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NAFLD Explained: Decoding Fatty Liver Disease

Published by Dr. Venn-Watson
Dr. Eric Venn-Watson’s Highlights
  • NAFLD is the most common type of liver disease in America. 

    Understanding the causes of NAFLD can help support your liver health and possibly assist with preventing NAFLD.

    There is no cure for NAFLD, but lifestyle changes can help you manage the condition. 

Most of us don’t think about our liver function unless we have a reason to. Even though our livers are vital for our survival (and perform over 500 jobs in our bodies), we don’t actively pursue liver health in the same way we might pursue cardiovascular health or even mental health. 

Unfortunately, that might be a mistake. NAFLD is the most common type of liver disease in the United States and the leading cause of liver transplants. Statistics show that about one in three American adults have NAFLD, and one in 10 American children will develop it, too.

The rise of NAFLD is concerning, and addressing the issue means understanding what it is, what causes it, and learning what we can do to prevent it and reverse it. Together, we’ll talk about these issues and decode the disease that is killing our livers. 

Why Does Liver Function Matter?

The liver has hundreds of important functions in the body. Without a healthy liver, it’s impossible to lead a healthy life. 

Some of the most important functions of the liver include:

  • Filtering the blood. The liver filters the blood in the body and removes toxins and poisonous substances. It also processes certain medications and ensures the body can use them properly.
  • Production of bile. Bile helps remove waste products from the body. 
  • Immunity. By removing bacteria from the bloodstream, the liver helps keep your body safe from infections and illnesses.

You can’t live without a liver, but your liver is also capable of regenerating itself from some damage. However, if you develop chronic liver disease that results in liver scarring, the damage may be irreversible. 

Liver disease is progressive and usually starts with excess fat storage on the liver. 

NAFLD: Everything You Need To Know

You might think that liver problems only happen to people who consume alcohol in excess. That type of liver damage does exist, but NAFLD, the most common form of liver disease, happens to people who drink little or no alcohol. 

What Is NAFLD?

Non-alcoholic fatty liver disease, or “NAFLD,” is a condition wherein excess fat is stored on the liver. The liver isn’t designed for fat storage, and fat stored in the liver can lead to irregular liver function, scarring, and even cirrhosis if it is not managed. 

NAFLD is most common in people who are overweight or obese, but it’s not limited to this class of individuals. In fact, it’s entirely possible to have fatty liver disease even if you maintain a healthy weight. 

What Causes NAFLD?

Researchers aren’t completely sure what causes some people to collect excess fat on their livers. However, they have identified some key risk factors most frequently associated with people developing NAFLD. 

  • Obesity. Being overweight and/or obese places a person at higher risk for developing NAFLD. Obesity is defined as having a BMI over 30. Being overweight is usually defined as having a BMI over 25. 
  • Having type 2 diabetes. If you are insulin resistant or have type 2 diabetes, you’re at higher risk of developing fatty liver disease than a person whose blood sugar is well managed. 
  • Having high cholesterol. Unregulated cholesterol levels are frequently associated with NAFLD. Having high blood triglycerides (fat in the blood) is also a key risk factor. 
  • Genetics. Researchers are currently exploring why a particular genetic modifier, known as PNPLA3, could predispose some people to fatty liver disease. 
  • Having polycystic ovary syndrome. 
  • Having metabolic syndrome. Metabolic syndrome is a cluster of health conditions that include insulin resistance, high cholesterol, high blood pressure, and excess weight (especially around the midsection). 
  • Thyroid problems. If you have thyroid problems, you are at a higher risk of developing fatty liver disease. 

Not everyone who gets fatty liver disease will have these risk factors, and it’s also possible that you can have different risk factors that aren’t included in this list. 

What Are the Symptoms of NAFLD?

NAFLD is often referred to as the “silent liver disease” because, most often, it doesn’t produce any symptoms. You may have NAFLD for years without ever having any noticeable symptoms. 

If you do have symptoms, it’s possible that your NAFLD has progressed to the second stage of fatty liver disease known as non-alcoholic steatohepatitis, or “NASH.”

If you do experience symptoms, they might include:

  • Fatigue and/or weakness
  • Pain in the upper right portion of the abdomen
  • An overall feeling of malaise or unwellness

As liver disease progresses, symptoms may worsen and can include jaundice (yellowing of the skin and eyes), swelling in the legs and feet, redness in the palms of the hands, unexplained weight loss, broken blood vessels in the skin, itchy skin, and abdominal swelling. 

How Is NAFLD Diagnosed?

The only way to know for sure if you have NAFLD is to have your healthcare provider order blood tests. The first test will measure your liver enzymes. If they are elevated, your doctor may then want to order imaging tests.

Imaging tests like ultrasounds, MRIs, and elastography (FibroScans) are used to determine the state of your liver disease and to measure liver stiffness and changes in liver tissue. If your doctor suspects that your liver disease has progressed, they will likely order a liver biopsy. 

A liver biopsy is the only way to know for sure if you have NASH, fibrosis, or cirrhosis. A liver biopsy usually does not require surgery and can be completed in-office with a needle. The procedure can be invasive and uncomfortable. 

What Happens if NAFLD Is Left Untreated?

NAFLD is the first stage of fatty liver disease. When diagnosed, it’s important that steps are taken to ensure liver health so that the disease does not progress. If left untreated, NAFLD may progress into NASH.

NASH is a form of NAFLD where the fat buildup in the liver has caused the liver to become inflamed. Liver inflammation can lead to liver damage through scarring. The development of liver scarring happens through a process known as fibrosis. Fibrosis can lead to cirrhosis of the liver, a condition where scar tissue has compromised the liver’s ability to function properly. 

Cirrhosis can be a life-threatening condition that can even lead to liver cancer and liver failure. The good news is that NAFLD does not have to progress to these damaging levels. With careful management and care, you can lead a full and healthy life with a diagnosis of NAFLD. 

Additionally, people with NAFLD are at higher risk of developing other negative health complications, like cardiovascular disease and the health conditions associated with metabolic syndrome. 

Managing and Caring for Your Liver With NAFLD

Your liver cells are capable of regeneration, but protecting them is essential, especially if you have a diagnosis of NAFLD. Experts agree that most people with NAFLD won’t develop serious liver problems as long as they take steps to manage their condition properly. 

Currently, there are no FDA-approved medications available for treating NAFLD, and lifestyle changes are the first line of defense for combatting complications and ensuring liver damage doesn’t progress. 

1. Lose Weight

The number one recommendation for people with NAFLD to help combat their illness is to lose weight. Weight loss is essential for managing NAFLD, and maintaining a healthy weight will help prevent NAFLD from progressing to NASH. 

Weight loss can be difficult, but your doctor and a nutritionist can help you get started. Avoid attempting to make weight loss more complicated than it actually is. Losing weight requires your body to burn more calories than you intake. 

There are two ways to help make sure this happens:

  1. Consume fewer calories with a healthy diet. That doesn’t necessarily mean eating less food but eating healthier foods. Whole foods (ones that are minimally processed) typically have fewer calories and are better for your body than processed options. 

  2. Burn more calories. You can burn calories through exercise. Aim for 30 minutes of exercise per day to support your weight loss goals. Exercise also helps prevent cardiovascular disease and helps support mental health, making it a total-body win. 

    Maintaining a healthy weight can be a challenge, but you can do it, and the health of your liver depends on it. 

    2. Limit or Eliminate Alcohol Use

    Alcohol is filtered by the liver, and people who consume excessive amounts of alcohol are at risk for developing alcoholic steatohepatitis. Even if you consume very little alcohol, it can negatively impact your liver function if you have NAFLD. 

    If you’ve been diagnosed with NAFLD, talk to your doctor about whether or not consuming alcohol is safe for your liver. Both NAFLD & NASH patients should seriously consider whether any amount of alcohol consumption is safe. 

    3. Manage Your Type 2 Diabetes

    Unregulated blood sugar plays a role in NAFLD. To ensure your liver is protected, take your type 2 diabetes medications as directed and keep an eye on your blood sugar levels. If you aren’t sure whether you have unregulated blood sugar, a blood test can show where your levels are and whether or not you need to take action to lower your blood sugar. 

    4. Keep Your Cholesterol in Check

    Your cholesterol and triglycerides must be well managed, especially if you have NAFLD. Making sure your levels are regulated through medication and/or lifestyle changes like diet and exercise are important for helping support your liver health, too. 

    5. Be Fat Smart

    Because NAFLD causes fat to be collected on the liver, avoiding fat in your food might seem important. That’s not entirely true. Although we’ve been told that all fat is bad for us, science doesn’t support that dated idea. 

    In fact, science supports that some fat is actually good for us and even essential for our bodies to thrive. One such fat is pentadecanoic acid, also known as C15:0. Higher circulating levels of this fatty acid are frequently associated with better metabolic, heart, and liver health

    Ensuring you’re getting enough of the fats you need and very little (if any) of the fats you don’t can help support your liver health and goals. 

    The Good Fat

    C15:0 was discovered by a team of scientists and is now accepted by the world as essential, which means our bodies need it to thrive but cannot make it on its own. C15:0 is an odd-chain, saturated fatty acid that supports the body by integrating into our cells and ensuring better cellular health. 

    Specifically, C15:0:

    • Strengthens cell membranes by 80%, helping our cells keep their shape and function
    • Rescuing failing mitochondria by increasing their energy output and reducing the creation of reactive oxygen species. 
    • Activating AMPK, which helps regulate whole-body homeostasis through functions like immunity, metabolic health, heart health, and liver health
    • Activating PPAR receptors that govern functions like mood, appetite, and sleep

    Additionally, multiple studies have been published that support C15:0 activity working at the cellular level to support liver health. By increasing your levels of C15:0, you can support your liver and your entire body in one fell swoop. 

    The best way to do it? By using fatty15, the first and only pure C15:0 supplement that helps restore your circulating levels of C15:0 and improve your cellular health and overall health and wellness

    Elevate your cells. Elevate your self.

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    Here’s To Your Liver

    A healthy liver is essential to a healthy life, and you can achieve it by simply making a few lifestyle changes and being a little more “liver conscious.” If you have NAFLD, you can still enjoy a long and healthy life and enjoy the benefits of a healthy liver. This year, make sure your liver health is a main focus and enjoy the benefits of being liver healthy. 


    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

    Genetic Predisposition in NAFLD and NASH: Impact on Severity of Liver Disease and Response to Treatment | PMC

    Non-alcoholic fatty liver disease (NAFLD) | NHS

    Definition & Facts of NAFLD & NASH - National Institute of Diabetes and Digestive and Kidney Diseases

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

    A review of odd-chain fatty acid metabolism and the role of pentadecanoic Acid (c15:0) and heptadecanoic Acid (c17:0) in health and disease | PMC

    Profile photo for Eric Venn-Watson

    Eric Venn-Watson M.D.

    Eric is a physician, U.S. Navy veteran, and Co-founder and COO of Seraphina Therapeutics. Eric served over 25 years as a Navy and Marine Corps physician, working with the special forces community to improve their health and fitness. Seraphina Therapeutics is a health and wellness company dedicated to advancing global health through the discovery of essential fatty acids and micronutrient therapeutics.

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