Fatty Liver Disease: What It Is and How to Reverse It - Dr. Axe

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What Is Fatty Liver Disease? 5 Dietary Steps to Get Rid of It


Diet for fatty liver disease - Dr. Axe

In the U.S., it’s estimated that fatty liver disease affects 20 to 40 percent of the population. The scary and surprising fact is that this type of liver disease often doesn’t cause any obvious fatty liver disease symptoms. Many people don’t even realize their livers are fatty until they have testing (such as a CT scan or ultrasound) for another health concern or they experience an obvious alert such as pain in the abdomen.

There are two main types of this disease: nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease. Having a fatty liver can leave you feeling tired or cause mild abdominal discomfort (fatty liver pain), but otherwise you may not have any symptoms. Signs of fatty liver can also include a feeling of fullness in the middle or upper right side of the abdomen, nausea, weight loss and a decrease in appetite. These are just some of the possible symptoms of fatty liver.

Is a fatty liver dangerous? It can be! The more severe type of NAFLD is NASH, which stands for non-alcoholic steatohepatitis. NASH causes the liver to swell and become damaged. According to the American Liver Foundation, NASH is one of the top causes of cirrhosis in adults in the United States and up to 25 percent of adults with NASH may already have cirrhosis. NAFLD is also linked to an increased risk of liver cancer.

Before you jump to the conclusion that a fatty liver may be a likely part of your future or a diagnosis you can’t do anything about, the good news is that the liver is highly regenerative — in fact, it’s the only organ that can regenerate itself.

That’s why it’s not that surprising that with the right fatty liver disease diet and some powerful yet easy-to-do fatty liver home remedies, you may be able to improve the state of your liver starting today!


What Is Fatty Liver Disease?

The human body’s largest organ is the liver. This vital organ stores energy, helps to digest food and removes toxins and poisons.

What is fatty liver disease? Fatty liver disease is a common health problem that results from a buildup of extra fat in the liver. It’s totally normal for the liver to contain a small amount of fat, but when fat storage reaches 5 to 15 percent of the liver’s total weight, then a person is said to have fatty liver disease.

The severity of a fatty liver (also called steatosis) can be a grade 1, grade 2 or grade 3 fatty liver. A fatty liver grade 2 is more serious and more likely to cause symptoms as compared to fatty liver grade 1. The more fat in the liver, the higher the grade and the more likely for the fatty liver to cause problems. There are also different kinds of fatty liver disease.

Nonalcoholic Fatty Liver Disease vs. Alcoholic Fatty Liver Disease

There are two main forms of fatty liver disease: non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease. What causes fatty liver?  In NAFLD, people have a buildup of fat in the liver that is not caused by alcohol use.

However, the build up of fat and damage to the liver is similar to what occurs in a case of alcoholic fatty liver disease, which is directly linked to consuming large quantities of alcohol. A “large amount” of alcohol is typically usually said to be more than one drink per day on average for women and more than two drinks per day on average for men.

Fatty Liver Disease Symptoms

Now that you know what is fatty liver, it’s time to take a look at some of the ways you can identify this disease by knowing the common nonalcoholic fatty liver disease symptoms. First, it’s important to note that it is possible to have non-alcoholic fatty liver disease and exhibit no symptoms. This is actually quite common. When symptoms do occur, there are several possibilities.

Signs of a fatty liver (due to alcohol or other causes) can include:

  • Fatigue
  • Weakness
  • Loss of appetite
  • Nausea
  • Abdominal pain especially in the upper right abdomen
  • Swelling in the upper abdomen
  • Spider-like blood vessels
  • Itching
  • Jaundice (yellowing of the skin and eyes)
  • A build up of fluid and swelling of the legs (edema) and abdomen (ascites)
  • Mental confusion

Fatty Liver Disease Causes

What causes a fatty liver? An excessive accumulation of fat leads to a fatty liver. In a diagnosis of alcoholic fatty liver disease, the main cause of fat accumulation is consuming large amounts of alcohol.

Suspected causes of nonalcoholic fatty liver disease (NAFLD) as well as non-alcoholic steatohepatitis (NASH) include:

  • Being overweight or obese
  • Insulin resistance
  • High blood sugar (hyperglycemia), indicating prediabetes or actual type 2 diabetes
  • High levels of fats, specifically triglycerides, in the blood

All of these possible causes seem to encourage excess deposits of fat within the liver with obesity likely being the most prevalent cause.

According to American College of Gastroenterology,

NAFLD is a very common disorder affecting and may affect as many as one in three to one in five adults and around one in ten children in the United States. Obesity is thought to be the most common cause of fatty infiltration of the liver. Some experts estimate that about two thirds of obese adults and half of obese children may have fatty liver.

Risk Factors

What are the risk factors for fatty liver disease? Nonalcoholic fatty liver (NAFLD) is more common in people who exhibit any of these health problems or features:

  • Obesity
  • Type 2 diabetes
  • Prediabetes
  • Metabolic syndrome or another metabolic disorder
  • Hispanic
  • Rapid weight loss
  • High blood pressure
  • Middle aged or older (NAFLD is most prevalent in people who are middle-aged or older, but younger people including children can also have NAFLD)
  • Certain infections like hepatitis C
  • Take certain drugs including corticosteroids and certain cancer drugs
  • Exposure to some toxins

According to the Cleveland Clinic, “Some genetic metabolic conditions or prescription medications, including amiodarone (Cordarone®), diltiazem (Cardizem®), steroids, and tamoxifen (Nolvadex®) also may increase the risk of non-alcoholic fatty liver disease. If you are taking one of these medications and are diagnosed with fatty liver, your doctor might substitute another drug.”

Is having a fatty liver life threatening? If left untreated and it progresses, a fatty liver can definitely be life threatening. Let’s take a look at possible fatty liver health complications.


Conventional Treatment

To diagnose a fatty liver, your doctor will likely perform blood and imaging tests. A liver biopsy may also be necessary.

Common conventional treatment recommendations for fatty liver disease involve eliminating or controlling the cause(s). For example, according to the National Institute of Diabetes and Digestive and Kidney Diseases, conventional fatty liver treatment may includes a doctor’s recommendation to lose weight, which helps to decrease fat in the liver as well as inflammation and fibrosis.

Rapid weight loss, however, is not a good idea since this can only make things worse. Gradually losing weight is the smart way to go. Some doctors may advise aiming to lose around 7 percent of body weight over a one year time frame.

Other recommendations may include:

  • Stop taking any drug that may be causing fatty liver
  • Better control diabetes
  • Lower triglyceride levels
  • Stop consuming alcohol

There are currently no approved medications to specifically treat NAFLD and NASH. Some doctors give their fatty liver patients vitamin E and thiazolidinediones (a class of drugs, including rosiglitazone and pioglitazone, commonly taken for diabetes) when alcohol is not the cause. However, these drugs can cause adverse effects and some say they don’t make enough of a difference long-term.

When NASH leads to cirrhosis, conventional treatment typically includes certain medications and possibly operations or procedures. When cirrhosis leads to liver failure, a liver transplant can be required.

Fatty Liver Diet and Supplementation

Are you wondering, how can I reduce my fatty liver? Some of the main natural tactics include following a healthy fatty liver disease diet loaded with whole foods. There are also a number of supplements that can be helpful as well.

1. Foods to Boost Liver Function

What foods to eat if you have a fatty liver? In general, you will want to incorporate more plant-based diet foods and choose helpful fatty liver foods including vegetables, fruits and healthy fats.

The following helpful foods are known to decrease inflammation while also aiding the body in its use of insulin, which is often a problem for people with a fatty liver:

  • Foods high in monounsaturated fats like olives, olive oil, avocados and nuts.
  • Foods rich in omega 3 fatty acids including wild-caught fish like salmon and sardines, chia seeds, flaxseeds and walnuts.
  • High antioxidant foods that can help to protect the liver cells from damage, especially items rich in vitamin E, which some research shows can improve the state of a fatty liver. Some healthy foods high in vitamin E include sunflower seeds and almonds.
  • Liver boosting vegetables including artichokes and bitter, leafy greens like mustard greens, chicory, arugul, and dandelion.
  • Green tea, which is rich in catechins, has been shown to help decrease body fat and discourage obesity.

2. A Mediterranean and Ketogenic Diet

You may want to consider following a Mediterranean diet, which some some studies have suggested can decrease fat in the liver. This diet emphasizes vegetables, fruits, whole grains, legumes, beneficial fat sources like extra virgin olive oil, and healthy proteins like sardines and other omega-3 fatty acid rich fish.

You can take it one step further and follow a Mediterranean ketogenic diet. A pilot study published in 2011 in the Journal of Medicinal Food finds that this type of combined diet plan which focuses on whole foods (especially healthy fats, proteins, and vegetables) can help people overcome metabolic syndrome, which is closely associated with nonalcoholic fatty liver disease.

So for people struggling with a fatty liver linked to metabolic syndrome, this study shows that the potential therapeutic properties of a Mediterranean ketogenic diet can improve metabolic syndrome along with NAFLD.

3. What Foods to Avoid

If you’re looking to follow a fatty liver diet menu and lifestyle that can help to improve the state of your liver, there are some things you’ll definitely want to avoid. Of course, excess alcohol is a huge no-no especially if you have alcoholic fatty liver disease.

There are also a number of foods and other items known to have a negative impact on the liver including:

  • Too much alcohol or caffeine
  • Packaged goods that contain refined vegetable oils, artificial ingredients, sweeteners and colors
  • Fruits and vegetables heavily sprayed with chemical pesticides and herbicides (non-organic crops)
  • Factory-farm animal products, farm-raised fish or conventional dairy (that has been pasteurized and homogenized)
  • Refined sugar as well as too much fructose
  • Refined grains
  • Uncooked shellfish
  • Certain medications (especially acetaminophen)
  • Eating poisonous wild mushrooms
  • Exposure to harsh chemicals especially endocrine-disrupting chemicals

You can check the LiverTox database provided by the National Institutes of Health to see if any medication, herb or supplement may be linked to liver injury so that you can avoid them as well.

3. Supplements that Boost Liver Health

According to a scientific review published in 2015, there are some supplements that have specifically been shown to help in the treatment of non-alcoholic fatty liver disease including:

  • Vitamin E and vitamin C: Since oxidative stress can play a significant role in the development of pathogenesis of NAFLD, antioxidant agents like vitamin E and vitamin C could be beneficial in the treatment of a fatty liver. However, so far study results are unclear. For example, Vitamin E may only be helpful for adults with NASH who do not also have diabetes or cirrhosis.
  • Vitamin D: Research has shown that a vitamin D deficiency can result in insulin resistance, metabolic syndrome and NAFLD.
  • Resveratrol: Found in red wine as well as foods like red grapes, raw cocoa (dark chocolate), berries and also available in supplement form, resveratrol appears to decrease the severity of NAFLD in animal models.
  • Anthocyanin: Animal research points towards anthocyanin‘s ability to decrease fat accumulation in the liver and counteract liver inflammation.
  • Green tea extract: Both in vitro and in vivo experiments demonstrate that green tea and EGCG (a type of catechin) may prevent steatosis by decreasing dietary absorption of fats and carbohydrates.
  • Garlic: Garlic-derived S-allylmercaptocysteine (SAMC) appears beneficial to nonalcoholic fatty liver disease thanks to its ability to regulate fat storage and glucose metabolism.
  • Ginger: May help to prevent NAFLD or slow down its progression to more severe liver diseases.
  • Probiotics and prebiotics: As the review points out, “The gut-liver axis is an important pathway in NAFLD development, which is associated with small intestinal bacterial overgrowth and increased intestinal permeability.” So in other words, SIBO and a leaky gut appear to be contributing factors to NAFLD, which is why prebiotics and probiotics can be so beneficial. You can incorporate more prebiotic and probiotic foods into your diet as well as high quality probiotic supplements.
  • Cinnamon: May improve insulin resistance and oxidative stress.
  • Curcumin: The active component of turmeric, curcumin, may reduce fat deposits in the liver. It may also prevent fatty liver progression with its “potent antioxidant and anti-inflammatory activities.”
  • Quercetin: Available as a supplement and also found in foods like apples and onions, quercetin may help to reduce inflammation and may be particularly helpful for people with a fatty liver as well as obesity and/or diabetes.

This review also points out how both epidemiological and animal studies have shown that drinking coffee (opt for organic to eliminate pesticide residues!) on a regular basis can decrease the risk of type 2 diabetes development, which is a known cause/risk factor for fatty liver disease.

4. Detox Your Liver

Check with your doctor first, especially if you have diabetes or struggle with blood sugar issues, but you may want to consider a 6-Step Liver Cleanse.

Risks and Complications

Non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of liver disease in the Western world. Having fatty liver disease means that you have fat deposits within your liver and these undesirable deposits can prevent the liver from doing its important job (and what’s so crucial to optimal health) — to remove toxins from your blood. This puts someone with this liver disease at serious risk for toxic buildup and all kinds of unpleasant symptoms of a poorly functioning liver including jaundice, edema, chronic fatigue, nausea and more.

When non-alcoholic fatty liver disease progresses and becomes severe, it is then non-alcoholic steatohepatitis (NASH). According to the National Institutes of Health (NIH), between 7 and 30 percent of people with NAFLD will develop NASH and at least one-third of people with NASH eventually develop cirrhosis.

The late-stage scarring of the liver known as cirrhosis is the main complication of NAFLD and NASH. When cirrhosis occurs, liver cells are progressively replaced by scar tissue and liver function deteriorates more and more.

According to Mayo Clinic, approximately 20 percent of people with NASH will progress to cirrhosis, which can lead to:

  • Abdominal fluid buildup
  • Swelling of veins in your esophagus, which can rupture and bleed
  • Confusion, drowsiness and slurred speech
  • Liver cancer
  • End-stage liver failure (the liver has stopped functioning)
  • The need for a liver transplant

People with NAFLD, NASH and cirrhosis are all believed to be at an increased risk of developing liver cancer.

Final Thoughts

  • What is a fatty liver? A liver which has a fat storage of five to 15 percent of its total weight. This equates to a diagnosis of fatty liver disease.
  • A fatty liver can result in no obvious symptoms or it can cause one or more common fatty liver symptoms such as abdominal pain, abdominal swelling, jaundice, nausea, loss of appetite, fatigue, weakness and itching.
  • Nonalcoholic fatty liver disease affects people who drink little to no alcohol while alcoholic fatty liver disease is the result of excessive alcohol consumption.
  • For people who don’t excessively consume alcohol, other fatty liver causes include being overweight or obese, insulin resistance, high blood sugar and high levels of fats, particularly triglycerides, in the blood.
  • A healthy diet for fatty liver should include plenty of whole foods like liver-boosting artichokes and bitter leafy greens, fish rich in omega 3s and olive oil, high vitamin E foods like sunflower seeds and almonds, and green tea.
  • Supplements like probiotics, resveratrol, curcumin, vitamin E, vitamin C and vitamin D may help to naturally improve a fatty liver.
  • It’s also important to get regular exercise, which can help you to maintain a healthy weight and decrease fat accumulation in the liver.
  • Talk with your healthcare provider before changing your diet or trying any new supplements if you have been diagnosed with fatty liver disease.

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