What is Non-Alcoholic Fatty Liver Disease?

Ask Dr. Lo

by Dr. Thomas K. Lo

Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat is stored in your liver. This buildup of fat is not caused by heavy alcohol use. When heavy alcohol use causes fat to build up in the liver, this condition is called alcoholic liver disease.

The two types of NAFLD are simple fatty liver and non-alcoholic steatohepatitis (NASH). Simple fatty liver and NASH are two separate conditions. People typically develop one type of NAFLD or the other, although sometimes people with one form are later diagnosed with the other form of NAFLD. Experts estimate that about 20 percent of people with NAFLD have NASH.

Simple Fatty Liver

It is normal for the liver to contain some fat. However, if more than 5-10 percent of the liver’s weight is fat, it is called a fatty liver (steatosis). A simple fatty liver is a form of NAFLD in which you have fat in your liver but little or no inflammation or liver cell damage. Simple fatty liver typically does not progress to cause liver damage or complications. Between 30 and 40 percent of adults in the United States have NAFLD.


NASH is a form of NAFLD in which you have hepatitis—inflammation of the liver—and liver cell damage, in addition to fat in your liver. Inflammation and liver cell damage can cause fibrosis, or scarring, of the liver. NASH may lead to cirrhosis or liver cancer. Between 3 to 12 percent of adults in the United States have NASH.

Who is More Likely to Develop NAFLD?

NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol, or high triglycerides. Rapid weight loss and poor eating habits also may lead to non-alcoholic fatty liver disease. Researchers have found NAFLD in 40 to 80 percent of people who have type 2 diabetes and in 30 to 90 percent of people who are obese. In research that tested for NAFLD in people who were severely obese and undergoing bariatric surgery, more than 90 percent of the people studied had NAFLD.

NAFLD can affect people of any age, including children. Research suggests that close to 10 percent of U.S. children ages 2 to 19 have NAFLD. However, people are more likely to develop NAFLD as they age.

While NAFLD occurs in people of all races and ethnicities, it is most common in Hispanics, followed by non-Hispanic whites. NAFLD is less common in African Americans. Asian Americans are more likely than people of other racial or ethnic groups to develop NAFLD when their weight is within the normal range.

What Are the Symptoms?

Both NAFLD and alcoholic fatty liver disease are usually silent diseases with few or no symptoms. When symptoms occur, they may include fatigue, weakness, weight loss and loss of appetite, nausea, abdominal pain, spider-like blood vessels, yellowing of the skin and eyes (jaundice), itching, fluid buildup and swelling of the legs (edema) and abdomen (ascites), and mental confusion.

What Are the Risks?

Non-alcoholic fatty liver disease may cause the liver to swell (steatohepatitis). A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure. Cirrhosis is a late stage of scarring (fibrosis) of the liver. Cirrhosis has four stages: Stage 1 is mild fibrosis without walls of scarring; Stage 2 is mild to moderate fibrosis with walls of scarring; Stage 3 is bridging fibrosis or scarring that has spread to different parts of the liver but no cirrhosis; and Stage 4 is severe scarring, or cirrhosis. Unlike healthy liver cells, scar tissue cells cannot self-repair or otherwise function. Because of this, fibrosis can reduce overall liver function and impair the organ’s ability to regenerate.

How is NAFLD Diagnosed?

   NAFLD is suspected if blood tests show high levels of liver enzymes. However, other liver diseases are first ruled out through additional tests. Often, an ultrasound will be used to confirm the non-alcoholic fatty liver disease diagnosis.

How is it Treated?

There are no medical treatments yet for non-alcoholic fatty liver disease. The first step is to treat the condition that is causing your cirrhosis to prevent any more damage. This could mean a few different things: Avoid alcohol if you drink. The goal is to protect the healthy tissue you have left. Lose weight, if you are overweight or obese. Control your diabetes. Lower your cholesterol and triglycerides. Eating a healthy diet and exercising regularly may help prevent liver damage from starting or reverse it in the early stages.

A study published online October 17, 2017, by Clinical Science, found that when healthy men, with a low level of liver fat, consumed at least 650 calories from sugar daily for 12 weeks, not only increased their liver fat, but also showed changes in their fat metabolism that are associated with a higher risk of cardiovascular disease and stroke. This is just one more reason to keep your sugar intake in check.

Studies also suggest that people with NAFLD have a greater chance of developing cardiovascular disease. Cardiovascular disease is the most common cause of death in people who have either form of NAFLD.

If you are struggling with health issues, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650 for a free consultation. Dr. Lo uses Nutritional Response Testing® to analyze the body to determine the underlying causes of ill or non-optimum health. The office is located at 7310 Grove Road #107, Frederick, MD. Check out the website at www.doctorlo.com.

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