Symptoms of Fatty Liver You Shouldn’t Ignore

Fatty liver disease is one of the most common liver conditions worldwide and it's often completely silent in its early stages. Known medically as hepatic steatosis, fatty liver occurs when excess fat builds up in liver cells, potentially impairing the organ’s ability to function over time.

There are two main types:

• MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease, formerly NAFLD)

• AFLD (Alcoholic Fatty Liver Disease, also known as alcoholic steatohepatitis)

Though they have different causes diet and metabolic conditions for MASLD, alcohol use for AFLD both can lead to inflammation, scarring, and eventually liver failure if not caught and managed early.

Early Symptoms of Fatty Liver Disease

In the early stages, fatty liver disease is often asymptomatic. That’s why it's sometimes referred to as a "silent disease."

However, you may notice:

• Mild fatigue

• General discomfort or dull pain in the upper right abdomen

• Unexpected lab results, such as elevated liver enzymes during routine bloodwork

These subtle symptoms are easy to overlook but could be your first sign of trouble.

Progression to MASH (Metabolic Dysfunction-Associated Steatohepatitis)

When fatty liver progresses and inflammation develops, the condition may become MASH (formerly NASH). At this point, damage to liver cells becomes more pronounced.

Symptoms may include:

• Worsening fatigue or weakness

• Unintentional weight loss

• Persistent itching

• Jaundice (yellowing of the skin and eyes)

• Spider-like blood vessels visible on the skin

With proper lifestyle changes and medical care, MASH may still be reversible making early detection critical.

Advanced Symptoms: Cirrhosis and Liver Damage

If left untreated, MASH and AFLD can progress to cirrhosis, the late stage of liver disease. At this point, the liver becomes heavily scarred and permanently damaged, and symptoms tend to become more obvious.

Common signs of cirrhosis include:

• Severe fatigue

• Loss of appetite and unintentional weight loss

• Nausea and vomiting

• Swelling in the legs or abdomen (edema and ascites)

• Bruising easily or prolonged bleeding

• Dark urine and pale stool

• Cognitive issues such as confusion or forgetfulness (due to toxin buildup)

• Sleep disturbances

• Increased jaundice

Cirrhosis is currently one of the top 10 causes of death in the U.S., highlighting the importance of early detection and management.

Complications of Advanced Liver Disease

As liver function declines, the risk of serious complications increases. These include:

• Hepatic encephalopathy: Brain inflammation leading to confusion or memory loss

• Ascites: Fluid accumulation in the abdomen

• Liver cancer: One of the most serious complications of cirrhosis

• Portal hypertension: High blood pressure in the vein supplying the liver

• Internal bleeding: Especially in the esophagus or stomach

• Hepatopulmonary syndrome: A rare condition impairing lung function

• Hepatorenal syndrome: Poor kidney function due to liver failure

These complications can be life-threatening and often require hospitalization or specialized care.

Who’s at Risk for Fatty Liver?

You're more likely to develop fatty liver disease if you:

• Drink alcohol regularly (for AFLD)

• Have obesity or insulin resistance

• Live with type 2 diabetes

• Eat a diet high in processed fats and sugars

• Have high cholesterol or triglycerides

• Have a history of rapid weight loss or malnutrition

You may also be at risk without any symptoms, which is why regular checkups and blood work are important.

When to See a Healthcare Provider

Consult a provider if you experience:

• Persistent or worsening fatigue

• Upper right abdominal pain

• Signs of jaundice

• Swelling in your legs or belly

• Unexplained weight loss

• A personal or family history of liver disease

A doctor may recommend blood tests, imaging, or a liver biopsy to evaluate the extent of fat accumulation and damage.

The Bottom Line

Fatty liver disease often develops silently but that doesn’t mean it’s harmless. When left unchecked, it can evolve into life-altering conditions like cirrhosis, liver cancer, and organ failure.

Paying attention to early signs like fatigue and liver discomfort, especially if you’re in a high-risk group, can help you get diagnosed early and take steps to reverse the damage.

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