Fatty Liver

Fatty liver simply means too much fat has accumulated inside liver cells.

Today, the metabolic form is commonly called MASLD (Metabolic dysfunction Associated Steatotic Liver Disease), previously known as NAFLD.(Non-alcoholic Fatty Liver Disease).

It is strongly associated with metabolic problems such as:

• Insulin resistance.
• Excess abdominal fat.
• Type 2 diabetes.
• High triglycerides, which most people confuse with cholesterol.
• Metabolic syndrome.

Some people still think a fatty liver is for the alcoholics.

You don’t have to drink alcohol to develop fatty liver. You can get it even when you have never tasted alcohol.

TWO ROADS TO A FATTY LIVER; FRUCTOSE & ALCOHOL.

Fructose and alcohol are very different substances, but both can put a significant metabolic burden on your liver.

If you know this, you will simply avoid things that can harm an organ that works tirelessly to protect you.

1. FRUCTOSE → TRIGLYCERIDES → FATTY LIVER

Fructose is largely metabolized by the liver.

When you repeatedly consume high amounts of fructose, especially from;

• Soda,
• Table sugar,
• Syrups,
• Sweets and chewing gum,
• Ultra-processed foods,
• Energy drinks,
• Modern fruits and fruit juices,
• Sugarcane and,
• Honey

The liver can convert some of this excess fructose into fatty acids through a process called De-novo lipogenesis.(Read about it).

These fatty acids are assembled into triglycerides. When you run a lipid profile, you will see; total cholesterol, HDL and LDL “cholesterol” and TGs(these are what I am talking about).

The liver can package some triglycerides into LDL(a vehicle that carries fats from the liver to the system), and send them into the bloodstream.

But when fat production and delivery exceed the liver’s ability to export or burn it, fat begins to accumulate in the liver.

This is one pathway toward fatty liver disease. The dietary fatty liver disease.

This is one reason someone can say: “But Doc, I don’t even drink alcohol. Why me?”

Again, there are no genes involved here. Don’t look further than the kitchen and your refrigerator.

2. ALCOHOL → FAT ACCUMULATION → FATTY LIVER.

Your liver is the main organ responsible for metabolizing alcohol.

Heavy alcohol metabolism changes the liver’s metabolic environment.

This shifts the liver away from burning fatty acids and promotes conditions that favor fat accumulation and triglyceride formation.

At the same time, acetaldehyde, a metabolite from alcohol causes oxidative stress to the cells and can damage liver cells and trigger inflammation.

Alcohol → Fatty liver → Alcohol associated hepatitis → Fibrosis(scaring) → Cirrhosis.

By the time you show symptoms, you are already in trouble.

AVOID ALCOHOL IN ALL FORMS. IT SERVES NO BENEFIT.

• Wines
• Spirits
• Vodka
• Whiskey
• Scotch
• Beer

Alcohol doesn’t improve digestion. It messes up your gut.

Also, if you need alcohol to have fun, you are definitely a boring person naturally.

The dangerous thing about liver disease is that you may have few or no symptoms in the early stages.

Some people may experience:

• Unexplained fatigue.
• General weakness.
• Discomfort or fullness in the right upper abdomen.
• Indigestion and sometimes fatty stool.

But many feel completely normal.

That is why you should not use symptoms alone to judge liver health.

As liver disease becomes advanced, warning signs can include:

• Yellow eyes or skin, jaundice.
• Swollen abdomen; ascites.
• Swollen legs.
• Easy bruising or bleeding.
• Severe itching.
• Confusion or unusual sleepiness.
• Dark urine or pale stools. By the way, do you guys check your stool? Or after depositing you just flash it out?

So, feeling OK doesn’t always mean you are OK.

Carry out that check up every 4-6 months.

The dangerous thing about liver disease is that you may have few or no symptoms in the early stages.

Some people may experience:

• Unexplained fatigue.
• General weakness.
• Discomfort or fullness in the right upper abdomen.
• Indigestion and sometimes fatty stool.

But many feel completely normal.

That is why you should not use symptoms alone to judge liver health.

As liver disease becomes advanced, warning signs can include:

• Yellow eyes or skin, jaundice.
• Swollen abdomen; ascites.
• Swollen legs.
• Easy bruising or bleeding.
• Severe itching.
• Confusion or unusual sleepiness.
• Dark urine or pale stools. By the way, do you guys check your stool? Or after depositing you just flash it out?

So, feeling OK doesn’t always mean you are OK.

Carry out that check up every 4-6 months.

Tests that can be done to check the liver health;

1. HbA1c
2. CRP or ESR
3. Liver function tests(LFTs)
4. HOMA-IR or C-Peptide test

Note:
Normal liver enzymes on LFTs, do not completely rule out fatty liver or significant fibrosis.

If need be;

• Abdominal ultrasound.
• MRI/CT scan.

A Fatty liver disease is reversible.

Your liver has an impressive ability to recover when the underlying cause is addressed.

• Losing that extra fat.
• Increase the gap between your meals to 6-8 hours.
• Start prolonged fasts;36,48,72.
• Go lift weights. Walking is also a full body workout. It comes in handy when losing initial weight before enrolling in the gym.
• Do away with sugar in all forms, whether natural or synthetic.
• Drop alcohol in all forms.
• Eat clean. Dietary fats are not the cause of a fatty liver. Keep enjoying that fatty meat and animal fats.
• Hydrate adequately.
• Rest.

Medications can be prescribed but, they won’t do away with the cause of the problem.

There is NO magical drink, concoction or herb that will “clean up ” the liver.

Save that money and buy fatty meat and eggs.

Not all liver disease is fatty liver disease.

When people hear “liver disease,” they often think only about alcohol.

The liver can be affected by many different diseases:

1. Metabolic fatty liver disease (MASLD).
   Closely associated with insulin resistance and metabolic dysfunction. We’ve just talked on how to reverse it.
2. Alcohol related liver disease.
   Caused by alcohol exposure over time. Whether you like it or not, that bottle will have to go.
3. Viral hepatitis.
   Especially hepatitis B and C, which can become chronic and damage the liver. You need a hospital diagnosis. Either way, even with medication, you will still do what needs to be done in that kitchen.
4. Autoimmune liver diseases.
   The immune system mistakenly attacks liver tissue or bile ducts. All autoimmune disorders start from a messed up gut. A missed signal to your army. Correct the gut.
5. Drug induced liver injury.
   Certain medicines, herbal products and supplements can damage the liver. Medications for cancer, TB, some antibiotics, Leshmaniasis, HIV etc damage the liver.
   A change of prescription and close monitoring by your doctor will be needed here.

Don’t diagnose every abnormal liver test as “fatty liver.”

Find the cause.

MYTHS.

1: Only alcoholics get liver disease.

2. Fatty liver only affects obese people. Meet the TOFI phenomenon:

T — Thin
O — Outside
F — Fat
I — Inside

Someone can look perfectly slim on the outside, even have a “normal” BMI but still carry significant visceral fat around internal organs and fat within the liver.
THIN ≠ METABOLICALLY HEALTHY.

3. Fatty liver is caused by eating fats. It’s a LIE.
4. Detox juices and herbal cleanses will clean my liver. LIE.