Fatty liver is caused by excessive intake of alcohol, unhealthy diets, and certain illnesses and medications. Certain genetic conditions and obesity can also lead to fatty liver disease.

Liver’s functions

The liver, located on the upper-right side of the abdomen, is the largest internal organ of the human body. The main functions of the liver are to remove toxins and process food nutrients. Blood from the digestive system filters through the liver before travelling anywhere else in the body. Your liver is an essential organ with multiple life-supporting functions. The liver’s functions are to:

  • Produces bile, which helps with digestion.
  • Makes proteins for the body.
  • Stores iron.
  • Converts nutrients into energy.
  • Creates substances that help your blood clot (stick together to heal wounds).
  • Helps you resist infections by making immune factors and removing bacteria and toxins (substances that can harm your body) from your blood.

How a liver becomes fatty.

It is unclear how a liver becomes fatty. The fat may come from other parts of your body, or your liver may absorb an increased amount of fat from your intestine. Another possible explanation is that the liver loses its ability to change fat into a form that can be eliminated. Some people get fatty liver disease without having any pre-existing conditions. But these risk factors make you more likely to develop it:

  • Having overweight/obesity.
  • Having Type 2 diabetes or insulin resistance.
  • Having metabolic syndrome (insulin resistance, high blood pressure, high cholesterol and high triglyceride levels).
  • Taking certain prescription medications, such as amiodarone (Cordarone®), diltiazem (Cardizem®), tamoxifen (Nolvadex®) or steroids.

Symptoms

A fatty liver produces no symptoms on its own, so people often learn about their fatty liver when they have medical tests for other reasons. NASH can damage your liver for years or even decades without causing any symptoms. If the disease gets worse, you may experience fatigue, weight loss, abdominal discomfort, weakness and confusion.

The forms of fatty liver disease

There are two main forms of fatty liver disease:

Alcohol-induced fatty liver disease

Alcohol-induced fatty liver disease is caused by heavy drinking. (Moderate drinking is defined as one drink a day for women and up to two drinks per day for men.) About 5% of people in the U.S. have this form of liver disease.

Non-alcohol related fatty liver disease

Non-alcohol related fatty liver disease (NAFLD) occurs in people who aren’t heavy drinkers. The condition affects one in three adults and one in 10 children in the United States. Researchers haven’t found the exact cause of non-alcohol related fatty liver disease. Several factors, such as obesity and diabetes, can increase your risk.

How to diagnosed fatty liver?

Because fatty liver disease often has no symptoms, your doctor may be the first one to spot it. Higher levels of liver enzymes (elevated liver enzymes) that turn up on a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured. To make a diagnosis, your doctor may order:

  • Ultrasound or computed tomography (CT scan) to get a picture of the liver.
  • Liver biopsy (tissue sample) to determine how far advanced liver disease has progressed.
  • FibroScan®, a specialized ultrasound sometimes used instead of a liver biopsy to find out the amount of fat and scar tissue in the liver.

Prevention or reversal of fatty liver disease

There’s no medication specifically for fatty liver disease. Instead, doctors focus on helping you manage factors that contribute to the condition. They also recommend making lifestyle changes that can significantly improve your health.

Some steps may help prevent or reverse some of the damage.

  • Lose weight – safely. This usually means losing no more than half to one kilogram (one to two pounds) a week.
  • Lower your triglycerides through diet, medication or both.
  • Avoid alcohol.
  • Control your diabetes, if you have it.
  • Eat a balanced, healthy diet.
  • Increase your physical activity.
  • Get regular check-ups from a doctor who specialises in liver care.

Medical treatment for fatty liver

Medical treatment for fatty liver is currently the focus of intense research. Scientists are studying whether various medications can help reduce liver inflammation, including new diabetes medications that may help you even if you don’t have diabetes. These include metformin, pioglitazone, rosiglitazone and betaine. Another drug being investigated is orlistat (Xenical), a medication that blocks the absorption of some of the fat from your food. Early results indicate that orlistat may reduce the amount of fat in the liver.

Fatty liver disease is a common condition caused by the storage of extra fat in the liver. Most people have no symptoms, and it doesn’t cause serious problems for them. In some cases, though, it can lead to liver damage. Consider fatty liver disease an early warning sign to help you avoid a fatal liver condition, like cirrhosis or liver cancer. Even if you don’t have symptoms or any liver function problems at this point, it’s still important to take steps to stop or reverse fatty liver disease with lifestyle changes.