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A collection of fats in the liver cells is called fatty liver. This condition is also called steatosis hepatis or steatorrhoeic hepatosis.
Fatty liver by itself though abnormal, is a relatively harmless condition. The liver is the largest organ in the human body. It plays many roles in keeping the biochemical balance intact. You should know some normal functions of the liver to understand how disease affects it.
Under normal conditions, your liver creates optimal nutrition for all the 50 trillion odd cells in you body. Different roles played by the liver are:
- Production of bile - which is necessary for proper digestion. Bile salts emulsify the fats and improve digestion. Also, when fat soluble vitamins A,D, and K are dissolved in bile, they are absorbed better. A good measure of toxic substances are produced in the body daily. Many of these are only fat soluble. These are dissolved in bile and finally emptied into the intestines to be thrown out as fecal matter. The liver thus helps in elimination of toxic byproducts from the body by producing bile.
- Production of many clotting factors and proteins from amino acids which are important for every process of healing, repair and cell growth.
- It is the largest storehouse of many vitamins (A, D, K + B12), iron and minerals. The liver also converts all the B-Complex vitamins into their active forms. Every nutrient, be it vitamins, minerals or amino acids, are converted into their biologically active forms by the liver.
Nutrients in foods and supplements are never in their active, absorbable forms. The liver makes them active thus, making them available for body functions.
- The liver has huge stores of energy. It produces glucose from the different sugars in our diet and stores it in the form of glycogens.
- It buffers any major fluctuations in glucose levels by converting glycogens to glucose when glucose levels are low and vice versa when glucose levels are high.
- It is vital in the removal of old, worn-out red blood cells from circulation.
- The thyroid hormone T4 is converted into its more potent form T3 within the liver
- Detoxification of the body is a major function. Chemicals, industrial pollutants, metabolic wastes from junk foods, drugs, insecticide residues, alcohol, etc. are some of the dangerous toxins eliminated through our liver.
What is Fatty Liver?
Fatty liver has large amounts of fats (triglycerides) accumulating within the liver cells. Excess aggregation of fats within the small hepatocytes swells them up and occasionally the whole liver is enlarged enough for feeling it.
Fatty liver can be a harbinger of more troublesome conditions. Steatosis simply means collection of fat vacuoles within the liver cells (hepatocytes).
Alcohol and obesity are two leading causes of fatty liver worldwide. Alcoholic Liver Disease (ALD) and Alcoholic Fatty Liver (AFL) are entities by themselves.
Obesity plus other non-alcoholic conditions comprise Non Alcoholic Liver Disease (NALD).
When these fat cells cause inflammation of the liver tissues, it's called steatotic hepatitis and it is of notable concern. Both alcohol as well as other conditions causing major biochemical changes in our bodies can cause steatotic hepatitis. When this condition is due to reasons other than alcohol, it's denoted by the term Non-Alcoholic Steatotic Hepatitis or more commonly as NASH.
Fatty liver when inflamed, can over a period of time cause scarring and fibroses of the liver. This condition called cirrhosis is serious and has serious side-effects if left unchecked.
Stages (Grades) of Fatty Liver
Fatty liver as mentioned is not a critical condition, its stages of development are divided in grades
Grade 1 and grade 2 of fatty liver can be controlled with proper medication.
Causes of Fatty liver
Why fatty liver occurs, is unknown. A fatty diet or overeating by itself never results in a fatty liver. The fat may come from increased absorption from the intestines or from elsewhere in the body. But, putting it generally, the liver loses its capacity to eliminate fats deposited within it.
Yet, 70% of persons suffering from NASH are found to be obese.
Some common causes of NASH are:
- Metabolic syndromes
Apart from alcohol, there are many conditions that cause an imbalance in the body's metabolic capacity
- High blood pressures (hypertension)
- High blood cholesterols
- Glycogen storage disease
- Congenital disorders like Wolman's disease
- Congenital diseases like Wilson's disease which affects copper levels
- Weber-Christian disease affecting nutrient absorption.
- Galactosemia - a disorder which affects the way milk is metabolized in the body.
- Infections like tuberculosis and malaria.
- Nutritional causes
- Severe mal-nutrition
- Sudden rapid weight loss
- Surgeries performed to reduce obesity - gastric bypass surgery, jejuno-ileal bypass, etc.
In extreme cases, amiodarone and methotexate can cause cirrhosis.
- Valproic acids ( used in epileptic patients)
- Medications for heart conditions like irregular heartbeats and high blood pressures e.g. amiodarone; diltiazem.
- Tamoxifen - used in treating breast cancer.
- Anti-retroviral drugs (indinavir)
- Overdose of Vitamin A.
- toxins from food stuffs like
- rancid peanuts - aflatoxins are extremely toxic
- mushroom poisonings
- phosphorus from environment
Risk factors for Fatty liver
Your chances of developing fatty liver are high if you
- are obese
- are an alcoholic
- Suffer from high blood pressures which often fluctuate or are on long-term medications for the same.
- Blood cholesterol levels are high.
Symptoms of Fatty liver
Mild Fatty liver is usually asymptomatic. It is detected incidentally during routine tests performed. However, some persons can have symptoms which are often vague.
- Malaise - or a feeling of severe discomfort, making the person want to rest,
- Fatigue - even with moderate exertion
- Fullness and heaviness in the abdomen, more in the right upper corner
- Occasionally the liver maybe painful on pressure.
However, with fatty liver unchecked can progress into cirrhosis which is life-threatening. Thereafter, features of liver failure present themselves.
- Yellowish discoloration of skin (jaundice), dark colored urine.
- Weight loss
- Nausea and vomiting
- Loss of appetite
- Mild to moderate reddish discolorations just below the superficial skin layers which blanch on pressure (spider naevi)
- Abdominal dissension (due to increased fluid in the abdomen - ascites)
- Easy bleeds from small trauma.
- Blood doesn't clot soon enough
- Fine to moderate tremors of the fingers
- Flapping tremors of the hands (asterexis)
- Itching in hands and legs which gradually spread all over the body
- Veins in legs, abdomen, seem engorged and distended.
- Poor memory, poor concentration, dullness of thoughts, mental confusion » this is an emergency (encephalopathy)!!
- Loss of sexual interest
Diagnosi of Fatty liver
Commonly, the diagnosis is incidental. Some tests which identify the disorder are:-
- Ultrasound (Ultrasonography): A painless, non-invasive test, when performed by an experienced personnel, it can accurately identify fatty liver. The liver size can be measured and this test can be valuable in grading the improvement.
- Liver Function Tests: Abnormal levels of liver enzymes in the blood identify as well as provide a deeper understanding of the cause of fatty liver. This test also provides insight into the efficacy of treatment and the improvement to be expected.
- Computed Tomography Scan (CT scan): non-invasive. Measures internal organs accurately and in detail by the use of X-rays.
- MRI: Also non-invasive. Uses radio waves in a magnetic field to scan the structures of internal organs.
Tips for prevention of Fatty liver
- Say No To Alcohol
Or if you have started having alcohol, try not to have more than two pegs in a week.
- Quit Smoking
Smoking can cause many biochemical and hemodynamic changes which make you more vulnerable to liver damage.
- Control Weight Gain
70% of persons suffering from NASH are found to be obese.
- Omega-3 Fatty Acids
Found to be promising in preventing fatty liver. Found in natural sources like walnuts, fish oils (cod, salmons), and flaxseed oils.
Treatmnt of Fatty liver
There is no standardized treatment for fatty liver. Treating the underlying cause can easily reverse the abnormal changes in the liver, provided, it is early in the disease.
Some common measures that improve fatty liver are:
- Exercise and weight loss programs: Obese patients have a Body Mass Index (BMI) of 30 or more. A realistic weight loss program should try reducing the BMI by two units of the existing one. Aerobic exercises are best suited to burn off fat. However, one should bear in mind that for long term success, it is not the intensity of the workout, but the sustenance that matters.
- Control cholesterol levels.: Besides regular workouts, a healthy approach to avoid consumption of saturated fats in diet can reverse fatty liver. Cholesterol lowering medications used in adjunct to exercise can reverse fatty liver.
- Control Diabetes: Effective management of sugar levels with life-style changes, medications and insulin can stop further advancement of fatty liver into something serious like cirrhosis or liver failure.
- Avoid harmful substances.: Certain drugs, alcohol, junk foods etc. are better avoided when once diagnosed with fatty liver. Talk to your doctor regarding medications that can cause fatty liver. Chances are he can suggest better alternatives.
Homeopathic treatment for Fatty liver
Homeopathy addresses the underlying causes behind fatty liver, improves liver functions and reduces the symptoms as well as modifies the disease process. Homeopathy is recommended for cases of Fatty Liver.
Cirrhosis of Liver