Fatty liver is characterized by an excessive accumulation of fat in liver cells. It is the most common response to liver injury. A lot of people have a fatty liver. Estimates range between one in four and one in five Americans.

The fat starts to invade the liver, gradually infiltrating the healthy liver areas so that less and less healthy liver tissue remains. The fatty liver has a yellow greasy appearance and is often enlarged and swollen with fat. Fatty liver occurs when fat accumulation is more than 5% of the liver weight. The most common types of fat (lipids) to build up inside the liver cells are triglycerides. If you have had a blood test that showed elevated triglycerides, there is a very good chance you have a fatty liver.

Fatty infiltration slows down the metabolism of body fat stores which means that the liver burns fat less efficiently, thus resulting in weight gain and inability to lose weight. However, some people have a fatty liver without being overweight. That’s because a number of factors can cause a fatty liver to develop.

Here are 6 common causes:

  1. Insulin resistance
    Insulin is a hormone that your pancreas secretes into your bloodstream after you have eaten. It enables the glucose from your food to enter your cells, where it is burned for energy. In people with insulin resistance, the insulin doesn’t work properly. If insulin is not doing its job properly, less glucose will be burnt for energy and more of it will be converted into fat. The liver ends up manufacturing a lot more fat, which causes the development of fatty liver, and also body fat accumulation. See my book called I Can’t Lose Weight and I Don’t Know Why for information on how to reverse insulin resistance.
  2. Small intestinal bacterial overgrowth (SIBO)
    SIBO is defined as an increased number and/or abnormal types of bacteria in the small intestine. The condition encompasses yeast overgrowth such as Candida too, but excess bacteria is more common and a bigger problem. There is not supposed to be a lot of bacteria in your small intestine. This part of your intestine is designed for nutrient digestion and absorption. Most of the bugs in your gut are supposed to live in your colon (large intestine). The bacteria present in SIBO are not necessarily bad bacteria, like the ones that cause gastroenteritis or food poisoning. The problem is, the bacteria are just in the wrong place. When too much bacteria is present in the small intestine, bacteria and bacterial metabolites end up travelling to the liver. This can cause damage to the liver and eventual fatty liver. SIBO can cause a lot of symptoms but abdominal bloating and irritable bowel syndrome are the most common. BactoClear was developed especially to assist those with SIBO.
  3. Celiac disease
    People with celiac disease (gluten intolerance) are at higher risk of getting a fatty liver and also more serious liver conditions. Celiac disease is an autoimmune disease. That means when people with the condition consume gluten, their immune system attacks their small intestine. The chronic inflammation to the gut lining can impair nutrient absorption and lead to many nutritional deficiencies. The most common ones are iron, calcium, vitamin D and other fat-soluble vitamins (A,E and K), and essential fatty acids. An inflamed gut lining can cause fatty liver in the same way that SIBO does. The inflammatory chemicals produced in any autoimmune disease also raise the risk of fatty liver. For more information see the book Healing Autoimmune Disease.
  4. Viruses
    Hepatitis B and C are well known for raising the risk of chronic liver inflammation. The inflammation usually begins as fatty liver but may progress in time to cirrhosis or liver cancer. This is more likely with hepatitis C. In fact, many people with hepatitis C eventually develop insulin resistance. This typically causes fat accumulation around the torso that is almost impossible to shift. Milder viruses such as Epstein Barr and cytomegalovirus are also capable of causing liver inflammation and fatty liver. Selenium is one of the best defenses against viral infections. Selenomune capsules provide 200 mcg of selenium per capsule, from three types of selenium for enhanced absorption.
  5. Medication
    Several different drugs can cause the development of fatty liver, particularly if used long term. Some anti-inflammatory drugs, pain killers, immuno-suppressants and cholesterol-lowering drugs are common culprits. Other drugs that may cause or contribute to fatty liver include Amiodarone, Perhexiline, acetaminophen, calcium channel blockers (eg. diltiazem and nifedipine), methotrexate, chloroquine, hycanthone, synthetic estrogens, glitazone drugs used in diabetics, and Tamoxifen. This list is not exhaustive and some people can have very severe unusual reactions to drugs that other people do not have; these are called idiosyncratic drug reactions. Always check with your doctor if you are taking long term medications, to find out if they have potential toxic effects on your liver. If they do, make sure that you have a regular liver function test, and if any damage shows up, ask your doctor to change your medications to a more liver-friendly type.
  6. Carbohydrate addiction
    A high intake of sugar and carbohydrate-rich foods overwhelms the liver with sugar. Too much sugar in the bloodstream is very harmful, so your liver tries to protect you by turning the sugar into fat. We all know that a high sugar diet is unhealthy; however, knowing and doing are two different things. Sugar causes the release of endorphins and dopamine. It can act as a soothing tranquilizer. Life is stressful and many people have never learned adequate stress-coping mechanisms. Food is a cheap drug that’s readily available at all hours of the day. Too many people use food as a way of managing negative emotions. Magnesium is very helpful because it relaxes your nervous system and improves sleep quality. Tyrosine is helpful because it helps your brain produce dopamine, helping you become less reliant on food for your mood. What really helps most people is having a plan to follow. The hardest part about coming off sugar is starting. The cravings and withdrawal symptoms only last a few days. The 15 Day Cleanse is a 3 part program designed to improve liver, gut and immune health. It comes with an eating plan that is easy to follow and full of tasty, satisfying meals and snacks. It will help to increase your energy, improve your mood and sleep quality, while helping you lose weight.

Because the word fatty is in the name, many people incorrectly assume a person needs to be overweight to get a fatty liver. You can see from this list that a variety of factors can be responsible. For information on reversing a fatty liver, see this article and my book Fatty Liver: You Can Reverse It.

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.