“Fatty Liver”, a guide for patients:
“Fatty Liver” is a common term referring to Metabolic dysfunction-associated steatotic liver disease (MASLD), which is a type of chronic liver disease. MASLD encompasses a syndrome of not only “Fatty Liver”, but diabetes, obesity and hypercholesteremia. It is the most common Chronic Liver Disease with a worldwide prevalence of 30%. Chronic fatty liver disease can also result from habitual alcohol consumption, viral hepatitis, and other underlying causes.
While it is common, it requires monitoring as it can progress to liver scarring, otherwise known as cirrhosis. This monitoring can be done with blood tests at your primary care provider’s office. Your primary care provider will have access to tools to help with risk stratification of liver disease to decide if you would require additional tests or referral to a specialist.
As a patient, there is a number of things you could do to reduce your risk of liver disease.
1. Lifestyle Modifications:
“Fatty Liver” can be managed by reducing weight, controlling diabetes, and cholesterol. It is easier said than done, and may require consultation with a Dietician to facilitate the process. Avoidance of alcohol is important as it is considered a toxin to the liver and can further damage the organ. If needed, addiction services are available and certain medications can be prescribed to help with stopping alcohol consumption.
2. Vaccinations:
When people with liver disease get infections, they can be quite ill. As such, vaccinations are recommended to prevent infections. Examples are the hepatitis A and B vaccines(Twinrix), influenza vaccine, COVID-19 vaccine on top of other routine age recommended vaccines. Additional pneumonia(Prevnar 20) and shingles vaccine(Shingrix) vaccines are recommended in liver cirrhosis.
3. Avoiding Certain Medications and Foods
Certain medications are primarily metabolized by the liver, including acetaminophen (Tylenol) and ibuprofen (Advil). Acetaminophen is generally safe for managing pain and fever when used appropriately, with a recommended maximum dose of 3 grams per day for healthy individuals.
​
In patients with liver cirrhosis, the maximum dose of acetaminophen should be reduced to 2 grams per day to minimize the risk of liver toxicity. Additionally, individuals with liver disease should avoid herbal remedies that lack a clear list of ingredients, as they may contain substances that can further harm the liver.
​
Uncooked shellfish, such as raw oysters, should also be avoided in liver cirrhosis due to the risk of severe infections, particularly from bacteria like Vibrio vulnificus, which can lead to life-threatening complications in individuals with compromised liver function.
Primary care doctors can help guide you through the process of managing your chronic liver disease.
References: