Fatty Liver: Causes, Concerns, and Management Tips - Gastroenterology and Hepatology

Liver issues?

Hello Doctor: Since I enrolled last year, my liver enzyme levels have been over a hundred during my physical examination.
Later, I visited Linkou Chang Gung Memorial Hospital for a consultation, where I underwent blood tests and an abdominal ultrasound.
The doctor diagnosed me with fatty liver and advised me to exercise more and reduce my intake of greasy foods; I was told to return for a follow-up in three months.
After that check-up, my liver enzyme levels had decreased, and I was instructed to come back again in another three months.
However, during one of the blood tests, my liver enzyme level was 158.
The doctor prescribed medication for chronic liver disease, and now my levels are in the eighties.
I asked the doctor what was wrong with my liver, but he only mentioned it was fatty liver and did not elaborate further.
I would like to know what could have caused this, but it seems the doctor is not providing any information! I do take medication regularly, and I might not be exercising enough, plus I usually go to bed around midnight.
What confuses me is that the doctor asked about my occupation and whether I have been exposed to chemical substances.
I am a student and have not been in contact with any chemicals.
Additionally, I have heard that frequently drinking cold beverages (especially in the morning) is bad for the spleen.
What is the function of the spleen? I apologize for writing so much and straining your eyes, I'm sorry!

A Yao, 20~29 year old female. Ask Date: 2004/04/27

Dr. Liang Jiade reply Gastroenterology and Hepatology

Hello, there are many causes of abnormal liver function, including viral infections (hepatitis A to E), bacterial infections, medications, staying up late, fatty liver, autoimmune diseases, and more.
Additionally, long-term exposure to certain chemicals (such as fluorinated compounds, arsenic, heavy metals, etc.) can also lead to hepatitis.
Currently, the most common causes of chronic hepatitis are chronic hepatitis B and C, as well as fatty liver disease.
For your abnormal liver function, it is advisable to have regular follow-up examinations.
The greatest impact of cold foods is on the gastrointestinal tract.
The spleen you mentioned is likely a reference from Traditional Chinese Medicine.
The spleen in TCM is different from the spleen (organ) in Western medicine.

Reply Date: 2004/04/27

More Info

Fatty liver disease, also known as hepatic steatosis, is a condition characterized by the accumulation of fat in liver cells. It is increasingly common, especially in developed countries, and can lead to more serious liver conditions if left untreated. Understanding the causes, implications, and management strategies for fatty liver is crucial for maintaining liver health.

Causes of Fatty Liver
The primary causes of fatty liver include:
1. Obesity: Excess body weight is the most significant risk factor for developing fatty liver. Fat accumulation in the liver is often associated with overall body fat.

2. Insulin Resistance: Conditions like type 2 diabetes and metabolic syndrome can lead to insulin resistance, which in turn increases fat accumulation in the liver.

3. Diet: A diet high in saturated fats, sugars, and processed foods can contribute to fatty liver. Regular consumption of alcohol can also lead to alcoholic fatty liver disease.

4. Medications: Certain medications, such as corticosteroids and some cancer treatments, can cause fat buildup in the liver.

5. Genetics: Genetic predisposition can play a role in the development of fatty liver disease.

6. Other Health Conditions: Conditions such as hepatitis, rapid weight loss, and certain metabolic disorders can also lead to fatty liver.

Concerns Associated with Fatty Liver
Fatty liver disease can lead to several health concerns, including:
1. Liver Inflammation: Fatty liver can progress to non-alcoholic steatohepatitis (NASH), which involves inflammation and can lead to liver damage.

2. Fibrosis and Cirrhosis: Continued inflammation can cause fibrosis (scarring of the liver), which may progress to cirrhosis, a severe condition that can lead to liver failure.

3. Increased Risk of Cardiovascular Disease: Fatty liver is associated with an increased risk of cardiovascular diseases due to the underlying metabolic issues.

4. Liver Cancer: Individuals with cirrhosis due to fatty liver disease have a higher risk of developing liver cancer.

Management and Treatment
Managing fatty liver disease primarily involves lifestyle changes:
1. Dietary Modifications:
- Reduce Caloric Intake: Focus on a balanced diet that is lower in calories, particularly from unhealthy fats and sugars.

- Increase Fiber: Incorporate more fruits, vegetables, whole grains, and legumes into your diet.

- Healthy Fats: Opt for healthy fats such as those found in avocados, nuts, and olive oil, while avoiding trans fats and excessive saturated fats.

- Limit Alcohol: If you have fatty liver, it's crucial to limit or eliminate alcohol consumption.

2. Regular Exercise: Engaging in regular physical activity can help reduce liver fat. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, along with strength training exercises.

3. Weight Management: If overweight, losing even a small percentage of body weight can significantly improve liver health.

4. Regular Monitoring: Regular check-ups with your healthcare provider to monitor liver function tests and overall health are essential.

5. Medications: In some cases, medications may be prescribed to manage underlying conditions like diabetes or high cholesterol, but there are no specific medications approved solely for fatty liver disease.

Additional Considerations
Regarding your concerns about late-night eating and the consumption of cold beverages, while there is no direct evidence linking cold drinks to liver health, it is essential to focus on overall dietary habits and lifestyle choices. The spleen, which you mentioned, plays a role in filtering blood and supporting the immune system, but it is not directly related to liver function.

In conclusion, fatty liver disease is a manageable condition with lifestyle modifications. By adopting a healthier diet, increasing physical activity, and maintaining regular medical follow-ups, you can significantly improve your liver health and overall well-being. If you have further questions or concerns, consider discussing them with your healthcare provider for personalized advice.

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