ANSWER TO QUESTION OF THE WEEK: (11/6/05)

No. The ingestion of protein and/or amino acid supplements, such as those commonly found in health food stores and groceries, can be dangerous to people with liver disease and should be avoided.

Protein supplements force the liver and kidneys to work overtime in order to get rid of the excess protein ingested. Excess protein can increase the risk of dehydration, as extra fluid is required to eliminate the byproducts of protein metabolism from the body. Also, protein supplements often contain a variety of vitamins, minerals and other food supplements which may cause dangerous excesses of these items in the body.  Furthermore, they are not regulated by the FDA in the body. Protein supplements are only required for people who are malnourished and unable to obtain adequate protein intake through their regular diets.

Most of the amino acid supplements that are available over- the- counter come in quantities that are far greater than the amount the body needs. Consumption of excessive amounts of amino acids may cause serious side effects. Probably the best known example of this involves L-tryptophan, an aromatic amino acid (AAA) used as a supplement to aid sleeping. Promoted for many years as safe and natural, L-tryptophan was eventually banned for sale by the FDA in 1990 because many people who consumed this amino acid developed a serious muscle disorder. Death even occurred in some people as a result of L-tryptophan ingestion. Some other amino acid supplements are high in AAA (for example, phenyalanine, tyrosine, and tryptophan), which have been demonstrated to be detrimental to some people with liver disease. Another amino acid, methionine, may induce encephalopathy ( brain fog) in people with liver disease. Vegetables contain very little methionine, yet have a high content of the branched-chain amino acids (BCAAs- such as leucine, isoleucine, and valine). Some experts believe BCAAs are beneficial to people with encephalopathy. However, under no circumstances should any form of amino acid supplement be added to the diet of a person with liver disease.

Dr. Palmer is an internationally renowned hepatologist who has been practicing medicine since 1985. She maintains perhaps the largest private medical practice devoted to liver disease in the United States. Dr. Palmer graduated from Columbia University with a B.A. and was trained in hepatology (as well as medical school) at the Mount Sinai School of Medicine in New York City. She has authored numerous scientific publications in the field of hepatology in such peer-reviewed journals as Hepatology, Gastroenterology, Seminars of Liver Disease, Transplantation and Archives of Internal Medicine.

She is frequently called upon by the media for her opinion on various topics related to liver disease. Dr. Palmer has appeared many times on television as a liver disease expert and has been quoted in such publications as TIME magazine, Cosmopolitan magazine, Prevention magazine, the Los Angeles Times, and Newsday. She also has appeared in numerous videos and CD-Roms aimed at educating doctors and the public about hepatitis C and other liver diseases, such as primary biliary cirrhosis.Dr. Palmer lectures to the medical and general public on liver disease-related topics on a regular basis. She also serves as a liver consultant to five major pharmaceutical companies.

Dr. Palmer is a board member of the New York chapter of the American Liver Foundation, and she sits on the nutrition subcommittee of the national chapter of the American Liver Foundation, the medical advisory board of the Latino Organization for Liver Awareness (LOLA) and the medical advisory board of the Primary Biliary Cirrhosis Organization (PBCers). She has also been a member of the practice guidelines committee of the American Association for the Study of Liver Disease(AASLD) and currently sits on the enduring educational materials committee of AASLD.

Dr. Palmer has performed trials on various experimental medication for the treatment of hepatitis. She is currently conducting research on new therapies for liver disease, specifically in the area of hepatitis C.

Her practice is located on Long Island, New York. (Main office located at: 1097 Old Country Road, Suite 104, Plainview, N.Y. 11803.

Satellite office located at 500 Portion Rd. Lake Ronkonkoma, N.Y. 11779)

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If you are interested in arranging an appointment with Melissa Palmer, M.D., please call (516) 939-2626.

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