Non-alcoholic Fatty Liver Disease
What is Non-alcoholic Fatty Liver Disease?
Non-alcoholic fatty liver disease, often called NAFLD, happens when too much fat builds up in your liver cells. This occurs even though you drink little or no alcohol. Your liver normally contains some fat, but when fat makes up more than 5 to 10 percent of your liver's weight, you have fatty liver disease.
NAFLD is incredibly common and affects about 25 percent of people worldwide. The condition exists on a spectrum. Simple fatty liver, the mildest form, usually causes no harm. However, some people develop non-alcoholic steatohepatitis, or NASH, where inflammation and cell damage occur alongside the fat buildup. NASH can progress to scarring, cirrhosis, and even liver failure over time.
The good news is that NAFLD often responds well to lifestyle changes. Your liver has remarkable healing abilities. When you reduce the fat in your liver through diet and exercise, you can reverse early-stage disease and protect your long-term health.
Symptoms
- Fatigue and general weakness
- Discomfort or dull ache in the upper right abdomen
- Unexplained weight loss
- Loss of appetite
- Yellowing of the skin and eyes, called jaundice
- Swelling in the abdomen or legs
- Confusion or difficulty concentrating
Most people with early-stage NAFLD have no symptoms at all. The disease is often discovered during routine blood work or imaging done for other reasons. This is why regular testing matters for catching liver problems before they advance.
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Causes and risk factors
NAFLD develops when your liver struggles to break down fats properly, causing them to accumulate in liver cells. Insulin resistance plays a major role in this process. When your cells don't respond well to insulin, your liver produces more fat and has trouble removing it. This creates a cycle that leads to fat buildup. Metabolic syndrome, which includes high blood sugar, excess belly fat, high triglycerides, and high blood pressure, significantly raises your risk.
Other risk factors include type 2 diabetes, obesity, high cholesterol, polycystic ovary syndrome, sleep apnea, and an underactive thyroid. Your diet matters too. Eating too much refined sugar, especially fructose, and consuming processed foods high in saturated fats can contribute to liver fat accumulation. Some people also have genetic variations that make them more susceptible to NAFLD, even at a healthy weight.
How it's diagnosed
NAFLD is typically diagnosed through a combination of blood tests, imaging, and medical history. Blood tests can reveal elevated liver enzymes like GGT, which leak into your bloodstream when liver cells are damaged. Testing for markers like oxidized LDL and TMAO can also provide clues, since high levels of these biomarkers are linked to fat accumulation in the liver. Your doctor may also order imaging tests like ultrasound, CT scans, or MRI to visualize fat in your liver.
Rite Aid offers blood testing that measures key biomarkers associated with NAFLD, including GGT, OxLDL, and TMAO. Regular testing helps you catch liver changes early and track your progress as you make lifestyle changes. In some cases, your doctor may recommend a liver biopsy to determine the extent of inflammation or scarring, especially if advanced disease is suspected.
Treatment options
- Lose 7 to 10 percent of your body weight through diet and exercise if you are overweight
- Follow a Mediterranean-style diet rich in vegetables, fruits, whole grains, and healthy fats
- Limit added sugars, especially fructose from sodas and processed foods
- Avoid or minimize alcohol consumption
- Exercise regularly, aiming for at least 150 minutes of moderate activity per week
- Manage underlying conditions like diabetes, high cholesterol, and high blood pressure
- Work with your doctor on medications for diabetes or cholesterol if lifestyle changes aren't enough
- Consider vitamin E or other supplements under medical supervision for certain cases of NASH
- Get regular monitoring through blood tests and imaging to track liver health
Concerned about Non-alcoholic Fatty Liver Disease? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
NAFLD is the umbrella term for fat buildup in the liver not caused by alcohol. NASH is a more serious form of NAFLD where inflammation and liver cell damage occur along with the fat. NASH carries a higher risk of progressing to cirrhosis and liver failure. Not everyone with NAFLD develops NASH, but those who do need closer monitoring and treatment.
Yes, early-stage NAFLD can often be reversed through lifestyle changes. Losing 7 to 10 percent of your body weight can significantly reduce liver fat. Improving your diet, exercising regularly, and managing conditions like diabetes help your liver heal. The key is catching the disease early before permanent scarring occurs.
Most people discover NAFLD through routine blood work that shows elevated liver enzymes. Your doctor may also find it during an ultrasound or CT scan done for another reason. Regular blood testing for markers like GGT, OxLDL, and TMAO can help identify liver problems early. If you have risk factors like obesity or diabetes, proactive testing is especially important.
Limit foods high in added sugars, especially those containing fructose like sodas and fruit juices. Reduce your intake of refined carbohydrates like white bread and pastries. Avoid fried foods and those high in saturated fats. Cut back on red meat and processed meats. Instead, focus on whole foods, vegetables, fish, and healthy fats from sources like olive oil and nuts.
NAFLD can increase your risk of liver cancer, but this typically happens after years of progressive disease. When NASH leads to cirrhosis, or severe scarring, the risk of liver cancer rises. This is why early detection and treatment matter so much. By addressing NAFLD early, you can prevent progression and reduce your cancer risk significantly.
Most doctors recommend blood tests every 3 to 6 months when you're first diagnosed and making lifestyle changes. This helps track your progress and shows if your interventions are working. Once your condition stabilizes, annual testing may be sufficient. Your doctor may also recommend periodic imaging to assess liver fat and scarring.
Yes, lean NAFLD affects about 7 to 20 percent of people with normal body weight. These individuals may have metabolic risk factors like insulin resistance despite not being overweight. Genetics, diet quality, and visceral fat around organs can all play a role. Thin people with NAFLD still benefit from the same lifestyle interventions as those who are overweight.
GGT is a liver enzyme that rises when liver cells are damaged by fat buildup. OxLDL, or oxidized LDL cholesterol, contributes to fat accumulation in the liver. TMAO is a compound linked to liver fat and inflammation. Elevated levels of these markers can signal NAFLD before symptoms appear, making them valuable for early detection and monitoring.
Currently, no FDA-approved medications specifically treat NAFLD. Treatment focuses on managing underlying conditions and making lifestyle changes. Your doctor may prescribe medications for diabetes, high cholesterol, or high blood pressure. Vitamin E has shown benefit in some people with NASH. Several new medications are in clinical trials and may become available in the coming years.
When your cells become resistant to insulin, your pancreas makes more insulin to compensate. High insulin levels signal your liver to produce and store more fat. At the same time, insulin resistance makes it harder for your liver to break down and export fat. This combination leads to fat accumulation in liver cells, creating NAFLD.