What is Non-Alcoholic Fatty Liver Disease (NAFLD)?
Updated: May 28, 2022
What is non-alcoholic fatty liver disease (NAFLD) and why are you not hearing more about it?
About 100 million individuals in the United States are estimated to have non-alcoholic fatty liver disease (NAFLD). NAFLD is the most common form of liver disease in children and has more than doubled over the past 20 years.
Non-alcoholic Fatty Liver Disease (NAFLD)
NAFLD is the buildup of extra fat in the liver cells, that is not caused by alcohol consumption.
It is normal for the liver to contain a small level of fat; however, when it reaches the 5% - 10% fat range, this is fatty liver (steatosis).
Non-alcoholic Steatohepatitis (NASH)
Non-alcoholic fatty liver disease can progress to where it swells and becomes damaged. This is Non-alcoholic steatohepatitis (NASH). I will be covering NASH in another article.
How does an individual get NAFLD?
Non-alcoholic fatty liver disease can develop in individuals who are overweight, obese, or have diabetes, high cholesterol or high triglycerides, and individuals with metabolic syndromes. Following fad diet trends, losing weight quickly, yo-yo dieting, weight loss, and poor eating habits can be contributing factors to the development of NAFLD.
Abusing medications is another way NAFLD can occur. Medications that can contribute to the cause of NAFLD include Aspirin, Cocaine, Valproate, Ibuprofen, Naproxen, and other similar medications. Now cocaine is an illegal substance and no one should be consuming it, so let's just assume that is not the cause.
The other medications, even if taken as prescribed, during long-term use can cause some liver damage. Now if you decide to take a little more, because maybe you have been taking it for so long taking just 2 doesn't cut it. That increase from 2 to whatever additional amount you decided to take, is now more than your liver has to process.
Some individuals are an exception and this did not cause their NAFLD. These individuals developed NAFLD even though they do not have any current identifiable risk factors. 25% of people in the United States have NAFLD and many live years without knowing. This disease tends to have no symptoms until it is too late.
If NAFLD is left untreated and no lifestyles changes have been made, it can progress to NASH and then cirrhosis.
How would I know if I have NAFLD?
When your doctor tells you to "get lab work done", you get your lab work done!
The tough part about this disease is that the symptoms if you get any, are very similar to other ailments. My diagnosis was discovered after a journey of advocating for myself. This was hard to do at first. I mean, they are the doctors who went to medical school and know what they are doing, right?
Even though that may be the case, I knew something was wrong beyond needing to just "sleep better, eat healthily and exercise more". Though all three (sleep better, eat healthily, and exercise more) were not bad advice, there had to be something else causing all of my symptoms. I was constantly itchy. It was not a stationary itch that occurred in the same location, it was ants all over my body. I was having abdominal pain, throwing up chunks of red, nausea, and an increase in my fibromyalgia pain.
At first, doctors thought nausea and stomach pain were just from IBS, the itching was my eczema becoming more severe, and from there, no further treatment was done.
How did I discover my disease, if every doctor I had seen, could not pinpoint the exact problem?
I decided to make my health and life my main priority. I researched internal medicine doctors that my insurance accepted, looked over their ratings and experience, and made an appointment with them and that was the launching point.
During my first appointment, my internal medicine doctor listened to my story and the history of my ailments. I provided her with a spreadsheet that I had created. It included the name of the symptom, the estimated timeframe when this began, any changes or new developments with a symptom, and how I currently cope with it. Even though she had all of this information in my chart, I knew that having the information in my own words would allow her to have a better understanding of my suffering.
After this first appointment, she ordered lab bloodwork to be completed.
Labs Ordered:
Hepatitis C Antibody Test - Aug 2, 2021
Comprehensive Metabolic Panel - Aug 2, 2021
Complete Blood Cell Count - Aug 2, 2021
Glycohemoglobin A1C - Aug 2, 2021
Thyroid Function (TSH) - Aug 2, 2021
Rheumatoid Factor (RA) Quantitative - Aug 2, 2021
Sedimentation Rate (ESR) - Aug 2, 2021
ANA IFA Screen w/RFLX to TITER/PATTERN - Aug 2, 2021
What did this bloodwork discover?
We discovered that my liver enzymes were elevated. Both my AST and ALT. The standard range for an Aspartate Aminotransferase (AST) test is 0 - 37 U/L, mine was 89 U/L. The standard range for an Alanine Aminotransferase (ALT) test is 0 - 60 U/L, mine was 145 U/L.
This was alarming and led my internal medicine doctor (PCP) to order an ultrasound of my liver. This ultrasound came back that my liver was larger than it is supposed to be for a woman or even a man.
My PCP referred me to a gastroenterologist. My gastroenterologist ordered me to get a fibroscan of my liver. This fibroscan is where everything changed and life became serious.
The blood work ordered by Dr. Wadhavkar has led to the chain effect that very well may have saved my life.
I have non-alcoholic fatty liver disease, NASH, stage 4 cirrhosis, compensated liver.
The moral of the story, ADVOCATE for yourself, no one else will.
Keep on advocating for yourself. I cannot express this enough. If it was not for advocating for myself and realizing that any form of pain and suffering is too much, I could have gone years without knowing that my life was at risk with this disease. Now I can spend the years of my life, through a new pair of lenses.
How is NAFLD treated?
This news may at first sound irritating, but hear me out. The main key to tackling this disease is eating healthy and exercising. I know as someone who is a little overweight myself, that statement is my least favorite thing to hear from the doctors. Though not everything can be solved with this 'eat healthily and work out an everyday way of living, it can certainly help with overall health.
The tough part of this disease is that currently there are no medical treatments. While researching my diagnosis, there is some talk about a medication that specialists have been trying to develop to help combat NAFLD. This form of treating NAFLD does appear to be a few years out still and is not a treatment option available at the moment.
So until then, it is 'eat healthily and exercise'.
Can you reverse NAFLD? Kinda. From my understanding, if you have stage 1 - 3 Non-alcoholic Fatty Liver Disease, you can help heal your liver and reverse some of the damage done. If you are like me (sorry to hear that), and have NAFLD stage 4 cirrhosis, you cannot repair the damage that has already been done. The focus at this point is to make the living condition for your liver the most comfortable as you can.
That means what exactly? You guessed it, we are right back at, 'eat healthily and exercise'.
Here are some other tasks you can do to help out your liver:
See your gastroenterologist or your hepatologist
Have an honest conversation with your doctor about your health
Talk with your doctor about lifestyle changes that can help improve your liver health
Lose weight, if you are overweight
Lower your cholesterol and triglycerides
Control your diabetes if you are diabetic
Pre-diabetic? Work to prevent it from becoming diabetes
Avoid all alcohol
Eat real fresh foods!
How can NAFLD be prevented?
The main way to try and prevent getting non-alcoholic fatty liver disease is to:
Maintain a healthy weight
Eat a healthy whole food diet
Exercise regularly
Limit alcohol consumption
Take medicines per the instructions on the bottle and follow dose instructions from your doctor
Although you may have done 'all of the above', life still may throw you a hardball and you can get NAFLD.
Questions to ask your doctor if you have been diagnosed with NAFLD:
What conditions or test results do I have that suggest NAFLD?
Can my stage of NAFLD be reversed? How long will the healing process take?
Do I have cirrhosis/scarring of the liver?
If I do have cirrhosis - how far has the scarring progressed?
What kind of lifestyle changes and dietary changes can I make?
Would it be possible to connect to a registered dietitian or nutritionist to help me make a specific meal plan?
What kinds of physical activities would be okay for me to do?
Is there a weight management clinic that I can be referred to? (This is something that my doctor has done for me.)
**Please note that this is not medical advice. I am in no way a medical professional and it is recommended that before starting anything new, you consult your primary care physician.
This blog is for me to document my journey, compile the information I learn about my chronic illness, and changing my life in the process. Information that my doctors have given me, new information that I learn about my disease, and as I grow on this journey I will update my blog to reflect that.**
Thank you for taking the time to read my post about NAFLD. As continue to educate myself on liver disease, I will write about what I learn and publish it on this blog!
Have a wonderful day!
Commenti