Understanding Fatty Liver Disease: Causes and Effective Ways to Reverse It

What You Need to Know to Protect Your Liver and Improve Your Health

Fatty liver disease is a silent threat to your health and affects millions of people worldwide.  Although it sounds like it is not a big deal, the accumulation of excess fat in your liver cells can impair its normal functions, leading to inflammation, scarring, and liver failure. Not to mention this condition often goes undiagnosed until it’s too late.

But there’s good news!

Fatty liver disease is not a death sentence. In fact, you can reverse it with the right lifestyle changes and medical interventions.

If you’re concerned about your liver health or have been diagnosed with fatty liver disease, join us as we explore the latest research on the condition and share expert-recommended strategies for reversing it.

What is fatty liver disease?

Also known as hepatic steatosis, it is a condition where excessive amounts of fat accumulate in the liver cells.

The liver is an essential organ that performs many critical functions in the body, such as processing nutrients, removing toxins, and producing bile to help you digest fats.^[1] However, when too much fat builds up in the liver, it can interfere with its normal functioning and cause inflammation and damage.

There are two main types of fatty liver disease:

• Alcoholic Fatty Liver Disease (AFLD): AFLD is caused by excessive alcohol consumption over an extended period, leading to fat accumulation in the liver cells and inflammation.^[2]
• Metabolic Associated Fatty Liver Disease (MAFLD): To address limitations and more accurately capture the nature of the condition as a metabolic dysfunction-related issue, the term Non-Alcoholic Fatty Liver Disease (NAFLD) has been recently replaced with the more encompassing name Metabolic Associated Fatty Liver Disease (MAFLD).^[3] This renaming acknowledges that the disease is not solely caused by alcohol consumption but is influenced by various metabolic factors such as obesity, type 2 diabetes, high cholesterol, and metabolic syndrome. MAFLD is now recognized as the predominant form of fatty liver disease, affecting individuals who abstain from alcohol or consume it in moderation.

Both AFLD and MAFLD can lead to liver damage and other complications if not treated properly, but because MAFLD is more common, we’ll focus this blog on the causes and treatment for MAFLD.

How do I know if I have fatty liver disease?

It often has no symptoms in the early stages, and it may be discovered incidentally during routine blood tests or imaging studies. However, as the condition progresses, some people may experience symptoms such as ^{[4] [5] [6] [7]}

• Fatigue
• Abdominal discomfort or pain
• Loss of appetite
• Nausea or vomiting
• Insulin resistance
• Hormonal imbalances
• Hypothyroidism
• Jaundice (yellowing of the skin and eyes)
• Enlarged liver or spleen

If you’re experiencing any of these symptoms, I encourage you to consult your provider, who may recommend additional testing to diagnose this disease.

Diagnosing Fatty Liver Disease

The diagnosis of MAFLD involves a combination of physical examination, laboratory tests, and imaging studies. These methods help uncover the presence of MAFLD and evaluate its severity. Here are some methods used for diagnosing fatty liver disease:

Blood Tests

Blood tests are performed to evaluate liver function and identify markers associated with MAFLD.

Common liver tests include:

• Liver function tests, including ALT and AST
• Alkaline phosphatase
• Bilirubin (total and direct)
• Gamma-Glutamyl Transferase (GGT) test

Recent studies have shown that relying solely on specific markers is not enough to diagnose it unless the individual has type 2 diabetes and an elevated ALT (>26). Unfortunately, any liver cell breakdown can release ALT into the bloodstream.  Although AST and ALT are typically called “ liver function tests,” this is inaccurate. These are tests of liver cell integrity. When they are elevated, it means that liver cells are being damaged, which can be caused by many things. True liver function tests include albumin, a form of protein produced by the liver, and prothrombin, which is related to protein created by the liver for clotting the blood.

Luckily with regard to assessing fatty liver disease, more comprehensive blood tests are available for at-risk individuals. Tests like APRI, FIB4, MultiScan, Fibrosure, Fibrotest, and Fibrospect, assess fat accumulation, fibrosis (scarring), inflammation, and liver iron levels. These advanced tests provide a deeper understanding of the condition and improve the accuracy of fatty liver disease diagnosis.

Imaging Studies

Imaging techniques can help evaluate the extent of liver fat accumulation and rule out other liver conditions.

The commonly used imaging modalities include:

• Ultrasound: Ultrasound uses sound waves to create images of the liver and can help identify fatty liver and evaluate its severity.
• FibroScan: This non-invasive test measures liver stiffness, which can indicate fibrosis in the liver. FibroScan can help assess the progression of MAFLD and the presence of liver damage.
• MRI or MREndoscopy: These advanced imaging techniques provide detailed information about liver fat content, inflammation, and fibrosis. They are more sensitive and specific than ultrasound but may not be available at all healthcare facilities.

The significance of this level of screening cannot be overstated. One clinical study involving patients with Type 2 diabetes found that 8% of lean individuals, 26% of overweight individuals, and a staggering 66% of those with a BMI greater than 40 met the criteria for fatty liver disease.^[8]

Causes of Fatty Liver Disease – Why are we seeing it so much?

It is becoming increasingly common worldwide, and there are several reasons why this is happening.

One of the leading causes is the rise in obesity rates, as excess weight is a significant risk factor for developing metabolic-associated fatty liver disease.^[9] When we consume more calories than our bodies need, the excess energy is stored in our fat cells. Over time, fat can also accumulate in the liver.

Other factors that can cause metabolic-associated fatty liver disease include:

Insulin resistance:

Characterized by reduced responsiveness to insulin in the body’s cells, insulin resistance leads to increased lipid production, impaired fat breakdown, elevated triglyceride levels, inflammation, and liver damage.^[10]

Type 2 diabetes:

People with type 2 diabetes are at a higher risk of developing this disease because the excess insulin in their bodies can cause the liver to store more fat.^{[11] [12]} This can lead to the progression of MAFLD and its more severe form, non-alcoholic steatohepatitis (NASH).

Obstructive Sleep apnea:

Sleep apnea, a sleep disorder characterized by interrupted breathing during sleep, leads to intermittent drops in blood oxygen levels, which can result in oxidative stress and inflammation in the liver. These mechanisms contribute to the accumulation of fat in the liver cells and the progression of MAFLD.^[13]

High blood pressure:

High blood pressure can damage the blood vessels in the liver and contribute to the development of fatty liver disease.^[14] Additionally, hypertension often coexists with other metabolic conditions, such as obesity, insulin resistance, and dyslipidemia, which can further contribute to the development and progression of MAFLD.

High cholesterol and triglyceride levels (Dyslipidemia):

High levels of cholesterol and/or triglycerides in the blood can lead to fat accumulation in the liver.^[15] Elevated levels of triglycerides can contribute to the progression of fatty liver disease in more severe forms and liver fibrosis.

Other liver diseases:

Various liver diseases can contribute to the development of fatty liver disease, including Hepatitis C, Wilson’s disease, Alcoholic liver disease, Autoimmune hepatitis, and some genetic disorders.^{[16] [17]} In these cases, inflammation or impaired lipid metabolism contributes to the development of MAFLD.

Certain medications:

Some medications, such as corticosteroids and NSAIDs, can increase the risk of developing fatty liver disease.^{[18] [19] [20]}

Environmental toxin exposure:

Environmental toxins can damage liver cells and disrupt normal liver function.^[21] Common toxins associated with it include pesticides and herbicides, air pollution, heavy metals, and endocrine-disrupting chemicals.^{[22] [23]}

MAFLD is also associated with the following:

• Endotoxemia
• SIBO
• Subclinical and overt hypothyroid
• Low testosterone in men
• Higher testosterone and visceral fat in women
• Increased visceral adiposity
• Metabolic syndrome
• Hyperuricemia

Effective Ways to Reverse Fatty Liver Disease

Research shows that lifestyle modifications can reduce the amount of fat in the liver and reverse fatty liver disease. However, reversing this disease is gradual and may take several months or even years to achieve.

Here are some effective ways to begin reversing fatty liver disease:

Treat Insulin Resistance

To reverse fatty liver disease, treating insulin resistance is key. This involves lifestyle modifications like regular exercise and maintaining a healthy weight. A balanced diet with reduced refined sugars and saturated fats is crucial. Effective management of diabetes, if present, through medication and blood sugar control is essential.

Lastly, addressing underlying conditions like obesity, hypertension, and dyslipidemia is also essential.

Weight Loss

Weight loss is a fundamental strategy for reversing fatty liver disease. Shedding excess weight can significantly improve liver health and reduce fat accumulation in the liver. Here’s how weight loss can effectively reverse fatty liver disease:

• Help reduce fat in the liver
• Improve insulin sensitivity
• Decreases inflammation

It’s important to note that weight loss should be gradual and achieved sustainably. Talk with your care provider to ensure a safe and effective weight loss plan.

Gut Health Support

Supporting gut health can play a significant role in reversing fatty liver disease. Here are some ways in which gut health support can be beneficial:

• Probiotics: Consuming foods rich in probiotics or a probiotic supplement can help restore a healthy balance of gut microbiota, promoting better digestion, nutrient absorption, and overall metabolic health.
• High-fiber diet: Increasing dietary fiber intake can aid digestion, promote regular bowel movements, and help control blood sugar levels.
• Avoiding processed foods: Processed foods, high in refined sugars, unhealthy fats, and artificial additives, can disrupt the balance of gut microbiota and contribute to inflammation in the liver.
• Minimizing antibiotic use: Overuse or misuse of antibiotics can negatively impact gut health by disrupting the natural balance of gut bacteria.

Gut health support should be combined with other lifestyle modifications to reverse it effectively.

Nutritional Supplements

Dietary changes and lifestyle modifications are the cornerstone of treating and reversing this disease. But some nutritional supplements may also help improve liver function and reduce liver fat.^[24] Here are some examples:

• Glutathione: This antioxidant, and its precursor, NAC, help increase the levels of glutathione in the liver, which help improve liver function and reduce inflammation.^[25]
• Fish Oil: Fish oil supplementation, rich in omega-3 fatty acids, can help reverse it by reducing liver fat accumulation, improving insulin sensitivity, and promoting a healthier lipid profile.^{[26] [27]}
• Phospholipids: Phospholipids are essential components of cell membranes and help reduce liver fat content, improve liver enzyme levels, and enhance liver function.^[28] They can also promote the breakdown of fats, increase the export of fats from the liver, and support the repair and regeneration of liver cells.

Nutritional supplements should be used in conjunction with other lifestyle modifications and under the guidance of your care provider.

Cutting Edge Source for Functional, Integrative, and Environmental Medicine

It is a serious health condition, but the good news is that it’s reversible in most people!

By making small but impactful changes to your diet, exercise routine, and overall lifestyle, you can help your liver heal and return to its optimal function.

Take control of your liver health today and start your journey towards reversing this disease with support from Dr. Kelly McCann and her team at The Spring Center.

Subscribe for your health today and gain valuable insight into living your healthiest life. Or, enroll in your health today and start your journey to optimal health.

Resources

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Resources

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