- Fatty liver, which most commonly presents as non-alcoholic fatty liver disease (NAFLD), is a condition where excess fat accumulates within the liver.
- NAFLD is usually symptomless and may progress to a more severe condition, including liver cirrhosis or liver cancer.
- Fatty liver may be reversed through lifestyle changes— particularly, diet and exercise.
- People who are overweight or obese and have co-morbidities like type 2 diabetes, high blood pressure, or PCOS, have a higher risk of developing fatty liver.
- Imaging tests and proactive screening of the body using a high-quality, full-body MRI scan may help detect abnormalities that can catch diseases like fatty liver early, giving individuals the chance of a better prognosis.
Fatty liver is a condition that’s characterized by too much fat in the liver cells. This condition may not show any apparent symptoms. However, if left untreated, it may progress to more severe conditions, including liver cancer. If detected early, it’s possible to stop the progression of fatty liver, and in many cases, even reverse it.
“How to reverse a fatty liver?” is a common question we’ll aim to answer in this article.
What is fatty liver?
A fatty liver, also called hepatic steatosis, is a condition in which there’s too much fat buildup in the liver.
Your liver is tasked with processing nutrients from your diet and detoxification. It also plays a central role in fat metabolism. During this process, liver cells store some fats in the form of triglycerides. But in certain conditions, this metabolism is altered and leads to liver cells storing more fats than is normal. As more fats accumulate within liver cells, it can lead to fatty liver.
Disturbances in fat metabolism in the liver may be a result of alcohol consumption (alcoholic fatty liver disease), nutritional issues, or conditions like diabetes (non-alcoholic fatty liver disease).
Non-alcoholic fatty liver disease (NAFLD) affects as many as 25-30% of the U.S. population and is the most common type of liver disease in adults and adolescents, mostly attributed to the high-fat, high-carb American diet.
NAFLD can progress to non-alcoholic steatohepatitis (NASH). In this condition, the progressive buildup of fat leads to inflammation of liver cells. This results in the death and eventual scarring of tissue, a condition called fibrosis. Fibrosis, over time, may get worse and result in extensive scarring of the liver, referred to as cirrhosis.
In this condition, a major part of the liver is “dead” and the liver function is hampered. People who develop cirrhosis are at risk of irreparable liver damage—liver cancer or liver failure. In such cases, a liver transplant is the only option to save the patient’s life.
Are there guidelines on how to reverse a fatty liver?
Non-alcoholic fatty liver disease may be reversible if you take action early. Doing so can help you avoid more serious, related problems.
NAFLD may be presumed to be more of a “lifestyle disorder,” as conditions like obesity, insulin resistance, high blood sugar, and high fats in the blood are linked to this disorder. Targeted lifestyle changes may help reverse this condition.
The fastest way to reverse NAFLD is to lose weight. While losing 10% of your body weight should be your ideal goal, research suggests that losing even 3-5% of body weight can have a positive effect on your liver’s health.
Weight loss can be achieved through a healthy diet along with regular exercise. A knee-jerk reaction might be to go on a “low carb, low fat” diet. Also, some people may be prompted to lose weight rapidly through fasting. But the preferred way is to make sustainable dietary changes, which include choosing healthy fats and complex carbohydrates over simple ones.
The American Liver Foundation suggests that a switch to the Mediterranean diet, along with calorie reduction and moderate physical activity, is key to liver health. It can help to reverse fatty liver disease and other disorders.
The Mediterranean diet is rich in healthy fats, complex carbohydrates, and antioxidants, as it relies on a wholesome combination of whole grains, lean proteins (seafood), olive oil, nuts, vegetables, legumes, and fruits.
It goes without saying that you have to abstain from alcohol as it may aggravate an already existing condition, or may cause alcoholic fatty liver disease if you aren’t careful.
Currently, there are no drugs approved to treat NAFLD. However, there are certain medications and supplements you may want to discuss with your healthcare practitioner. For example, GLP-1 receptor agonists are compounds that have been shown to help control diabetes by reducing A1C. They also help to reduce weight, blood pressure, and lipids in the blood — all risk factors for NAFLD. GLP-1 receptor agonists have been approved by the U.S. FDA. You’ll need to discuss with your healthcare practitioner whether they are appropriate for you.
It’s advisable to get vaccinated against hepatitis A and B. If you get infected by these viruses while having fatty liver, it may lead to liver failure. It’s also recommended to get a flu shot and pneumococcal vaccine. In this context, it’s also advisable to get the Covid-19 vaccine, because scientists have found a correlation between liver disease and coronavirus infection.
Some studies suggest a positive role of vitamin E in treating NAFLD. The main reason why vitamin E seems to work is because it’s a potent antioxidant. One of the major reasons behind the development of NAFLD is oxidative stress. Knowing this, the recommendation of a Mediterranean diet that includes foods with natural antioxidant activity makes sense.
If you have conditions that are precursors for NAFLD—diabetes, high blood pressure, and cardiovascular diseases—you need to manage those conditions with appropriate medications and other recommended lifestyle changes.
However, you should always speak to your healthcare practitioner before starting any medication for treating fatty liver and managing conditions that can lead to NAFLD.
What are the symptoms of fatty liver?
The liver is a very resilient organ. It’s also the only organ that can regenerate. Diseases originating in and concerning the liver usually go unnoticed for a very long time, and symptoms are usually seen when the disease has progressed.
NAFLD develops slowly and in most cases presents no symptoms at all. In some individuals, some or all of these symptoms may be seen:
- Pain in the upper right side of the abdomen
- Severe fatigue and weakness
- Swelling in the stomach due to fluid retention (ascites) and legs (edema)
- Inexplicable weight loss
- Yellowing of the skin and eyes (jaundice)
If the condition has progressed to NASH, and further to cirrhosis, the following symptoms may occur, along with those mentioned above and cirrhosis symptoms:
- Formation of spider-like blood vessels on the skin
- Persistent itching
Are you at risk of a fatty liver?
If you’re overweight or obese, have pre-diabetes or diabetes, or have high levels of fat in your blood, you’re more likely to have a fatty liver. Other risk factors associated with fatty liver disease are metabolic syndrome, polycystic ovary syndrome (PCOS), sleep apnea, and thyroid problems.
If you have any of these risk factors, you should aim to manage them and consider getting regular tests done to check your liver health. This will not only help you stay a step ahead of liver disease but also give you a headstart on how to reverse a fatty liver.
How is fatty liver disease diagnosed?
Because fatty liver disease does not usually present symptoms, it comes to medical attention during examination for some other issue. Some tests done during a routine checkup may also point to a liver disease and may warrant further examination.
Liver function tests (LFTs) are blood tests that determine the amount of enzymes vital in liver functioning. LFTs are usually part of routine blood work. If these test results show elevated amounts of these liver enzymes, it might suggest a problem with the liver. On the basis of these test results, your healthcare practitioner may order more tests to diagnose the actual problem.
Other blood tests that may point to a potential liver problem are:
- Fasting blood sugar and HbA1C, both of which determine if you have prediabetes or diabetes
- Lipid profile, which measures the amount of fats, such as cholesterol and triglycerides, in the blood
Higher than normal values may point to conditions that can put stress on the liver and cause fatty liver.
A fatty liver is enlarged. Imaging tests help determine the size of the liver and in turn also help in understanding the severity of the condition.
- Ultrasound: An ultrasound imaging of the abdomen is often the first test to be done when a liver condition is suspected.
- Transient elastography: An advanced type of ultrasound that can measure the stiffness of the liver. Stiffness in the liver may indicate fibrosis or cirrhosis. The amount of stiffness may indicate how advanced the disease is.
- Abdominal CT (computerized tomography) and MRI (magnetic resonance imaging) scan: These advanced imaging tests can show abnormalities in tissues and organs.
CT scans vs MRIs
CT scans use ionizing radiation and may increase your risk of developing cancer. MRI scans, on the other hand, use a combination of radio waves and magnetic fields to create high-definition images of the inside of your body. MRI scans screen for a variety of abnormalities, and Ezra members have found results ranging from fatty liver disease to cancer.
The Ezra Scan is a full-body MRI scan that screens 13 organs for signs of abnormalities, including cancer. The scan takes around an hour. The service also includes a 45-minute consultation with a medical provider to understand your report and to plan next steps. You’ll also be guided by a Personal Care Advisor throughout the Ezra experience, who can answer any questions you might have.
If other tests return inclusive results, a biopsy may be ordered. This includes a minor surgical procedure that removes a small part of your liver tissue for examination in the lab.
Take control of your liver health.
Your lifestyle choices can have a huge impact on your health. It’s in your best interest to follow a healthy diet and exercise regimen to keep risk factors for conditions like fatty liver at bay.
It’s also helpful to get screened for potential problems that might not be apparent through signs and symptoms. A full-body MRI like the Ezra Scan helps you to take charge of your health through early detection.