Fatty liver disease: What it is and what you can do to manage it

Non-alcoholic fatty liver disease (NAFLD) can be related to a range of conditions whose main characteristic is too much fat stored in the liver. In the US this is the most common form of chronic liver disease, affecting 25% of the population.

This disease is predominantly without symptoms and is often only picked up through standard blood work. With non-alcoholic fatty liver disease, your AST (aspartate transaminase) and ALT (alanine amino transferase) levels will be elevated. 

AST  and ALT are markers of liver cell injury. They take part in gluconeogenesis, which is the process of extracting sugar from proteins and fats.

ALT is an enzyme found inside cells in predominantly large concentrations inside the liver. AST is also found inside cells, but not just in the liver. It also occurs in heart muscle, skeletal muscle, the brain, kidneys, pancreas and lungs.

The ratio of AST to ALT also indicates the progression of the disease. A healthy AST to ALT ratio should be <1.

The symptoms of fatty liver disease

If symptoms are present it may only show as fatigue, as well as discomfort in the upper right abdomen. In 50% of cases, there is a enlarged liver present.

In some cases the disease can progress into a condition called non-alcoholic  steatohepatitis (NASH). NASH is a aggressive form of fatty liver disease with marked inflammation and possible scarring of the liver, and ultimately liver failure.

Possible symptoms may include red palms, abdominal swelling due to fluid build-up, an enlarged spleen, jaundice (yellow eyes and skin), and enlarged blood vessels under the skin’s surface.

Without lifestyle adjustments, fatty liver disease can morph into something more serious. Image: Adobe Stock

The cause of the disease is unknown and the progression for some individuals from NAFLD to NASH is also not fully understood. Links have been made to obesity, high fat levels in the blood (triglycerides), high blood sugar levels (hyperglycemia) indicating a secondary onset diabetes or prediabetes and insulin resistance, sleep apnoea, an underactive thyroid and a underactive pituitary gland.

NASH seems to be more predominant in the elderly, in diabetics and people with high fat concentrations around the middle.

The complication you want to avoid is liver cirrhosis, which is scarring in the liver that results as the liver reacts to the inflammation in NASH. As the liver tries to stop the inflammation, areas of scarring are produced. If the inflammation is not stopped the scarring (fibrosis) continues, and more and more liver damage results.

Prevention of fatty liver disease

The old adage “prevention is better than cure” definitely applies here, and can feel as restrictive and boring as the repetitive advice of self-care. When life is difficult and restrictions are the order of the day in the context of COVID-19, the need to feel alive doesn’t always align with conscious eating and sensible living.

Especially when young, feeling that life is passing you by and having a fatalistic approach is common. Yet, when looking at the metabolic links that NAFLD has, and the drastic increase of this also linked with polycystic ovarian syndrome, we might not have much of a choice.

Losing weight gradually best for liver

Losing weight slowly is key. Moderate — and I stress moderate — exercise is essential, as is eating a diet rich in plants and whole grains, and low in processed fats and sugars.

The distinction between non-alcoholic and alcoholic FLD is made with the amount the person drinks daily. For men having less than 30g and women less than 20g of alcohol per day means it is non-alcoholic FLD.

That does not mean a person with NAFLD has no alcohol and that is another factor you can manage. Either stop alcohol consumption or manage its intake very strictly. Now tell that to the matrics having 2020 Rage!

Holistic help for a healthier liver

A healthy liver is a key part of overall physical health. Image: Adobe Stock

Holistically speaking, considering the emotional aspects in your life, managing anxiety and stress so it is easier to live consciously, so that the need to mask pain through unhealthy habits can be dealt with on a more conscious level and hopefully better managed.

The substance Betaine, found in certain digestive enzymes, has been found to have liver-protective and in some cases liver-regenerative properties. Managing cholesterol levels and cardiac health with Coq10 and Vitamin B3 could be worth discussing with your health-care practitioner.

Herbs like milk thistle, dandelion root, artichoke, gymnema and schisandra are worth investigating.

In colour therapy, the colour yellow can be used to support liver function.

Homeopathic support for your liver

There are several homeopathic formulations sold in pharmacies or health shops that have liver-supporting actions. Look at Febro 1 and Febro 2 by Natura as a start to support your liver, or, even better, speak to someone who can advise you.

Creating healthy lifestyle supporting habits become easier over time and it doesn’t mean there is no more fun to be had — it is just done with more control and moderation.