NAFLD the silent disease and your health
This week I will discuss the liver. Specifically, non-alcoholic fatty liver disease (NAFLD).
A prevalent liver disease worldwide, implicated in various metabolic disorders.
Impaired liver function leads to significant medical problems. Especially when there is no current medication which can treat this condition.
The hallmark of NAFLD is the excess accumulation and infiltration of fat in the liver.
History
Let’s back up and look at the historical context because I think it’s important to understand disease progression and evolution. It gives us insights on how it developed and what could potential treatments would be beneficial.
In 1980, NAFLD first appeared in the medical literature as an observation by Dr. Lundwig. There was a specific subset of individuals found with inflamed liver cells and increased fat infiltration despite the lack of alcohol consumption.
Research conducted in the late 1990s to early 2000s revealed mild inflammation had the potential to develop into severe liver disease, including cirrhosis and cancer.
While NAFLD is an isolated disease, further research links several other processes with this condition. Most disease processes are metabolic disorders like Diabetes, insulin resistance, obesity and dysregulation of lipid metabolism.
I will focus only on writing about the liver because it is one of the most fascinating organs in the body.
The liver cells have an astonishing capacity to regenerate quickly and effectively. If 75% of your liver were to be lost, the remaining healthy 25% could regenerate and restore it to its original size.
The liver cells' remarkable aptitude showcases the importance of its overall function in the body. Most organs have a few functions at best, but the liver is the OG of processing. It’s like an amazon warehouse.
Function of the liver
Metabolism of Nutrients:
After the digestion and absorption of your food, your body actively transports most of the nutrients to the liver, where it processes and sends them to the rest of your body.
Storage of Glycogen:
The liver stores glucose as glycogen and releases it into the bloodstream when blood sugar levels drop, helping to maintain steady glucose levels.
Detoxification:
By filtering and eliminating toxins, drugs, and metabolic byproducts from the bloodstream, the liver detoxifies harmful substances.
Synthesis of Proteins:
The liver produces a range of proteins, including blood-clotting factors, albumin, and digestive enzymes.
Production of Bile:
Produced by the liver, bile is a digestive fluid that assists in the digestion and absorption of fats in the small intestine by emulsifying them.
Storage of Vitamins and Minerals:
Vitamins like A, D, and B12, as well as minerals like iron and copper, are stored and released by the liver as required for physiological processes.
Regulation of Cholesterol Levels:
The liver plays a role in regulating cholesterol levels by producing, processing, and removing cholesterol from the blood.
Immune Function:
Kupffer cells in the liver contribute to the immune system by removing bacteria and foreign particles from the blood and producing immune-related substances.
Regulation of Blood Clotting:
The liver synthesizes clotting factors and produces proteins necessary for blood coagulation, contributing to regulating blood clotting.
Bilirubin Processing:
Bilirubin, a byproduct of old red blood cell breakdown, undergoes processing by the liver and is then excreted in bile. Elevated bilirubin levels can lead to jaundice.
My goal is to not only bring awareness to this ever-prevalent disease. But to show how we can prevent, screen and reverse NAFLD.
Screening
If you have markers of metabolic dysfunction, then doctors should screen you.
Some high-risk categories are being overweight, Obese or having diabetes
Blood work showing high triglycerides, low HDL and insulin resistance
Abnormal liver panel on blood work with the above findings should lead to imaging studies
Ultrasound: This non-invasive imaging method can detect fat in the liver and evaluate liver size.
Transient Elastography (FibroScan): This specialized ultrasound measures liver stiffness, providing a sign of fibrosis (scarring).
Treatment
A meta-analysis of 148 clinical trials yielded enlightening results for evidence backed treatment options.
Diet
Supplements
Physical Activity
Medications related to weight loss
Anything with Anti-inflammatory and antioxidant activity.
Summary
NAFLD is a marker of metabolic dysfunction. It’s bad. NAFLD occurs in approximately 25-35% of the general population. 70% of patients with DM and obesity have it. It is important to note that the prevalence of NAFLD in lean patients is 13.11% among the global population. It is a silent disease ninja. NAFLD is frequently associated with the metabolic syndrome. If you notice from the list above, there are various methods to reverse NAFLD. You want to mobilize the fat from the liver and reduce the resulting inflammation. Any method that boosts energy expenditure, promotes fat loss, reduces inflammation, and enhances antioxidant activity would be advantageous.