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Fatty Liver


Comparison of healthy liver and fatty liver disease. Human healthcare concept vector illustration on white background.

INTRODUCTION

In general, fatty liver disease is a medical condition in which fat builds up in the liver. There are two main types of fatty liver disease: (a) non-alcoholic fatty liver (b) alcoholic fatty liver disease.

  • Non-alcoholic fatty liver disease (NAFLD) is a type of fatty liver disease that is not related to heavy alcohol use.
  • Alcoholic fatty liver disease is another type of fatty liver disease which is due to heavy alcohol use. The harmful substances which are generated during the alcohol breaking process may accumulate and damage liver cells. Alcoholic fatty liver disease is the earliest stage of alcohol-related liver disease.

WHO IS AT RISK FOR FATTY LIVER DISEASE?

According to researchers, the cause of non-alcoholic fatty liver disease is unknown, but this condition is more common in people who:

  • Have type 2 diabetes
  • Obesity with a high level of belly fat
  • Are Hispanic or Asian
  • Are middle aged or older
  • Have high levels of fats in blood, such as cholesterol and triglycerides
  • Have high blood pressure
  • Have rapid weight loss
  • Have certain metabolic disorders, including metabolic syndrome
  • Take certain drugs, such as corticosteroids and some cancer drugs
  • Have certain infections, such as hepatitis C
  • Have been exposed to some toxins

Alcoholic fatty liver disease only happens in people who are heavy drinkers, especially those who have been drinking for a long period of time.

SYMPTOMS

Fatty liver disease is usually a silent disease with few or no symptoms until the disease progresses to cirrhosis of the liver. If you do have symptoms, they may include:

  • Abdominal pain or a feeling of fullness in the upper right side of the abdomen
  • Nausea or weight loss
  • Jaundice
  • Swollen abdomen and legs (oedema)
  • Tiredness and weakness

HOW IS FATTY LIVER DISEASE DIAGNOSED?

Laboratory abnormalities are often the only sign of non-alcoholic fatty liver disease. The most common abnormal laboratory test results are elevated alanine transaminase (ALT) and aspartate transaminase (AST). There are other methods to diagnose fatty liver disease, doctor may order:

  • Ultrasound or CT scan to get a picture of the liver
  • Liver biopsy to determine how far advanced liver disease has progressed

TREATMENT OF FATTY LIVER DISEASE

There is no medication specifically for fatty liver disease. Instead, doctors focus on helping the patient to control factors that contribute to the condition.  Treatment includes:

  • Avoiding alcohol for alcoholic fatty liver disease
  • Losing weight for non-alcoholic fatty liver disease.
  • Avoiding certain medicine that may cause NAFLD
  • Taking medications to control diabetes, cholesterol and triglycerides
  • Taking vitamin E and thiazolidinediones (drugs used to treat diabetes) in specific instances, but more studies are needed to support this.

PREVENTION OF FATTY LIVER DISEASE

The best way to avoid fatty liver disease is to do the things that maintain overall health:

  • Stay at a healthy weight.
  • Exercise regularly
  • Limit or reduce alcohol consumption
  • Take medication as prescribed

SUPPLEMENTS

Dandelion

Dandelion root contains high amounts of a substance called kynurenic acid, which is an amino acid that is the key for bile production. Researchers found that dandelion is amongst a group of healing herbs that can be highly beneficial for the gallbladder that can improve bile flow.

Dandelion also supports the liver by providing first-layer support for blood detoxification. It’s a great preventative for jaundice, gentle support for those who have hepatitis, and can also help with anaemia since it can encourage iron absorption. Another way that dandelion cleanses blood is by working with pancreas to remove excess sugars. So, dandelion is not only beneficial for liver detoxification, it can balance blood glucose level as well.

Flavonoids in dandelion promote increased urination, which can assist the liver in cleansing toxins out of the body at a more rapid rate.

Dandelion helps the liver to break down and absorb minerals. This is due to dandelion is a great source of vitamin A, B, C, E, K and key minerals, including calcium and potassium. Vitamin C is an important liver helper because it can assist in the breakdown of key minerals like iron.

Milk thistle

Milk thistle is an anti-fibrotic, which means it protects against tissue scarring. Thus, milk thistle can be used to combat liver damage and inflammation caused by acetaminophen, alcohol, chemotherapy and carcinogens.

Milk thistle has the powder to stimulate healing in the liver and protect it from future damage.

When the liver become too overloaded with toxins like heavy metals and pollutants, milk thistle supports the liver’s detoxification process. Milk thistle helps the liver effectively purify the blood, remove harmful substances from the body, produce hormones, and perform countless other essential responsibilities.

Artichoke

Contains a compound called luteolin, which is a potent antioxidant that prevents the synthesis of cholesterol.

The metabolism of cholesterol can be increased by consuming artichoke extract. Thus, it encourages the cholesterol breakdown and elimination. The overall effect is reducing levels of bad cholesterol (LDL) and increases levels of good cholesterol (HDL) in the body.

REFERENCE

  1. Topics, H., 2022. Fatty Liver Disease | MedlinePlus. [online] Medlineplus.gov. Available at: <https://medlineplus.gov/fattyliverdisease.html> [Accessed 11 January 2022].
  2. Cleveland Clinic. 2022. Fatty Liver Disease: Risk Factors, Symptoms, Types & Prevention. [online] Available at: <https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease> [Accessed 11 January 2022].
  3. Panahi Y, Kianpour P, Mohtashami R, Atkin SL, Butler AE, Jafari R, Badeli R, Sahebkar A. Efficacy of artichoke leaf extract in non-alcoholic fatty liver disease: A pilot double-blind randomized controlled trial. Phytother Res. 2018 Jul;32(7):1382-1387. doi: 10.1002/ptr.6073. Epub 2018 Mar 9. PMID: 29520889.
  4. Wirngo, F. E., Lambert, M. N., & Jeppesen, P. B. (2016). The Physiological Effects of Dandelion (Taraxacum Officinale) in Type 2 Diabetes. The review of diabetic studies : RDS, 13(2-3), 113–131. https://doi.org/10.1900/RDS.2016.13.113
  5. Jacobs BP, Dennehy C, Ramirez G, Sapp J, Lawrence VA. Milk thistle for the treatment of liver disease: a systematic review and meta-analysis. Am J Med. 2002 Oct 15;113(6):506-15. doi: 10.1016/s0002-93

HEPATITIS


Hepatitis is an inflammation of the liver that is caused by a variety of infectious viruses and non-infectious agents such as drugs, toxic agents, alcohol or certain genetic disorders leading to a range of health problems, some of which can be fatal. In some cases hepatitis is also the result of auto-immune reaction when the immune system mistakenly attacks the liver.

There are five main viral classifications of hepatitis, which are hepatitis A, B, C, D, and E. Different virus is responsible for each type of viral hepatitis. The World Health Organization (WHO) estimates that around 354 million people are currently living with hepatitis B and C.

Hepatitis A

Hepatitis A is caused by hepatitis A virus (HAV). It can be spread through contaminated food and water. It is the easiest to be transmitted from one person to another person, especially among children, but is also the least likely to damage the liver. This type of infection is a short-term disease and is completely resolved within six months.

Hepatitis B

Hepatitis B is caused by hepatitis B virus (HBV). It can be spread through exposure to contaminated blood, needles, syringes or bodily fluids and from mother to baby. This is a chronic condition, in some cases it may lead to liver damage, liver cancer and cirrhosis in long term.

Hepatitis C

Hepatitis C is caused by hepatitis C virus (HCV). Hepatitis C is only transmitted through infected blood or from mother to baby during childbirth. It also can lead to cirrhosis and liver cancer in long term.

Hepatitis D

Hepatitis D is only found in people who are also infected with hepatitis B.

Hepatitis E

Hepatitis E is a waterborne disease that results from exposure to the hepatitis E virus (HEV). Hepatitis E is usually spread via contact with food or water that was contaminated with an infected person’s stool.

Autoimmune Hepatitis

In some cases, the immune system mistakes the liver cells as harmful invaders and attacks them. This causes ongoing inflammation that can range from mild to severe, often hindering liver function. It’s three times more common in women than in men.

Symptoms

Fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-coloured urine and jaundice.

Causes

  • Viral hepatitis can be caused by several viruses such as hepatitis viruses A, B, C, D, and E. 
  • Alcoholic hepatitis can be caused by excess alcohol consumption.
  • Toxic hepatitis can be caused by certain medicines, chemicals, poisons.
  • Autoimmune happens when the immune system attacks liver cells, this condition is usually chronic.

Risk of Hepatitis

  • Sharing needles or other objects that might be contaminated with hepatitis viruses
  • Engaging in unsafe sexual contact, such as not using a condom during sex, having rough sex, or having multiple sexual partners
  • Working around toxic chemicals. Examples of occupations routinely exposed to such chemicals include dry cleaners, painters, healthcare providers, or farm workers.
  • Drinking untreated water or eating food that has not been safely or properly prepared (ex. unwashed produce)
  • Drinking large quantities of alcohol over a long period of time
  • Taking medications believed to be linked to hepatitis
  • Not being vaccinated against viral hepatitis, specifically HAV and HBV
  • Having an acute or chronic infection with one or more hepatitis viruses
  • Having an autoimmune disorder, such as autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECE)
  • Being born to a mother who is infected with a hepatitis virus, particularly hepatitis B

Diagnosis of Hepatitis

  • Doctor will first take your medical history and symptoms.
  • Physical exam will be done, which may or may not reveal a swollen, enlarged liver.
  • Liver function tests, blood test (to check the presence of viral hepatitis) or ultrasound
  • A liver biopsy to check for liver damage.

Treatment of Hepatitis

Treatment for hepatitis depends on which type of hepatitis you have and whether it is acute or chronic.

  • Bed rest, refraining from alcohol, and taking medication to relieve symptoms.
  • Most people who have hepatitis A and E get well on their own after a few weeks.
  • Chronic Hepatitis B can be treated with antiviral medications
  • Hepatitis C can be treated with a combination of antiviral drugs.
  • Liver transplant may be needed if patient’s chronic hepatitis may lead to liver failure or liver cancer.

Prevention of Hepatitis

Get vaccines for hepatitis A and hepatitis B

Vaccination for hepatitis A is available and can help to prevent the contraction of HAV. The hepatitis A vaccine is a series of two doses and most children will be vaccinated at age 12 to 23 months. This vaccination is also available for adults and can also include the hepatitis B vaccine.
The CDC recommends hepatitis B vaccinations for all newborns. Doctors typically administer the series of three vaccines over the first 6 months of childhood.
The CDC also recommends the vaccine for all healthcare and medical personnel. Vaccination against hepatitis B can also prevent hepatitis D.
There are currently no vaccines that can prevent contraction of hepatitis C or E.

  • Wash your hands after going to the bathroom and before handling food or eating.
  • Use latex condoms, which may lower the risk of transmission.
  • Don’t share drug needles.
  • Don’t share personal items such as toothbrushes, razors and nail clippers with an infected person.
  • Avoid raw or undercooked shellfish and oysters
  • Take precautions when getting any tattoos or body piercings.
  • Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get vaccinated before your trips.)
  • Drink bottled water when traveling.

References

World Health Organization (WHO). Hepatitis. Available at  https://www.who.int/health-topics/hepatitis#tab=tab_1
Healthline. Hepatitis. Available at https://www.healthline.com/health/hepatitis
MedlinePlus. Hepatitis. Available at https://medlineplus.gov/hepatitis.html
Johns Hopkins medicine. Health. Hepatitis. Available at https://www.hopkinsmedicine.org/health/conditions-and-diseases/hepatitis
Verywell health. Causes and risk factors of hepatitis. Available at  https://www.verywellhealth.com/hepatitis-causes-and-risk-factors-4689127#:~:text=Environmental%20risk%20factors%20associated%20with,blood%20infected%20with%20hepatitis%20viruses
Cleveland clinic. Viral hepatitis. Available at https://my.clevelandclinic.org/health/diseases/4245-hepatitis-viral-hepatitis-a-b–c#:~:text=There%20are%20many%20ways%20you,washing%20with%20soap%20and%20water

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