Non-alcoholic fatty liver, an epidemic

Did you know that non-alcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver disease in the US and around the world?  Yes!  It is.  Researchers think that nearly one-third of Americans has this disease.  There is a spectrum of disease, from mild to end-stage cirrhosis.

Do these patients drink alcohol?  Most NAFLD patients consume no alcohol or only a modest amount.

Do the patients have symptoms?  Rarely.  Most are asymptomatic.

How is this found?  Most have abnormal liver function tests on routine (or preventive health screening) blood work.  (Take out your lab work:  Most NAFLD patients have (elevated and) higher serum ALT levels than serum AST levels)

What else is NAFLD associated with?  Type 2 diabetes and obesity and high cholesterol.  In fact, nearly 70% of type 2 diabetes patients develop fatty liver and its consequences.

What can you do?

  • Decrease carbohydrates (starchy foods).  Avoid saturated fats, simple carbohydrates and sweetened drinks.
  • Lose weight!
  • Exercise.  Aerobic exercise improves skeletal muscle insulin sensitivity and helps decrease the underlying mechanism causing NAFLD.
  • Don’t use medicines (like orlistat) to help lose weight.
  • Consider bariatric (weight loss) surgery.  This may lead to the most reliable method for achieving “sustained weight loss in morbidly obese individuals.”  But, more long-term studies are needed to confirm this.
  • Consider medications.  Ask your doctor!  Vitamin E at 800 IU a day was shown to improve the hepatocytes (the individual liver cells under a microscope)  But, Vitamin E may cause increased risk of all-cause mortality and hemorrhagic strokes in the brain.  So, more studies on this are needed.  Other medications considered are metformin, and statins. But, the more research is needed to confirm that they help NAFLD and do not cause harm.

How can you help decrease your risk of cirrhosis from NAFLD?  Decrease your other risk factors!  Ask to be screened for type 2 diabetes.   Watch your blood pressure with the goal being under 140 and under 90 (> 140/90).  Treat your elevated cholesterol.   Test for obstructive sleep apnea if you have disorganized sleep, wake tired, or snore.

I hope this helps….IMG_4185

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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