Some fat in the liver is normal. But if the fat in your liver makes up more than 5-10% of your liver’s weight, you may have alcoholic or nonalcoholic liver disease . In some cases, these diseases can lead to serious complications. Look out for the following guide to help you understand the symptoms, causes, and treatments for fatty liver .

Fat in the liver from alcoholic liver disease

More than 15 million people in the United States simply abuse alcohol. Almost all of them – 90% -100% – develop fat in the liver.

Fatty liver can occur after drinking moderate or large amounts of alcohol . It can even occur after a short period of heavy alcohol use ( acute alcoholic liver disease ).

Genetics or heredity (what is passed from parent to child) plays a role in the development of liver fat from alcoholic liver disease in two ways: It can influence the amount of alcohol you consume and your likelihood of developing alcoholism . And also, it can affect the levels of liver enzymes involved in the breakdown (metabolism) of alcohol.

Other factors that can influence the likelihood of developing alcoholic fatty liver disease include:

  • Hepatitis C (which can lead to inflammation of the liver)
  • An iron overload
  • Obesity
  • Diet

Fat in the liver from nonalcoholic liver disease

Nonalcoholic fatty liver disease is now the most common cause of chronic liver disease in many parts of the world, such as the United States. Some people with excess fat in their liver simply have what is called a fatty liver. Although this is not normal, it is not serious if it does not lead to inflammation or damage.

Others have what is called nonalcoholic steatohepatysis . Although similar to alcoholic liver disease, people with this type of fatty liver disease drink little or no alcohol.

The NASH can lead to permanent liver damage The liver can become enlarged, and over time liver cells can be replaced by scar tissue. This is called cirrhosis of the liver . The liver cannot function well, and liver failure, liver cancer, and liver-related death may develop. Nonalcoholic steatohepatitis is one of the main causes of cirrhosis .

Both types of nonalcoholic liver disease are becoming more common. Up to 20% of adults may have fatty liver or nonalcoholic steatohepatysis. And more than 6 million children have one of these conditions, which are more common in Asian and Hispanic children. Recent evidence indicates that nonalcoholic steatohepatysis increases the risk of heart disease in children who are overweight or obese.

Causes of liver fat from nonalcoholic liver disease

The cause of nonalcoholic fatty liver disease is unclear. Certain factors tend to increase risk, but in some cases, no risk factors are present. However, the development of fat in the liver from nonalcoholic liver disease tends to run in families.

It also occurs more often in people who are middle-aged and overweight or obese. These people often have high cholesterol or triglycerides and diabetes or prediabetes (insulin resistance), too.

Other potential causes of fatty liver disease include:

  • Medicines
  • Hepatitis viral
  • Autoimmune or inherited liver disease
  • Rapid weight loss
  • Malnutrition

Recent studies show that an overgrowth of bacteria in the small intestine and other changes in the intestine may be associated with nonalcoholic fatty liver disease . Some researchers now suspect that this may play a role in the progression of non-alcoholic liver disease and non-alcoholic steatohepatysis.

Acute fatty liver of pregnancy

Although very rare, fat accumulates in the mother’s liver during pregnancy, putting both mother and fetus at serious risk. Either one can develop liver failure, kidney failure, severe infection, or bleeding. No one fully understands its cause, but hormones can play a role.

Once the diagnosis is confirmed, the baby has to be born as quickly as possible. Although the mother may need intensive care for several days, liver function often returns to normal within a few weeks.

Fatty liver symptoms

Accumulating fat in the liver is often silent, it does not produce symptoms, especially at first. If the disease progresses – which is usually over a period of years, or even decades – it can cause problems such as:

  • Fatigue.
  • Weight loss or loss of appetite.
  • Weakness.
  • Nausea.
  • Confusion, impaired judgment, or trouble concentrating.

These symptoms may also be present:

  • Pain in the center or upper right part of the abdomen
  • Enlarged liver
  • Irregular dark discoloration of the skin, usually on the neck or armpit area

With alcoholic liver disease, symptoms may worsen after periods of heavy alcohol use. With fatty liver from nonalcoholic liver disease, the disease process can be stopped or reversed, or it can get worse. If there is cirrhosis, the liver loses its ability to function. This can cause signs and symptoms such as:

  • Fluid retention
  • Loss of muscle mass
  • Internal bleeding
  • Jaundice (yellowing of the skin and eyes)
  • Liver failure

Diagnosis of fatty liver disease

Often times, the diagnosis of a fatty liver comes during a routine checkup. The doctor may notice that the liver is slightly enlarged or see signs of fatty liver in a blood test. Or, the doctor may suspect a problem after taking a health history or doing a physical exam.

  1. Blood test. During routine blood tests, elevations of certain liver enzymes may appear. These could include alanine aminotransferase or aspartate aminotransferase.
  2. Imaging studies. A fatty liver can also show up on imaging tests, such as an abdominal ultrasound.
  3. Liver biopsy. The only way to confirm the diagnosis of liver fat is with a liver biopsy. This is usually done once other causes have been ruled out. After application of local anesthesia, the doctor inserts a needle through the skin to remove a small piece of liver. This is examined under a microscope for signs of fat, inflammation, and damaged liver cells. If inflammation or damage is not present, the diagnosis is simply a fatty liver.

How to treat fat in the liver

There is no specific treatment at this time for fatty liver disease. However, getting treatment for any underlying disease, such as diabetes, is essential. And you can take other steps to improve your condition.

Stop drinking alcohol

If you have alcoholic liver disease and are a heavy drinker, quitting is the most important thing you can do . Find the support you need to be successful. With adrenoleukodystrophy, continued use of alcohol can lead to advanced disease, including alcoholic hepatitis or cirrhosis. Even for people with nonalcoholic fatty liver, however, avoiding alcohol can help.

A balanced and healthy diet towards the recovery of liver health can make a big difference.

Eat a proper diet to lose weight

If you are overweight or obese, enter a suitable regimen to gradually lose weight – no more than 1 to 1.5 kilos per week. A recent study showed that losing weight of at least 9% over a period of months can help reverse non-alcoholic steatohepatitis. Even less weight loss than this can help decrease the accumulation of fat in the liver.

Avoid refined foods and opt for fresh and natural foods

Diet is very important, of course, and if you are one of the people who had not taken care to eat a healthy diet, it is time to start thinking about it. Proper nutrition, a balanced and healthy diet can make a big difference, research with a certified specialist what might be the best for you and immediately get to work.

Avoid diets rich in refined carbohydrates, digested quickly. Avoid foods like bread, semolina, rice, potatoes, corn, and concentrated sugar found in sports drinks and juices. Another important and complementary point to all this is to exercise regularly.

Avoid unnecessary medications

Avoiding unnecessary medications can also help delay or reverse the disease . Clinical trials are also studying the efficacy of certain newer diabetes medications and antioxidants in treating fatty liver disease (caused by the disease’s link to oxidative stress and diabetes). These include:

  • Vitamin E
  • Selenium
  • Betaine
  • Metformin
  • Rosiglitazone
  • Pioglitazone

Make use of nutrients directly from natural foods such as fruits, vegetables and seeds

Be aware that even vitamins and minerals can cause health problems . The best way to reap its benefits is through the food sources that contain them.

New findings on the role of bacteria in the development of fatty liver disease may lead to even more options for treatment , such as countering unbalanced diets with probiotics. These are dietary supplements that contain healthy live bacteria or yeast.

If cirrhosis becomes severe, a liver transplant may be needed. A surgeon removes the damaged liver and replaces it with a healthy one. These in cases, as we have said, are really severe where life is already exposed.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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