Fatty Liver
(Nonalcoholic Fatty Liver Disease [NAFLD] and Nonalcoholic Steatohepatitis [NASH])

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Nonalcoholic fatty liver facts

  • Nonalcoholic fatty liver (NAFLD) is the accumulation of abnormal amounts of fat within the liver.
  • NAFLD can be divided into isolated fatty liver in which there is only accumulation of fat, and nonalcoholic steatohepatitis (NASH) in which there is fat and damage to liver cells.
  • NASH progresses to scarring and ultimately to cirrhosis, with all the complications of cirrhosis, for example, gastrointestinal bleeding, liver failure, and liver cancer.
  • Isolated fatty liver does not progress to NASH or cirrhosis.
  • The development of NAFLD is intimately associated with and is probably caused by obesity and diabetes.
  • NAFLD is considered a manifestation of the metabolic syndrome.
  • The symptoms of NAFLD are primarily those of the complications of cirrhosis in patients with NASH; isolated fatty liver infrequently causes symptoms and usually is discovered incidentally.
  • The differentiation of isolated fatty liver from NASH requires a liver biopsy.
  • The most promising treatments for NAFLD are weight loss including bariatric surgery and exercise.
  • Several drugs have been studied in the treatment of NASH. There is little evidence that any drug is effective in slowing the disease progression of NASH.
  • Many diseases are associated with NASH and are part of the metabolic syndrome. These diseases should be screened for and treated, for example, high blood pressure, dyslipidemia and diabetes.
  • NAFLD, including NASH affects young children as well.
  • NASH will become the number one reason for liver transplantation unless effective and safe treatments are found.
Medically Reviewed by a Doctor on 7/9/2014

Patient Comments

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Fatty Liver - Symptoms Question: The symptoms of fatty liver can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Fatty Liver - Causes Question: What caused your fatty liver?
Fatty Liver - Diet Question: What changes have you made to your diet since being diagnosed with a fatty liver?
Fatty Liver - Treatment and Medications Question: What kinds of treatment, including medication, have you been given for your fatty liver?

Statins for Fatty Liver Disease

Medical Author Dr. Dennis Lee
Medical Author Dr. Jay W. Marks

Viewer question: My doctor told me that I have fatty liver and high cholesterol. He also said that my liver is slightly inflamed because my liver tests are mildly abnormal. He wants me to lose weight, exercise and take Lipitor to lower my cholesterol. I also read that Lipitor can have liver side effects. Is it safe to take Lipitor in somebody like me?

Doctor's response: Low dose statins like atorvastatin (Lipitor) are safe in patients with mild liver disease (for example, patients with fatty liver and mildly abnormal liver tests in the blood such as ALT and AST). Since many patients have fatty livers due to obesity as the cause of their mildly elevated AST and ALT; losing excess weight helps to normalize the liver tests. Nevertheless, there is insufficient data on the safety of statins in patients with more severe liver disease with moderate or severe elevations of AST or ALT. It also is important to monitor test levels periodically since statins should be stopped if liver tests become progressively more abnormal.

Thank you for your question.