As I decipher ongoing liver issues, at least my treasured coffee is good for me

The other day, I read a column from a colleague about how coffee can have a positive effect on liver disease. It caught my attention immediately, as I was actually drinking a cup and waiting on a call from my hepatologist to discuss the results of my recent biopsy. I took another sip.

We’ve been trying to figure out what’s going on with my liver for a while now. Lab tests show elevated liver enzymes and inflammation, suggesting possible autoimmune hepatitis. Scans show steatohepatitis with fibrosis. And now, this: “focal chronic inflammation with abundant ceroid-laden macrophages.”

At first glance, it’s almost another language. I read it again, piece by piece, trying to understand. Chronic inflammation. I know all about that. Sarcoidosis, rheumatoid arthritis, endometriosis — these are all inflammatory conditions that I’ve been living with for decades. Macrophages? I’ve heard that word before! Macrophages are immune cells that can cluster together to form granulomas, a signature feature of sarcoidosis.

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This naturally led to the questions that arise with any new symptom or abnormal test result: Is it sarcoidosis? Has it progressed to another organ?

Sarcoidosis can affect the liver in up to 80% of patients, but hepatic sarcoidosis often goes undiagnosed. Many patients have no symptoms, and those who do might not make the connection. Aside from jaundice (a yellowing of the skin or eyes), the symptoms that may present — fatigue, itchy skin, and joint pain — don’t necessarily point toward the liver as a cause.

I didn’t have jaundice, and all of the other symptoms could easily be attributed to other conditions. Still, my liver enzymes have been elevated for years. There have been a few occasional spikes that worried my doctors briefly, but for the most part, they quickly returned to what has become my norm: high enough to monitor, but not so high that we have to do anything about it. Until now, perhaps.

My grandmother always used to say “doctors make you sick,” and in a way, I get it. It feels like every time I see a doctor lately, there’s just … more. The more we look into things, the more we find (though, frustratingly, what we find often leads to more questions than answers). That’s why many people prefer to avoid doctors altogether. But with so many overlapping conditions and potential complications, it’s crucial to stay on top of things.

The biopsy was also “suggestive of drug-induced liver injury.” Since many medications are processed through the liver, this is always something to keep in mind when determining which treatments to try. In 2020, after an aforementioned enzyme spike, I had to stop taking methotrexate immediately and switch to hydroxychloroquine, which is safer for the liver. Now, my doctors and I are reviewing all of my medications to see what we can safely reduce or eliminate.

My happy place

This all leaves me thinking — and stressing — about my liver, and trying to figure out what I can do about it. On my last cruise, I tried a few mocktails when my friends were enjoying adult beverages, but most offerings had so much sugar that they didn’t exactly feel like a healthier option. My husband recently picked up a bottle of nonalcoholic riesling for us to try next.

And that’s why the column (and the research on which it was based) made me smile.

Coffee has always been my happy place. One of my earliest blogs was about taking time to enjoy the simple pleasures in life, and how coffee was that for me. When I was still working, I used to make a mid-afternoon Dunkin’ run every day; when a supervisor questioned it, I explained that it took less time than other people’s cigarette breaks, and it helped me function better for the rest of the day. I’ve even brought my own coffee press to the hospital on infusion days!

So it’s exciting to know that coffee isn’t just good for my mind; it’s also good for my body. There’s no evidence that it helps with sarcoidosis per se, but research shows that it can reduce fat and inflammation in the liver, mitigating progression from fibrosis to cirrhosis and lowering the risk of death from liver disease. Sounds good to me!

At this point, I don’t know if I have hepatic sarcoidosis. I don’t know if the medications I’m taking to treat my other types of sarcoidosis are causing this liver damage. I don’t know which medications I’ll have to stop, what I can try in their place, or how effective or harmful the alternatives will be.

What I do know is that every answer I don’t have stresses me out more than the last, and that stress is certainly not good for my body. But at least I know one thing I can do to de-stress: I’m going to have another cup of coffee. Cheers!

Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to sarcoidosis.