The liver is a dynamic organ with a remarkable ability to regenerate after suffering damage, such as that caused by fatty liver. The National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK, says that cases of fatty liver caused by alcohol and nonalcoholic fatty liver disease have reversed on their own without treatment. In addition, some cases dramatically improve with a little help from diet and exercise. Public health officials aren't sure why some fatty liver conditions get better on their own, while others follow a steady progression toward serious liver injury.
Fatty Liver Disease in the U.S.
Two kinds of fatty liver disease exist. Alcoholic fatty liver is a complication of excessive drinking, but people who don't drink at all can suffer the same consequences. Nonalcoholic fatty liver disease, and its more advanced cousin nonalcoholic steatohepatitis, are increasingly common among Americans, affecting up to 30 percent of the adult population. Fatty livers start with a buildup of fat cells in the liver, called simple steatosis, a more or less benign condition. When fat cells make up more than 5 to 10 percent of the weight of your liver, you've progressed to a diseased state. In 2011, the National Institutes of Health was funding several experimental studies to determine how to best treat the growing epidemic of fatty liver, but no established method was yet in routine medical practice beyond diet and exercise and treating co-occurring problems like diabetes.
Liver Self-Repair
Fatty liver disease can progress in stealth mode. If you have it, you may feel well until the disease progresses to a more serious stage. The NIDDK says the process can take decades, stop and reverse on its own without any specific therapy. This is true of both alcohol-induced and non-alcohol-related fatty liver. Part of the reason for this is that the liver will attempt to heal itself from the damage done by the buildup of fat and other injuries to the organ. According to Colorado State University, injury to the liver leads to proliferation, or reproduction, of all cells within the organ. Within several hours, DNA synthesis is initiated in these cells. Within weeks your liver can be whole again, conducting its normal business of supporting glucose and lipid metabolism and filtering chemicals.
Scarring Makes It Difficult
As long as the buildup of fat continues, which could occur in the context of alcoholism and poor dietary practices, more scar tissue can form, making it increasingly difficult for the liver to function properly and regenerate completely. The appearance of scar tissue is in part evidence that the liver is attempting to heal itself. In addition to regenerating cells, the liver can section off parts of itself that have been too damaged by fat and operate close to normally with the remaining healthy portions of the organ. When scar tissue begins to overtake live tissue, you may have cirrhosis, which could lead to liver failure and is associated with risk for liver cancer.
Lifestyle Interventions Can Help
The NIDDK says that improvements have been made in the features of fatty liver disease with just diet and exercise as therapy. Fatty liver is increasing with the epidemic of obesity, making weight loss a key player in the reversal of fatty liver. The American Liver Foundation says eating a healthy diet and getting more physical activity may help to reverse fatty liver in its earliest stages. Public health authorities are still trying to figure out which dietary approach works best -- for example, whether doctors should advise you to avoid animal proteins and whether boosting your antioxidant intake would be helpful. Vitamin E, SAMe and other antioxidants have been promising in experimental trials of treating fatty liver, notes NIDDK. In a study of 247 people published in the May 6, 2010, "New England Journal of Medicine," vitamin E helped resolve a fatty liver condition entirely in some of the participants.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Action Plan for Liver Disease Research: Chapter 7: Fatty Liver Disease
- American Liver Foundation: Nonalcoholic Fatty Liver Disease
- Colorado State University Pathophysiology of the Digestive System: Regeneration of the Liver
- "New England Journal of Medicine"; Pioglitazone, Vitamin E or Placebo for Nonalcoholic Steatohepatitis; Arun J. Sanyal et al.; May 2010
- "University of Iowa Hospital & Clinics"; Liver Disease: Frequently Asked Questions Douglas R. LaBrecque; May 2001
- "Harvard Letter"; When the Liver Gets Fatty; January 2011
