It was a routine request for a preoperative consultation in the hospital.
I cheerfully introduced myself to my 33-year-old female patient. She had presented to the emergency room with upper abdominal pain. She had an ultrasound of her abdomen performed which revealed inflammation of her gallbladder. She was scheduled to have surgery the following day.
I briefly read the ultrasound report I noticed an additional abnormality. I asked her to tell me about herself. She had a history of high blood pressure otherwise considered herself healthy. She did not drink alcohol but consumed several cans of soda a day. She had a twin sister recently diagnosed with type 2 diabetes. Her mother who was present in the room, also had type 2 diabetes. It seemed to be coming together in my mind.
I assured her that I thought she would do well with the surgery, however, that I had found a slight concern on the ultrasound. The ultrasound showed that she had fat in her liver. I explained to her what this meant and some of the things in her history that had put her at risk for this happening. I shared with her that because she was obese with a history of high blood pressure as well as having a family history type 2 diabetes mellitus she was at increased risk of developing type 2 diabetes herself.
So what is fatty liver disease?
My patient had is a condition called non-alcoholic fatty liver disease, commonly called fatty liver disease. Fatty liver disease is becoming more common with some studies showing that up it affects up to 46% of adult Americans. It is more common in women. It usually develops between 40 and 50 years of age, although there are some young people in their teens being diagnosed with fatty liver disease. Many people do not know that they have fatty liver disease. Up to 2-3% of people have a more condition called nonalcoholic steatohepatitis (NASH). NASH can progress to advanced liver disease called cirrhosis.
Some Conditions associated with fatty liver disease
- Obesity– more than 70% of people with fatty liver disease are obese. Of more concern is abdominal obesity. The waist circumference is a measure of fat in the abdominal cavity. Measuring the waist circumference helps to determine abdominal obesity. A waist circumference (over 31.5 inches in women and 37 inches in men). Fat can accumulate around organs as well as inside organs such as the liver. Fat cells produce harmful substances increase inflammation in the body and can lead to chronic illness. In the liver the fat cells can cause inflammation called nonalcoholic steatohepatitis (NASH) and can eventually lead to a condition called cirrhosis.
- Type 2 diabetes – Up to 75% of people with fatty liver disease have type 2 diabetes
- Metabolic syndrome– Metabolic syndrome is not a disease, but a collection of symptoms. Metabolic syndrome increases the risk for type 2 diabetes, hypertension and heart disease. Click here to read more about an article I wrote about metabolic syndrome and the link between type 2 diabetes and hypertension.
- High triglycerides– Between 20-80% of people with fatty liver disease have high triglycerides.
- Exposure to certain toxins and drugs– some medications that are used to treat medical conditions can cause fatty liver disease. These include steroids (prednisone and hydrocortisone, methyl prednisolone) amiodarone, tamoxifen
What are the signs or symptoms of fatty liver disease?
Unfortunately most people with fatty liver disease do not have any symptoms. At other times a routine blood test performed by your healthcare provider might show abnormal liver enzymes which may be a clue that there may be some inflammation in the liver .
How do you to treat fatty liver disease?
The good news is that if addressed early, fatty liver disease is reversible. Here are some things you can do:
- Weight loss- If you have been informed by your healthcare provider that you have fatty liver disease, please take this seriously. Lose weight. Lose weight gradually. Rapid weight loss has been found to worsen fatty liver disease. Do not just look at this as a ‘weight loss plan’, rather look at ways to improve your lifestyle. Work with your healthcare provider to create a lifestyle plan that works for you and allows you to thrive.
- Eliminate high fructose corn syrup- High fructose corn syrup is a manufactured chemical sweeter that is present in a lot of foods. It is very common in soda as well as several other processed foods including salad dressing and even ketchup. There are some studies that show a relationship between high fructose corn syrup and liver disease.
- Reduce processed foods. Increase fruits and vegetables- processed foods contain a lot of simple carbohydrates. These simple carbohydrates get turned into sugar. Excess sugar gets taken up into the liver and converted to fat. Reduce simple sugars and increase the amount of fruits and vegetables in your diet. This way you are getting more fiber, vitamins, minerals and powerful nutrients that have healing properties.
- Treat diabetes – If you have been diagnosed with type 2 diabetes or borderline diabetes get this treated.
This is the time to focus on making healthy lifestyle changes. If left untreated, fatty liver disease could progress and cause severe damage to the liver. Be proactive. This is your life. I want to see more women thrive into their older years rather than suffer from the effects of chronic illness. If you would like more information about working with me click here.
To your health and wellbeing,