What Is Fatty Liver Disease?

Fatty Liver Disease (also called hepatic steatosis) occurs when too much fat builds up in the liver. While it’s normal for the liver to contain some fat, excess fat can lead to inflammation, scarring, and long-term liver damage if left untreated.
There are two main types:

• Nonalcoholic Fatty Liver Disease (NAFLD): Fat buildup not caused by alcohol use.
• Alcohol-Associated Fatty Liver Disease (AFLD): Caused by heavy or long-term alcohol use.

Over time, fatty liver can progress to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, or even liver failure if it’s not identified and managed early.

Common Symptoms of Fatty Liver Disease

Fatty liver disease is often called a “silent condition” because most people have no noticeable symptoms in the early stages. However, as the condition progresses, you might notice:

• Fatigue or low energy
• Discomfort or dull pain in the upper right abdomen
• Unexplained weight loss
• Weakness or general feeling of being unwell
• Mild nausea or poor appetite

Hidden or Subtle Signs to Watch For

Because early fatty liver often goes unnoticed, it’s important to recognize less obvious symptoms that can indicate your liver is under stress:

• Brain fog or difficulty concentrating – the liver’s reduced ability to filter toxins can affect mental clarity.
• Unexplained skin changes – such as dark patches (especially on the neck or underarms), redness on the palms, or small clusters of blood vessels (spider veins).
• Abdominal bloating or feeling “full” quickly after eating – due to fluid buildup or an enlarged liver.
• Unexplained weight gain, especially around the midsection.
• Swelling in legs or ankles (edema).
• Changes in mood or sleep – liver dysfunction can affect hormone balance and metabolism.

These signs can be subtle and easy to overlook, which is why routine checkups and blood tests are so important.

Image Source: Continental Hospitals

How Fatty Liver Is Diagnosed

Fatty liver disease is often found incidentally during routine bloodwork or imaging. Your provider may use:

• Liver function tests (ALT, AST)
• Ultrasound or FibroScan to measure fat and stiffness in the liver
• CT or MRI imaging
• Liver biopsy (in select cases) to confirm inflammation or fibrosis

Why Early Detection Matters

When detected early, fatty liver can often be reversed with lifestyle changes and proper medical care. Early management can:

• Prevent progression to liver scarring or cirrhosis
• Improve energy, metabolism, and overall health
• Reduce risks for diabetes, heart disease, and other metabolic conditions

How to Support Liver Health

Simple steps can make a big difference:

• Maintain a healthy weight
• Eat a balanced diet rich in vegetables, whole grains, and lean proteins
• Limit sugar, refined carbs, and processed foods
• Engage in regular physical activity
• Avoid excessive alcohol and unnecessary medications
• Schedule regular checkups with your healthcare provider

When to Talk to Your Provider

If you experience ongoing fatigue, abdominal discomfort, unexplained weight changes, or any of the hidden symptoms listed above, it’s important to discuss them with your healthcare provider.
At Verity Health PNW, we’re committed to helping you identify and manage liver concerns early — supporting your journey toward long-term health and wellness.

Comparison Table

Symptoms of Fatty Liver Disease Comparison Table

Medical professionals rely on systematic assessment to identify fatty liver disease patterns. We have organized the twelve warning signs to help you understand their characteristics and clinical significance.

Symptom	Key Characteristics	Primary Mechanism	When to Seek Help	Prevalence (if mentioned)
Fatigue and Weakness	Debilitating weariness that persists despite rest; affects physical and mental clarity	Liver inflammation disrupting CNS communication; altered melatonin production	When exhaustion persists despite rest or interferes with daily activities	50-85% of chronic liver disease patients
Mild Abdominal Discomfort	Dull or aching pain in upper right abdomen; feeling of fullness	Liver enlargement causing pressure on liver capsule	Persistent pain that doesn’t resolve with rest; severe sudden pain	Not mentioned
Unexplained Weight Changes	Sudden weight gain or loss without lifestyle changes	Decreased liver function affecting metabolism; insulin resistance	Weight changes of 5% or more within months	Over 50% experience significant changes within 1-2 years
Elevated Liver Enzymes	Increased ALT, AST, ALP, and GGT levels in blood	Liver cell damage causing enzyme leakage into bloodstream	Any elevation in liver enzymes, even without symptoms	Most common cause of elevated enzymes in US adults
Dark Urine	Brown or tea-colored; clear despite dark color	Disrupted bile flow leading to bilirubin buildup	Persistent dark urine despite hydration	Not mentioned
Red Palms	Symmetrical redness in palms; warm to touch; blanchable	Elevated estrogen levels causing blood vessel dilation	Persistent redness with other liver symptoms	23% of cirrhosis patients
Swelling in Legs/Ankles	Soft, painless swelling; leaves temporary indentation	Portal hypertension causing fluid leakage	Swelling that doesn’t improve with elevation	50% within 10 years of cirrhosis
Cognitive Issues	Memory problems; poor concentration; personality changes	Toxin buildup in brain; chronic inflammation	Increasing confusion or disorientation	Up to 70% of NAFLD patients
Persistent Upper Right Pain	Sharp, stabbing sensations under right ribcage	Liver enlargement pressing on Glisson’s capsule	Severe pain interfering with daily activities	One-third of NAFLD/NASH patients
Itchy Skin	Generalized itching worse at night; no visible rash initially	Bile acid accumulation in bloodstream	When itching interferes with sleep or daily activities	20% of NAFLD patients
Jaundice	Yellowing of skin and eyes; dark urine; light stools	Bilirubin buildup due to impaired liver function	Immediate medical attention needed	Not mentioned
Spider Veins	Web-like red/blue patterns with central red spot	Hormone imbalance causing blood vessel dilation	When multiple spider veins appear (>3)	95% specificity for chronic liver disease

Verity Health looks forward to supporting your liver wellness journey. Our comprehensive services include metabolic health guidance and personalized treatment approaches.
We believe in empowering community health through early detection and evidence-based care.

Your liver health matters to your overall wellbeing. Schedule a consultation if you’ve noticed any of these symptoms or have risk factors like diabetes or family history.
We look forward to helping you protect your liver function and enhance your health for years ahead.

FAQs

Q1. What are the early warning signs of fatty liver disease? Early signs include persistent fatigue, mild abdominal discomfort in the upper right quadrant, and unexplained weight changes. However, many people with fatty liver disease don’t experience noticeable symptoms in the early stages, which is why regular check-ups are important.

Q2. How does fatty liver disease affect cognitive function? Fatty liver disease can impact cognitive function by causing memory problems, difficulty concentrating, and even personality changes. This occurs due to toxin buildup in the brain and chronic inflammation associated with liver dysfunction.

Q3. Can fatty liver disease cause skin changes? Yes, skin changes can be indicators of fatty liver disease. These may include jaundice (yellowing of skin and eyes), itchy skin without a visible rash, red palms, and the appearance of spider veins, particularly on the face, neck, and upper chest.

Q4. Is weight gain always associated with fatty liver disease? While weight gain is common, fatty liver disease can also cause unexplained weight loss in some cases. Significant weight changes in either direction without changes to diet or exercise routines can be a sign of liver dysfunction.

Q5. How is fatty liver disease diagnosed? Fatty liver disease is often initially suspected due to elevated liver enzymes in routine blood tests. Further diagnosis may involve imaging tests like ultrasound or FibroScan, which can assess liver fat content and stiffness non-invasively. In some cases, a liver biopsy may be necessary for definitive diagnosis.