Understanding Fatty Liver Disease: Causes, Symptoms, and Connection to Other Health Issues
Fatty liver disease is an increasingly common condition, especially in Western countries, because of the rise in poor dietary habits and sedentary lifestyles.
It occurs when fat accumulates in the liver, a vital organ responsible for many essential bodily functions.
What Does the Liver Do in the Body?
The liver is one of the most important organs in the body, responsible for several critical functions, including metabolism, detoxification, and bile production.
Metabolism
The liver plays a key role in metabolizing nutrients such as carbohydrates, proteins, and fats. It helps regulate blood sugar levels by converting excess glucose into glycogen for storage and releasing glucose when energy is needed.
Detoxification
One of the liver's primary functions is detoxification. It filters toxins, drugs, and alcohol from the blood, breaking them into less harmful substances the body can safely eliminate.
Bile Production
The liver produces bile, a digestive fluid that helps break down fats in the small intestine. Without sufficient bile production, fat digestion and absorption become less efficient, and when excess fat is built up in the liver, fatty liver disease can occur.
What Is Fatty Liver Disease?
Fatty liver disease occurs when fat accumulates in the liver cells. Normally, the liver contains little to no fat. However, when excess fat builds up (more than 5% to 10% of the liver’s weight), normal liver function can get disrupted.
There are two primary types of fatty liver disease:
- Non-alcoholic fatty liver disease (NAFLD): Caused by diet and lifestyle factors, not by alcohol
- Alcoholic fatty liver disease (AFLD): Resulting from excessive alcohol consumption
Those who drink alcohol excessively may consider the possibility of fatty liver disease, but non-alcoholics who get involved with fatty liver disease usually have no clue, as it doesn’t show specific signs.
Why Are There Usually No Signs of Fatty Liver Disease?
In many cases, fatty liver disease has no symptoms in its early stages. Most people with this condition are unaware they have it because the liver itself has very few pain receptors, meaning it does not hurt when affected by fat buildup.
This silent nature makes it difficult to detect until it becomes more advanced, making fatty liver disease a common illness.
How Common Is Fatty Liver Disease?
Fatty liver disease affects millions of people worldwide. In the United States, it's estimated that non-alcoholic fatty liver disease (NAFLD) affects 25% to 30% of adults.
It is most common in individuals who are obese, have type 2 diabetes, or lead sedentary lifestyles.
Although it is generally asymptomatic, fatty liver disease can lead to severe health problems, including fibrosis, cirrhosis or liver failure, heart disease, and cancer, if not treated.
How Is Fatty Liver Disease Connected to Heart Disease and Cancer?
There is a strong connection between fatty liver disease and other serious health conditions, especially heart disease and cancer.
When fat accumulates in the liver, it can trigger inflammation and insulin resistance, both of which are risk factors for cardiovascular disease.
In addition, studies show that people with NAFLD are more likely to develop liver cancer or other types of cancer, as the continuous damage to liver cells from fat buildup creates a higher risk for malignant transformations.
So, it’s necessary to be cautious about small signs and symptoms of any abnormality.
Signs and Symptoms of Fatty Liver Disease
Although fatty liver disease often has no symptoms at the beginning, certain signs may develop as the condition progresses:
Dull Abdomen Pain (Upper Right Side) and Right Shoulder Pain
The liver is located in the upper right part of the abdomen. A fatty liver can cause dull, persistent pain in this area, radiating to the right shoulder due to the proximity of the liver to surrounding tissues.
Man Boobs and Hormonal Imbalance
In men, gynecomastia (enlarged breast tissue, or "man boobs") can be a sign of fatty liver disease.
The liver plays a role in regulating hormones, including estrogen. Therefore, an imbalance in estrogen due to liver dysfunction can cause this condition.
Women may experience estrogen imbalances as well, leading to hormonal-related symptoms.
Spider Veins and Estrogen Imbalance
Spider veins, or small, visible blood vessels on the skin, can be a sign of estrogen imbalance, which is linked to liver dysfunction. When the liver cannot properly break down excess estrogen, it circulates in the bloodstream, causing these visible veins.
Swollen Legs (Thumbprint Test)
Liver problems can lead to fluid retention, especially in the legs. This can cause swelling (edema), which is noticeable when pressing a thumb into the swollen area and leaving a persistent thumbprint.
Midsection Protruding (Visceral Fat)
A protruding belly or excess fat around the abdomen can be a sign of visceral fat accumulation, which is closely linked to fatty liver disease. This type of fat surrounds the organs and is a major risk factor for metabolic syndrome and liver damage.
So, please carefully consider these signs, and if you suspect you have fatty liver disease, you can ask your doctor to perform tests to confirm the diagnosis.
Tests for Fatty Liver Disease
There are various tests, including the following, to ensure if you have fatty liver disease.
Blood Tests (GGT, ALT, AST)
- Gamma-glutamyl transferase (GGT): High levels of GGT can indicate liver damage or inflammation.
- Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST): These enzymes are elevated when there is liver injury.
Insulin Test (CPT Code - 83525)
An insulin test can help measure insulin levels in the blood, as fatty liver disease is closely tied to insulin resistance.
Using CPT code 83525, your doctor can check total insulin levels, which is critical for understanding your risk for metabolic diseases.
So, if we did the tests and ensured we have fatty liver disease, what can we do to get rid of it?
Solution: Fix Your Diet
The most effective way to reverse fatty liver disease is through dietary changes. In the first step, you should reduce sugar and carbohydrate intake, as these lead to fat buildup in the liver.
Going on low-carb ketogenic diets can help you get rid of the fatty liver disease, as such diets eliminate or minimize carbohydrates by allowing only certain foods.
What to Eat?
- Bacon, butter, and fatty meats: These foods are high in healthy fats and low in carbohydrates. Consuming healthy fats while avoiding sugar and refined carbohydrates helps the liver burn fat instead of storing it.
- Whole, unprocessed foods: Focus on nutrient-dense, natural foods like leafy greens, fatty fish, and organ meats.
So, by adopting a low-carb, high-fat diet, you can reduce fat accumulation in the liver, improve metabolic health, and reverse fatty liver disease.
Dr Ken Berry's Book
- Lies My Doctor Told Me Second Edition: Medical Myths That Can Harm Your Health
- Common Sense Labs: Blood Labs Demystified
About Dr Ken Berry
Ken Berry, MD is a family physician in Camden, Tennessee and is affiliated with Henry County Medical Center. He received his medical degree from University of Tennessee College of Medicine. He is the author of the bestseller Lies My Doctor Told Me which exposes myths and misleading health advice from well-meaning doctors, such as avoiding fat. Dr. Berry’s own health dramatically improved when he embraced a ketogenic diet.
