Fatty Liver/Steatosis

Background: Understanding Hepatic Steatosis

Fatty liver is classified into two broad categories:

• Non-Alcoholic Fatty Liver Disease (NAFLD): Fat accumulation without significant alcohol use, commonly associated with insulin resistance, obesity, and metabolic syndrome.
  
• Alcoholic Liver Disease (ALD): Related to chronic alcohol intake causing inflammation, fat deposition, and potential liver damage.
  
  

NAFLD may progress to Non-Alcoholic Steatohepatitis (NASH), fibrosis, cirrhosis, and liver cancer if not appropriately managed.

Signs and Symptoms

Fatty liver is often asymptomatic early on. Common symptoms when present may include:

• Fatigue or malaise
  
• Upper abdominal fullness or discomfort
  
• Unexplained weight loss
  
• Elevated liver enzymes such as ALT
  
  

Signs of advanced liver disease include jaundice, ascites, and peripheral edema.

Diagnostic Evaluation of Fatty Liver

Early identification allows for effective intervention. Evaluation involves:

Blood Tests:

• ALT and AST for hepatocellular injury
  
• GGT to assess cholestasis
  
• Hemoglobin A1c and glucose for glycemic control
  
• Ferritin to assess oxidative stress and hepatic inflammation
  
  

Imaging Studies:

• Ultrasound for initial fat visualization
  
• CT or MRI for detailed evaluation
  
• FibroScan® to assess liver fibrosis and steatosis
  
  

Liver Biopsy:

Reserved for cases where staging or diagnostic clarity is needed.

Causes and Contributing Factors

Common root causes include:

• Insulin resistance promoting hepatic lipogenesis
  
• Diets high in refined sugars and low in fiber
  
• Physical inactivity
  
• Chronic alcohol use
  
• Metabolic syndrome and obesity
  
  

Conditions Associated with Fatty Liver

If untreated, fatty liver increases the risk of:

• Liver cirrhosis
  
• Hepatocellular carcinoma
  
• Cardiovascular disease
  
• Type 2 diabetes mellitus
  
  

Interfering Factors and Clinical Considerations

Confounding factors when evaluating fatty liver include:

• Medication effects (e.g., corticosteroids, methotrexate)
  
• Acute illness or systemic inflammation
  
• Non-hepatic causes of elevated AST/ALT
  
• Inconsistent fasting status for labs
  
  

Functional Medicine Approach at Intercoastal Health

Our strategy emphasizes metabolic restoration and root-cause resolution.

Nutrition Strategies:

• Anti-inflammatory, low-glycemic diet
  
• Emphasize vegetables, fiber, healthy fats, and lean proteins
  
• Avoid refined carbohydrates and trans fats
  
• Support liver detoxification with cruciferous vegetables and antioxidant foods
  
  

Exercise Recommendations:

• Moderate aerobic exercise and strength training
  
• Target 150+ minutes weekly
  
  

Targeted Supplementation:

• Omega-3 fatty acids (EPA/DHA)
  
• Berberine and curcumin for metabolic support
  
• Milk thistle and NAC for hepatoprotection
  
  

Weight Optimization:

• 5–10% weight loss shown to significantly reduce liver fat
  
  

Monitoring:

• Periodic assessment of liver enzymes, glucose, and lipid profile
  
• Imaging as needed to assess hepatic fat and fibrosis

Conclusion

Fatty liver disease is a critical marker of systemic metabolic dysfunction, but it is reversible with early functional intervention. Addressing underlying causes through individualized care helps prevent disease progression and supports long-term liver and metabolic health.

In conclusion, a comprehensive evaluation by a functional medicine nurse practitioner in Florida facilitates identification of cellular-level and molecular imbalances driving cardiometabolic dysfunction. By integrating evidence-based therapies with regenerative medicine and medical weight loss services—where cardiovascular health is often impacted—we offer patients a regenerative, preventive framework to rebuild resilience and optimize wellness. Call tel:(904) 799‑2531 or schedule online to request your personalized cardiovascular and metabolic health assessment.

Further Reading

• Nonalcoholic fatty liver disease: Pathogenesis, diagnosis, and treatment
  
• Nutritional Management of Nonalcoholic Fatty Liver Disease: An Evidence-Based Review
  
• Omega-3 Fatty Acids for the Treatment of NAFLD and NASH: A Review of Current Evidence
  
• Impact of Lifestyle Intervention on Fatty Liver Disease: A Meta-Analysis
  
• The Role of Inflammation in Nonalcoholic Fatty Liver Disease