Blood tests Your doctor may suspect you have NAFLD if your blood test shows increased levels of the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Your doctor may use the results of routine blood tests to calculate special scores, such as the FIB-4 or APRI.
Fatty liver is most commonly diagnosed by a routine liver function test drawn from your blood. The alanine aminotransferase (ALT) is a specific marker for liver inflammation and is typically elevated in individuals with a fatty liver.
NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out. But blood tests do not always pick up NAFLD. The condition may also be spotted during an ultrasound scan of your tummy.
How is fatty liver disease diagnosed? Because fatty liver disease often has no symptoms, your doctor may be the first one to spot it. Higher levels of liver enzymes (elevated liver enzymes) that turn up on a blood test for other conditions may raise a red flag. Elevated liver enzymes are a sign your liver is injured.
If you have NASH, no medication is available to reverse the fat buildup in your liver. In some cases, the liver damage stops or even reverses itself. But in others, the disease continues to progress. If you have NASH, it's important to control any conditions that may contribute to fatty liver disease.
In a community-based study of 1346 Japanese patients with diagnostic criteria of NAFLD, the cutoff value of ALT for diagnosis of this disease was estimated to be 25 U/L in men and 17 U/L in women[39].
Causes of fatty liver disease. Eating excess calories causes fat to build up in the liver. When the liver does not process and break down fats as it normally should, too much fat will accumulate. People tend to develop fatty liver if they have certain other conditions, such as obesity, diabetes or high triglycerides.
It takes upwards of ten years for alcohol-related liver disease to progress from fatty liver through fibrosis to cirrhosis to acute on chronic liver failure. This process is silent and symptom free and can easily be missed in primary care, usually presenting with advanced cirrhosis.
Blood tests
A low level of serum albumin suggests your liver is not functioning properly. A blood test may also look for signs of abnormal blood clotting, which can indicate significant liver damage.
Steatosis at 30% is the accepted lower limit where steatosis can be detected reliably by ultrasound (currently the most commonly used diagnostic test for fatty liver). In addition to the imaging techniques assessed by these guidelines, fatty liver can also be detected using computed tomography (CT).
Medications commonly implicated in causing fatty liver include corticosteroids, antidepressant and antipsychotic medications and, most commonly, tamoxifen.
But if your liver isn't able to complete its tasks due to too many accumulated toxins, you'll suffer from symptoms of hormonal imbalance. This important — but little-known — connection between your liver and your hormones can lead to one of the most frustrating symptoms of hormonal imbalance: stubborn weight gain.
“Many people, and even some doctors, think fatty liver is just something you have to live with.” says Dr. Halegoua-DeMarzio, “But it's not. If ignored, it can lead to serious complications including cancer or liver transplant.”
THE FATTY LIVER AND THE AST:ALT RATIO
A normal AST:ALT ratio should be <1. In patients with alcoholic liver disease, the AST:ALT ratio is >1 in 92% of patients, and >2 in 70%. AST:ALT scores >2 are, therefore, strongly suggestive of alcoholic liver disease and scores <1 more suggestive of NAFLD/NASH.
Healthy liver cells should contain little or no fat. More than 5% fat stored in liver cells is considered too much, and this can result in a fatty liver.
In general, high levels of ALT may be a sign of liver damage from hepatitis, infection, cirrhosis, liver cancer, or other liver diseases. The damage may also be from a lack of blood flow to the liver or certain medicines or poisons.
So what does liver pain feel like? It manifests in different ways, but a common form is a dull throbbing. For some people, it occurs as a sharp, stabbing pain. Sometimes the pain migrates to other nearby areas, such as the right shoulder blade and the back.
A group of blood tests called liver function tests can be used to diagnose liver disease. Other blood tests can be done to look for specific liver problems or genetic conditions. Imaging tests. An ultrasound, CT scan and MRI can show liver damage.
Stage 1: Inflammation
In the early stages of liver disease, the liver will become swollen or inflamed as the body's natural response to injury. Liver inflammation, or hepatitis, can also occur when there are more toxins in the blood than the liver is able to manage. The earlier the diagnosis, the better.
Dietary changes. Obesity is often an underlying cause of fatty liver disease. If you're overweight or have obesity, experts recommend losing about 3% to 5% of your body weight. Losing this much weight can help you lower the amount of fat in your liver and the inflammation that fatty liver disease can cause.
In many people, fatty liver by itself doesn't cause too many problems. But in some people the fatty liver gets inflamed, causing a more serious condition called non-alcoholic steatohepatitis, or NASH. Ongoing inflammation may scar the liver, which can lead to cirrhosis. This is a serious illness.
Avoiding Alcohol
Moderate or heavy alcohol use can cause additional damage and fat accumulation in the liver in people with NAFLD. Therefore, patients with NAFLD should avoid alcohol entirely if possible.