Each part of our body plays an important role to keep us healthy. One body part that’s especially important is the liver. The liver is a vital organ that performs over 500 functions that we can’t live without.¹
But like any part of the body, the liver can become damaged and diseased. There are many types of liver disease, and if not treated in time, they can all lead to permanent liver damage and even cause liver failure.
And the tough thing is that liver disease doesn’t usually cause symptoms until it’s too late.
The most common way that liver disease is diagnosed is a combination of blood work and imaging. And if there’s concern that liver function is getting worse and becoming permanent, many people will end up getting a liver biopsy to confirm this. However, this type of test is painful, invasive, and downright risky.
But what if I told you there’s other options for diagnosing and managing your liver disease?
At Noble Functional Medicine, we offer an imaging test called FibroScan that helps us see just how well your liver is functioning. And if you’re found to have a form of liver disease, we can help you find the cause, get personalized treatment, and make sure your liver is healing.
But before we learn more about FibroScan, let’s go over exactly why taking care of your liver is so important.
What Does the Liver Do?
The liver is a large organ that sits in the upper right part of your abdomen. Its size is similar to a football, and it’s mainly known for filtering toxins, like alcohol, out of the body. But it does so much more than that.
The liver is also responsible for:²
- Producing bile, which is a fluid needed to digest fat from the foods we eat
- Absorbing certain vitamins, including vitamin D
- Breaking down old blood cells, a process called hemolysis
- Producing proteins that allow our blood to clot
- Storing glucose (sugar) in our cells for our body to use later
- Creating albumin, a protein that helps the body keep fluid in the blood vessels
- Breaking down hormones like insulin and estrogen
- Processing medications
- And more…
Because of all of the functions that the liver has, it’s no wonder that we get concerned when it starts to get damaged or diseased.
So what exactly is liver disease?
The Types of Liver Disease
Liver disease is pretty common – it affects about one in three Americans.³
While there are many different types of liver disease, the most common one is metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD occurs when fat builds up in your liver and replaces healthy liver cells. It was previously known as nonalcoholic fatty liver disease (NAFLD).
MASLD affects around 25% of people in the world, and it’s the second-leading cause of liver failure in Europe and America.⁴ It’s important to note that MASLD is treatable and reversible. But if MASLD isn’t caught early, it can progress and cause dysfunction and inflammation of the liver – a condition called metabolic dysfunction-associated steatohepatitis (MASH). And once MASH occurs, the liver is damaged, and it’s difficult to reverse. MASH was previously known as nonalcoholic steatohepatitis (NASH).
The stages of liver damage.⁵
If MASLD and MASH are left untreated, the liver can become permanently scarred, damaged, and inflamed. This results in a condition called fibrosis which is followed by cirrhosis. Cirrhosis is the number one cause of liver failure, and people with cirrhosis are at an increased risk of liver cancer.⁶
What Are the Causes of Liver Disease?
There are many different causes of MASLD, but one of the biggest causes is something called metabolic syndrome. Metabolic syndrome is a group of conditions linked to obesity.
Metabolic syndrome is present if you have any three of the following:⁷
- Large waist size
- High triglyceride levels
- Low HDL cholesterol levels
- High blood pressure
- High blood sugar levels
Having metabolic syndrome or any of the traits of metabolic syndrome increases your risk of developing MASLD. This is because these conditions are putting increased stress on the liver to detox.
Additionally, eating a diet high in sugar, fat, and too many calories also puts extra stress on the liver. And when the liver runs out of room to store extra calories, it instead stores it in the form of fatty deposits. Alcohol and other toxins also damage the liver.
Other causes of MASLD that aren’t as common include genetic conditions like:
- Hemochromatosis, which causes high levels of iron to be stored in the liver
- Wilson’s Disease, which causes a build-up of copper in the liver
It’s important to understand the different causes of MASLD, especially when it comes to treatment. Because if we don’t understand the root cause of the liver damage, we can’t properly treat it.
The Signs and Symptoms of Liver Disease
The signs and symptoms of liver disease may be difficult to notice, especially in the early stages. So this means that many people with MASLD may not know it because they feel okay and don’t have any symptoms.
But as MASLD progresses and MASH starts to develop, people may have symptoms like:⁶
- Dull, achy pain over the liver
- Fatigue
- Weight loss
- Weakness
Because the symptoms of liver disease are often absent and hard to detect, it’s important to have routine blood work and testing done to monitor for any signs that your liver isn’t working properly. Being on top of this can help prevent liver damage.
How is Liver Disease Diagnosed?
One sign that the liver isn’t working well can be found on blood work. Elevation of liver function tests (LFTs) on blood work tells us that the liver is under stress and possibly being damaged. The two main LFTs include:
- Aspartate aminotransferase (AST)
- Alanine aminotransferase (ALT)
If your LFTs are found to be high, the next step is getting imaging done of your liver to find out what’s wrong. However, it’s important to note that even if your LFTs are in the “normal range,” this doesn’t necessarily mean that you don’t have liver damage.
“Normal” ranges on blood tests are based on averages of people getting the blood tests. And because the people getting frequent blood tests are the ones with health conditions, these “normal” ranges are often higher than they should be.
For this reason, I advise all of my patients to get imaging of their livers if either their ALT or their AST is above 30.
Testing For Liver Disease: Imaging and Biopsies
Typically, the first type of imaging test that most health care providers order is an ultrasound of the liver. This will simply tell us if there are fatty deposits in the liver, which are consistent with a diagnosis of MASLD.
But unfortunately, an ultrasound isn’t able to tell us exactly how much fat is in the liver or if scarring is starting to occur, especially in the earlier stages of liver disease.
Other imaging tests like MRIs and CT scans can provide more detail to check for liver damage. But unfortunately, they’re expensive, time consuming, and difficult to have done routinely.
And sometimes, liver biopsies are done to see if scar tissue is present in the liver. But biopsies are painful, invasive, and come with the risk of complications like infection and bleeding.
For these reasons and more, we at Noble Functional Medicine, use an imaging study called FibroScan.
What is FibroScan?
FibroScan is a FDA-approved imaging test that uses technology called elastography to measure liver stiffness and the amount of fat in the liver. The stiffer the liver tissue is, the more scarring (or fibrosis) is present. Instead of just showing that fat or scarring is present in the liver, FibroScan is able to tell exactly how much scar tissue and fat there is. This is especially useful for tracking changes in liver health over time and to see if certain treatments for liver disease are working. And because of its sensitivity for detecting scarring of the liver, it can sometimes be used in place of a liver biopsy.
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FibroScan is completed in a way similar to ultrasound. When you have a scan done, a small amount of gel is placed on the skin. Then, a probe is placed over the right upper part of the abdomen to take different measurements of your liver. Each scan takes 5-10 minutes and is completely painless.
Plus, results of each scan are available immediately, which means that you don’t have to wait days to see if your hard work is paying off.
Who Should Get A FibroScan?
Liver damage can happen without you even knowing. And even if you get your annual bloodwork done, having liver enzymes in the “normal” range doesn’t mean your liver is completely healthy.
For this reason, I recommend you get a FibroScan done if you have:
- Waist circumference over 35 inches in females and 40 inches in males
- Fasting blood sugar over 100
- Elevated triglycerides and low HDL cholesterol
- High blood pressure, specifically a top number over 130
- Family history of cirrhosis
- Personal history of hepatitis
Additionally, if you’ve gotten bloodwork and notice that one or both of your LFTs are over 30, it’s time to get a FibroScan to find out the exact cause. By doing this, you’ll be able to get treatment and reverse your liver disease before it becomes permanent.
Treatment for Liver Disease
When it comes to treating liver disease and maintaining overall liver health, there are certain lifestyle changes that have been proven to work. Some of these lifestyle changes include:
- Weight loss of 3-5% of your body weight decreases fat stores and improves liver health in those with MASLD⁸
- Exercising 150 minutes each week can help reverse MASLD⁹
- Eating a ketogenic diet lowers inflammation in the liver, helping to prevent MASLD¹⁰
- Implementing intermittent fasting into your diet can keep MASLD from progressing and also help with weight loss ¹¹
But treating liver disease isn’t a one-size-fits-all process.
The type of treatment plan that’s recommended depends entirely on the cause of the liver disease, how severe it is, and your medical history.
For example, if we determine that your cause of liver disease is obesity, then treatment options would be losing weight, changing your diet, and adding in an exercise routine. But if your MASLD is caused by uncontrolled diabetes, then treatment would be focused around getting better control of your blood sugar.
Other genetic causes of MASLD like Wilson’s disease and hemochromatosis require specific treatment with medication and other therapies.
But no matter what’s causing your MASLD, getting regular FibroScans allows us to make sure the treatment is working and your liver is healing.
Take Charge of Your Liver Health Today
Your liver is an organ you can’t live without. And because liver disease develops slowly and silently, early detection is key to preventing permanent damage.
One of the safest, most accurate ways to assess liver health is with FibroScan. And by finding out the root cause of your liver disease, you can receive a personalized treatment plan to reverse damage, heal your liver, and improve your overall health.
To learn more about FibroScan and book a free consultation, check out the link below.
References:
1. Liver: Anatomy and Functions – (hopkinsmedicine.org)
2. Physiology, Liver – (nih.gov)
3. Liver Disease Statistics – (liverfoundation.org)
4. Global burden of liver disease: 2023 update – (journal-of-hepatology.eu)
5. Liver Cirrhosis – (kieronlimgastro.com)
6. Features, Diagnosis, and Treatment of Nonalcoholic Fatty Liver Disease – (cghjournal.org)
7. Symptoms & Causes of NAFLD & NASH – (nih.gov)
8. Treatment options for alcoholic and non-alcoholic fatty liver disease: A review – (nih.gov)
9. The Effects of Physical Exercise on Fatty Liver Disease – (nih.gov)
10. Beneficial effects of the ketogenic diet on nonalcoholic fatty liver disease: A comprehensive review of the literature – (nih.gov)
11. Intermittent fasting improves hepatic end points in nonalcoholic fatty liver disease: A systematic review and meta-analysis – (nih.gov)
