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Writer's pictureDr. Kogan

Understanding Non-Alcoholic Fatty Liver Disease


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Let us dive into a topic that might not be on your radar but should be—Non-Alcoholic Fatty Liver Disease, or NAFLD for short. NAFLD affects about 30% of adults in America. I find it particularly worrisome that this disease was practically unknown 50 years ago but is so widespread now.


So, what exactly is NAFLD? In simple terms, it is when your liver starts accumulating too much fat. There are many contributing factors to why this happens. Among them:  obesity, insulin resistance, high fructose, elevated uric acid, low adiponectin and high leptin hormones, elevated iron, and even environmental toxicity. A little extra fat around the liver is not usually a big deal, but when it gets out of control, it can lead to serious health problems, like hepatitis, cirrhosis, or even liver failure. NAFLD often does not come with flashy symptoms—it is more like a silent intruder in your liver. However, in some cases, your liver might send out distress signals. You might feel more tired than usual or notice unexplained bloating or discomfort in your belly. Early detection can make a big difference, so it is important to stay preventive with routine checkups.


Basic liver fat - screening tools include blood tests and an ultrasound. Once fatty liver is detected, there are some new tests available at major labs like Quest, called Fib-4 and the Enhanced Liver Fibrosis (ELF) score that can help navigate this disease. Fibroscan is another new great diagnostic tool for those with very fatty liver.


As a medical doctor certified in functional medicine, I like to focus on identifying and addressing the root causes of diseases rather than just treating symptoms. For NAFLD, this means focusing on treating obesity, sedentary lifestyle, diabetes, hyperlipidemia, and stress, among other contributing factors. I develop a plan custom-tailored to each patient’s unique lifestyle and the patient understands that this is a journey. We meet at regularly scheduled intervals to assess how far we have come, to emphasize what works and to change what does not work. This is also a wonderful way to motivate and inspire a patient on this healing path.


The cornerstone of our periodic meetings typically is:

  • Review of the diet, which is usually a Mediterranean type, anti-inflammatory diet. This typically includes:

  • High fiber foods which help in maintaining healthy blood sugar levels and improving gut health.

  • Healthy fats which help reduce liver fat.

  • Antioxidants which help combat oxidative stress in the liver.

  • Fermented foods for gut health optimization

  • Minimizing or eliminating alcohol

  • Review of the patient’s current physical activity regimen. Exercise is crucial for improving insulin sensitivity and reducing liver fat.

  • Review of Stress Management techniques, such as mindfulness, meditation, yoga, adequate quality sleep, and many others. This is especially important because chronic stress can exacerbate insulin resistance and inflammation, leading to more fat deposits in the liver.

  • There are also some great supplements available that had statistically significant success in human trials, which can be utilized in this multi-pronged approach, and they are custom-tailored to each patient as well.


NAFLD might not be making headlines, but it is a common disease that deserves attention and life-long education. Your liver works hard for you—show it some love in return!


 

The author of Diet Slave No More!, Svetlana Kogan, MD, IFMCP is a Board-Certified Internal Medicine, Holistic & Functional Medical Doctor with 25 years of experience.    CustomLongevity.com | 239.676.6883


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