Many people have fatty liver disease and don’t even know it. The term “fatty liver” can sound simple, but it actually refers to the buildup of fat and other substances in the liver—including triglycerides, cholesterol esters, bilirubin, and sometimes iron or cellular waste. Over time, this accumulation can stress the liver and affect its ability to function properly.
I know this personally—I’ve had fatty liver since I was a child. Back in the 1980s, when fatty liver wasn’t widely recognized, I experienced liver issues that taught me a lot about how this organ works and what it needs.
Ferritin and Iron: Why They Matter
Ferritin is the protein that stores iron in the body. Each ferritin complex can hold thousands of iron ions, and when ferritin is overloaded, the body starts storing iron as hemosiderin, which can damage the liver.
High ferritin may contribute to fatty liver, while low ferritin can indicate impaired iron recycling, often linked to spleen function. Balancing iron is important for liver health. In some cases, controlled blood donation (phlebotomy) can help reduce excess iron, but this should only be done under medical supervision.
Liver Enzymes and Proteins
Doctors often check liver enzymes such as AST, ALT, and GGT to assess liver function:
- AST and ALT indicate liver cell stress or damage.
- GGT can rise with toxin exposure, bile flow issues, or certain medications.
The liver also produces proteins like albumin and globulins, which reflect overall liver health. Chronic liver disease can cause low albumin and high globulin levels.
Gallbladder Health
The liver’s partner, the gallbladder, plays a crucial role in digesting fats. Blockages from sludge or gallstones can impair liver function. High bilirubin levels, particularly direct bilirubin, may indicate gallbladder obstruction. Some natural remedies, such as chanca piedra or Bhumi amla, may support gallbladder health, but persistent issues require medical evaluation.
The History of Fatty Liver
Historically, doctors only recognized fatty liver in people who consumed alcohol. Today, we know that nonalcoholic fatty liver disease (NAFLD) and its more severe forms—nonalcoholic steatohepatitis (NASH) or metabolic dysfunction-associated steatotic liver disease (MASLD/MASH)—can develop in people without alcohol involvement. Environmental toxins can also contribute, sometimes labeled as toxicant-associated fatty liver disease (TAFLD/TASH).
Fatty Liver Progression
Fatty liver disease progresses in stages:
- Simple fatty liver – fat accumulation only
- Steatohepatitis – fat plus inflammation
- Fibrosis – chronic inflammation and scarring
- Cirrhosis – extensive scarring, impaired liver function
The earlier the detection, the more reversible the condition.
Reversing Fatty Liver
Lifestyle changes are the foundation for reversing fatty liver:
- Diet: Reduce sugar, refined carbs, excess animal protein, and alcohol. Focus on nutrient-rich foods, including vitamins B2 and B5, magnesium, copper, and phosphorus.
- Exercise: Regular physical activity helps reduce liver fat and improve metabolism.
Certain supplements and herbs may support liver health:
- Choline – helps remove fat from the liver
- IP6-Inositol – may help manage excess iron
- Ayurvedic herbs: Kutki, Bhumi amla, and amla (Indian gooseberry) may support liver regeneration and detoxification.
Important: Herbs and supplements should be used as adjuncts, not replacements for medical care.
Monitoring Your Liver
Regular testing helps track progress:
- Ferritin: ideally below 75 ng/mL
- AST & ALT: ideally below 20 U/L
- GGT: ideally below 30 U/L
- Serum albumin: 4.1–4.8 g/dL
- Globulin: 2.2–2.8 g/dL
- Direct bilirubin: below 0.3 mg/dL
Imaging, such as an ultrasound, can detect fat accumulation and gallbladder issues.
Key Takeaways
- Fatty liver is common and often silent, but it can progress to serious disease if untreated.
- Balanced iron, healthy liver enzymes, gallbladder function, and proper diet are essential.
- Herbs like Kutki, Bhumi amla, and amla, plus supplements like choline and IP6, may support liver recovery.
- Lifestyle—diet, exercise, and avoiding toxins—is critical.
- Always consult a healthcare professional before starting new supplements or procedures.
Your liver is resilient, but it needs help. With attention to diet, nutrients, and overall health, fatty liver can often be reversed. Start today—the liver will thank you tomorrow.