Not a Drinker? Liver Disease Could Still Affect You

How to Protect Your Liver From Non Alcoholic Fatty Liver Disease (NAFLD)

“What?!? I’m not even fat! How can I have a “fatty liver?!” Ronald was surprised. He had always been a physical person who loved sports and exercise. He was feeling frustrated, however, because he was getting fat around the waist, even though he was doing more abdominal workouts.

Non-alcoholic fatty liver disease (NAFLD) is the build-up of extra fat in liver cells that is not caused by alcohol. Fatty liver is quite common. Up to one third of Americans have evidence of it, making it the most common cause of abnormal liver tests.[1] Most people don’t know they have it because there are no symptoms until it is very advanced and permanent damage is done.

What Causes Fat in the Liver?

One of the primary functions of the liver is to store energy – or fuel – for the body. But the liver can only store a limited amount of that energy in the form of glycogen. Once full, excess glucose must be turned into fat. Normally, very little fat is stored in liver cells, because the fat can be used by the rest of the body for energy. But if the body isn’t able to use it, then the fat begins to accumulate in the liver, waiting for a time when it can be used. “Fatty liver” means that excess fat builds up (accumulates) in liver cells.[2]

In the past, the most common cause of fatty liver was alcohol. Alcohol is always toxic to the liver. Every sip of alcohol damages liver cells, but they regenerate quickly and most people don’t notice any ill effects. Chronic alcoholism, however, can continuously damage liver cells faster than they can regenerate, causing fatty liver, and even progressing to cirrhosis. Besides toxicity, alcohol is a carbohydrate that disrupts the normal energy cycle of the liver.

Today, there is a new disease that is taking over alcoholic fatty liver by far – NAFLD (Non-Alcoholic Fatty Liver Disease). NAFLD results from the accumulation of too much fat in the liver in the absence of excessive alcohol consumption. NAFLD is strongly associated with anything that disrupts the energy of the body, such as obesity, diabetes, and metabolic syndrome and toxins.

The risk factors for developing NAFLD include:

• Genetic factors
• Drugs
• Malnutrition
• Inflammation
• Infections
• Toxins

Genetic Factors for NAFLD

Some people have a genetic predisposition to NAFLD. We often worry about our genes as if they determine who we are, or what illnesses we will get. Genes account for about 10 percent of human disease.[3] Genes only provide the potential for disease; they don’t guarantee anything. There must be additional factors present. For example, there are indigenous Americans who are very susceptible to fatty liver and diabetes, but it only happens if they eat a high carbohydrate diet. If they live on their traditional diet of wild game and garden vegetables, they never have any of these problems. The genes only tell us what is possible. We create the problems by how we live.

In short, there is a full range of factors that influence our health. If genes cause less than 10 percent of disease, it follows that our diet, lifestyle, and environment drive the remaining 90 percent. Genes may load the gun, but our lifestyle pulls the trigger.

Drug Induced NAFLD

Many medications that can damage the liver and cause fatty liver include:[4]

• Corticosteroids (cortisone analogs)
• Antidepressants (Elavil, Trazodone, Prozac, and so forth)
• Antipsychotic medications (Haldol, Abilify, Remeron, and so forth)
• Diabetes medications (insulin, and those that increase insulin)
• Tamoxifen (used for breast cancer)
• Amiodarone (for arrhythmias of the heart)
• Methotrexate (for arthritis)
• Valproic Acid (for seizures)

These medications are primarily metabolized in the liver. Or, there is an increased risk of liver toxicity associated with use of this medication. There is usually another problem, such as a nutrient deficiency or genetic abnormalities that allow toxicity of drugs.

Diabetes medications mostly increase insulin, and thus insulin resistance, which leads to worsening of fatty liver. Fatty liver is well-known as a precursor to type 2 diabetes, but maintaining a healthy weight through diet and exercise can help keep your liver in tip-top shape (and can help manage your diabetes if you’ve already got it).

NAFLD Caused by Malnutrition

Lack of nutrients can slow energy production or detox mechanisms in the liver. There are several vitamin and nutrient deficiencies that can lead to fatty liver. The most well-known are: