Cirrhosis: Understanding Its Causes and Prevention

Cirrhosis of the liver has long been associated with excessive alcohol consumption. If you don’t drink alcohol or only drink it in small quantities, you might think you’re safe from liver-related issues. Unfortunately, that isn’t the case. 

Nonalcoholic fatty liver disease, or “NAFLD,” is a disease of the liver that affects people who do not drink or seldom drink alcohol. NAFLD is common, affecting about one in three adults and one in 10 children. Left untreated, it can progress into cirrhosis.

Understanding the underlying causes and symptoms of liver disease can help you take steps to prevent it or manage it if you have it. Together, we’ll discuss what liver disease is, what causes it, and how it can progress to cirrhosis. 

We’ll also talk about what you can do to support your liver health to prevent cirrhosis from happening. 

What Is Liver Disease?

The liver is one of the most important organs in your body. It has over 500 identified functions. Some of the most important are filtering your blood and removing waste products and toxins. It also plays a role in your immunity and breaks down medications.

You can’t live without a liver, so it’s incredibly important to keep it healthy. The liver can regenerate, even regrowing itself, but certain types of damage are irreversible. Scarring of the liver, like the kind that happens with cirrhosis, cannot be reversed. 

If your liver becomes damaged to the point it no longer functions, you may enter liver failure. Currently, liver failure from cirrhosis due to diseases like hepatitis C and chronic alcohol use are the two most prevalent reasons for liver transplants. 

NAFLD

NAFLD is a widespread liver disease affecting millions of Americans. NAFLD is a condition in which excess fat begins to build up in the liver. 

Researchers aren’t completely sure why some people store fat on their livers and others don’t, but there are risk factors that are closely associated with NAFLD:

• Obesity. If you have a BMI over 30, you’re at a higher risk of developing NAFLD. 

• Having metabolic syndrome. This condition includes a cluster of conditions like insulin resistance (or type 2 diabetes), high cholesterol, high blood pressure, and excess weight (especially around the midsection)

• High blood triglyceride levels

• Having polycystic ovary syndrome

• Being of Hispanic descent

• Having a genetic predisposition to NAFLD

These conditions place you at higher risk of developing NAFLD, but you don’t have to experience all of them to get NAFLD.

What Are the Symptoms of NAFLD?

NAFLD is a silent liver disease. Most of the time, you won’t have any symptoms, especially during the earliest stages. You may experience fatigue, weakness, or pain in the upper right portion of your abdomen, but usually no symptoms are present. 

How Is NAFLD Diagnosed?

You’ll need your healthcare provider to order a blood test to check your liver enzymes. If they are elevated, your doctor may order additional imaging tests to determine if you have NAFLD.

Imaging tests include elastography, magnetic resonance imaging (MRI), and ultrasound. If imaging suggests you have further damage, your doctor may order a liver biopsy. 

A biopsy is performed in-office and can be invasive and uncomfortable. This test, however, will show your healthcare provider if your liver has permanent damage. If so, you may be diagnosed with NASH, the next progression of fatty liver disease. 

NASH

Nonalcoholic steatohepatitis, also known as “NASH,” is a progressive form of fatty liver disease. A person with NASH has excess fat stored in their liver, which is now causing inflammation in the liver. 

NASH is a serious condition that can lead to irreversible liver scarring. NASH is also one of the known causes of cirrhosis. NASH can occur as a result of undiagnosed fatty liver disease or by not managing your fatty liver disease well. 

What Are the Symptoms of NASH?

NASH may not have symptoms in its earliest stages, but it can produce fatigue, pain in the upper right abdomen, and jaundice (or the yellowing of the skin). 

If left untreated, NASH symptoms can include:

• Ascites. This condition causes fluid to collect in the abdomen.
• Broken blood vessels that look like spiders on the skin
• Loss of appetite and/or sudden unexplained weight loss
• Bleeding and bruising easily
• Itchy skin

NASH is almost always diagnosed through imaging tests and a liver biopsy. 

Cirrhosis

Cirrhosis is a liver disease that causes severe scarring in the liver, a condition known as fibrosis. If you have cirrhosis, your healthy liver tissue has been replaced by scar tissue. This impacts liver function and may lead to liver failure or liver cancer. 

Causes of Cirrhosis

Cirrhosis doesn’t just occur; there are diseases and conditions (like NAFLD and NASH) that occur before the development of cirrhosis. In addition to NAFLD and NASH, there are other health conditions that can lead to cirrhosis.

• Hepatitis B and C. Both hepatitis B and hepatitis C are viral hepatitis infections. There is no cure for hepatitis B, although there are treatments available to help prevent or delay liver damage. Hepatitis C is curable for most people with a course of medication. Left untreated, both infections can cause severe, permanent liver damage that can be life-threatening. 

• Alcohol misuse. Chronic misuse of alcohol can lead to cirrhosis of the liver. Alcohol causes fat to be stored in the liver, which can lead to alcoholic liver disease and cirrhosis. 

• Autoimmune hepatitis. This type of hepatitis is caused by an autoimmune disorder that causes the body’s immune system to incorrectly target liver cells. 

• Diseases that cause the buildup of minerals like iron and copper in the liver, like Wilson Disease and hemochromatosis

• Certain medications

• Primary Sclerosing Cholangitis is a condition that destroys the bile ducts that support the liver. 

If you suffer from any of the above conditions, it’s important to talk to your doctor about how to manage your illness to prevent it from progressing into cirrhosis. 

Complications of Cirrhosis 

Once you develop cirrhosis, you’re at a higher risk of developing other negative health conditions like:

• Portal hypertension. This condition causes higher-than-normal blood pressure in the portal vein that supplies blood to the liver. 

• Edema. This causes swelling in the legs and abdomen.

• Splenomegaly. This condition causes the spleen to become enlarged. 

• Excessive bleeding if an injury occurs and poor blood clotting.

• Malnutrition. When hepatic function is compromised, you may not be able to get the nutrients your body needs. 

• Hepatic encephalopathy. The liver flushes toxins out of the blood. If it can’t perform this function, toxins may begin to build up in the brain, leading to hepatic encephalopathy. This can lead to mental confusion, slurred speech, and even coma.

The takeaway? Cirrhosis is serious and dangerous and can lead to liver cancer. 

It can be life-threatening and decrease your longevity. That’s the bad news. The good news? For most people, cirrhosis is preventable with lifestyle changes and management of existing liver conditions. 

Preventing Cirrhosis

The most common causes of cirrhosis are viral hepatitis, alcohol abuse, and fatty liver disease. All of these conditions can be preventable or managed in a way that prevents them from developing into cirrhosis. 

Vaccinations

Vaccinations are available for certain types of hepatitis, including chronic hepatitis B. There’s no vaccine for the hepatitis C virus, but you can make healthy lifestyle choices to avoid contracting it. 

Hepatitis C is spread through blood contact with an infected person. Taking steps to protect yourself against coming in contact with blood from others is one way to prevent the spread of hepatitis C. 

Management of Chronic Liver Disease

If you have NAFLD or NASH, working with your doctor to make sure your condition is well managed will ensure you prevent or delay cirrhosis. Most people who develop NAFLD will never develop cirrhosis with proper care. 

Even with NASH, it’s possible to prevent further liver damage by taking steps to protect your liver like:

• Avoiding alcohol
• Using over-the-counter medications only as directed
• Losing weight if you are overweight
• Regulating other metabolic conditions (like type 2 diabetes) 

Getting regular CT scans or other imaging tests can also help determine the changes in your liver from one year to the next and help you determine how well your liver disease is being managed. 

Weight Loss

The first line of defense for NAFLD is weight loss. If you are obese or overweight, speak to your doctor about how you can lose weight and protect your liver. Losing weight during the early stages of NAFLD can dramatically impact your liver health and prevent you from ever developing cirrhosis. 

A Healthy Diet

Adopting a healthy diet is vital for your nutrition and your liver. Avoiding processed foods can help you eliminate excess salt and sugar, leaving room for more whole foods, like fresh fruits and vegetables, lean meats, and complex carbohydrates. 

Your diet can also play a role in your ability to lose weight. Along with exercise, it’s a great way to jump-start your weight loss journey. 

Use Alcohol Sparingly

Alcohol can negatively impact your liver. The CDC recommends that people who do not drink alcohol should not start, and if you do drink alcohol, you should limit your intake to one beverage per day for women and two for men. 

If you think you might not be able to quit, reach out to your healthcare provider to get advice and find resources to help. 

Be Fat Smart

You might be avoiding fat, especially if you have a diagnosis of fatty liver disease. That’s no surprise. For an entire generation, we’ve been told some pretty misleading information about fat, what it is, and how it works. 

Although we’ve been told that all fat is bad, science doesn’t support this worn-out idea. A new important class of fatty acids — odd-chain saturated fatty acids — were discovered that improve our liver health. 

One of these odd-chain saturated fatty acids, pentadecanoic acid, or C15:0, is an essential fatty acid. Meaning, our bodies don't make it, and we have to get it through our diets.

Science supports that higher levels of C15:0 are not only associated with better liver health, but actively work at the cellular level to improve our liver health. 

C15:0: The Fat Your Liver Loves

Anextensive series of studies has shown that C15:0 improves cellular resilience, repairs mitochondrial function, and naturally targets receptors found throughout our bodies (called PPARs) that regulate our metabolism, immunity, mood, sleep, and appetite. 

These studies also showed that daily supplementation with C15:0 promoted healthy glucose and cholesterol levels, as well as healthy liver and red blood cell function in relevant models. Importantly, dozens of large-scale population studies have linked C15:0 to better metabolic and heart health in humans.

Getting it into your body through your diet, however, is not straightforward. C15:0 is found in trace amounts in whole-fat dairy products like whole milk and full-fat butter, however increasing your intake of whole milk and butter would mean eating more sugars and packing in excess calories. 

Further, whole-fat milk and butter have much higher levels of the “bad,” even-chain fatty acids that are proinflammatory. 

Thankfully, there is a solution. Fatty15. Fatty15 is the first and only supplement that was born from scientific research and contains just one ingredient: the pure, vegan-friendly, sustainably-produced, and award-winning version of C15:0 known as FA15™. 

Just one capsule per day is enough to restore your circulating level of C15:0 and help support your liver health. 

Just Say No to Cirrhosis

Cirrhosis is a severe liver disease that can become life-threatening. Still, you can take measures to ensure you don’t develop it, even if you’ve already gotten a diagnosis of fatty liver disease. 

Taking steps to support your liver, like taking fatty15, can help you get your liver health on track. So go ahead, get a little fatty in your life, and enjoy improved liver and whole-body health. 

Sources:

The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis | Science Direct

Liver Functions, Location, Anatomy and Disease | Columbia Surgery

Nonalcoholic fatty liver disease - Symptoms and causes | Mayo Clinic

Non-alcoholic Steatohepatitis (NASH) | Cedars-Sinai

Cirrhosis | NIDDK

Efficacy of dietary odd-chain saturated fatty acid pentadecanoic acid parallels broad associated health benefits in humans: could it be essential? | Scientific Reports