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By Dr Raghuram Y.S. The tricky thing about fat is that, it can accumulate underneath the skin (to cause obesity) and also in some organs. Liver is one such organ wherein excessive fat accumulation can lead to a condition called Fatty liver disease or Steatosis. Liver is located in the right upper part of abdomen, its upper surface
being just below your right lung (right chest cage) separated by a muscular layer called diaphragm. A part of right rib cage protects your upper part of liver. But when the fat quantity fat increases so as to contribute to more than 5-10% of its weight, the condition is known as Fatty Liver Disease. Fatty Liver Disease (FLD)
is a condition in which the liver cells accumulate abnormally increased amounts of fat. Excessive consumption of alcohol is a very common cause of Fatty Liver. It is a reversible condition wherein large vacuoles of triglyceride fat accumulate in liver cells via a process of steatosis (abnormal retention of lipids within the cell). FLD is associated with other diseases that influence fat metabolism. When this process of fat metabolism is disrupted, the fat can accumulate in the liver in excessive amounts, thus resulting in fatty liver. Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis) called steato-hepatitis. By considering the contribution of alcohol, fatty liver may be termed as alcoholic steatosis or non-alcoholic fatty liver disease (NAFLD) and the more severe forms as alcoholic steatohepatitis and Non-alcoholic steatohepatitis (NASH)
Hepatic steatosis
Diet for fatty liver:
Eat a balanced and healthy diet. Limit extra-carbs from the food schedule such as bread, grits, rice, potatoes and corn. Cut down on consuming sugar-rich drinks like sports drinks and juices. Have food rich in vitamin E – Sunflower seed, almond, pine nuts, peanuts, spinach, taro root, flaxseed oil, soyabean, pistachio. Broccoli, carrots, chard, mustard and turnip greens, mangoes, nuts, papaya, pumpkin, red peppers
Have food rich in Omega 3 fatty acid – Flax seeds, walnut, sardines, salmon, soyabean, tofu, shrimp, brussel sprout, cauliflower, winter squash, fish oil, egg oil, krill oil, chia seeds, Canola oil, camellia
Have food rich in Vitamin D – yogurt, cheese, orange juice, zuccini, tomato,Salmon, Tuna, Cod liver oil, Fish, fortified cereals, oysters, fortified soy products, ham, dairy products, egg, mushroom,
Quit alcohol. Avoid excess oily foods, fried foods, milk, dairy products and heavy-to-digest non veg food. Obesity predisposes you to have fatty liver disease. Tips for fatty liver disease:
Excess of Iron intake can cause it. If you are taking iron supplement, then have a talk with doctor. Many of Ayurvedic medicines also contain natural iron. Example: Lohasava, Saptamrit lauh, etc. Malnutrition and starvation also causes it. Make sure to eat healthy and eat nutrition rich diet. Certain drugs like Tamoxifen, Methotrexate, Diltiazem etc cause it. (full list of medicines given below). Talk to your doctor. Inflammatory bowel disease causes it. if you have it, get proper treatment. Types of fatty liver disease:
There are mainly 2 types of Fatty Liver Disease (FLD). They are –
Alcoholic Liver Disease (ALD)
Non-alcoholic Fatty Liver Disease (NAFLD)
Note: Some women get Fatty liver changes during pregnancy
liver
Home remedies for fatty liver:
1. Triphala Kashaya – 20 ml, mixed with a teaspoon of honey, 2 times a day, before food. Learn how to prepare Triphala Kashaya
2. Giloy Kashaya: Decoction of Tinospora cordifolia – 30 ml, mixed with a teaspoon of honey and is administered once a day.
3. Regular consumption of 2 grams of long pepper powder along with a teaspoon honey, once or twice a day for a month time.
4. Guduchi Churna (Giloy – powder of Tinospora cordifolia) + Musta Churna (Powder of Cyperus rotundus) – 2 grams of each of these two mixed and administered once a day, along with hot water.
5. 3 grams of Paste of the roots of Sharapunkha (Tephrosia purpurea) is mixed in a cup of buttermilk and is administered once a day.
6. 20 ml of Water decoction (Kashayam) prepared by steam heating the flowers of Shalmali (Bombax malabaricum) tree is given after mixing it with mustard powder.
7. Powders of cardamom, cumin seeds, Bhumyamalaki (Phyllanthus niruri) and Sugar – taken in equal quantities – 3 grams, mixed with half a teaspoon of ghee should be taken early in the morning
8. The powder of dry garlic, long pepper root and Haritaki (Terminalia chebula) – 3 – 5 grams per day should be consumed for a period of 2 months time.
9. Paste of turmeric – 2 grams, mixed with 3 teaspoons of juice of Amalaki (Emblica officinalis) is administered once or twice a day. Symptoms of Fatty Liver Disease:
Fatty liver rarely causes symptoms until the liver disease is far advanced. Fatty liver is found or suspected when:
Abnormal liver tests are found on routine blood testing
Fat is seen in USG, when USG of abdomen is performed for other reasons ex. For the diagnosis of gallstones
Infrequently when the liver is enlarged on physical examination of the patient
Early symptoms of Liver dysfunction due to FLD
As already said you may have a FLD and still not realize it. At the beginning FLD is asymptomatic (no symptoms). The symptoms manifest in a later period of time. It often takes years to decades for the symptoms to manifest. The common symptoms of FLD are:
Feeling tired
Loss of weight
Loss of appetite
Weakness
Nausea
Confusion
Poor judgement
Trouble in concentrating
Other symptoms:
Hepatomegaly (your liver may get larger in size than normal)
Pain: You may feel pain or discomfort in the centre or right upper part of your abdomen (belly)
Dark coloured patches: You may find dark patches on your neck or under your arms
Note: If you have an ALD, you may notice that the symptoms get worse after a period of heavy drinking
Liver Cirrhosis:
If you have FLD or ALD, you may get Liver Cirrhosis (scarring of liver). When the liver disease is far advanced (cirrhosis), signs and symptoms of cirrhosis predominate. They are as said below:
Liver Cirrhosis presents with:
Fluid accumulation due to portal hypertension that causes fluid to leak from blood vessels and the inability of liver to make the major blood protein, albumin
Wasting of muscles
Excessive bleeding due to inability of the liver to make blood-clotting proteins
Gastro-intestinal bleeding due to portal hypertension that increases the pressure in intestinal blood vessels
Jaundice (yellowing of skin and eyes) due to inability of the liver to eliminate bilurubin from the blood
Mental changes (encephalopathy) due to the liver’s inability to eliminate chemicals from the body those are toxic to the brain. Coma too may occur. Liver cancer
Liver failure
Diseases associated with NAFLD:
Diseases associated with metabolic syndrome:
Obesity
Elevated blood triglycerides
Low – HDL cholesterol
High blood pressure
Elevated blood sugar (diabetes)
Other associations:
Fatty pancreas
Hypothyroidism
Colon polyps
Elevated blood uric acid
Vitamin D deficiency
Polycystic Ovaries
Obstructive sleep apnoea
Note:Half patients with NAFLD have obstructive sleep apnoea and most patients with obstructive sleep apnoea have NAFLD.
