Fatty liver: recognizing symptoms and adjusting your diet

The liver is one of the largest and most important organs in the body and is responsible for many vital functions, such as detoxifying the blood and storing vitamins and minerals. But what happens when liver health is at risk, such as in the case of fatty liver disease? Below, we explore this condition in more detail, how to recognize its symptoms, and how dietary changes can improve liver health. With Homed-IQ’s liver function blood test, you can test your liver function at home without needing an appointment with a doctor.

Table of Contents

• What is fatty liver disease?
• What functions does the liver perform in our body?
• What causes fatty liver?
• What are the symptoms of fatty liver?
• What are the consequences of untreated fatty liver disease?
• How is fatty liver diagnosed?
• How is fatty liver treated?
• Summary

What is fatty liver disease?

Fatty liver disease, also known as hepatic steatosis, occurs when fat accumulates in liver cells. This can lead to inflammation and damage to the liver and poses a serious health risk if left untreated.

The liver is the second-largest organ in the body and performs a number of vital functions. In healthy individuals, about 5% to 10% of the liver’s weight is made up of fat. However, in the case of fatty liver, this percentage can increase significantly, leading to liver cell damage and an increased risk of inflammation and cirrhosis. Unfortunately, fatty liver often goes unnoticed in many people, as it causes few or no symptoms in the early stages (MedlinePlus, 2017).

What functions does the liver perform in our body?

The liver is one of the most important organs in our body and performs various functions that are crucial to our health. Here are some of the liver’s main tasks:

• Detoxification: The liver plays a central role in detoxifying the body by neutralizing and removing harmful substances that enter the body through food, medications, or the environment.

• Storage of nutrients: The liver stores key nutrients from food, such as vitamins and minerals (e.g., iron or zinc), and releases them into the bloodstream when needed.

• Production of bile: The liver produces bile, a fluid necessary for digesting fats and excreting waste products.

• Regulation of blood sugar levels: The liver regulates blood sugar by storing glucose and releasing it into the bloodstream when needed to meet the body’s energy demands.

• Cholesterol regulation: The liver produces cholesterol and proteins needed to transport fats in the body. It also plays a key role in converting excess cholesterol into bile acids, which are then excreted through the intestines.
  Source: Yetiskul et al., 2023

These and many other functions make the liver an essential organ that ensures the smooth functioning of many bodily processes. However, in the case of fatty liver, the liver’s ability to perform these functions can be impaired, with potentially serious consequences for overall health.

What causes fatty liver?

Fatty liver can be caused by various factors and lifestyle habits. It is generally divided into two main categories: non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD).

Non-alcoholic fatty liver disease (NAFLD):

NAFLD is a condition in which excess fat accumulates in the liver without excessive alcohol consumption. Around 25% of the global adult population is affected by this condition (Mitra et al., 2020). NAFLD is often caused by a combination of genetic factors, dietary habits, and lack of physical activity. Overweight and obesity are the main causes and significantly increase the risk. Additionally, type 2 diabetes and insulin resistance, which are closely linked to obesity, can contribute to NAFLD. The metabolic syndrome—characterized by high blood glucose, high triglycerides, low HDL cholesterol, and high blood pressure—also increases the risk of developing NAFLD (NICE, 2016). NAFLD consists of two main stages:

• Non-alcoholic fatty liver (NAFL): In this milder form of NAFLD, the liver contains excess fat but shows no signs of inflammation or damage. People with NAFL usually do not experience liver-related complications.

• Non-alcoholic steatohepatitis (NASH): This more severe form of NAFLD is characterized by fat accumulation in the liver, inflammation, and liver cell damage. NASH can lead to serious liver diseases over time, including cirrhosis and liver cancer. Cirrhosis is a chronic, progressive condition in which healthy liver tissue is replaced by scar tissue, resulting in impaired liver function.

Not everyone with NAFLD develops NASH. In general, the risk of progression to NASH is higher in people with relevant risk factors.

Alcoholic fatty liver disease (AFLD):

Alcoholic fatty liver disease is caused by excessive and prolonged alcohol consumption. Alcohol is broken down in the liver, producing toxic substances that can damage liver cells, cause inflammation, and lead to fat accumulation. These processes can ultimately result in fatty liver. If left untreated, it may progress to serious liver diseases such as alcoholic hepatitis and cirrhosis.
Sources: NIDDK, 2021; American Liverfoundation, 2022

What are the symptoms of fatty liver disease?

Fatty liver disease is often a “silent” condition, with few or no symptoms, especially in the early stages. When symptoms do occur, they may include:

• Fatigue and weakness

• Non-specific discomfort in the upper right abdomen

• Loss of appetite or unintentional weight loss

• Yellowing of the skin and eyes (jaundice)

• Confusion and difficulty concentrating

• Fluid buildup in the abdomen (ascites)
  Sources: NHS, 2022; NHS, 2022

What are the consequences of untreated fatty liver disease?

The complications of fatty liver disease, whether alcohol-related (AFLD) or non-alcohol-related (NAFLD), can be serious and require appropriate medical care.

• Steatohepatitis: This inflammation of the liver can lead to fibrosis, in which healthy tissue is replaced by connective tissue. This can impair normal liver function and blood flow through the liver, potentially causing further complications.

• Cirrhosis: A severe condition in which healthy liver tissue is replaced by scar tissue, disrupting normal liver function. Both AFLD and NAFLD can lead to liver cirrhosis.

• Liver cancer (hepatocellular carcinoma): Patients with advanced cirrhosis are particularly vulnerable to developing liver cancer.

• Portal hypertension and varices: Scarring of the liver can increase pressure in the portal vein, which supplies blood to the liver. This can lead to varicose veins in the esophagus and stomach, which may rupture and cause severe, life-threatening bleeding.

• Ascites and hepatic encephalopathy: In advanced liver disease, fluid can accumulate in the abdominal cavity (ascites), and brain function may be impaired (hepatic encephalopathy), causing confusion and even coma.

• Non-liver-related complications: Fatty liver is also associated with an increased risk of cardiovascular disease, type 2 diabetes, and kidney disease. It is important that patients diagnosed with fatty liver are also screened for these conditions.
  Source: Cleveland Clinic, 2020

Early diagnosis and treatment of fatty liver disease are crucial to prevent or delay these potentially life-threatening complications.

How is fatty liver diagnosed?

Accurate diagnosis is essential for starting effective treatment and avoiding complications. The following procedures may be used:

• Medical history and physical exam: The doctor will ask about your health, lifestyle (including alcohol use), family history of liver disease, and possible symptoms of fatty liver.

• Blood tests: Blood tests can help diagnose fatty liver, including a complete blood count, liver function tests (e.g., ALT, AST, ALP, GGT, bilirubin), and inflammation markers (C-reactive protein).

• Imaging procedures: Ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can help detect fat in the liver. Sometimes elastography is performed to measure liver stiffness, which may indicate fibrosis or cirrhosis.

• Liver biopsy: In some cases, a liver biopsy may be required to confirm fatty liver disease and assess the extent of liver damage. A small tissue sample is taken from the liver and analyzed under a microscope.

If you notice symptoms of fatty liver disease or have risk factors, seek medical advice. Even without symptoms, early diagnosis and treatment can reduce the risk of complications.
Source: NIDDK, 2021

Want to gain insight yourself?

Homed-IQ offers a liver function test that you can easily perform at home. This test measures the levels of certain enzymes and proteins in the blood that are produced by the liver. Elevated values may indicate liver damage. Homed-IQ’s liver test provides a simple and convenient way to monitor liver health and alert you to potential problems, such as fatty liver.

How is fatty liver treated?

Treatment primarily focuses on reducing risk factors and making lifestyle changes. Key treatment strategies include:

• Weight loss: Moderate weight loss of 3% to 5% if you are overweight can help reduce fat accumulation in the liver.

• Dietary changes: Diet plays a crucial role in treating fatty liver. Reducing saturated fats and eating healthy unsaturated fats is essential. Omega-3 fatty acids, found in fatty fish like salmon, mackerel, and sardines, as well as in flaxseeds, chia seeds, and walnuts, are beneficial. Increasing fiber intake to stabilize blood sugar and limiting sugar consumption are also important. Sufficient intake of certain vitamins and minerals, especially vitamins E and D for liver and immune function, as well as minerals like zinc and selenium, is also important.

• Regular exercise: Physical activity helps with weight control and improves liver function. It is recommended to exercise at least 30 minutes a day, five days a week.

• Monitor blood sugar and cholesterol levels: If you have diabetes or high blood lipids (cholesterol), medications and dietary changes can help control these conditions and improve liver health. Homed-IQ’s blood glucose test is crucial in the context of fatty liver because it helps detect elevated blood sugar levels. This test measures average blood glucose over 2 to 3 months via HbA1c levels and can reveal fluctuations that may indicate disrupted glucose metabolism.

• Avoid alcohol and unnecessary medications: Both alcohol and certain medications can damage the liver and should be avoided or only taken under medical supervision.

It is important for people with fatty liver to regularly visit their doctor and be monitored for complications such as cirrhosis and liver cancer. Any changes in treatment or lifestyle should be discussed with a physician.
Sources: Harvard Health, 2020; NIDDK, 2021

Summary

Fatty liver is a serious condition that can lead to many health complications. Although it is often asymptomatic, it can be prevented and treated through healthy lifestyle choices, including a balanced diet and regular exercise. At Homed-IQ, we are proud to offer scientifically backed medical information to support you on your journey to better health.