time, their experts concluded: “Based on all the evidence, at a minimum, we recommend vitamin D levels of 30 ng/mL, and because of the vagaries of some of the assays, to guarantee sufficiency, we recommend between 40 and 60 ng/mL for both children and adults.”

But wait, there’s more…

A more recent opinion on the right target level of vitamin D is presented in an article titled “Vitamin D Deficiency: Is There Really a Pandemic?” published in the New England Journal of Medicine. In this piece, several of the leading epidemiologists and endocrinologists who were on the original IOM committee argue for a lowering of the currently accepted cutoff level of 20, stating that the level they estimated as acceptable was never intended to be used to define vitamin D deficiency. They feel that we are over-screening for vitamin D deficiency, and unnecessarily treating individuals who are perfectly fine.
Based on their analysis, a more appropriate cutoff for vitamin D deficiency would be much lower, 12.5 ng/mL. They examined a massive amount of data from the National Health and Nutrition Examination Survey (NHANES) for 2007 through 2010, and found that less than 6% of Americans had vitamin D levels less than 12.5. A cutoff of 12.5 ng/mL would most certainly eliminate the “pandemic” of vitamin D deficiency.
And the controversy boils on, with many articles and statements made to support one or the other guideline.

Some perspective on what is, and isn’t, vitamin D deficiency

I spoke with osteoporosis expert Dr. Joel Finkelstein, associate director of the Bone Density Center at Massachusetts General Hospital, whose research in this field spans over three decades. He agreed with the authors of the NEJM article that we are currently over-screening for vitamin D deficiency, and overtreating people who are getting enough vitamin D through diet and sun exposure. “Vitamin D has been hyped massively,” he states. “We do not need to be checking the vitamin D levels of most healthy individuals.”
He points out that from an evolutionary standpoint, it doesn’t make sense that higher vitamin D levels would be beneficial to humans. “Vitamin D is actually quite hard to find in naturally occurring food sources,” he points out. “Yes, we can get vitamin D from the sun, but our bodies evolved to create darker skin in the parts of the world that get the most sun. If vitamin D is so critical to humans, why would we evolve in this way, to require something that is hard to come by, and then evolve in such a way as to make it harder to absorb?”

So who should be screened for vitamin D deficiency?

Dr. Finkelstein and his colleagues published a study of over 2,000 perimenopausal women who had been followed for almost 10 years, and they found that vitamin D levels less than 20 were associated with a slightly increased risk of nontraumatic fractures. They concluded that because few foods contain vitamin D, vitamin D supplementation is warranted in women at midlife with levels less than 20 ng/mL. “For perimenopausal women or other groups of people with higher fracture risk, certainly a level of 20 or above is ideal,” and he adds: “For the vast majority of healthy individuals, levels much lower, 15, maybe 10, are probably perfectly fine, and so I would say I agree with what the authors of the New England Journal perspective article are saying.”
All that said, most experts, including Dr. Finkelstein, agree we should be checking vitamin D levels in high-risk people — those most at risk for a true deficiency. These include people with anorexia nervosa, people who have had gastric bypass surgeries, who suffer from other malabsorption syndromes like celiac sprue, or who have dark skin, or wear total skin covering (and thus absorb less sunlight). In addition, certain populations will require that vitamin D level of 20 ng/ml or higher. This can include perimenopausal women, people diagnosed with osteopenia (reduced bone density, but not osteoporosis) and osteoporosis or other skeletal disorders, as well as pregnant and lactating women. All of these groups should be screened and treated as appropriate.

Note how the article, above, suggests that people who suffer from a malabsorption syndrome may need more vitamin D3. You'd think they would have listed cirrhosis on that list, but... nope. But I cannot think of another disease where a person could have a greater "malabsorption problem" than someone with cirrhosis!!! (Except for, maybe a person who is LITERALLY starving because they have no food available).

There are sooo many reasons why a person doesn't absorb nutrients properly, if they have cirrhosis. Like the blurb below, states: "Mulnutrition, portal hypertension, lack of secretion of bile acids, pancreatic disease and mucosal changes of small intestine have been listed as possible causes for malabsorption in patients with cirrhosis."

I mean.... hello! How could cirrhosis not be classified as a malabsorption syndrome? 

Here's what you get, when you google:
"Is cirrhosis a malabsorption syndrome?"

by DCH Sun - ‎1967 - ‎Cited by 88 - ‎Related articles
The PRESENCE of a malabsorption syndrome in patients with cirrhosis has long been suspected. Mulnutrition,1,2 portal hypertension,3 lack of secretion of bile acids,4-6 pancreatic disease7-10 and mucosal changes of small intestine3 have been listed as possible causes for malabsorption in patients with cirrhosis.
 I recently got a weird hunch that it could be good for lowering bilirubin levels, so I googled it, and it appears that it might. The study below is for newborns but I believe this could be just as applicable for adults. 

A recent case-control study published by the journal Science Direct found that low vitamin D levels were associated with jaundice among newborns. Newborns develop jaundice when excessive bilirubin is present in the blood. ... Another effective treatment for jaundice is phototherapy.Jan 20, 2017
It also appears that low vitamin D levels could cause liver enzymes to rise (not a good thing!).  Some people worry that D3 could cause elevated liver enzymes, but it appears to be the opposite... people with low vitamin D3 are the ones who are more likely to have elevated liver enzymes!
Can vitamin d3 cause elevated liver enzymes?
Vitamin D deficiency is common among patients with liver diseases. Both cholestatic and non-cholestatic liver diseases can cause vitamin D deficiency. ... The risk of having a high level of ALT, AST, or GGT tended to be higher for lower vitamin D levels, although not statistically significant.Nov 23, 2013
I just sent an email to my husband while he was at work a few days ago, after seeing the reviews for this brand of high-dose vitamin D3 (and other high-dose brands with VERY high average review ratings), and wanted to share it with you. I pasted my email to him, at the bottom of this page.

Many people are scared to take Vitamin D because they worry about taking too much (the medical industry seems to work very hard to warn people not to take too much), and yet, it seems like it's practically a miracle supplement (at least it was for me... seriously, it seemed to take away back pain I'd suffered with for years), and the people who take high quantities seem to get even more health benefits (provided they are monitoring themselves). 

Please note, I cannot say for sure what is safe for anyone else and encourage you to do your own research, but I had to share this with you!  

You can read a book about the miraculous effects that can be achieved by taking very high doses of Vitamin D, by CLICKING HERE. There is a kindle version of this also, that is not too expensive.

I do believe that it could be true that a person with cirrhosis might not be able to take a very high dose like a normal person, but for all I know maybe it could work incredibly well for them. My husband never took more than 10,000 IU.  I just wish there were more studies showing how much is safe for a person with cirrhosis.
Also, please read this post I wrote about Vitamin D3 in 2014. It seems to hold a lot of promise for fibrosis. As the study showed, it "deactivates the switch governing the fibrotic response in mouse liver cells"  Just click here to see the study:

What I wrote to my husband:
I was reading reviews for Vitamin D today, and it seems like the brands with solid 5-star ratings are the ones for high potency - 10,000 or 50,000 IU!  See screen shot at the bottom of this page, to see what I mean.  I have heard that it's better to take a large dose of vitamin D, like, once a week, vs. doing it every day? But I never did that myself cause I seemed to get so much benefit from taking it as I already did (10,000 IU daily), I just never switched. 
The one below is the one I would buy myself, if I had to pick one!  I highlighted in yellow, some of the benefits of this supplement. 


(this one below is like an 8 month supply of the same one below... probably not necessary)... 

About the product

  • THE SUNSHINE VITAMIN: Enjoy the benefits of the vitamin D, found in sunlight, without the harmful effects of the sun's UV rays. This is a safe and natural way to get this vital vitamin.
  • STRENGTHENS BONES & TEETHVitamin D3 helps decrease risk of bone fractures and maintains bone strength. It also plays a crucial role in promoting healthy teeth & reducing decay. Preferably, take it with a meal.
  • DAILY OR WEEKLY SUPPLEMENT: Vitamin D may help improve immune system function by helping the body produce bacteria fighting antimicrobial peptides and increases muscle protein synthesis which reduces body fat.
  • FOR BREASTFEEDING MOMS: This supplement is especially useful for anyone who is vitamin D deficient, and for nursing mothers to pass on to their babies. Pick from 5,000, 10,000 or 50,000 iu for a daily, bi-daily or weekly dosage.
  • ALL NATURAL: These veggie capsules are non GMO, soy free and free from dairy, gluten, eggs and nuts. They are tested for absorption, to ensure proper digestion.

 (note this is a screenshot below, not clickable links... I'm just posting it here so you can see how high the ratings are, for the brands that have a very high I.U.)

Hope this helps!