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Fatty Liver, Common, Under-diagnosed, and a treatable disease.
Many of my patients come to my practice with advanced liver disease from fatty liver. Many of them have no idea they have Non-Alcoholic Hepatosteatosis, also known as Fatty Liver Disease. I spend a lot of time educating patients on what Fatty Liver is, and how to repair the damage.
What is Fatty Liver?
Fatty liver disease is the name that is often applied for the condition called non-alcoholic hepatic steatosis. In this disease, normal liver tissue is replaced by fatty deposits. This is problematic because the liver loses its ability to perform important detoxing and metabolism.
Non-alcoholic fatty liver disease (NAFLD) has a global prevalence of about 25%. Incidence is increasing with rising levels of obesity, type 2 diabetes and the metabolic syndrome, and NAFLD is predicted to become the leading cause of cirrhosis requiring liver transplantation in the next decade (1).
The liver has many important functions. It is an organ of detoxification and metabolism. Every chemical that enters the body must pass through the liver. The liver is responsible for making substances less toxic, easier to excrete, or easier to absorb.
The liver also helps in energy maintenance. Every time you consume calories, some of those are stored in the liver in the form of glycogen, a form of sugar that is stored within the liver. Glycogen is released very slowly between meals to maintain blood sugar.
If too much sugar is available in the bloodstream, the liver is forced to store more sugar than needed. In order to maximize space in the liver, glycogen is converted into fat in a process called gluconeogenesis.
The fat stored in the liver causes damage by occupying usable space in the liver. The fat is also inflammatory, causing damage to the liver. The pathological progression of NAFLD follows a ‘three-hit’ process namely steatosis, lipotoxicity and inflammation. The presence of steatosis, oxidative stress and inflammatory mediators like TNF-α and IL-6 (2).
Who gets Fatty Liver Disease?
Fatty Liver Disease is common. Nearly 25% of the world’s population. People living with Diabetes, obesity, and high cholesterol are at increased risk of developing Fatty Liver Disease.
Fatty Liver Disease often proceeds the development of diabetes. Many diabetics present with Fatty Liver Disease before starting treatment for diabetes.
Is Liver Disease Fatal?
Death from Fatty Liver Disease is rare, but if the disease is not reversed, and can lead to permanent liver damage.
How is Fatty Liver Disease Diagnosed?
Fatty liver diseases diagnosed from blood work and imaging of the liver. Blood work can detect abnormal levels of ALT, AST, Alkaline Phosphatase, and Bilirubin. It’s usually a good idea to check your kidney function, hemoglobin and platelets.
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How Do I Heal Fatty Liver Disease?
Healing Fatty Liver Disease is very possible. It starts with healing your lifestyle. This means improving your nutrition, sleep, stress, reducing unhealthy habits and increasing healthy movement.
Healing Fatty Liver disease also heals Diabetes, High Blood Pressure, Depression, and Fatigue.
A personalized, tailored plan would include addressing nearly every aspect of your life. While this seems like a lot of effort, it would be worthwhile to prevent severe disease.
Fatty Liver, Diabetes, High Blood Pressure, autoimmune disease all in common: Inflammation.
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- Maurice, J., & Manousou, P. (2018). Non-alcoholic fatty liver disease. Clinical medicine (London, England), 18(3), 245–250. https://doi.org/10.7861/clinmedicine.18-3-245
- Cobbina, E., & Akhlaghi, F. (2017). Non-alcoholic fatty liver disease (NAFLD) – pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug metabolism reviews, 49(2), 197–211. https://doi.org/10.1080/03602532.2017.1293683