Fatigue after eating fat

Does anyone else experience fatigue after eating fat? Lately I have been experiencing this. It usually comes on while eating a meal with a high fat content and then be with me for hours. I have noticed that eating a low fat meal does not have the same effect.

That is a common occurance with PSC. The liver has to work so hard to process the fat due to the disease and the bile not being able to flow fast enough to break down those fats will cause fatigue. I certainly had it many times. The catch 22 for me though was there were many “regular” foods I just couldn’t stomach due to the smell of them, etc., so I often reverted to fast food. And yes, I usually paid for it later in a variety of ways.
I think the Ursodiol though does help with thinning the bile that fat breakdown is improved but certainly not at normal levels of a healthy liver.


Thanks Mark. I’m not in urso as my hepatologist doesn’t think it is necessary for small duct psc. Did the urso have any effect in reducing fatigue in your opinion?

I did not make that connection, but my fatigue did not really need anything to trigger it.

No. It just helps more bile to flow enabling a more stable digestive system.

Fatigue is just something you’ll have to live with till transplant. Sorry.


Hello Rick! I usually call this the fat-paradox. It’s not uncommon for PSC-patients to experience the same things you experience. At the same time, if you completely stop eating fat, your body wont absorb fat-soluble vitamins. There’s a solution to this. Long-chain fatty acids trigger bile production (which causes your symptoms), but medium-chain triglycerides don’t. Few doctors know about this, but you could try replacing some regular fat in your food with medium-chain triglycerides. :slight_smile:

Thanks Andreas. I will give that a go. From some research it seems coconut oil is the best source. I will need to look at where I can cut out other fats from the rest of my diet.

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Coconut oil is the best natural source at around 60% MCT. They also sell MCT oil that is 100% MCT. This stuff is tasteless, but oily and may take some getting used to as it is pure fat. I would dump a tablespoon in a drink or meal to get additional calories and help absorb fat soluble vitamins. Medium-chain triglycerides are absorbed very quickly so take close in time with your ADEK foods/supplements.

Yup! Fat will do it alright! I stay away from fatty foods, even now that I am post-transplant. And, eating smaller portions more frequently (4 instead of 3 meals) helps me digest food without difficulty.

Fat definitely plays a role. Like @JTB mentions i also started eating coconut oil. I buy the one that is i think 80% MCT oil. Coconut oil does not need bile to breakdown all other oils do. Plus it has the good fat like avacado so healthy to eat. As always anything eaten in moderation is the trick. I quit eating all dairy, includes cheese, butter and any other dairy products. For yogurt i switch to coconut yogurt (make it at home). I also stay away from gluten which i a common irritant for the GI tract.

Considering this topic, how much is important to cut down fat in your diet? How much shall be the daily intake of fat for person with PSC? I’ve read somewhere 30 g. My hepatologist says that it is not important (that I can eat everything in normal limits), but somehow I’m worried. I apologize if this topic is already covered somewhere.

If fatty meals don’t seem to exacerbate symptoms there is no need to cut back. As Andreas pointed out, cutting back on fat, that we have a hard time absorbing anyway, can contribute to a few problems. Fat is twice as calorie dense as carbs or protein, so it can be harder to maintain weight on a lower fat diet. Fat is also needed to absorb fat soluble vitamins and we tend to be deficient in this area due to cholestasis.

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I have small duct PSC and the Urso has helped tremendously with my labs.

Hi Carol, that’s really interesting. I was led to believe that urso was of no use to me because I have small duct psc. My alp and alt are sitting around the 1.5x upper limit. Are yours lower than this?

Thank you jtb :slight_smile:

@Andreas I tried the mct oil this morning in my smoothie - No fatigue! Thanks for the tip. :slight_smile: Hopefully it will help me get all the benefits from all the fat soluble vitamins in my green smoothie.

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No problem! That’s what this forum is for. :slight_smile: For best effect, take it together with vitamin rich foods.