Don’t Call My Liver Fat!

Isn’t there enough to contend with having diabetes? You need to take care of your eyes, feet, heart… Now you have to worry about your liver? Well, yes. Fatty liver disease may be something you’re not all that familiar with, but if you have Type 2 diabetes, it’s a good idea to know about this. Hence this week’s posting!


Liver 101
Let’s back up for a minute and talk about your liver. The liver is one of the largest organs in the body, weighing about three pounds. It’s located in the right upper abdomen, below the diaphragm. It’s pretty amazing what the liver does, if you stop and think about it. Here’s a brief run-down:

• Detoxifies harmful substances
• Produces proteins that help blood to clot
• Breaks down fat for energy
• Makes bile (which is needed for fat breakdown)
• Helps keep blood glucose levels constant
• Metabolizes protein
• Stores vitamins and minerals

Given all that the liver does, you can see why it’s so important to keep it in shape.

Fatty liver disease
The actual name of this condition is non-alcoholic fatty liver disease, or NAFLD, for short. This is a condition in which extra fat builds up in liver cells, and, as the name implies, it’s not due to drinking alcohol (that’s a whole other issue). The liver normally contains some fat, but if more than 5% to 10% of the liver’s weight is due to fat, you’ve got a fatty liver.

Who gets NAFLD? It’s most common in people who:

• Are overweight or obese
• Have Type 2 diabetes
• Have high blood cholesterol or triglycerides
• Are losing weight quickly
• Have poor eating habits

NAFLD can run in the family. It may also be caused by certain medicines and viral hepatitis. But according to the American Liver Foundation, some people have NAFLD and have no risk factors. It’s the most common cause of liver disease in the US and affects up to 25% of people in the United States. NAFLD is also a leading cause of end-stage liver disease requiring liver transplantation (other causes include hepatitis and alcohol abuse). If not treated, this disease can lead to swelling of the liver, cirrhosis, liver cancer, or liver failure.

NAFLD symptoms
NAFLD usually causes no symptoms in the early stages of the disease. Symptoms may occur as the disease progresses, and include fatigue, weakness, weight loss, yellowing of the skin and eyes, itching, fluid buildup, and confusion. A person may feel pain in the right upper part of the abdomen and have patches of dark skin on the neck or under the arms.

NAFLD may be diagnosed during a regular physical exam. Your provider may notice that your liver is enlarged. Or you might report that you’ve been having right upper quadrant pain. Liver enzymes may be checked through a blood test (high levels are suspicious), and a fatty liver can show up on an ultrasound. A definitive diagnosis is made by having a liver biopsy, which can detect extra fat, inflammation, and damaged liver cells.

There’s no medical treatment for NAFLD at this time. The thiazolidinedione drugs Avandia (rosiglitazone) and Actos (pioglitazone) have been shown to reduce fat in the liver, but these are not FDA-approved to be used for NAFLD. However, as with diabetes, lifestyle changes can help. Losing weight (if you need to), controlling your blood glucose and cholesterol levels, cutting down on refined carbohydrate foods, getting more physical activity, and avoiding alcohol all can help prevent the condition from worsening and, in the early stages, may even reverse NAFLD. In addition, talk with your provider before taking certain medicines or dietary supplements, as some can be harmful to the liver.

Do what you can to keep your liver healthy. Talk to your health-care provider to learn more or if you have any of the symptoms previously mentioned.

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  • jim snell

    Amy: thank you for placing this article. Work done by the University Of Tyne – Dr. Roy Taylor and his MRI spectography lab, staff and crew have raised most interesting data about fat in the Pancreas and liver.

    Their concern was that folks on extreme diet restriction like those on Bariatric surgery, intestine liner all show an amazing return to better function of the pancreas and liver well before any weight/belly fat loss.

    The MRI spectography enables real time non invasively watching the specific organs – pancreas and liver and watch the amazing changes.

    It seems what they are watching is fat absorption and removal of extra fat in pancreas and liver by slamming back the available calories for the body.

    I believe your article is most timely and extremely interesting! Thank you!

  • Becki O

    When I was diagnosed as Type 2 (Oct 2013, early 40’s woman) my PCP was also worried about indicators for NAFLD. Instead of allowing her to do the ultasound and battery of tests, I convinced her to let me go after it with lifestyle changes, since I knew I would be making so many.

    What I did (for both conditions):
    Made sure to walk the dogs 4+ times a week.
    Very low carb, high protien diet.
    Took liver cleanse suppliments (mainly boosted milk thistle seed extract), leafy veg suppliments (knowing I wasn’t eating enough natively) and multivitamin.
    Completely removed from my diet: High-fructose corn syrup; other high-fructose sugar substitutes (maple syrup, agave); all cured meat products (bacon, ham, pastrami and the like); all wheat products.

    Between those changes and Metformin, after 3 months my A1c is 5.5% (from over 7); all cholesterol numbers are normal, all liver function indicators are normal. (Also lost 4 inches off my waist, but I have at least 6 inches more to lose before I can try to manage my Type 2 with diet alone.)

    Permanent dietary changes are: the reduction in processed foods; the limiting of fructose and sugar alcohols; being wheat-free. Once I get my waist to an acceptable waist-hip-ratio for me, I will be able to experiment with getting off Metformin and finding my personal maintenance-level carb count.

    Encouraged by those results, I will stop the suppliments (except the multivitamin) when the bottle is gone. I’m adding back to my diet some cured meats, but watching quantity and opting for nitrate-free where possible. My next blood test is in 4 months.

    So I believe (and a great deal of my online research supports) that if caught early, it is reversable with dedication. And some trial and error on the part of the individual to see what specific combination of foods is the problem.

    As always, this is just IMO, and whats working for me (at least it is right now). But it certainly supports this article! Thank you.

  • Steve Parker, M.D.

    Very-low-carb diets work better than standard reduced-calorie diets for reduction of liver fat. Here’s the evidence:

    Jim Snell thoughtfully refers to the work of Dr. Roy Taylor. His group is the one that “cured” T2 diabetes with a 600 calorie/day diet in 2011. At the same time, study participants had a dramatic reduction in liver fat. In fact, Dr. Taylor suggests that T2 diabetes is caused by fat build-up in the liver and pancreas.