Most people with fatty liver don’t even know they have it! Learn the symptoms of fatty liver and 4 ways to test.
Note from Dena: This post was co-written with Sandra Johnson, Dietetic Intern, as part of a research partnership between Back To The Book Nutrition and post-graduate nutrition students from the University of Houston.
We recently discussed 12 root causes of Fatty Liver, but how do you know for sure if you have it? Today we’ll review common symptoms and health conditions related to fatty liver, as well as four ways to test for it.
Fatty Liver Symptoms
What makes this condition so dangerous is that many people don’t have any symptoms to alert them something is wrong. More advanced cases may lead to some of the symptoms listed below. (5)
- No symptoms at all
- Pain or discomfort in the upper right abdomen (this may come and go and may extend around the right side or as far back as the shoulder-blades)
- Itchy skin
- Yellowing of skin or the whites of your eyes
Health Conditions Related to Fatty Liver
Whether or not you’re experiencing symptoms, the following conditions increase your risk for fatty liver. (3, 5) If you have any of these, talk with your doctor of healthcare provider about getting tested for fatty liver.
- Obesity (about 1/3 also have fatty liver)
- Metabolic syndrome (a combination of high blood pressure, high blood sugar, high cholesterol, and belly fat) – this is presently the strongest known predictor of fatty liver
- Type 2 Diabetes
- High cholesterol
- High triglycerides
- High blood pressure (50% of patients also have fatty liver)
- Sleep apnea
- Polycystic ovary syndrome (PCOS)
- Celiac Disease
- Iron overload
- Low testosterone
- Hepatitis C
- Fatty pancreas or Pancreatitis
- Gallbladder Dysfunction/Gallstones
- Menopause in women
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Tests for Fatty Liver: 4 Options
If you have some of the symptoms or health conditions above, getting tested for fatty liver is probably a good idea. Here are four options to discuss with your provider.
1. Fatty Liver Index Calculation (FLI)
This method is a rarely discussed, but is a simple, affordable, and 84% accurate way to predict whether you have Fatty Liver (1). Newer research shows the FLI may also help predict diabetes, high blood pressure, and heart disease (2). It’s a simple calculation you can do yourself if you have a few basic lab markers and body measurements on hand. Here’s what you’ll need:
- BMI (a ratio of your weight to height) – Calculate your BMI here.
- Waist Circumference
- Triglyceride levels (blood test) – Order your own triglycerides here for around $15.
- GGT (blood test) – Order your own GGT here for around $20
Once you have your numbers, plug them into the calculator below and, voila!
Calculate your Fatty Liver Index here!
2. Blood Tests
The lab tests below aren’t definitive, but high levels increase the likelihood you have a fatty liver (3,4). Since they are affordable and non-invasive, practitioners may use them to help screen for fatty liver. Remember, fatty liver can also be present when these values are normal.
- High ALT
- High AST – Order your own ALT and AST here for around $20
- High GGT – Order your own GGT here for around $20
- High Serum bile acids – Order your own Serum bile acids here for around $20
3. Diagnostic Imaging (Ultrasound, CT, or MRI)
When the above markers indicate an increased likelihood of fatty liver, a physician can order abdominal imaging. An enlarged liver or one with fatty appearance usually confirms the diagnosis. (3)
4. Liver Biopsy
This is the most definitive way to diagnose fatty liver. A doctor can perform this, but it isn’t as common since it’s so invasive and only evaluates a tiny fraction of the liver tissue, possibly missing other dysfunctional portions.(3)
Are there Natural Remedies for Fatty Liver?
Yes! Fatty liver is extremely responsive to diet, supplement, and lifestyle changes! Stay tuned for our next post to learn all about it!
Check out these related posts!
What Really Causes Fatty Liver?
Fatty Liver Diet and Supplements
About the Co-Author
Sandra Johnson, Dietetic Intern has a B.S. in Human Nutrition and Foods from the University of Houston. When she started changing her eating patterns and improving her health to be a better influence for her children, she discovered her passion for nutrition and food.
Disclaimer: Information on this site is intended only for informational purposes and is not a substitute for medical advice. Always consult with a trusted healthcare provider before implementing significant dietary change. Read additional disclaimer info here.
1. Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., & Tiribelli, C. (2006). The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC gastroenterology, 6, 33. https://doi.org/10.1186/1471-230X-6-33
2. Khang, A. R., Lee, H. W., Yi, D., Kang, Y. H., & Son, S. M. (2019). The fatty liver index, a simple and useful predictor of metabolic syndrome: analysis of the Korea National Health and Nutrition Examination Survey 2010-2011. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 181–190. https://doi.org/10.2147/DMSO.S189544
3. Zhang, J. Z., Cai, J. J., Yu, Y., She, Z. G., & Li, H. (2019). Nonalcoholic Fatty Liver Disease: An Update on the Diagnosis. Gene expression, 19(3), 187–198. https://doi.org/10.3727/105221619X15553433838609
4. Gottlieb, A., & Canbay, A. (2019). Why Bile Acids Are So Important in Non-Alcoholic Fatty Liver Disease (NAFLD) Progression. Cells, 8(11), 1358. https://doi.org/10.3390/cells8111358
5. Cleveland Clinic. Fatty Liver Disease. Accessed: https://my.clevelandclinic.org/health/diseases/15831-fatty-liver-disease
I was first diagnosed with fatty liver amd eventually found out that i have diabetes.. Bloating is one of the ewrly symptoms i got and they had to ultrasound me for that.. Since then i was advised to eat healthy and also to regularly check my sugar level
So glad you got a prompt ultrasound and diagnosis!
Oh wow I had never even heard of this!
Thank you for writing this. This article culd be a life saver as it teaches us to watch out for our liver.
s scary when people have a fat liver and they dont know or notice it. It`s good to be aware of these symptoms. Thank you for sharing
This was an informative post. I had a friend who had a fatty liver and bloating was one of her symptoms
The first step to fighting or preventing any diseases is awareness and purposefully researching about their symptoms. Thanks for sharing this
It`s good to know the symptoms of a fatty liver. We can know if we have it or not and actually do something about it
Yes, there’s SO much you can do naturally for fatty liver! 🙂
Interesting to know about this fatty liver and how to know if we have it or not. Thank you for sharing!
You’ve brought things to my mind that I never really things about. Thank you for educating us all.
This is a very knowledgeable post and something I’ve never learned about honestly. Thank you for the share!