One of the most common conditions I see in my practice is fatty liver disease. It is so important to diagnose and treat this common illness as it may interfere with so many important functions in the body.

What does my liver do?

Your liver is largest organ inside the body. It has a vital role in many bodily functions including:

What is Nonalcoholic Fatty Liver Disease?

Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for a range of illnesses that are a defined as excess fat stored in the liver. This is one of main causes of liver cancer in the US. It can occur in people who drink little to no alcohol. NAFLD is very common, affecting approximately 25% of the US population and is the most common cause of liver disease beating out Alcoholic Fatty Liver Disease (AFLD) which affects less than 5% of adults in America.

How do we develop NAFLD?

The the fat cell in our body become overwhelmed, the fat spills over into non-fat tissues like the liver. Excess fat on the liver creates a constant state of inflammation which leads to liver cell dysfunction and destruction. This may lead to a more severe form of this disease called Nonalcoholic Steatohepatitis (NASH) which may progress into fibrosis (scarring of the liver) and then to cirrhosis (severe scarring), which can lead to liver cancer and end stage liver failure. This damage is similar to the effects of excessive alcohol use which occurs in 20% of heavy drinkers. Keep in mind that alcohol use can also contribute to NAFLD and drinking large amounts of alcohol for even a few days can lead to excessive build-up of fat on the liver.

What are the dangers of NAFLD?

The end stages of NAFLD can lead to cirrhosis, liver cancer and death. But, even less severe cases are can lead to elevated blood sugar, elevated blood pressure, kidney disease, fatigue, hormone imbalance, digestion issues like GERD (acid reflux), sleep apnea, weight gain and more.

What are the risk factors for NAFLD?

There are many risk factors including genetics, high cholesterol (especially high triglycerides), pre-diabetes and type 2 diabetes, hypothyroidism, sleep apnea, obesity (especially for those who carry fat in the abdomen) and polycystic ovarian syndrome. Although there are genetic factors that contribute to this disease, for many, NAFLD is directly linked to lifestyle factors including excessive caloric intake, especially of processed foods and sugars and inadequate exercise.

What to Expect

How do I know if I have it?

We can assess risk by doing bloodwork. Often your liver enzymes will be elevated (but not always). There are also other blood panels like the FIB-4 or APRI which indicate risk of scarring or cirrhosis. Imaging such as ultrasound, MRI and CT scans are helpful tool to detect the presence of excess fat in the liver. The gold standard for determining whether a liver has progressed to NASH is a biopsy. We have recently started offering a special ultrasound test in our office called a Fibroscan which is an excellent and non-invasive tool for measuring both the quantity of fat in the liver and the presence of scarring.

What can I do about it?

We can treat some of the causes of NAFLD like pre-diabetes, diabetes and high triglycerides with medication; however, there are no medications that have been approved for treating NAFLD and NASH. The good news is that your liver cells are marvelous at regenerating themselves. There are many lifestyle changes that can prevent progression and even reverse NAFLD including avoiding or reducing alcohol and use of some over-the-counter medications such as acetaminophen (Tylenol), reducing intake of processed foods and sugar, increasing intake of healthy Omega-3 fats, and increasing activity levels. These actions will also help with fat loss and decrease your risk of diabetes and heart disease. Your healthcare provider can instruct you more on diet, supplements, exercise protocol and supportive medications.

One final note: avoid “liver cleanse” or “detox programs”

There are several products on the market that purport to help you “detox” your liver. The “fast detoxes” do not work and may cause more harm that good as the these formulas often are processed through the liver. Recovery from fatty liver disease takes time, dedication and patience. There are no shortcuts. Visit us to find out how we can help you take care of your fatty liver.