It is estimated that 10 to 20 percent of chronic heavy drinkers suffer from clinically diagnosed alcoholic fatty liver disease. However, nonalcoholic fatty liver disease (NAFLD) is believed to be more prevalent, as it can often be reversed through lifestyle modifications. The signs and symptoms of this condition can be easily overlooked or mistaken for other issues once they emerge. This diagnostic challenge, in part, contributes to the ongoing uncertainty among researchers regarding the exact causes of fatty liver disease.
High triglyceride levels are among the most common indicators of fatty liver disease. Typically, these lipids are stored in fat cells and utilized for energy. However, when there is an excessive amount of fat in the blood, it is not metabolized efficiently, causing the body to store the surplus in the liver, ultimately leading to fatty liver disease. Plasma triglyceride levels exceeding 200 mg/dL are considered high, while readings surpassing 500 mg/dL are deemed very high. The exact causes of this disease remain unknown, but some medical professionals speculate that hypertriglyceridemia may be more of a risk factor rather than a direct symptom of fatty liver disease.
Enlarged Liver and Spleen
Splenohepatomegaly is a condition in which both the liver and spleen become enlarged, potentially indicating fatty liver disease. When the liver accumulates excessive fat, its increasing weight and size can cause pressure on surrounding tissues. Both the spleen and the liver are crucial for detoxifying the body, and when they don’t function optimally, the risk of infection rises significantly. It’s important to note that the enlargement of the spleen and liver can happen concurrently or independently.
Fluid Build-up in the Abdomen
The peritoneal cavity is home to a lubricating fluid that resides between the lining of the abdominal wall and internal organs. Ascites refers to the buildup of excessive fluid in this cavity, leading to abdominal swelling. While numerous health conditions can cause ascites, the most prevalent is high blood pressure in the veins responsible for delivering blood to the liver, known as portal hypertension. This condition is often a result of fatty liver or other liver diseases.
Fatigue is a prevalent early symptom in approximately half of all fatty liver disease cases. In about a quarter of these instances, the fatigue is severe enough to significantly impact the individual’s overall quality of life. Mental fatigue is also common, making it difficult for affected individuals to perform both mental and physical tasks. This may be linked to the depression and anxiety that often develop alongside a fatty liver. Research indicates that impaired communication between the liver and the brain could contribute to these symptoms. One particular area of the brain that may be affected is the basal ganglia, which is responsible for voluntary motor control and emotional regulation.
Yellowing of the Skin and Eyes
Bilirubin, a by-product created when the body breaks down old red blood cells, is partially composed of bile and typically passes through the small intestine as direct bilirubin. However, when the liver isn’t functioning properly, bilirubin fails to be excreted correctly and accumulates in the blood. This build-up can lead to noticeable symptoms of fatty liver disease, such as yellowing of the skin and eyes and dark-colored urine. While these are visible signs, other less apparent symptoms of liver problems may prompt a doctor to order a bilirubin test even before these manifestations occur.
Individuals suffering from fatty liver disease frequently report experiencing vague pain. In certain instances, this pain may be a secondary symptom. Nonalcoholic steatohepatitis (NASH), a type of nonalcoholic fatty liver disease, can lead to cirrhosis, or scarring of the liver, which in turn causes bodily tenderness that can curiously be mistaken for shoulder pain. Additionally, ascites, a condition that results in the accumulation of fluid in the abdominal cavity, can cause discomfort by exerting pressure on nearby tissues and organs.
Fatty liver disease can lead to indigestion, which may be worsened by blocked stomach acid. The liver’s primary role is to remove toxins from the body, but fatty liver disease hinders its ability to do so. As a result, waste accumulates, causing symptoms such as GERD, nausea, and unexplained vomiting. Individuals experiencing indigestion may not realize it’s related to liver disease and may turn to over-the-counter medications for relief. However, research indicates that attempting to alleviate stomach acidity can result in an overgrowth of intestinal bacteria, which can cause inflammation, additional digestive symptoms, and further liver damage.
Estradiol, a type of estrogen, is produced by the sex organs and adrenal glands and is metabolized in the liver. When the liver malfunctions, estradiol levels can become abnormal, leading to an increase in this hormone. This elevation may result in palmar erythema, a condition characterized by the reddening of the palms.
High Insulin Levels
After a meal, blood sugar levels naturally increase, causing the pancreas to release insulin into the bloodstream. This hormone allows cells to either utilize sugars for energy or store them as fat. However, when cells become insulin resistant, they fail to respond properly, leading to the release of even more insulin and ultimately resulting in a condition called hyperinsulinemia. This issue not only indicates liver dysfunction but also contributes to the fatigue and mental fogginess often experienced by those with fatty liver disease.
Long-term excessive alcohol consumption is the primary cause of hepatic encephalopathy, a brain disorder often linked to alcoholic fatty liver disease. When the liver is impaired, it struggles to neutralize toxic substances like ammonia, which then build up in the bloodstream and affect the brain. This can lead to symptoms such as forgetfulness, mood swings, and difficulty with fine motor skills in hand movements. Hepatic encephalopathy is 70% more likely to develop in individuals with severe liver cirrhosis, but it can also occur in those with fatty liver disease.