The most common cause of fatty liver is alcoholism and heavy drinking. In many cases, doctors don’t know what causes fatty liver in people who don’t drink much alcohol.

Fatty liver develops when the body creates too much fat or cannot metabolize fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Eating a high-fat, high-sugar diet may not directly result in fatty liver, but it can contribute to it.

Besides alcoholism, other common causes of fatty liver include:

  • obesity
  • hyperlipidemia, or high levels of fats in the blood
  • diabetes
  • genetic inheritance
  • rapid weight loss
  • side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex), and tetracycline (Panmycin)

What are the types of fatty liver?

There are two basic types of fatty liver: non-alcoholic and alcoholic.

Nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) develops when the liver has difficulty breaking down fats, which causes a buildup in the liver tissue. The cause is not related to alcohol. NAFL is diagnosed when more than 10 percent of the liver is fat.

Alcoholic fatty liver

Alcoholic fatty liver is the earliest stage of alcohol-related liver disease. Heavy drinking damages the liver, and the liver cannot break down fats as a result. Abstaining from alcohol will likely cause the fatty liver to subside. Within six weeks of not drinking alcohol, the fat will disappear. However, if excessive alcohol use continues, cirrhosis may develop.

Nonalcoholic steatohepatitis (NASH) and alcoholic steatohepatitis

When enough fat builds up, it will cause the liver to swell. If the original cause is not from alcohol, it’s called nonalcoholic steatohepatitis (NASH). This disease can impair liver function.

Symptoms can be seen with this disease. These include:

  • appetite loss
  • nausea
  • vomiting
  • abdominal pain
  • jaundice

If left untreated, steatohepatitis can progress to permanent scarring of the liver and eventual liver failure.

Acute fatty liver of pregnancy

Acute fatty liver is a rare, and potentially life-threatening, complication of pregnancy.

Symptoms begin in the third trimester. These include:

  • persistent nausea and vomiting
  • pain in the upper-right abdomen
  • jaundice
  • general malaise

Women who are pregnant will be screened for this condition. Most women improve after delivery and have no lasting effects.

Who’s at risk for fatty liver?

Fatty liver is the buildup of extra fats in the liver. It’s more likely to develop if you’re overweight or obese. Having type 2 diabetes also may increase your risk for fatty liver. Fat accumulation in the liver has been linked to insulin resistance, which is the most common cause of type 2 diabetes. Studies have shown that a high-choline diet is associated with a lower risk of fatty liver disease.

Other factors that may increase your risk for fatty liver are:

  • excessive alcohol use
  • taking more than the recommended doses of certain over-the-counter medications, such as acetaminophen (Tylenol)
  • pregnancy
  • high cholesterol
  • high triglyceride levels
  • malnutrition
  • metabolic syndrome

How is fatty liver diagnosed?

Physical exam

If your liver is inflamed, your doctor can detect it by examining your abdomen for an enlarged liver. Let your doctor know if you’ve been experiencing fatigue or loss of appetite. Also, tell your doctor about any history of alcohol, medication, and supplement use.

Blood tests

Your doctor may find that liver enzymes are higher than normal on a routine blood test. This doesn’t confirm a diagnosis of fatty liver. Further analysis is necessary to find the cause of the inflammation.

Imaging studies

Your doctor may use an ultrasound to detect fat in your liver. The fat will show up as a white area on the ultrasound image. Other imaging studies may also be done, such as CT or MRIscans.

Another imaging test similar to ultrasound is a FibroScan. Like an ultrasound, a Fibroscan utilizes sound waves to determine the density of the liver and the corresponding areas of fat and normal liver tissue.

Imaging studies can detect fat in the liver, but they cannot help your doctor confirm any further damage.

Liver biopsy

In a liver biopsy, your doctor will insert a needle into the liver to remove a piece of tissue for examination. Your doctor will give you a local anesthetic to lessen the pain. This is the only way to know for certain if you have fatty liver. The biopsy will also help your doctor determine the exact cause.

Treatment of  Fatty Liver

Usually your conventional doctor will offer ways to reduce your risk factors. These recommendations include:

  • limiting or avoiding alcoholic beverages
  • managing your cholesterol and reducing your intake of sugar and saturated fatty acids
  • losing weight
  • controlling your blood sugar

If you have fatty liver because of obesity or unhealthy eating habits, your doctor may also suggest that you increase physical activity and eliminate certain types of food from your diet. Reducing the number of calories you eat each day can help you lose weight and heal your liver.

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