Vitality Medical and Wellness Consulting

How to Reverse Fatty Liver Naturally

Fatty liver disease has risen in prevalence alongside the global increase in metabolic syndrome, diabetes, and obesity. As a lifestyle-related condition, it is often reversible for many individuals. This comprehensive guide aims to illuminate the path to better liver health through Evidence-based lifestyle changes, Including nutrition adjustments, integration of diverse movements, and systemic support with natural supplements. Highlighting the importance of nutrition and supplements contributing to fatty liver, we explore how to harness the benefits of coffee, apple cider vinegar, and specific supplements like glutathione, alpha lipoic acid, and berberine to combat the disease.

Definition

Fatty liver can manifest in two primary forms: nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NAFLD, the milder of the two dangers, involves fat accumulation within the liver without significant inflammation or damage. We can measure liver inflammation through enzymes produced by liver cells, which show up as elevations on standard blood tests. NAFLD is often reversible. In contrast, NASH is more severe and includes liver inflammation and damage, leading to fibrosis or scarring. This scarring can advance to cirrhosis, a stage where the liver is permanently destroyed.

Prevalence

Globally, the incidence of NAFLD is estimated at 47 cases per 1,000 individuals annually, with a higher prevalence in males than females. Studies indicate that approximately 32% of adults worldwide have NAFLD, with the prevalence increasing over the past decades. In the United States, about 24% of adults are estimated to have NAFLD, and between 1.5% and 6.5% suffer NASH. These rates reflect the growing impact of lifestyle factors, such as the standard American diet, chronic physical inactivity, prolonged stress, and damage from toxins on liver health across various populations.

Causes and Risk Factors

The development of NAFLD is linked to several factors:

  • Genetics: Certain genetic predispositions can affect the likelihood of developing NAFLD. Those individuals with South Asian, American Indian, and Pacific Island ethnicities have an exceptionally high risk.
  • Overweight/Obesity: High body mass index (BMI) and abdominal obesity are critical contributors. If the narrowest portion of your waist is greater than 35 inches for a woman or 40 inches for a man, you are at risk for fatty liver disease. If you are of an Asian ethnicity, the criteria are more strict.
  • Metabolic Syndrome: Components such as insulin resistance, high blood sugar, high blood pressure, and abnormal cholesterol levels elevate the risk.
  • Diet and Lifestyle: Excessive caloric intake for your body’s needs and a sedentary lifestyle exacerbate the risk that your body will store excess energy. Assessing your basal metabolic rate and calculating your body’s protein requirements are essential elements of creating a health-promoting nutrition protocol.
  • Other Conditions: Polycystic ovary syndrome, an underactive thyroid, and sleep apnea also increase the likelihood of NAFLD.

Research indicates that metabolic syndrome and its components, like insulin resistance, high triglycerides, and low HDL cholesterol, are particularly influential in the progression of NAFLD. Despite these associations, some individuals develop NAFLD without risk factors, suggesting other contributing mechanisms such as hormonal imbalances. Managing and, in many cases, reversing NAFLD through targeted lifestyle changes and therapeutic interventions is possible.

Symptoms

Symptoms of fatty liver disease are generally absent, making it a silent condition. When symptoms do manifest, they can include fatigue, discomfort in the upper right of the abdomen, and more severe indicators such as jaundice and abdominal swelling in advanced stages like cirrhosis.

Diagnosis

Diagnosis involves a combination of medical history, physical examination, and various tests. Blood tests are crucial, revealing elevated liver enzymes that suggest liver damage. It is essential to note that standard ranges listed on laboratory reports for what is “normal” on various liver tests are incorrect. A normal ALT, for example, should be less than 20 for a woman and less than 25 for a man. Liver chemistry tests should be measured annually for any individual at risk for liver disease. When abnormalities are identified, and repeat testing within a few weeks confirms the elevation persists, imaging tests should be pursued to determine if fatty liver is present. Early identification and aggressive intervention make a significant difference in long-term outcomes. Imaging tests like ultrasound, CT scans, and MRIs help detect fat deposits in the liver, although they cannot differentiate between NAFLD and NASH. The definitive diagnosis, to distinguish NASH from NAFLD and to assess the liver damage extent, is often achieved through a liver biopsy. This procedure involves extracting a small liver tissue sample and examining it for inflammation, fibrosis, and other damage signs.

Dietary Recommendations for Reversing Fatty Liver

Foods and Drinks to Limit

Individuals should reduce and ideally eliminate their processed foods and sugar intake to mitigate fatty liver disease. This includes avoiding fast-food items, which are often high in unhealthy fats and sugars and contribute to increased liver fat. Additionally, sugary beverages, such as those containing high-fructose corn syrup, should be eliminated as they lead to liver fat accumulation. Reading labels to avoid added sugars in packaged foods, including snacks, baked goods, and even some store-bought coffees and teas, is crucial.

  • Reduce Sugar Intake: High consumption of sugar, especially fructose found in sweetened beverages like soft drinks, sports drinks, coffees or teas, and baked goods and candies, increases liver fat. Reducing these alleviates liver inflammation and stress is advisable.
  • Avoid Fatty Foods: Foods high in saturated and trans fats contribute to liver fat accumulation. These include red meat, processed meats like bacon and deli, full-fat dairy products, and fried foods.
  • Limit Salt and Processed Snacks: High sodium levels can be harmful, and processed snacks often contain high salt and saturated fat content. Opting for low-sodium alternatives and reducing consumption of processed foods can benefit liver health. Usually, when people feel the need to snack, they need to consume more protein or water.
  • Alcohol can affect liver health. For individuals with fatty liver, reducing or eliminating alcohol consumption is crucial to prevent further liver damage.

Adhering to these guidelines and incorporating a diverse diet, such as the Mediterranean diet, can help individuals manage and reverse fatty liver disease.

Foods and Drinks to Add

A diet that emphasizes whole foods including unprocessed vegetables, fruits, unrefined grains, beans, nuts, legumes, and olive oil. Moderate amounts of fish, seafood, grass-fed animal products (meat, cheese, eggs, high protein yogurts), and sweets are reserved for special occasions. The ideal diet will be rich in antioxidants, vitamins, and minerals. It will also include healthy (unsaturated) fats, avoiding saturated and trans fats. 

Limiting complex carbohydrates to small quantities and incorporating unsaturated fats into the diet can enhance insulin sensitivity, help the liver manage glucose levels more effectively, and reduce fat storage in the liver cells. It is essential to understand that eating too large of a serving of any of these components in a 24-hour cycle sabotages the attempt to heal the liver. For example, eating several servings of whole grains, fruits, or starchy vegetables will result in high amounts of fructose, glucose, and other sugars circulating in the bloodstream, forcing the pancreas to increase insulin production and store these sugars in the liver as energy for a future time. Instead, we want the liver to burn the fatty acids it keeps in storage to reverse fatty liver and heal. Additional essential components of a diverse and robust diet to reverse fatty liver include:

  • Omega-3 fatty acids are found in fatty fish like salmon, sardines, tuna, trout, flaxseeds, walnuts, and certain vegetable oils.
  • Monounsaturated fats, abundant in olives, avocados, and nuts, help improve insulin sensitivity and thus reduce the liver’s fat storage.
  • High-fiber foods, such as legumes, whole grains, and oats, support digestion and help manage liver health.
  • Coffee and tea: Regular consumption of coffee and green tea may protect against NAFLD due to their ability to prevent the buildup of fat and collagen in the liver.

The Role of Natural Supplements

Evidence-Based Supplements for Liver Health

Herbal and nutritional supplements have gained attention for their potential liver health benefits, but it is essential to rely on evidence-based options. While beneficial for some, these supplements should be used with caution. Thus, using these supplements in moderation and under professional guidance is essential to ensure safety and efficacy. 

  • Milk Thistle: Known for over 2,000 years, milk thistle supports healthy bile flow and liver detoxification by reducing oxidative stress. Some studies suggest it can improve liver function and reduce liver damage in conditions such as NAFLD, cirrhosis, chronic hepatitis, and those exposed to industrial toxins. The active ingredient, silymarin, is a group of flavonoids (silybin, silydianin, and silychristin) known for their antioxidant and liver-protecting qualities. They aid liver cell regeneration and support a healthy inflammatory response. It has also shown the potential to lower blood sugar levels in type 2 diabetes. 
  • Glutathione: Often referred to as the “master antioxidant,” plays a crucial role in maintaining liver health by neutralizing harmful free radicals and detoxifying the liver. It comprises three amino acids: glutamine, cysteine, and glycine. This powerful antioxidant supports liver function has show in studies to decrease oxidative stress through removing toxins and promoting the regeneration of liver cells. As a result, adequate levels of glutathione are essential for optimal liver health and overall detoxification processes.
  • Alpha Lipoic Acid: This versatile antioxidant is a powerhouse that helps protect the liver from oxidative stress and inflammation. Its unique water- and fat-soluble nature allows it to function in various cell parts, making it a confident choice for liver health. ALA enhances liver health by promoting the regeneration of other antioxidants, such as glutathione and vitamins C and E. Additionally, studies report it supports liver function by improving insulin sensitivity and aiding in the metabolism of glucose and lipids, which are essential for maintaining healthy liver function. 
  • Berberine: A natural compound found in several plants, including goldenseal, barberry, and Oregon grape. It has been traditionally used for its antimicrobial and anti-inflammatory properties. Recent studies have shown that berberine supports liver health by regulating lipid metabolism, reducing fat accumulation, and improving insulin sensitivity. It also possesses antioxidant properties that help protect the liver from oxidative damage and inflammation, making it a valuable supplement for liver health.
  • Apple Cider Vinegar: This popular natural remedy known for its numerous health benefits, including supporting liver health. It contains acetic acid, which aids in detoxifying the liver by promoting the elimination of harmful toxins. ACV also helps improve digestion and metabolism, reducing the burden on the liver. Additionally, its antioxidant properties protect liver cells from oxidative damage. Incorporating ACV has shown potential benefits in studies for lowering lipids, improving glucose levels and maintaining a healthy liver.
  • N-Acetyl-L-Cysteine (NAC): NAC is crucial for detoxification. It aids in breaking down toxins and supports liver health through its antioxidant properties and by promoting a healthy inflammatory response. Studies are ongoing to determine the clinical application of NAC, but preliminary research on NAC for NAFLD suggests that it may be a tool in an arsenal of options for managing NAFLD. 
  • Probiotics: These beneficial bacteria support digestive health, which is essential to reducing the liver’s workload in toxin absorption and thereby supporting liver function. If you use a probiotic, be sure it has the correct strains, sufficient quantities of those strains, and includes a prebiotic. 
  • Omega-3 Fatty Acids: These benefit liver health by reducing inflammation. Research suggests that Omega-3 supplementation can reduce liver fat and the risk of non-alcoholic fatty liver disease (NAFLD). Regular intake of Omega-3 may improve insulin sensitivity and liver fat metabolism, further aiding in preventing and managing liver disease.
  • Vitamins and Antioxidants: These are crucial elements of liver health, particularly in managing nonalcoholic fatty liver disease (NAFLD). Vitamins A, B3, B6, B9, B12, C, D, and E are essential due to their influence on various normal processes in the liver. Vitamins A, D, and E are all fat-soluble, while vitamin B is water-soluble. Incorporating these vitamins through nutrition choices or supplements can help prevent and manage fatty liver disease, highlighting their importance in maintaining optimal liver health.

Lifestyle Modifications

  1. Physical Activity: This helps reduce liver fat and improve blood sugar control, blood pressure, and fats like cholesterol and triglycerides. Additionally, it assists with weight management, enhances cardio-respiratory fitness, and improves body composition by reducing fat and increasing muscle mass. Aerobic activities help enhance blood flow to the liver, reducing inflammation and managing blood pressure and fats like cholesterol and triglycerides. Resistance exercises promote muscle strength, endurance, and body composition by reducing fat and increasing muscle mass.
  2. Managing Stress: Chronic stress exacerbates liver conditions by promoting inflammation and insulin resistance, which can increase fat storage in the liver. Effective stress management strategies include regular physical activities and mindfulness practices such as meditation, prayer, journaling, and reading. Seeking support from coaches, healthcare experts, peers, friends, and family is critical. These intentional choices not only help reduce stress but also improve liver health by mitigating behaviors that contribute to liver damage, such as excessive eating, alcohol intake, and other harmful habits. 
  3. Improving Sleep Quality: Achieving optimal liver health extends beyond diet and exercise; it involves enhancing sleep quality. Sleep is pivotal in repairing cells and flushing out toxins, with the liver playing a significant role in these processes. Adults should aim for 7-9 hours of sleep daily to manage mood, boost the immune system, and enhance memory. Creating a calming bedtime routine can help improve sleep quality. This starts several hours before bedtime. 
  4. Reducing Alcohol Intake: The current CDC guidelines are that men limit their intake to two servings per day and women to one, with a weekly limit of 14 for men and 7 for women. This does not apply to individuals with liver disease! For individuals with NAFLD and alcohol-related liver disease (ARLD), abstinence from alcohol is crucial. In many instances, the liver can heal and reverse damage if alcohol consumption stops. Lifelong abstinence is recommended for those with severe forms of NAFLD and cirrhosis to prevent further liver damage and potential liver failure. For those finding it difficult to stop drinking due to alcohol dependency, interventions such as medically supervised detox programs, psychological therapy like cognitive behavioral therapy (CBT), and medications may be necessary to support the cessation process. 
  5. Avoiding Non-Alcoholic Harmful Substances: To safeguard the liver, individuals should be cautious of the substances they expose themselves to. Reading warning labels on chemicals and avoiding medication overuse can prevent liver damage. Avoid environments where exposure to industrial chemicals like vinyl chloride or carbon tetrachloride is possible. Even over-the-counter medicines like acetaminophen, ibuprofen, and various prescription drugs, when misused, can lead to severe liver conditions, including toxic hepatitis or liver failure. Additionally, certain herbal supplements, despite being natural, can be harmful to liver health. Supplements like aloe vera, black cohosh, and kava have been identified as hepatotoxic. Avoiding recreational drugs and practicing safe sex are also crucial to prevent hepatitis B and C or HIV infections that can harm liver health. 

Long-Term Strategies for Liver Health

Managing Other Health Conditions

Maintaining a healthy weight is crucial in preventing and managing non-alcoholic fatty liver disease (NAFLD). Individuals who are overweight or obese are at a higher risk of developing fatty liver, which can progress to more severe liver conditions. Additionally, managing other health conditions like type 2 diabetes, high blood pressure, and high cholesterol through proper medication adherence and lifestyle choices can slow the progression of metabolic dysfunction-associated steatotic liver disease (MASLD). Integrating the lifestyle recommendations above is crucial for holistic health. 

Regular Health Screenings

Regular health screenings are crucial for individuals managing fatty liver disease. These screenings should include comprehensive blood tests to monitor liver enzymes, which can indicate liver health status. Additionally, imaging tests such as ultrasound or FibroScan can assess the liver’s condition and track changes over time. It is recommended that individuals undergo these screenings at intervals suggested by licensed healthcare professionals based on the severity of their condition and health profile. It is reasonable to have blood tests assessed every 3-6 months, depending on the disease severity. 

Consulting Healthcare Professionals

Consulting licensed healthcare professionals is essential for personalized guidance and treatment adjustments. These professionals can provide advice based on the latest research and clinical data. For those integrating natural supplements and nutraceuticals into their treatment plan, consulting a licensed healthcare provider is vital to ensure these supplements are used safely and effectively, complementing conventional treatments without adverse interactions. Refrain from trusting the opinion of someone on an online forum or in the supplement aisle of the store for recommendations on what products you should use! 

Conclusion

Reflecting on the integrative approach to reversing fatty liver, it’s clear that dietary adjustments, increased physical activity, and judicious use of supplements and nutraceuticals stand at the core of effective management and potentially reversing this condition. The concerted efforts to embrace a diverse, whole food-based diet, reduce processed foods and sugar intake, incorporate regular movement into daily routines, and implement lifestyle changes underscore the holistic strategy required to combat fatty liver disease. Understanding the pivotal role that specific supplements play in liver health reinforces the importance of incorporating these nutraceuticals thoughtfully into one’s regimen. It’s imperative to consult licensed healthcare professionals who have training in integrating supplements and nutraceuticals alongside traditional treatments. By adopting these coordinated strategies, individuals can enhance their liver health, underscore the potential for reversing fatty liver disease naturally, and uphold their well-being for the long term.

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