Symptoms of fatty liver

The liver typically does comprise of some fat. However, when the fat levels build-up (fat levels exceed more than 5%), it can result in serious health complications. Such a condition is called fatty liver disease. This condition restricts the normal functioning of the liver.
This article will cover the symptoms, causes, treatment, prevention, and more for fatty liver disease.

What is the Normal Liver size?

Liver size varies with sex, age, height, weight, and body size. A normal liver span is usually <16 cm in the midclavicular line (an imaginary line parallel to the long axis of the body). Males tend to have a bigger liver size in comparison to females.

So, what is a fatty liver? Fatty liver, also known as hepatic steatosis happens when too much fat builds up in the liver cells. It usually happens when too many calories are consumed. The actual reason for fatty liver is still unknown. Fat builds up in the liver that limits its proper functioning resulting in fatty liver disease. People with health conditions like obesity, diabetes, or high triglycerides are at an increased risk of developing a fatty liver illness.

Symptoms of Fatty Liver Problems

The liver is a vital organ of the body that plays an important role in food digestion and eliminating toxins from the body. A liver disorder or illness can be genetic i.e., inherited. Symptoms of liver problems are usually not noticeable. So, what are the symptoms of liver damage? Several symptoms of liver disease may include;

• Chronic and ongoing fatigue and tiredness – it is a common symptom of the liver's reduced functional ability and illness
• Jaundice – yellow eyes and skin color - Jaundice occurs due to the build-up of bilirubin (a yellow-orange bile substance) in the blood. A build-up of bilirubin happens when hemoglobin breaks down as part of the normal process of recycling old or damaged RBCs (red blood cells) and it is not processed effectively by the liver and excreted into the digestive tract.
• Swelling and pain in the abdomen (ascites), legs, and ankles – this occurs due to fluid retention. The presence of ascites is a sign of liver failure
• Itchy skin – skin becomes itchy due to jaundice (yellowing of the skin)
• Dark urine color - Urine that is brownish, dark orangish, amber, or cola-colored can be a sign of liver disease. The color is due to an increased level of bilirubin (a yellow-orange bile substance) building up as a result of the liver's inability to break down normally
• The tendency of easy bruising – Because of liver disorder, its ability to produce clotting factors also reduces due to which you may bruise easily
• Pale, bloody, or black stool – Bile salts released from the liver are responsible for giving the right color to the stools. If stools are too dark (black tarry) or pale or accompanied with blood, it may indicate a serious issue or problem with the liver or other part of the biliary drainage system.
• Nausea or vomiting (feeling of sickness) – this happens because of the build-up of toxins in the blood due to the liver's reduced capacity to eliminate toxins from the body
• Reddened palms (palmar erythema) - Roughly a 1/4th of people with a liver illness like liver cirrhosis develop palmar erythema – a reddening of the skin on the palms
• Loss of appetite

Types of fatty liver disease

There are 2 types of fatty liver disease — NAFLD (non-alcoholic fatty liver disease) and alcoholic fatty liver disease.

• Non-alcoholic fatty liver disease

This is the primary form of fatty liver disease. Symptoms of non-alcoholic fatty liver disease include – pain, fatigue, enlarged liver, jaundice, ascites, etc.

• Alcoholic fatty liver disease

This is caused when people consume excessive alcohol as consumption of alcohol excessively may develop alcoholic fatty liver disease. This can result in liver cell damage and inflammation. Alcoholic fatty liver disease can develop into alcoholic hepatitis or cirrhosis.

Stages of fatty liver

Fatty liver (hepatic steatosis) can progress through 4 stages:

• Simple fatty liver - A build-up of increased fat in the liver
• Steatohepatitis – inflammation along with increased fat in the liver
• Fibrosis (A formation of fibrous tissues) – scarring in the liver due to inflammation
• Cirrhosis - a late stage of scarring (fibrosis)

So, what is liver cirrhosis? Cirrhosis is a fatal and serious complication in which there is scarring of the liver and eventually loss of liver cells. This could even lead to liver failure. Cirrhosis is irreversible and once it happens, it is almost impossible to treat it. Hence, it is important to prevent it from developing and progressing in the first place.

Stages of liver cirrhosis

Stages of liver cirrhosis include;

• Stage 1 cirrhosis - scarring of the liver with no complications.
• Stage 2 cirrhosis - worsening and aggravating portal hypertension and the development of varices.
• Stage 3 cirrhosis - swelling in the abdomen and advanced liver scarring and serious complications
• Stage 4 cirrhosis - end-stage liver disease (ESLD).

As the disease spreads and progresses, symptoms of liver cirrhosis can include:

• Itchy skin
• Loss of appetite
• Swelling in feet, lower legs, and ankles (edema)
• Bruising or bleeding
• Swollen blood vessels in the skin
• Breast augmentation
• Memory problems and confusion
• Esophageal varices
• Swelling in the feet or lower legs
• Dark stool from digested blood
• Bloating
• Shortness of breath
• Yellow discoloration in the skin – eyes turn yellow (jaundice)

These symptoms eventually are symptoms of liver failure.

Complications of Fatty Liver Disease

Scarring of your liver or cirrhosis is the major complication caused due to fatty liver disease. As a result, there is a lot of inflammation in the liver which can result in serious health complications like;

• Due to the erratic functioning of the liver, there is fluid build-up in your abdomen. it's known as ascites
• Swollen veins in Oesophageal varices that can burst and bleed. This happens when normal blood flow to the liver restricted by a blood clot or scar tissue in the liver
• Confusion and drowsiness
• Liver cancer – So, what is liver cancer symptoms? Liver cancer is cancer that begins in the cells of the liver. The symptoms include; weight loss, stomach pain, vomiting, and yellowed skin, abdominal pain, and White, chalky stools.
• Liver failure

Diagnosis of fatty liver

For diagnosing fatty liver, your doctor first studies your medical history and then conduct a physical examination, and order a few tests.

Medical history

In investigating medical history, a doctor would ask

• Family medical history for liver illness
• Lifestyle habits which include alcohol consumption
• Any medications subscribed or over the counter
• Any surgeries, existing health conditions
• If you've been experiencing fatigue, loss of appetite, or other unexplained symptoms, let your doctor know.

Physical exam

This is conducted by pressing the abdomen. If there is a problem in the liver-like liver enlargement – the doctor might be able to feel it.

Blood tests

• Blood tests are the most common method to diagnose fatty liver and elevated liver enzymes.
• For example, the ALT - the alanine aminotransferase test and AST - aspartate aminotransferase test (AST)
• These tests are done to check the elevated liver enzymes due to which the liver becomes inflamed.
• If the blood test shows a positive result for elevated liver enzymes, the doctor may advise additional tests to figure out the cause of liver inflammation.

Imaging studies

Imaging tests that are carried out by the doctor to diagnose any liver illness include:

• ultrasound exam
• A computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Vibration-controlled transient elastography (VCTE, FibroScan) which includes the use of less-frequency waves is also advised by the doctor sometimes to investigate the liver stiffness. Stiffness helps in diagnosing liver scarring.

Liver biopsy

Liver illness and liver disease are also assessed by liver biopsy. In the liver biopsy, a needle is inserted in the liver to scrap a piece of liver tissue for investigation and examination. The biopsy helps to diagnose in case you have fatty liver, cirrhosis, or liver scarring.

What are the causes of fatty liver?

What causes a fatty liver? Several causes of fatty liver include;

• Eating excess calories that result in obesity or overweight
• Hyperglycemia - High blood sugar, indicating prediabetes or type 2 diabetes
• Increased level of triglycerides, in the blood
• An underactive thyroid (hypothyroidism)
• Alcohol abuse, rapid weight loss, and malnutrition are other reasons for fatty liver

Risk factors for fatty liver disease

• Excessive weight (BMI - body mass index of 25-30)
• Obesity (BMI - body mass index above 30)
• Metabolic syndrome
• Sleeping disorders like sleep apnoea
• Polycystic ovary syndrome
• High Blood sugar (Diabetes)
• High levels of triglycerides in the blood

How to reduce fatty liver? (Prevention)

To prevent fatty liver and liver disease, some tips and fatty liver home remedies include;

• Consume alcohol in moderation
• Use precaution during sex
• Avoid the use of illicit intravenous drugs, and sharing of needles to inject drugs
• Get vaccinated (hepatitis A and hepatitis B vaccines)
• Avoid contact with other people's blood and body fluids
• Maintain proper hygiene
• Protect your skin
• Maintain a healthy weight by daily workout and at least 30 minutes of exercise
• Some research studies suggest that vitamin E supplements serve as a remedy for the treatment of liver disease.

It is always advised to consult your doctor before you try any supplement or remedy for the treatment of your fatty liver. Some remedies might not go well with your body.

Additional ways to treat liver disease

In addition to following a strict and balanced diet, some lifestyle changes are also recommended to improve your liver health. These include:

• Get more active

Work out and exercise coupled with a healthy and balanced (nutrient-rich) diet helps you manage your weight and thus keeps the liver healthy. Brisk walk and at least thirty minutes of aerobic exercise every day help keep a check on weight and boost liver health.

• Lower cholesterol

Avoid eating sugar and sugary items. Also, avoid saturated fats as these increase your cholesterol and triglyceride levels.

• Control of diabetes

People who are diabetic are at an increased risk of fatty liver disease. A healthy and nutrient rich diet and exercise helps in managing both conditions. If diabetes is still at an increased level, consult the doctor as he will be able to prescribe medication to lower it.

How to detox the liver naturally?

Several simple tips are beneficial to detox the liver naturally. These include;

• Consume turmeric

Turmeric is a medicinal spice that boosts liver enzymes which remove dietary toxins from the body. A glass of warm water with half a teaspoon of turmeric every day is very effective for a healthy liver.

• Avoid processed sugar

Sugar is one fatty liver food to avoid. Added or table sugars are bad for health as they inhibit the potential of the liver to produce several enzymes that are helpful in the detoxification process.

• Avoid processed foods

Processed foods (frozen foods, bacon) is bad food for the liver and serve as a hindrance in the proper functioning of the body system as they contain preservatives, synthetic ingredients, and chemicals that stress the liver and inhibit liver detoxification.

• Alcohol is poison for the liver – so avoid that

Avoid booze as it puts a heavy detoxification burden on the liver.

• Lukewarm water

Lukewarm water detoxifies the liver and removes toxins from the body. You can have a glass of Luke warm water mixed with half a lemon to it every morning. 10-12 glasses of warm water daily are very good for the liver.

• Dark leafy greens

Leafy veggies like spinach, bitter gourd, kale, arugula, mustard greens, and chicory contain detoxifying compounds that help in removing toxins from the liver naturally

• Green tea

Green tea is effective in reducing overall fat content, fight against oxidative stress, and minimizes NAFLD – non-alcoholic fatty liver disease.

Other Helpful Detox Tips

Certain dietary changes and adopting several lifestyle habits may aid in reducing toxin load and support your body's detoxification system.

• Eat sulfur-containing foods
• Try out chlorella
• Flavor dishes with cilantro
• Support glutathione (eggs, broccoli, and garlic)
• Switch to natural cleaning products
• Choose natural body care

Bottom line

Fatty liver disease occurs when fat builds up in the liver. This limits the activities of the liver and it stops functioning properly. Usually, this condition does not show any symptoms unless the build-up of fats in the liver cells results in some health complications. Symptoms to look out for include, fatigue, weight loss, etc. If the fatty liver disease progresses and develops into cirrhosis, several signs that an individual may experience include yellowing of skin and eyes (jaundice), itching, and swelling.

The actual reason and cause of fatty liver disease are not known, but certain medical conditions may contribute to its development. Treatment is a little complex. However, by following a strict and fat-free diet, taking regular exercise, very little alcohol consumption, and healthy lifestyle choices, a person can help or prevent fatty liver disease. If a person experiences any symptoms of fatty liver disease, they should immediately consult their doctor.