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| Fatty Liver |
Last updated: Nov 19, 2009 |
Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Other conditions that may be present | Recommendations
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Fatty liver is the build-up of fat in the liver cells. Although this is not a normal condition, fat in the liver usually causes no damage by itself. However, on some occasions it can be a sign that other more harmful conditions are at work.
It would seem logical that eating fatty foods would cause a fatty liver, but this is not the case. The liver does play an important role in the metabolism or breakdown of fats, but something goes wrong in this process of metabolism, although it is still not known what does cause fat to build-up in the liver. This condition is usually reversible when the underlying causes are treated or removed.
There are usually no symptoms that are noticeable to the patient. In fact, fatty liver is frequently uncovered during a routine physical examination. There may be a rise in certain liver enzymes found in the blood, and sometimes the liver is slightly enlarged. Fatty liver may also be discovered while the physician is evaluating a patient for other illnesses. For example, an ultrasound exam of the abdomen done for other reasons may show fat in the liver. To be certain of a diagnosis of fatty liver, the physician may recommend a liver biopsy. Under local anesthesia, a slender needle is inserted through the right lower chest. A small piece of liver tissue is taken out with the needle and examined under a microscope.
Steatohepatitis is inflammation of the liver related to fat accumulation. Heavy alcohol use can lead to fatty liver and inflammation, usually called alcoholic hepatitis. Steatohepatitis resembles alcoholic hepatitis, but it can and does occur in people who seldom or never drink alcohol. In this instance, it is often called nonalcoholic steatohepatitis or NASH. Both alcoholic hepatitis and steatohepatitis can lead to serious liver damage and cirrhosis.
Studies have shown that many people who are significantly overweight have developed, or will develop, steatohepatitis. It can also occur with rapid weight loss. Steatohepatitis has been connected to estrogen hormones in some women.
In most instances, treatment of fatty liver and steatohepatitis requires control of the underlying conditions. This may include reduction of high blood triglycerides, good control of diabetes, or not drinking alcohol. In some cases, surgical reversal of intestinal bypass for obesity is required.
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 Signs, symptoms & indicators of Fatty Liver: | | | | | | Symptoms - Liver / Gall Bladder | Counter-indicators:
 Absence of fatty liver |
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Conditions that suggest Fatty Liver: | | | | | | Organ Health |  Cirrhosis of the Liver | Fatty liver may be associated with or may lead to inflammation of the liver. This can cause scarring and hardening of the liver. When scarring becomes extensive, it is called cirrhosis, a very serious condition. |
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Uro-Genital |
Male Infertility (Low Sperm Count)| | Researchers in Hong Kong compared mercury levels in fertile and infertile couples. The results were as follows:
Fertile men 15% with high mercury, Infertile men 35% with high mercury
Fertile women 3.8% with high mercury, Infertile women 23% with high mercury
So for infertile men, the chance of mercury toxicity over fertile men was 2.3 times higher and for women, 6 times higher. Mercury disruption of sperm membrane permeability may be responsible for this lose of fertility.
The researchers recorded how much seafood the couples consumed and found that those eating more seafood tended to have higher blood mercury levels. [Fertility and Sterility, 78: 2, August 2002, pp. 426-428] |
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Risk factors for Fatty Liver: | | | | | | Addictions | Alcohol-related Problems |
Autoimmune |
 Ulcerative Colitis| | Scientists believe a fatty liver can occur when the immune system triggers inflammation in other parts of the body. These problems are usually mild and go away when the colitis is treated. |
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Diet |
Protein Deficiency| | Among children and in the developing countries, malnutrition, especially protein and iron deficiencies, are the most common cause of fat buildup in the liver. |
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Drug Side Effects |
Prescription Drug Side-Effects| | Fatty liver may occurr with the use of certain drugs such as valproic acid (trade names: Depakene/Depakote) and corticosteroids (cortisone, prednisone). |
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Infections |
Tuberculosis |
Lab Values |
Elevated Triglycerides |
Metabolic |
Problem Caused By Being Overweight| | It is known that fat accumulates in the liver with a number of conditions, the most common being obesity. |
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Nutrients |
Vitamin A Toxicity
Iron Requirement |
Organ Health |
Diabetes Type II| | In the case of diabetes mellitus, researchers believe steatohepatitis may develop only in those patients whose diabetes is not properly controlled. |
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Symptoms - Food - Intake |
High refined white flour consumption| | A new US study on mice suggests that a diet rich in carbohydrates with a high glycemic index (GI) not only expands waistlines but may also lead to fatty liver, a condition that results in liver failure and death.
The study is published in the September 2007 issue of the journal Obesity and is the work of Dr David Ludwig, director of the Optimal Weight for Life program at Children's Hospital Boston, and colleagues.
Fatty liver is increasing in line with rising rates of obesity among Americans. The researchers hope to confirm their findings in a newly launched clinical trial with overweight children and to show that the trend can be reversed through changes in diet.
Fatty liver is becoming especially common among children, said Ludwig. Although many adult cases can be caused by alcoholism, that is not so in children, where between 1 in 4 and 1 in 2 overweight American children are thought to be affected by non-alcoholic fatty liver disease (NAFLD).
That means millions of children are at elevated risk of getting full blown liver disease in adulthood, said Ludwig, who called it a "silent but dangerous epidemic".
"Just as type 2 diabetes exploded into our consciousness in the 1990s, so we think fatty liver will in the coming decade," he added.
High GI foods include white bread, white rice, most processed grains such as breakfast cereals, and concentrated sugar. They raise blood sugar quickly because the starch is broken down into sugar quickly. These are also called rapidly absorbed carbohydrates (RAC). |
High refined sugar consumption |
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Fatty Liver suggests the following may be present:
Recommendations for Fatty Liver: | | | | | | Amino Acid / Protein |  Glutamine| | Glutamine is beneficial for the liver, since it cleanses the liver of the waste products of fat metabolism, and helps prevent fatty buildup. It can aid in the treatment of early-stage cirrhosis. Once liver damage is advanced, however, glutamine cannot help since the liver can no longer metabolize it properly. |
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Animal-based |
 Probiotics / Fermented Foods| | Probiotics may interfere with the development of NASH at various levels:- Decreases in proinflammatory cytokines, such as TNF.
- Alteration of the inflammatory effects of pathogenic strains of intestinal bacteria, through changes in cytokine signaling.
- Replacement of pathogenic strains of bacteria.
- Improved epithelial barrier function, thereby avoiding excessive exposure of the liver to LPS and bacterial ethanol.
Evidence in experimental animal models of fatty liver disease, as well as clinical data on other gastrointestinal diseases, strongly suggest that probiotics might be beneficial in NASH. [J Hepatol 38:pp. 681-687, 2003] Data from an uncontrolled clinical trial with NASH patients show promising results, with improvement of liver enzymes in treated patients. [Am J Gastroenterol 97:pp. 2144-2146, 2002] |
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Botanical |
Silymarin/Milk Thistle (Silybum marianum) |
Diet |
 Alcohol Avoidance
Weight Loss| | Since being overweight is by far the most critical factor, weight loss is the key to ridding the liver of fat. This is especially necessary if damage to the liver is occurring, and early signs of scarring are present on biopsy. High blood triglycerides and diabetes are also worse with obesity. So, when steatohepatitis is present with these conditions, people gain even greater benefits from losing weight.
Weight loss should be slow, not the result of fasting or ultra-low caloric diets. This is because free fatty acids are mobilized during weight loss and too many can increase the deposition of fat in the liver. Gradual weight loss with reduced caloric intake and exercise is highly recommended. A major attempt should be made to lower body weight into the healthy range.
Other medical conditions often present, such as diabetes, high blood pressure, or elevated cholesterol should be treated also. |
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Nutrient |
TMG (Tri-methyl-glycine) / SAMe| | The therapeutic indication for SAMe in intrahepatic cholestasis and alcoholic liver disease is based on it's anti-steatotic, anti-inflammatory, anti-oxidant and anti-fibrotic properties. An oral dose of 600 mg/day or intramuscular administration of 50 to 100 mg/day have shown therapuetic benefit regarding biochemical, histological, and echographic parameters of liver steatosis. |
Lecithin / Choline / GPC| | Lecithin protects the cells of the liver and acts as a fat mobilizer, thus helping to prevent a fatty liver. |
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Vitamins |
Vitamin E| | Alpha-tocopherol is effective in improving the liver biochemistry and histological lesions of NASH because of its actions as an antioxidant agent and as an inhibitor of TGF-ß, a cytokine involved in liver fibrogenesis. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
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