I often have patients come to me and say, “after my last blood test, my doctor told me to stop drinking alcohol because I’m developing a fatty liver, however, I don’t drink”. Usually, we associate liver issues with alcohol, so what is this about!

NAFLD stands for non alcoholic fatty liver disease. It is described as the accumulation of fat in the liver of people who do not consume excessive alcohol. In fact, some sufferers consume no alcohol at all.

People with NAFLD usually have one of two things in common, gut issues and /or a high carbohydrate diet. Not necessarily a high-fat diet, but a high carbohydrate diet. In fact, it can take as little as 4 days of an overindulgent diet for NAFLD to develop. Gut issues can allow bowel contents to ferment, sending by-products to the liver which are akin to alcohol.

NAFLD affects approximately 25% of the Australian population and this percentage is growing. Approximately 75% of overweight people have NAFLD and within 20 years NAFLD will be the leading cause of liver-related mortality.

NAFLD is the most common reason for mildly abnormal liver test results. It is completely reversible in the early stages, however, as fatty liver disease progresses, scarring and liver damage occurs causing liver structure and function to be compromised. This is known as cirrhosis of the liver and is irreversible.

There are a number of risk factors and conditions which coincide with NAFLD or make it worse. These include:

• Gastric bypass surgery
• Obesity
• Diabetes
• High triglycerides
• Polycystic ovary syndrome
• Hypothyroidism
• Hyperthyroidism
• Diverticulosis, Small intestinal bacterial overgrowth (SIBO)
• Low vitamin D
• Leaky gut
• Hepatitis C
• Menopause (Without oestrogen, the liver makes less choline, and choline is protective against NAFLD. This is also part of the reason why NAFLD is more common in men.)
• Sleep aponea (the liver needs lots of oxygen and when you stop breathing during your sleep, your body is deprived of oxygen. Hypoxia (lack of oxygen) leads to oxidative damage of the liver, allowing fatty acids to accumulate.)

• Slow weight loss of half to one kilogram per week
• Increased physical activity
• A healthy, balanced diet low in sugars and with adequate amounts of quality protein
• Ensure you fast for a minimum of 12 hours overnight
• Address your gut health and microbiome balance (an area naturopathy excels in)
• Address your sleep aponea (you may need a CPAP machine)
• Breathe from the stomach all the time. Oxygenation is key as you can’t burn off the fats without oxygen.
• Supplement vitamin D
• Eat a diet high in antioxidants (to prevent and reverse liver damage)
• Take a really good quality anti-oxidant supplement (for example vitamin C, vitamin E, lipoic acid, CoQ10 etc)
• Supplement the herb St Mary’s Thistle which is highly protective of the cells of the liver