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Fatty Liver Disease

Fatty Liver Sketch

Non-alcholic fatty liver disease (NAFLD) occurs when excess fat accumlates in the liver in the absence of high alcohol intake. NAFLD is on the rise in the population, affecting 30% of adults worldwide, and 55% of people with type 2 diabetes.

Why it happens:

  • As we consume excess energy and store fat, our "healthy fat storage" under the skin becomes full, and the excess fat begins to accumulate in other organs like the liver
  • Risk factors for NAFLD include sedentary lifestyle, gaining weight, type 2 diabetes/prediabetes, elevated blood triglycerides or low HDL cholesterol, high blood pressure

How it shows up:

  • The two most common reasons NAFLD is discovered is abnormal blood test results (ALT above 30 U/L in men or 25 U/L in women) or excess liver fat seen on imaging like ultrasound or MRI

Why it matters:
Some people with NAFLD will have progressive abnormalities in the liver that can lead to liver failure

  • NASH (non-alcoholic steatohepatitis). NAFLD with inflammation in the liver
  • NASH with fibrosis. NAFLD with inflammation and scarring.
  • Cirrhosis. NAFLD with inflammation, scarring, and permanent destruction of liver tissue

NAFLD/NASH is one of the most common causes of liver failure requiring liver transplant. Additionally, people with NAFLD are at a higher risk for cardiovascular disease and multiple types of cancer.

What you can do if you have NAFLD:

  • Eat healthy food and lose weight if overweight
  • Get regular exercise
  • Avoid or limit alchohol
  • Avoid medications that might harm the liver
  • Talk with your provider about your risk for more advanced liver disease, in which case medications (pioglitazone, semaglutide) or referral to a liver specialist might be recommended

Maintaining a healthy lifestyle and body weight are the best approaches to avoiding NAFLD in the first place. We only get one liver. It's important to take care of it.

Going Deeper:
UpToDate information about NASH

Have a great week,

Dr. Topher Fox

P.S. If you missed any previous emails, the content is posted weekly here

P.P.S. Below are the pictures from my exam room wall which we are exploring for this email series. 

Dr. Christopher Fox I am a board-certified endocrinologist in Superior, CO, and I have been in private practice since 2003. People I work with achieve success when they learn all the ingredients of healthy lifestyle and the system to consistently follow through on good intentions. I use my knowledge of endocrine science, psychology, neuroscience, and human behavior to help people make meaningful, lasting changes in their health that they can sustain long-term.

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