Nonalcoholic Fatty Liver Disease (NAFLD)

Overview

Nonalcoholic fatty liver disease – or NAFLD – includes several liver conditions that affect people who drink little or no alcohol. The main characteristic of this condition is liver cells that store high levels of fat.

Nonalcoholic fatty liver disease causes

Experts haven’t yet pinpointed the exact cause of NAFLD, but they do believe that the following situations may be linked to the condition:

• High levels of triglycerides (fats) in the blood
• Hyperglycemia, or high blood sugar
• Insulin resistance (cells do not process sugar as they should)
• Overweight or obesity

Nonalcoholic fatty liver disease risk factors

Having one or more of the following health conditions can put you at an increased risk for developing NAFLD:

• High cholesterol
• High levels of triglycerides (fats) in the blood
• Hypopituitarism (underactive pituitary gland)
• Hypothyroidism (underactive thyroid)
• Metabolic syndrome
• Obesity, especially with fat stored in the abdomen
• Polycystic ovarian syndrome (PCOS)
• Sleep apnea
• Type 2 diabetes

Being older also puts you at an increased risk of developing NAFLD.

Nonalcoholic fatty liver disease symptoms

In many cases, NAFLD in the early stages does not cause any symptoms. When they do occur, signs and symptoms may include:

• Abdominal swelling
• Enlarged blood vessels that can be seen just below the skin
• Enlarged spleen
• Fatigue
• Pain in the upper right area of the abdomen
• Red palms of your hands
• Yellowing of the skin and eyes (jaundice)

Nonalcoholic fatty liver disease diagnosis

Your specialist will use one or more of the following tests to diagnose alcoholic NAFLD.

Blood tests

Your doctor may order one or more types of blood tests to pinpoint your diagnosis of NAFLD. These blood tests may include:

• Celiac disease screening
• Complete blood count (CBC)
• Fasting blood sugar
• Hemoglobin A1C
• Lipid profile
• Liver enzyme and liver function test
• Tests for hepatitis A, hepatitis B and hepatitis C

Imaging tests

Your doctor will likely order imaging tests – such as an abdominal ultrasound, computerized tomography (CT scan) or magnetic resonance imaging (MRI) – to diagnose your NAFLD. These imaging tests produce detailed images of the inside of your body and can help your doctor determine the extent of your condition and the next steps of your treatment plan.

Liver biopsy

During this test, your provider inserts a thin needle into your abdomen near your liver and then removes a small tissue sample (biopsy) for close analysis in the lab. Lab technicians can determine if your liver has been damaged.

Physical examination

Your doctor will ask about your health history and symptoms specific to NAFLD. Your doctor will feel your abdomen to check for an enlarged spleen or tender upper right area of your abdomen.

Nonalcoholic fatty liver disease treatment

Your doctor may recommend one or more of the following treatment options for NAFLD.

Lifestyle modifications

Your doctor will likely recommend you make some changes to your lifestyle to help manage NAFLD. The changes that you need to make may including losing weight (if needed), eating a healthy diet and exercising regularly. To avoid further damage to your liver, you should not drink alcohol. Check with your doctor before taking any medications, including over-the-counter medicines or supplements.

Liver transplant

If NAFLD has severely damaged your liver, you may need to undergo a liver transplant. During this procedure, your surgeon removes your damaged liver and replaces it with a partial or whole donor liver. The donor liver may come from a deceased liver donor, or a family member may be able to donate a partial liver.

Manage other health conditions

If you have other underlying health conditions, such as diabetes or high cholesterol, you should be sure to keep these conditions under control with medications or other treatments.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a liver specialist for more specialized treatment.