Non Alcoholic Fatty Liver

Non Alcoholic Fatty Liver disease (NAFLD)

Incidence of fatty liver has been increasing globally. Overall pooled global prevalence has been reported to be around 24%. However, in westernized Asian populations, including in Singapore, its prevalence appears to be higher; prevalence rates as high as 40% been reported which is alarming.

Although we know that fatty liver largely occurs in alcoholics, it can occur in non-alcoholics too and hence the name NAFLD.

A healthy Fatty liver has around 5% of normal fat. When there is excess fat, it leads to NASH ( Non alcoholic steato hepatosis, Inflammation over time leads to formation of scar tissue >>> leading to dead tissues nodules called cirrhosis. Cirrhosis can lead to hepato cellular cancer.

Most times, NAFLD is not symptomatic and people do not notice any bad effects for years until mild symptoms of low energy, brain fog, digestive disturbances start to resurface. However, NASH and NAFLD is reversible if treated early.

Most common causes of NAFLD: Lifestyle plays a huge role in fat accumulation in liver.

Over eating
Excess carb intake
Certain medications
Environmental toxins ( PCB, POPS, mercury, lead, glyphosate)
Fructose consumption
Abdominal excess fat
Overweight / obesity.

Other important correlations we see with NAFLD are,

Hormonal disturbances
Obstructive sleep apnea
Gut issues and SIBO

Diagnosis:

Diagnosis can be made through regular labs. There is a misconception that liver enzymes are a reliable predictor of fatty liver. I have learnt that they are not always. Half of the patients with NAFLD have liver enzymes that fall within normal reference ranges. GGT is usually higher in NAFLD, other liver enzymes are higher in NASH. Serum ferritin, other inflammation markers, fasting insulin are all important markers to check. Although, ultrasound may be used to screen fatty liver but may not be reliable in obese patients.

Treating Fatty liver:

Nutrition:

Studies have shown treatments targeted at weight loss with healthy nutrition are crucial for treating fatty liver.

Whole foods low carb diet
Healthy oils: mono un saturated fatty acids such as avocado, olive oils, nuts, etc.
Greens and other multi-color vegetables.
Choosing fish with high omega fats
Limiting consumption of sugars, fructose, alcohol, conventional meat, poultry, refined carbs etc.
Removal of food intolerances can help greatly (check with your Naturopathic doctor)

Environmental:

Limit over the counter medications such as fever reducers and other medications.
Reduce exposure to toxic chemicals like herbicides and pesticides, fragrances etc. Use organic and clean products wherever possible. These toxins have shown to induce insulin resistance and thereby increase deposition of fat in the liver cells

Exercise: In addition to all the above, exercise has shown to lower the fat levels in liver. Low intensity cardio, high intensity training has all proven to be effective. It is important that exercise is consistent and doing things that you enjoy are important.

Obstructive sleep apnea (OSA):

Get tested for OSA if you snore or feel tired during the day. OSA is associated with cardiovascular disease, obesity. So it is important to get tested and treated.

Supplements to boost liver metabolism:

Several supplements have shown promising results in fatty liver such as alpha lipoic acid, green tea, Milk thistle, dandelion, berberine, vitamin E etc. Discuss these with your naturopathic doctor to find out if these are right for you.

Liver is a very resilient and only organ that can regenerate fully. Take action and protect your liver, get your energy levels back.

If you have been diagnosed with Fatty liver or unsure if you have a fatty liver, want to increase your energy levels, prevent liver damage, give us a call. We can help.

Sources:

https://europepmc.org/article/med/26017679

https://www.ncbi.nlm.nih.gov/pubmed/24923704 https://www.ncbi.nlm.nih.gov/pubmed/26463276

Gut Health

Non Alcoholic Fatty Liver

Dr Radhika Kamat

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