Fatty Liver Disease
Fatty liver, or hepatic steatosis, occurs when excess fat builds up in the liver. It is often linked to lifestyle factors such as diet, weight, and alcohol intake, but can also be associated with certain medical conditions. While it may not cause symptoms initially, fatty liver can lead to liver inflammation and, in some cases, more serious liver disease if left unmanaged.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Liver
The liver is a large organ located in the upper right part of the abdomen. It performs many important functions that keep the body healthy:
- Storing energy: The liver stores glucose from food as glycogen. When your body needs energy, the liver releases glucose back into the blood. It also stores iron and vitamins.
- Processing substances: The liver helps remove or break down alcohol, medicines, and other substances from the body.
- Making proteins: The liver produces proteins that are essential for blood to clot properly.
- Producing fats: It makes cholesterol, which the body needs, although too much can be harmful.
- Digesting fat: The liver produces bile, a fluid that helps break down fats in food so they can be absorbed in the intestines.
Understanding Fatty Liver Disease
Fatty liver disease occurs when too much fat builds up in the liver. This can affect how well the liver works and, over time, may lead to inflammation, scarring, or other liver problems. Many people do not have symptoms in the early stages, and it is often found during routine blood tests or scans.
Fatty liver disease can be caused by different factors, and is usually classified into two main types:
- Alcohol-related Liver Disease (ARLD) – Caused by regular, excessive alcohol consumption. The liver can become inflamed and damaged over time if alcohol intake exceeds what the liver can safely process.
- Metabolic-Associated Fatty Liver Disease (MAFLD) – sometimes called non-alcoholic fatty liver disease (NAFLD), is linked to metabolic factors such as being overweight, having type 2 diabetes, high cholesterol, or high blood pressure. In this condition, fat builds up in the liver even in people who drink little or no alcohol.
Fatty liver disease can sometimes develop from causes other than alcohol or metabolic risk factors. Certain medications and medical conditions can lead to fat buildup in the liver. In some cases, doctors cannot identify a clear cause; this is referred to as cryptogenic fatty liver disease.
Risk Factors
Fatty liver disease can affect anyone, but certain factors make it more likely to develop. These include lifestyle, metabolic, and hormonal conditions that increase the buildup of fat in the liver.
| Metabolic Conditions | -Type 2 Diabetes -Metabolic Syndrome (insulin resistance, high blood pressure, high cholesterol) |
| Hormonal Conditions | -Polycystic Ovary Syndrome (PCOS) -Hypothyroidism (low thyroid homones) -Hypopituitarism (low pituitary gland hormones) -Hypogonadism (low sex hormone levels) |
| Lifestyle Factors | -Frequent or heavy alcohol use -Being overwieght or obese |
| Other Contributing Factors | -Long- term use of certain prescription medicines, such as tamoxifen -Obstructive sleep apnoea |
Diagnosing Fatty Liver Disease
Fatty liver disease is often found by chance during tests for other conditions, as it may not cause noticeable symptoms. Your doctor will start by reviewing your medical history, lifestyle, and risk factors such as alcohol use or metabolic conditions. A blood test may be done to check liver function and look for signs of inflammation or damage. If results suggest a problem, further tests may include:
| Ultrasound | A painless test that can detect fat build-up in the liver and assess its size, shape, and texture. It is often the first-line imaging test for fatty liver. |
| FibroScan® or elastography | Measures liver stiffness to identify scarring (fibrosis) and monitor progression over time, helping guide management decisions. |
| MRI or CT scan | Provides a more detailed view of the liver when further assessment is needed, for example, if there are other liver concerns, or to better characterise the extent of any associated changes. |
| Liver biopsy | Occasionally performed to confirm the diagnosis, determine the degree of inflammation or fibrosis, and guide personalised treatment decisions. |
Treatment Options
Fatty liver disease is very common in the UK, affecting around 1 in 5 people. In most people, it causes no serious problems and can often be improved or even reversed with lifestyle changes such as maintaining a healthy weight, eating well, and reducing alcohol intake.
However, if too much fat builds up in the liver over time, it can cause inflammation and scarring (known as fibrosis). In a small number of people, this may progress to cirrhosis or liver failure if left untreated. The good news is that early detection and healthy habits can greatly reduce this risk and help keep your liver healthy.
There is no specific medicine to directly treat fatty liver disease, but it can often be reversed or improved through lifestyle changes and by addressing underlying causes.
| Weight management | Achieving and maintaining a healthy weight can significantly improve liver health and reduce fat build-up. Even gradual changes can make a positive difference. |
| Healthy eating | A balanced, nutritious diet supports liver function and helps prevent further damage. Try to include plenty of fresh foods and limit processed or high-fat options. |
| Regular exercise | Staying active helps reduce liver fat, manage weight, and improve overall health. Find activities you enjoy and can do regularly. |
| Reducing alcohol | If alcohol is a factor, reducing or stopping drinking is key. Even in metabolic fatty liver disease, avoiding alcohol completely helps reduce further liver stress. |
| Managing other conditions | Controlling related health problems such as type 2 diabetes, high blood pressure, and high cholesterol helps protect your liver. Your doctor may adjust or start medications to support this. |
Ongoing monitoring through blood tests and scans helps track improvement. Your doctor may also review your medications to avoid those that can affect the liver.
How can Lanthorn help?
Liver Ultrasound - £300
A painless scan that detects fat in the liver and assesses its size, shape, and texture. Elastography measures liver stiffness at the same time, helping to identify any scarring (fibrosis) and monitor changes over time.
Blood Tests - From £99
Routine liver function and other blood tests help assess liver health, detect early signs of inflammation or damage, and guide further investigation.
Additional imaging - From £550
If your consultant recommends further assessment, MRI or CT can provide a detailed view of the liver to clarify findings, evaluate complications, or better understand the extent of fat accumulation and any associated changes.
