Fatty Liver Disease: Supporting the Liver with Nutrition

Written By Isabella Meneses-Furuseth

What is the Liver and What does it do?

The liver is both an organ and gland that is in charge of hundreds of functions that help keep us healthy. It also has the ability to make proteins and hormones. The liver’s primary role is detoxing toxins and harmful substances that are floating around in the body. Blood travels through the liver, which acts like a filtration system, filtering about 250 gallons of blood per day (1). It gets rid of old red blood cells as well as releases something called bile, which aids in digestion and breaking down food. The liver is like a chemical factory that decides what substances will get converted into something useful and be sent to where they are needed or if they need to be sent to get excreted out. For example, it can choose to store vitamins or send them to places in the body that needs them. In the case of toxins, it decides that the body doesn't need or want them so it breaks them down via the three phases that we will discuss below. 

Alcoholic Fatty Liver Disease happens because too much alcohol is being consumed and the liver cannot keep up with it, causing excess fat accumulation (2). When the liver has excess fat, it can no longer function at its full capacity. This may lead to cell failure and dysfunction. One example is dysfunction to the mitochondria, which is essential for energy production (3). Without the liver performing at its best it also allows for excess toxins in the body which leads to inflammation and eventually cell death (3). 

Symptoms of Fatty Liver Disease

  • Jaundice, or yellowing to the skin and/or eyes

  • Build up fluid to the belly, which may look like bloating  

  • Pain in right abdomen  

  • Itchy skin 

  • High cholesterol 

  • Tremors 

  • Weakness 

  • Fatigue

  • Nausea, vomiting 

  • Fever

  • Diarrhea 

  • Or no symptoms at all 

  • Sleep disturbances - waking up feeling even more tired 

  • Anger and frustration 

  • Lab Work

    • If the liver is injured, it releases enzymes into your bloodstream and they can be seen in lab work. The ones medical professionals will look out for are called alkaline phosphatase (ALP) and alanine transaminase (ALT). 

Who is at Risk for Developing Fatty Liver Disease?

  • Women who drink more than 8 servings of alcohol per week and men who drink more than 15 servings per week (2). 

    • One serving of alcohol looks like this: 12 oz of beer, 5-6 oz of wine, 1.5-2 oz of liquor (7). 

  • Genetics; if you have a family history of fatty liver disease. 

  • Those with type II diabetes or insulin resistance. 

  • Obese people are at higher risk of developing fatty liver disease. 

  • Those who are exposed to chemical toxins regularly, including over the counter medication, prescription or recreational drugs, alcohol, and chemicals. 

What Should You Do with your Diagnosis?

The good news is that the liver is an organ with capacities to heal and return to normal again with a little bit of love. The liver detoxes toxins and harmful substances in 3 different phases. Starting with phase I where the toxins enter into the liver, phase II where the toxins are made less dangerous, and phase III where they are excreted out. Please start supporting your liver with phase III; Starting with Phase I may do more harm than good if the other phases are not functioning properly. 


Phase I 

Phase I is where the liver brings in newly found harmful substances from the blood or from the digestive tract. It will break down these substances into smaller molecules so they can be more easily broken down. However, when they are converted into these smaller molecules they are quite dangerous. They have not been made into a safer substance yet so there’s several harmful small molecules floating around preparing to enter into phase II. 

Recommendations Phase I (AFTER supporting phase II): 

  • Milk Thistle 

    • * be cautious because this is a great supplement to stimulate phase II, but if phase II and III have not been supporting, you could be adding more toxic burden onto the liver

  • Cytochrome P450 enzymes 

    • * be careful because it can decrease the effect of medications. Please talk to your health care providers before taking

  • B vitamins

  • Vitamin C

  • Sulfur (cruciferous vegetables) 

  • Magnesium 

  • Iron


Phase II 

Phase II is going to bring in the several pieces of the harmful substances and join them together with something to make them less reactive and less dangerous. Not only are they less dangerous but they become more like water versus like fat, making them easier to excrete through the urine. 

Recommendation Phase II (After supporting phase III): 

  • Amino acids: glycine, cysteine, glutamic acid, methionine

  • Ex: eggs, fish, meat, bone broth, quinoa, and mushroom

  • Sulfur: Cruciferous vegetables like brussel sprouts, broccoli, cabbag

  • Vitamin B12: Animal liver, sardines, fish, and beef  

  • Glutathione: Cruciferous vegetables 


Food and Lifestyles Recommendations to Begin with: 

Phase III 

Phase III is all about transporting the molecules and excreting them out of the body or sending them somewhere they are needed. Majority of toxins will be sent to the kidneys to get excreted in urine or to the bile to be excreted in stool. This does not make you safe yet though. Until these substances have fully left, there is a chance they can be recycled into the system. This is why we want to support digestion. 

Food Recommendations: 

  • Dietary Fiber 

    • Fiber is highly linked to healthy bile so increasing things like vegetables can help support liver and provide several essential micronutrients

  • Exercise 

    • Getting your body moving can also help getting your stomach and bowel moving. 

  • Apple cider vinegar or something bitter (like arugula) before meals 

    • Creating an acidic environment before eating can help stimulate stomach juices and aid in digestion.

  • Chewing thoroughly 

  • Drink half your body weight in ounces 

  • Probiotics to improve gut microbiome which can help with inflammation, cholesterol, and reducing live enzymes. 

  • Avoid Saturated fats because they are processed in the liver and we want to decreases the livers burden as much as possible

Lifestyle Recommendations 

  • Avoid Alcohol 

    • With alcohol fatty liver disease it is essential that alcohol is completely cut out so that the liver can begin to heal. This is not to say it will be forever, but until the liver repairs you must opt out of drinking or it could escalate to liver scarring, which is then irreversible. 

  • Decrease Exposure to Toxins  

    • As discussed earlier, the liver's main job is to filter the body and get rid of toxins. When there are too many toxins going in, the liver may be overworking and accumulating fat due to excess demands. Toxins include alcohol, smoking, illegal and prescription drugs. It also includes chemicals like parabans, sulfates, personal care products and polyfluoroalkyl substances (PFAS) like those in non-stick cookware, stain and water repellent carpets and fabric and food packaging, especially foam (4).

I want you to pick 2-3 that you feel pertains most to you and see how it goes for 1 month and then reevaluate, if necessary. I hope you can use this on your journey and refer back to the different phases when needed. 

Signs your Liver is Recovering 

  • Increased energy

  • Improved sleep 

  • Improved lab values 

  • Reduced brain fog  

  • Stabilized weight 

  • Improved appetite 

  • Improved digestion 

  • Better mood 


References
1. Fatty liver disease and NASH may cause harm| Taking on Fatty Liver & NASHs. Taking on Fatty Liver & NASH - Education Website. Accessed June 21, 2024. https://www.takingonfattyliverandnash.com/

  1. John Hopkins Medicine. Alcohol-Induced Liver Disease. www.hopkinsmedicine.org. Published 2022. https://www.hopkinsmedicine.org/health/conditions-and-diseases/alcoholinduced-liver-disease

  2. Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev. 2017 May;49(2):197-211. doi: 10.1080/03602532.2017.1293683. Epub 2017 Mar 17. PMID: 28303724; PMCID: PMC5576152.

  3. ‌National Institutes Of Health. Study links synthetic chemicals to liver damage. National Institutes of Health (NIH). Published May 9, 2022. https://www.nih.gov/news-events/nih-research-matters/study-links-synthetic-chemicals-liver-damage

  4. Pandak WM, Kakiyama G. The acidic pathway of bile acid synthesis: Not just an alternative pathway. Liver Res. 2019 May 21;3(2):88-98. doi: 10.1016/j.livres.2019.05.001. PMID: 32015930; PMCID: PMC6996149.

  5. Seitz HK, Bataller R, Cortez-Pinto H, Gao B, Gual A, Lackner C, Mathurin P, Mueller S, Szabo G, Tsukamoto H. Alcoholic liver disease. Nat Rev Dis Primers. 2018 Aug 16;4(1):16. doi: 10.1038/s41572-018-0014-7. Erratum in: Nat Rev Dis Primers. 2018 Aug 28;4(1):18. doi: 10.1038/s41572-018-0021-8. PMID: 30115921. 

  6. https://www.piedmont.org/living-real-change/how-quickly-the-liver-can-repair-itself 

Isabella Meneses-Furuseth https://www.roothealingnwa.com
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