Understanding Fatty Liver: A Silent Threat

The liver is considered the body’s most important organ. It is responsible for filtration, metabolism, detoxification, and other vital functions. Nowadays, more people are suffering from nonalcoholic fatty liver disease (NAFLD). This condition is often associated with obesity, Type 2 diabetes, dyslipidaemia, PCOS, and metabolic syndrome.

Let's Understand the Organ: The Liver

The liver is the body’s largest gland and heaviest organ. It is highly vascular and receives approximately 30% of resting cardiac output. The liver metabolizes virtually all nutritional substances. Because it plays a crucial role in fat metabolism, it is the most common site for fat accumulation. Depending on the cause and extent of this accumulation, fatty change can be mild and reversible or severe, leading to irreversible cell injury and death. Fatty liver results from disruptions in lipid metabolism caused by various factors.

What is Fatty Liver?

Fatty liver is an abnormal accumulation of certain fats (triglycerides) inside liver cells. It is a reversible condition where large amounts of fat accumulate in liver cells due to the steatosis process. Fatty liver occurs when the fat content of the liver exceeds 5% of its total weight or more than 30% of the liver cells.

There are two main forms of fatty liver disease:

Alcoholic Liver Disease

Alcoholic fatty liver is the accumulation of fat in the liver due to heavy drinking.

Nonalcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) occurs when fat accumulates in the liver due to conditions other than excessive alcohol consumption. NAFLD is most common in individuals with at least one component of metabolic syndrome, such as:

• Obesity or excess body weight
• High fat levels in the blood (triglycerides and cholesterol)
• Insulin resistance
  
  

NAFLD-related liver inflammation is known as non-alcoholic steatohepatitis (NASH).

Fatty Liver Causes

The most common causes of fatty liver include:

• Excessive alcohol consumption
• Obesity
• Metabolic abnormalities such as excess body weight, insulin resistance, and high levels of fats (triglycerides and cholesterol) in the blood
• Certain medications, including corticosteroids, tamoxifen, and chemotherapy drugs
• Hereditary metabolic disorders
  
  

The combination of excess body weight, insulin resistance, and high triglyceride levels is referred to as metabolic syndrome. These conditions cause fat to accumulate in liver cells by increasing fat synthesis or slowing fat processing and excretion. Consequently, fat builds up and is stored within liver cells. A high-fat diet alone will not result in fatty liver.

Symptoms of Fatty Liver Disease

People with fatty liver disease often experience no symptoms until the disease progresses to cirrhosis of the liver. If symptoms do occur, they may include:

• Abdominal pain or a feeling of fullness in the upper right side of the abdomen
• Nausea and loss of appetite
• Swollen abdomen and legs (edema)
• Extreme tiredness or mental confusion
• Symptoms associated with PCOS, insulin resistance, or hormonal imbalance in women
• Associated hyperlipidaemia
  
  

Complications of Fatty Liver Disease

Fatty liver disease typically does not cause major problems for most individuals. However, it can progress to more serious complications, such as cirrhosis of the liver. Untreated cirrhosis can eventually lead to liver failure or liver cancer. The risk increases when fatty liver is accompanied by obesity, high cholesterol levels, high blood pressure, or hormonal imbalances. Together, these factors can contribute to metabolic syndrome.

Fatty Liver Treatment

The primary goal of fatty liver treatment is to reduce or eliminate the underlying causes. Recommended actions include:

• Quitting alcohol consumption
• Avoiding fatty foods
• Stopping any medications that could contribute to fatty liver
• Losing weight
• Controlling diabetes and lowering triglyceride levels
  
  

A 5% reduction in body weight can lower liver fat content. A 7% reduction can reduce inflammation and nonalcoholic steatohepatitis, while a 10% reduction can help reverse scarring and fibrosis.

Ayurveda Treatment for Fatty Liver

Ayurveda, known for its safe and effective treatments, has significant potential in managing fatty liver. Virechana is a suitable detoxification method indicated for liver disorders. Effective and safe hepatoprotective herbs can treat various liver diseases.

When fatty liver progresses to the next stage and dhatus become involved, treatment should focus on the prasadana of rasa and rakta, as well as yakritshothahara chikitsa. The importance of Guda Ardraka Yoga and Gomutra Haritaki Prayoga in fatty liver disease is well-documented in Ayurvedic classics.

Numerous Ayurvedic formulations for fatty liver are mentioned in classical texts, including:

• Pippali Churna
• Patoladi Churna
• Mahasudarshana Churna
• Rohitaka Choorna
• Agnitundi Vati
• Arogyavardhini Vati
• Patola Katurohinyadi Kashaya
• Rohitakarishta
• Pippalyasava
• Kumaryasava
• Kalameghasava
• Yakrit-Plihari Loha
  
  

Consulting an Ayurvedic physician is essential before using these formulations.

Foods to Include for Fatty Liver

Ayurveda recommends certain foods that are crucial for individuals with fatty liver. Vegetables that are bitter in taste, astringent, and light to digest are beneficial. Some of these include:

• Kulattha (Horsegram)
• Mudga (Green Gram)
• Yava (Barley)
• Takra (Buttermilk)
• Lasona (Garlic)
• Ardraka (Ginger)
• Shigru Phala (Drumstick)
• Laghu Tikta Deepana (Bitter gourd, Methi leaves, curry leaves, etc.)
  
  

Foods to Avoid for Fatty Liver

Certain foods should be avoided to manage fatty liver effectively:

• Refined carbohydrates like white rice, white bread, noodles, and pasta should be eliminated from the diet.
• Processed junk foods that contain excess greasy fats must be removed. Breakfast cereals are also highly processed and should be avoided. Baked goods like cakes, cookies, scones, and puff pastries require excess fats for baking and should be eliminated.
• Deep-fried sweets and savories should be avoided. Red meats such as lamb, pork, and beef, along with meat products containing animal fats, should also be excluded.
• Dairy-rich products like cheese, butter, margarine, mayonnaise, ice cream, and fruit yogurt should be avoided.
  
  

By following these dietary guidelines and treatment options, individuals can effectively manage fatty liver disease and improve their overall liver health.