Fatty liver is a condition (grades 1, 2 & 3) that has several common myths including its causes, symptoms, and treatment. The role of the liver is to produce bile juice to digest fat and filter the toxins from the body. It helps in maintaining a healthy blood sugar level and performs other vital functions too. But sometimes, medical misinformation and incomplete information give rise to medical myths. The continuous circulation of these myths related to one’s health can cause severe harm to the patient, resulting in worsening the condition even more. Fatty liver is one of the severe conditions that need immediate attention and also more awareness related to the myths out there.

People of any weight can get fatty liver disease and enlargement of the liver (hepatomegaly) even if they do not have any other underlying health problems. Fatty liver can come from living an unhealthy lifestyle; not eating the right foods or exercising regularly.

What is the root cause of fatty liver disease and complications?

The most common cause of fatty liver disease is the accumulation of extra fat in the liver. Eating excess calories from a fatty diet causes fat to build up in the liver. When the liver does not process and break down fats as it normally should, too much fat will accumulate. The nutritional causes of fatty liver disease are starvation and protein malnutrition. People tend to develop fatty liver due to certain conditions which are obesity, type 2 diabetes, insulin resistance, increase in lipid/cholesterol in the blood, high blood pressure, genetic factors, and some drugs and chemicals. In addition to these metabolic risk factors, age, sex, and ethnicity can also have a major influence on the risk of fatty liver.

Also Read: Why Cholesterol Matters: Its Important Role in Maintaining Our Health

Myths and Facts

 1: Fatty liver isn’t dangerous

Many people with fatty liver don’t even know they have the condition. Sometimes, it causes no problems at all. But that doesn’t mean we should ignore it. Why? This is because a build-up of fat damages your liver cells and causes inflammation. While a healthy liver contains small amounts of fat, a build-up of fat amounting to more than anything over 5% of your liver’s weight can lead to fatty liver disease.

The liver is the only organ in your body that can regenerate itself by replacing old, damaged cells with new ones. As your liver struggles to get rid of the fat, scar tissue builds up, making it difficult for your liver to transport nutrients around the body and increasing pressure in the surrounding veins. In time, fatty liver can increase your risk of more serious conditions including cirrhosis (scarring of the liver), liver disease, and liver cancer.

2: Alcohol is the main cause of fatty liver

Anybody can develop fatty liver. One can be born with liver disease, contract it from a virus, develop it from what you eat and drink, be exposed to various toxins, or suffer from it for unknown reasons. Alcohol only causes one out of more than 100 different types of liver disease. There are several factors that contribute to fatty liver, and excessive alcohol consumption is only one of them. Whether you feel dependent on alcohol or not, drinking anything over the recommended ‘safe limit’ may put the body at risk of fatty liver. 

Apart from alcohol, non-alcoholic fatty liver sometimes develops when the liver naturally struggles to break down fats, which can lead to non-alcoholic steatohepatitis (NASH), or swelling/enlargement of the liver in which inflammation of the liver (hepatitis) and liver cell damage is present in addition to fat in the liver. People are more likely to have NASH if they have one or more conditions like obesity, high blood pressure, high levels of triglycerides or abnormal levels of cholesterol in the blood and type 2 diabetes, unhealthy diet (high fat, high sugar), medications, thyroid disorder and sometimes genetic.

 3: Drinking hard liquor is worse than drinking beer or wine

Contrary to popular belief, the type of alcohol you drink doesn’t make a difference – what matters is how much you drink.

4: Fatty liver disease cannot be reversed

Although there is currently no specific targeted medication (modern or natural) to treat fatty liver, certain lifestyle changes can prevent it from getting worse and even reverse the condition. As the fatty liver is associated with certain health conditions such as diabetes and high cholesterol, getting the right treatment to manage these conditions, avoiding alcohol, high sugar intake, and fatty foods, and keeping to a healthy weight can help to reduce further damage. Eating a healthy diet with plenty of fresh fruits, vegetables, whole grains and lean meats like chicken and fish can make a big difference in managing the condition.

5: Women are more likely to develop fatty liver

Both men and women are equally susceptible to developing fatty liver disease and enlarged liver symptoms. Therefore, it is essential to manage your lifestyle and diet regardless of your gender.

6: Only obese people develop fatty liver

As mentioned, obesity is one of the risk factors. Even lean people can develop fatty liver, a condition called ‘lean NASH’.

7: Fatty liver is not a big deal

Up to 30% of patients with fatty liver can have progressive liver disease and may end up with an irreversible condition called liver cirrhosis. Also, fatty liver complication is associated with other metabolic conditions like diabetes, hypertension, sleep apnea, cancer, obesity, and others.

8: NASH fatty liver is irreversible

Once there is fatty liver, some of them can progress to the next stage called NASH (Non-alcoholic steatohepatitis) and later to cirrhosis. Only cirrhosis is irreversible. Fatty liver/ NASH is reversible with lifestyle modifications and medications. 

9. There is no treatment for fatty liver

Lifestyle modification is the most important way of managing fatty liver. Weight reduction, exercise, a healthy diet, and control of blood sugar and cholesterol play the most important role. There are various fatty liver medications and treatments available as well.

10. No need to meet a liver specialist

Most of the patients do well with lifestyle modifications. However, some of them require special tests like liver function tests in blood, ultrasound, fibroscan, and rarely liver biopsy. The need for medications may depend upon the above results. Some may require frequent monitoring of the tests. Patients with liver cirrhosis may end up with a liver transplant as well. Hence it is important to consult a liver specialist.

11. Liver cleanses (detoxification) can correct existing liver damage

Liver cleanses have not been proven to treat existing liver damage. There are many other forms of treatment available for those who are affected. Despite the promise of newer, healthier well-marketed products and programs that are meant to cleanse the digestive system, the liver does not need to be cleansed – it does that job itself. As for overconsumption of alcohol or food, less is always best when it comes to liver health, and cleanses have not been proven to rid your body of damage from excess consumption.

References

1. Liver cancer. Retrieved 29 November 2021 from https://www.mayoclinic.org/diseases-conditions/liver-cancer/symptoms-causes/syc-20353659. 18 May 2021
2.  Fatty Liver Disease. Retrieved 29 November 2021 from https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease#management-and-treatment. 
3.  Nonalcoholic Fatty Liver Disease. Retrieved 21 September 2020, from https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/diagnosis-treatment/drc-20354573. 31 July, 219.
4. Fatty Liver Disease. Retrieved 15 December 2021 from https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease. 31 July, 2020.
5. Cirrhosis. Retrieved 21 September 2020, from https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487(n.d.) Non-alcoholic Fatty Liver Disease & NASH. Retrieved 21 September 2020, from https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash. December 7, 2018.
6. Fatty Liver (Hepatic Steatosis). Retrieved 6 July 2018 from https://www.healthline.com/health/fatty-liver#symptoms. August 19, 2017.