Fatty Liver: Causes, Risks, and Dietary Solutions - Gastroenterology and Hepatology

Fatty liver disease issues?

Hello Doctor, I have abnormal liver enzyme levels from a blood test: GOT=30 and GPT=52 (with normal values being below 40).
My previous blood tests were normal, and this time it is abnormal.
The doctor arranged for me to have an ultrasound, which indicated that I have moderate to severe fatty liver.

1.
Can my abnormal liver enzyme levels be affected by fatty liver? Does this indicate that my liver is inflamed, fibrotic, or cirrhotic? Is a slight increase in enzyme levels very serious? Am I at risk of dying soon?
2.
The doctor mentioned that weight loss can reduce fatty liver.
Is the damage to the liver reversible, or is it irreversible and will I not be able to recover liver function?
3.
I would like to ask how I should adjust my diet to reduce fatty liver.
I am currently developing a habit of drinking oatmeal daily and adjusting my diet to reduce calories.
Is this helpful?
4.
I have seen two different opinions online: (1) Severe fatty liver means there is a lot of fat in the liver, but it does not necessarily mean the liver is severely damaged; it depends on the individual's health condition.
(2) Severe fatty liver indicates significant liver damage, approaching cirrhosis.
What is the correct understanding of severe fatty liver? I am 176 cm tall, weigh 105 kg, and am 21 years old.
I hope to reduce fatty liver through dietary adjustments and resuming exercise habits.
I would appreciate your clarification on this matter.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/09/04

Dr. Chen Shidian reply Gastroenterology and Hepatology

Severe fatty liver disease (high liver fat content) can lead to liver inflammation (i.e., steatohepatitis), and over time (over several decades), there is a risk of cirrhosis (which can be assessed through out-of-pocket fibrosis markers) and an increased likelihood of developing diabetes or cardiovascular diseases.
Currently, the primary treatment is weight loss (aiming for a 7% reduction), with dietary control as the main focus and exercise as a supplementary measure.
If necessary, out-of-pocket weight loss medications may be used, although they are not officially approved treatments.

Reply Date: 2021/09/04

More Info

Fatty liver disease, or hepatic steatosis, is a condition characterized by excessive fat accumulation in liver cells. Your recent blood tests showing elevated liver enzymes (GOT and GPT) and the ultrasound indicating moderate to severe fatty liver suggest that your liver is indeed affected. Let's address your concerns systematically.

1. Liver Enzyme Abnormalities and Fatty Liver: Elevated liver enzymes can be indicative of liver inflammation or damage. In your case, the fatty liver may be contributing to these elevated enzyme levels. Fatty liver can lead to inflammation (non-alcoholic steatohepatitis, or NASH), and over time, if not managed, it can progress to fibrosis (scarring) and eventually cirrhosis (severe scarring). However, a slight elevation in liver enzymes does not necessarily mean immediate danger or that you will face severe health consequences in the short term. It is crucial to monitor your liver function and follow your doctor's recommendations.

2. Reversibility of Liver Damage: The good news is that fatty liver disease is often reversible, especially in its early stages. Weight loss (around 7-10% of your body weight) can significantly reduce liver fat and improve liver function. If the liver has not progressed to advanced fibrosis or cirrhosis, there is a strong possibility that your liver can recover its function with lifestyle changes, including diet and exercise.

3. Dietary Adjustments: To manage and potentially reverse fatty liver, dietary changes are essential. A balanced diet that is low in saturated fats, refined carbohydrates, and sugars is recommended. Incorporating whole grains, such as oats (which you mentioned), fruits, vegetables, lean proteins, and healthy fats (like those from fish, nuts, and olive oil) can be beneficial. Reducing caloric intake and focusing on nutrient-dense foods will help in weight management. Regular physical activity is also crucial; aim for at least 150 minutes of moderate-intensity exercise weekly.

4. Understanding Severe Fatty Liver: The distinction between severe fatty liver and its potential damage is nuanced. While severe fatty liver indicates a significant amount of fat in the liver, it does not automatically mean that the liver is severely damaged. The extent of damage depends on various factors, including the duration of the condition, underlying health issues, and lifestyle choices. Regular monitoring through blood tests and imaging studies will help assess the progression of your condition.

In summary, while your situation requires attention, it is manageable with the right lifestyle changes. Focus on a balanced diet, regular exercise, and weight loss. Regular follow-ups with your healthcare provider will ensure that your liver health is monitored and that any necessary interventions are made promptly. Remember, many individuals with fatty liver disease successfully improve their liver health through lifestyle modifications, so stay positive and proactive in your approach.

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