Two years ago, Isaac came to see me because he was worried about his elevated liver enzymes. He had been living with prediabetes, high cholesterol, and hypertension for years, and like many of us, he was also carrying a little extra weight.
Despite these health concerns, Isaac felt fine—he was busy with work and raising two young kids, leaving little time to focus on himself. For years, his annual blood work looked okay, until suddenly, it didn’t. His doctor told him he had fatty liver.
So, what exactly is fatty liver, and can a damaged liver heal? Let’s talk about it.
There are two types of fatty liver disease: one caused by alcohol and one that isn’t.
Here, we’re focusing on Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD happens when fat builds up on the liver, and over time, it can lead to serious complications like fibrosis, cirrhosis, or even liver cancer. Unlike liver disease caused by alcohol, NAFLD isn’t due to drinking or conditions like hepatitis B or C.
Early on, NAFLD doesn’t usually cause symptoms, and the liver damage can still be reversed. But as inflammation progresses, the damage can become permanent, leading to cirrhosis and, eventually, the need for a liver transplant. This is why catching it early through regular blood work is so important.
In recent years, NAFLD has been renamed Metabolic Associated Fatty Liver Disease (MAFLD)—a name that points directly to its root cause: metabolic syndrome.
Metabolic syndrome includes conditions like obesity, type 2 diabetes, high blood pressure, high cholesterol, and a larger waistline. Essentially, it’s a sign the body’s metabolic processes aren’t functioning properly, causing insulin resistance and fat buildup around vital organs, including the liver.
Metabolic Associated Fatty Liver Disease affects about a quarter of the U.S. population, and while there is no approved drug treatment yet (despite hundreds of clinical trials), the truth is, medication isn’t the ultimate solution.
The most effective treatment for Metabolic Associated Fatty Liver Disease lies in diet and lifestyle changes.
When patients come to me with concerns about high blood pressure, cholesterol, weight, or blood sugar, I always take the opportunity to explain that these conditions are often the result of how we’ve been eating and how sedentary we’ve been over the last 5–10 years. Yes, genetics and age-related hormonal changes can play a role, but the foods we eat and how we move our bodies have a massive impact.
For someone with MAFLD, the focus needs to be on reducing insulin resistance and improving overall metabolic health. This means learning which foods cause blood sugar spikes and adjusting meals to minimize them. It means building muscle by consuming enough protein and incorporating regular strength training. It means lowering cholesterol by eating plenty of colorful fruits and vegetables, while cutting back on processed foods, meats, and sugary treats.
Herbs and supplements can help too, but they won’t work if the foundation—diet and lifestyle—isn’t addressed. If we don’t treat the root cause, we’ll eventually need stronger medications to manage symptoms, and that’s just masking the problem rather than solving it.
If you’re dealing with fatty liver disease, I urge you to look beyond quick fixes like statins for cholesterol or metformin for blood sugar. Instead, seek out a healthcare provider who can guide you through the right steps to truly treat the root cause.
If you want to learn more about what we do, feel free to schedule a quick 10-minute consultation with the team at Naturopathic Family Health. We’re here to help you take charge of your health and turn things around. You’ve got this!
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Dr. Sherry Su, ND, FABNG
Naturopathic Doctor San Jose
