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Fatty Liver Disease: What Men Need To Know
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Fatty Liver DiseaseFatty liver disease happens when fat builds up in your liver. This can cause damage, inflammation, and other complications.
There are two main types of fatty liver disease:
Nonalcoholic fatty liver disease (NAFLD). As this name suggests, this type of fatty liver disease isn't caused by drinking alcohol.
Alcoholic fatty liver disease. This is also known as alcoholic steatohepatitis. It's caused by heavy alcohol consumption.
It's possible to have both types of fatty liver disease at the same time.
About one in four people worldwide have nonalcoholic fatty liver disease. It's the most common cause of liver disease in the United States.
NAFLD is broken down further into two types:
Nonalcoholic fatty liver (NAFL). Also known as hepatic steatosis or simple fatty liver disease, this occurs when there is too much fat in the liver but minimal inflammation or damage to the liver cells.
Nonalcoholic steatohepatitis (NASH). With this type of fatty liver disease, you'll have fat in your liver, inflammation, and liver cell damage. This can lead to cirrhosis (liver scarring) and liver cancer.
Most people with NAFLD have nonalcoholic steatohepatitis. Healthcare professionals aren't sure why some people develop nonalcoholic fatty liver while others develop NASH.
If you have fatty liver disease, you're more likely to develop health conditions like:
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Symptoms of Fatty Liver DiseaseFatty liver disease is known as a "silent disease" as it has few symptoms.
In fact, you might have fatty liver disease and not even know it. You may not experience any symptoms at all until it causes health problems.
When symptoms are present, they can include fatigue and discomfort in the upper right side of your abdomen.
In very severe cases, as the condition progresses, you might experience:
If fatty liver disease leads to cirrhosis, you might experience:
Fatigue
Weakness
Nausea
Loss of appetite
Weight loss
Swelling
Jaundice
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Causes of Fatty Liver DiseaseIt's unclear exactly what causes fatty liver disease when it isn't caused by alcohol.
Potential causes may include:
Alcoholic fatty liver disease is caused by drinking too much alcohol over an extended period of time.
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Risk Factors for Fatty Liver DiseaseHaving overweight or obesity is a major risk factor for fatty liver disease. Estimates suggest that up to 75 percent of people with overweight have NAFLD, and more than 90 percent of people with severe obesity have the condition.
The risk factors for alcoholic fatty liver disease include drinking heavily, especially if you've been drinking heavily for a long time.
Among those who drink a lot, you'll have a higher risk of fatty liver disease if you:
Have obesity
Are female
Have certain genes
Other risk factors for nonalcoholic fatty liver disease include:
Prediabetes (Learn more about Prediabetes.)
Type 2 diabetes
Obesity
High blood pressure
Having high cholesterol or triglycerides
Metabolic syndrome
Rapid weight loss
Infections like hepatitis C
Some medications
Toxin exposure
Age
Ethnicity (you're more likely to develop NAFLD if you're Hispanic)
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Diagnosing Fatty Liver DiseaseFatty liver disease can be easy to miss, as many people don't experience symptoms. If you get a liver function test for another reason, your healthcare provider might notice abnormal results and want to check for fatty liver disease.
To start, your healthcare provider might ask you about your medical history. This may include questions about:
We know it can feel uncomfortable talking about your drinking habits, but it's important to be honest here.
Your healthcare provider isn't here to judge — only to help you take charge of your health. They'll need an accurate idea of how much alcohol you drink to help diagnose and treat fatty liver disease.
Next, your healthcare provider might do a physical exam. This may include checking your eyes for signs of jaundice. They may feel your abdomen to see if it's painful or enlarged.
Your provider may also order tests to help diagnose fatty liver disease.
These tests may include:
Blood tests
Imaging tests
A liver biopsy
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Fatty Liver Disease TreatmentThe type of treatment you need for fatty liver disease will depend on which type you have. The following are a few common treatments.
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Weight LossIf you have overweight or obesity, your healthcare provider may recommend weight loss to help manage nonalcoholic fatty liver disease.
Losing weight can help reduce steatosis (fat build-up), inflammation, and fibrosis (thickening or scarring in the liver).
Research suggests that losing three to five percent of your body weight can improve fat build-up, while losing 10 percent can reduce liver inflammation.
If you lose weight, you might find your NASH switches to NAFL — i.E., liver inflammation and damage improves, but you still have some fat build-up in your liver.
If you've struggled to keep weight off in the past, your provider may recommend weight loss medications.
These include:
Semaglutide (Ozempic®, Wegovy®, Rybelsus®, compounded semaglutide)
Tirzepatide (Mounjaro®, Zepbound®, compounded tirzepatide)
Liraglutide (Victoza® and Saxenda®)
Metformin
Topiramate
Weight loss is highly individual, so your best bet is to speak with a healthcare provider who can give you personalized advice on achieving your goals — and what those goals should look like.
To reach your weight loss goals, you can also try:
Making healthy food choices. Reach for fruits, vegetables, lean protein, legumes, and whole grains like brown rice and whole-wheat bread.
Drinking less. Alcohol has lots of calories and contributes to weight gain.
Getting more activity. Make regular activity a habit. This can be structured exercise like workout classes or general movement, like walking more each day. (Learn more about What Is the Best Sport to Lose Weight?.)
Drinking more water. Water can help you feel fuller and promote the breakdown of fat.
Prioritizing sleep. Aim for seven to nine hours of sleep a night. Keeping a regular sleep schedule, drinking less caffeine, and maintaining a relaxing bedtime routine can help you get more shut-eye.
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Medication for Fatty Liver DiseaseYour healthcare provider may recommend medications for fatty liver disease.
These include:
In March 2024, the U.S. Food and Drug Administration (FDA) approved resmetirom — sold under the brand name Rezdiffra® — for people with NASH and moderate to advanced liver scarring.
In clinical trials, Rezdiffra helped improve liver scarring or resolve NASH after 12 months.
Weight loss injections like semaglutide have also been found to directly improve fatty liver disease.
A 2023 systematic review examined three clinical trials including almost 460 participants with NAFLD. Findings suggest that semaglutide helped improve the participants' liver health.
Those taking semaglutide had a higher likelihood of their NASH resolving compared to those taking a placebo.
Semaglutide led to improvements in:
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Cutting Out AlcoholFor alcoholic liver disease, treatment will include cutting out alcohol.
You can do this by:
Getting support from a therapist, addiction specialist, or support group.
Speaking to a healthcare provider about medication that can help curb alcohol cravings.
Quitting drinking together with a close friend or family member.
Avoiding triggers — these might be certain places, people, or times you often drink.
Making lifestyle changes like finding a new hobby, playing a sport, or adopting a new workout routine.
Replacing alcoholic drinks with sparkling water or mocktails.
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Other TreatmentsIf your NAFLD is caused by a certain medication, you might be advised to stop this medication. Your healthcare provider will give you instructions on how to stop your medication and whether to start an alternative treatment.
Depending on the severity of your condition, you may need further treatment. For example, fatty liver disease can lead to cirrhosis. Cirrhosis can cause serious health issues that require medication, surgery, or even a liver transplant.
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Fatty Liver Disease Prevention TipsTo reduce your risk of developing fatty liver disease, aim to maintain a healthy weight and limit your alcohol consumption.
Other steps you can take include:
Eating a healthy diet. Focus on eating mostly fruits, vegetables, legumes, fish, and whole grains. The Mediterranean diet and the DASH eating plan are good examples of healthy eating.
Getting regular physical activity. Aim for a mix of cardio and strength training.
Staying on top of your health. See your primary care provider regularly to limit your fatty liver disease risk factors.
This article originally appeared on Hims.Com and was syndicated by MediaFeed.Org.
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More from MediaFeedYou May Have Serious Liver Damage If You Experience These 5 Warning Signs, Doctor Says
The liver does a lot of heavy lifting.
The largest internal organ, it regulates clotting and removes toxins, yet research suggests many of us live with compromised liver function — and don't even know it.
It's estimated that more than 100 million people in the U.S. Have some form of liver disease, a broad term used to describe several conditions, including non-alcoholic fatty liver disease (NAFLD), hepatitis and liver cancer.
Referred to as the "silent epidemic," experts suspect between 80 million and 100 million adults in the U.S. Have NAFLD.
More than 100 million people in the U.S. Have some form of liver disease. Crystal light – stock.Adobe.ComAs its name implies, NAFLD is marked by the presence of fat in the liver.
The primary cause is weight gain, along with metabolic risk factors such as Type 2 diabetes, high blood pressure, high triglycerides and obstructive sleep apnea.
The condition is also known as MASLD (metabolic dysfunction-associated steatotic liver disease), reflecting the association between fatty liver and metabolic syndrome. Fatty liver disease is associated with an increased risk of liver cirrhosis and liver cancer.
Fatty liver disease is associated with an increased risk of liver cirrhosis and liver cancer. Eranicle – stock.Adobe.ComWhile preventative measures like diet, exercise and abstaining from alcohol can help stave off liver disease, problems arise because symptoms are subtle or altogether absent.
Dr. Bubu Banini a hepatologist and assistant professor at Yale School of Medicine tells HuffPost, "Signs and symptoms of liver disease do not typically present until there is significant liver damage," Dr. Bubu Banini, a hepatologist and assistant professor at Yale School of Medicine, recently told HuffPost.
Experts like Banini urge people to seek medical attention if they experience the following issues.
Bruising and bleeding easily The liver produces proteins that create clots. KMPZZZ – stock.Adobe.ComThe liver produces proteins that the body needs to form blood clots.
When the liver is damaged or otherwise fails to function, people are more prone to bleeding and bruising, a common side effect, according to the Cleveland Clinic.
Confusion and brain dysfunction Experts say an unexpected culprit of brain fog and cognitive impairment is late-stage liver failure. Drobot Dean – stock.Adobe.ComA medical professional should always address a change in mental state or cognitive function. Still, experts say an unexpected culprit of brain fog and cognitive impairment is late-stage liver failure.
"A person who is otherwise healthy can develop acute liver failure that could manifest as changes in mental state or personality such as disorientation, confusion or sleepiness," Banini explained to Huff Post.
Specifically, hepatic encephalopathy is a brain dysfunction caused by liver issues, according to the Cleveland Clinic, whose experts say it can arise by affecting:
Banini notes that liver disease can manifest as jaundice, a yellowing of the skin or eyes. When the body breaks down red blood cells, it creates the pigment bilirubin, according to the National Institutes of Health.
Typically, the liver processes and removes bilirubin, but an excess of it can cause jaundice and point toward liver issues.
Dark urine If you're drinking plenty of water but notice that your urine is consistently dark, talk to your doctor. STOATPHOTO – stock.Adobe.ComIf you're adequately hydrated but notice that your urine has a persistently dark hue, it could be a sign of a serious liver condition.
Just as an excess of the pigment bilirubin can cause yellowing of the skin and eyes, it can turn pee darker hues of orange or amber.
Cirrhosis-fueled swelling When fluid collects in the legs and ankles, it's called edema. Daryakomarova – stock.Adobe.ComCirrhosis, or liver scarring, can cause swelling in the ankles, legs and abdomen.
Per the Mayo Clinic, cirrhosis slows blood flow and increases pressure in the portal vein within the liver. This pressure can cause fluid accumulation; when fluid collects in the legs, it's called edema; in the abdomen, it's known as ascites.
The swelling may also indicate that the liver is not producing enough blood proteins.
Semaglutide Improves Liver Fibrosis In New Trial Analysis
In the ESSENCE trial, semaglutide improved liver fibrosis in patients with metabolic dysfunction-associated steatohepatitis (MASH).
Two separate phase 3 trials show that semaglutide improved fatty liver disease and reduced hospitalizations related to cardiovascular risk in obese patients. Novo Nordisk's semaglutide is marketed as Ozempic to treat patients with diabetes and Wegovy is marketed for weight loss.
In the ongoing ESSENCE trial, 37% of the 800 adults with metabolic dysfunction-associated steatohepatitis (MASH) and moderate-to-advanced liver fibrosis achieved improvement in liver fibrosis with no worsening of steatohepatitis compared with 22.5% of patients on placebo. Additionally, 62.9% of people treated achieved resolution of steatohepatitis with no worsening of liver fibrosis compared with 34.1% on placebo.
MASH — also called nonalcoholic steatohepatitis (NASH) — is a severe form of fatty liver disease. It is a leading cause of liver-related mortality, especially for those with hypertension and type 2 diabetes and affects between 1.5% and 6.5% of U.S. Adults. The number of people in advanced stages of the disease is expected to double by 2030.
"Among people with overweight or obesity, one in three live with MASH. This has a serious impact on their health and represents a significant unmet need," Martin Holst Lange, executive vice president and head of Development at Novo Nordisk, said in a news release.
Part 1 of the ESSENCE trial evaluated the effect of once-weekly semaglutide 2.4 mg on liver tissue (histology) compared with placebo on top of standard of care for the first 800 randomized people at 72 weeks.
Novo Nordisk expects to file for regulatory approvals in the United States and European Union in the first half of 2025. Company officials said detailed results will be presented at an upcoming conference. In part 2 of the ESSENCE trial, semaglutide 2.4 mg is being evaluated to determine if it can lower liver-related clinical events compared with placebo at 240 weeks. Results of part 2 are expected in 2029.
Related: Providing Access to Rezdiffra for NASH and the Therapies to Come
Earlier this year, the FDA granted accelerated approval for Rezdiffra (resmetirom), the first drug approved specifically for MASH. Traditionally, treatments that have been used for MASH have included lifestyle modification and off-label use of therapies such as semaglutide or tirzepatide (marketed as Mounjaro for diabetes and Zepbound for weight loss).
Rezdiffra, developed by Madrigal Pharmaceuticals, is an oral therapy to treat advanced liver fibrosis, and it launched with a wholesale acquisition cost of $47,400 per year. As of Sept. 30, 2024, coverage for Rezdiffra was in place for more than 80% of commercial lives covered by health insurance in the United States, according to a company news release. Rezdiffra is being assessed in the MAESTRO-NASH OUTCOMES trial the treatment of patients with compensated cirrhosis, which is an earlier, asymptomatic stage of liver disease.
In a separate Novo Nordisk trial, the SELECT phase 3 cardiovascular outcomes trial, an exploratory post hoc analysis showed semaglutide 2.4 mg reduced hospital admissions and overall length of hospital stay for adults with obesity or who were overweight with established cardiovascular disease (CVD) and without diabetes.
Obesity increases the risk of cardiovascular disease, including heart attack and stroke, while also contributing to the progression of other cardiovascular risk factors including elevated blood pressure and cholesterol.
The analysis of SELECT indicated that a lower percentage of patients taking semaglutide experienced a first hospital admission for any indication versus placebo and for serious adverse events. In addition, the number of total hospitalizations was lower in the semaglutide group versus placebo for all indications.
Safety data collected in the SELECT trial was limited to serious adverse events (including death), adverse events leading to discontinuation, and adverse events of special interest. In the trial 16% of semaglutide 2.4 mg-treated patients and 8% of placebo-treated patients, respectively, discontinued the study drug due to an adverse event. The most common adverse event leading to discontinuation was gastrointestinal disorders, occurring in 10% of patients in the semaglutide group and 2% in the placebo group
These results were presented during an oral session at the annual ObesityWeek conference. The trial, initiated in 2018, enrolled 17,604 adults and was conducted in 41 countries at more than 800 investigator sites.
Related: Wegovy Cuts Risk of Serious Cardiovascular Events By 20% in Those Without Diabetes, Study Finds
Data from the SELECT trial on the impact of semaglutide on cutting cardiovascular risk was first presented last year at the American Heart Association Scientific Sessions. The trial enrolled 17,604 adults aged 45 years or older with obesity and established cardiovascular disease with no prior history of diabetes.
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