Fatty Liver Disease

A very wise man told me once that if you find yourself explaining the same thing to three different people, you need to write it down to have a handout.  Well there’s a topic that’s been following me around this week like somebody stuck one of those funny signs on my back.  This week I need to talk about fatty liver disease.

What is fatty liver disease?  This is a condition where the cells in the liver get little droplets of fat in them.  You can see the fat on liver biopsy (although that’s not always done) and it changes the way the liver looks on ultrasound.  The most common way we pick it up, however, is that the liver enzyme blood tests go up.

Before we talk about what causes fatty liver disease, I want you to think about something.  Everything you eat, drink, breathe, and put on your skin must be processed and got rid of.  What goes in must come out, right?  Carbon dioxide from burning sugar and fat for fuel gets breathed out through the lungs.  Extra water, salt, urea from protein metabolism and other substances are eliminated in urine.  Undigested plant fibers in our food are a big component of our stool.  Heavy metals and some toxins are eliminated in sweat.

The workhorse organ in your body for neutralizing toxic stuff you eat, drink, breathe and wear is your liver.  It is an amazing powerhouse, chock full of enzymes to detoxify chemicals and get rid of them.  Unfortunately in today’s toxic world often the poor liver is overworked.  Although medical science hasn’t given us a definitive answer, my belief is that fatty liver disease is what happens when we overwork our livers.

Fatty liver disease was first described in alcoholics.  In fact the fatty liver disease that I see most often is sometimes called “nonalcoholic steatohepatitis” or NASH.  It was felt that the liver damage in alcoholics was a form of chronic alcohol poisoning.  I think they were right on the money and that the nonalcoholic fatty liver disease we’re seeing as an epidemic now is from chronic “life” poisoning.

Where are the poisons coming from?  In the last 20 years we have seen an explosion of fast food, convenience food, and food additives.  I truly believe the poisons are in our food and water supply.  Artificial food ingredients like artificial colors, sweeteners, flavors and preservatives are everywhere!  Partially-hydrogenated vegetable oils are artificial fats created to extend the shelf life of processed foods.  Pesticide use in agriculture continues to climb (and the runoff winds up in our drinking water). Nobody knows what effect genetic modification of food crops has on the human body.  About 80% of the antibiotics used in the USA are used in livestock, not people, to help the animals survive the conditions in which they are raised and to make them grow faster.  Those antibiotics are detectable in the food products made from those animals.

If you have been told you have fatty liver disease, there are a number of things you can do.  Read labels and avoid partially-hydrogenated vegetable oils like the plague.  Avoid artificial sweeteners (they are NOT better for you than sugar, even if you are diabetic), colors and chemical preservatives.  Buy organic produce.  If your budget won’t allow you to buy ALL your produce organic, then get the list from the Environmental Working Group and buy at least the Dirty Dozen Plus organic.  Buy your dairy products organic or switch away from dairy altogether.  I discussed some other recommendations recently in this post.

What about beverages?  Obviously, be careful with your alcohol intake.  Also PLEASE give up soft drinks, and don’t let your kids drink them either.  They have NO nutritional value and often contain caramel color, artificial sweeteners and other harmful chemicals. Organic fruit juice is good for an occasional treat.  Coffee, hot and iced tea, homemade lemonade are all good options.

Most of what you drink should be good old water.  Fresh, clean water tastes SO good!  Filtered tap water is the most economical solution (no plastic bottles to wind up in the landfill).  Choose one with a good rating by the Water Quality Association to remove the contaminants found in your tap water.  Northern Ohio residents can find our water quality report here.  Did you know our drinking water contains detectable amounts of chloroform?  Yikes!  My family uses Shaklee’s Get Clean Water pitcher, which removes all the nasty stuff and filters twice as much water per filter block than the “other” brands.

OK, I can hear some of you saying, “But my husband and I eat the same foods and drink the same water.  He drinks beer and I never drink alcohol.  Why do I have fatty liver and he doesn’t?”  Great question!  Turns out that there is about a thousand-fold variation in individual people’s livers’ ability to detoxify stuff.  And men’s livers do this better, on average, than women’s.  The development of fatty liver disease depends both on how much toxic stuff you’re asking your liver to process AND how good your liver is at doing the job.  It’s like asking a Great Dane and a Dachshund to both run a mile.  They’ll both get there, but the Dachshund might be worn out at the end, and the Great Dane will still be ready to play.

So how do you know if you’re at risk for fatty liver disease?  The next time you get your annual physical, ask your doctor to check liver bloodwork (better yet, ask for a Complete Metabolic Panel) along with your routine cholesterol.  It’s covered by insurance in general.  The best test to check how well your liver is handling the job you’re asking it to do, as far as processing toxins, is a GGT (gamma glutamyl transferase).  This one you will probably have to pay for unless your doctor finds your routine liver tests (called AST, ALT and Total Bilirubin) are elevated.  GGT goes up in response to a strain on the toxin-processing system.  Normal range is up to 85 but I start getting concerned at about 40-50.  I consider those levels as a warning that the liver is starting to complain.

Fatty liver disease is a big deal.  According to the American Liver Foundation, it’s estimated that 25% of adults in the USA may have fatty liver disease.  It can progress to cirrhosis and liver failure, and ultimately need a liver transplant.

Be nice to your liver!  It works very hard to protect you, and it has to last!


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  1. Pingback: Why You Need Dietary Fiber - Jennifer Wurst, MDJennifer Wurst, MD – Helping Parents Create Healthy Families

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