Been diagnosed with Fatty Liver: What can I do about it?

My doctor told me I have a fatty liver. I’m 75; I drink 2-4 glasses of wine daily because it helps my fibromyalgia. Lately, I have very low energy and get overtired by doing very little. Because of that, I can’t exercise much.

Even though my AST and ALT numbers are fine, my hematologist tells me I have NASH. I asked what I could do about it and was told "lose weight." Not particularly helpful as I have lost 140 pounds over the last five years. I reached out to a Ragen Chastain (who has a great newsletter on health and weight) and was referred to a HAES (health at every size) paper which alerted me to the AST and ALT numbers and also offered that 2 cups of coffee a day is protective for NASH. Also, on my own, I found a paper stating that estrogen is protective for NASH. (Fat produces estrogen.) I've been on Anastrozole for 4 1/2 years, so my estrogen is nil. Looking forward to being off it and hoping that will help with the NASH.

Hello everyone. I am a 29 y.o. man. A couple days ago, it was confirmed that I have a fatty liver. I have heart disease and had an open-heart valve repair at 15 and this past December @ 28 y.o., I had my valve replaced with a mechanical. I have been on medications for this since I was 8. Around middle-to-high school, a little over a decade ago, I started having severe OCD and depression, and endured the most severe bullying. All the medications from heart, to a seizure medication to help treat mood disorders, to good ole fashion SSRIs — from what I have read (correct me if I’m wrong), these types of medications seem to be more harmful. I smoked cigarettes for about a decade and have indulged in an immense amount of alcohol for the past decade. The next step is to see what stage I am on. The doctor said he doesn’t think it is horrible, based on the scans. Liver conditions also run in my family. My brother and I also have Gilbert’s syndrome which affects how the bilirubin processes. If anything, it’s not a “how” did this happen, it’s more of “what to do” next. I have done some research and it seems to be straightforward. I guess I am just writing this for moral support. I am so glad I came across everyone here. For me, I blame myself. On the other hand, I guess I can take an educated guess of what happened to my liver, but what if it wasn’t my fault? Will I ever know? I am very emotional and truthfully, just scared. Thank you for listening and letting me vent. Everyone is in my heart and thoughts. Again, thank you for your stories. -Kyle
P.S. I have also been on Coumadin/Warfarin since heart surgery in December and will be on it for life, unless something big changes. My INR has been inconsistent since the beginning and we are still working on finding the proper dose.

@kylecentralflorida Hey this is pam from East Texas I was diagnosed with a fatty liver over 20 years ago. Not sure of the reason ,I'm 59 years old and have been disabled nearly half my life now. To many medical problems to go on about but I will say that some of the ones you mentioned I also take medication for as well as many more. Lifting you up prayer with all those who I shall pray for tonight,always pam

Hi @kylecentralflorida - welcome to Mayo Clinic Connect. It sounds at though you've been through a lot.

Ultimately, determining causation is unlikely to be fruitful to beat yourself up about, in my estimation. Depending on what your doctor thinks caused your situation (and perhaps it's just unknown), he or she may have lifestyle or environment tips to share with you privately for going forward. Or all this could just be a fluke.

When I found out after a colonoscopy two years ago that a neuroendocrine tumor was removed, with the professionals originally thinking it was a polyp, I had intense fears that certain relatives might blame my cancer on me, especially due to my non-ideal weight at the time.

This had to do with my perception of these relatives' attitudes over time about how I could end up with all kinds of maladies due to not being at ideal weight and seeming bias/looking down on me for this.

In the end, I had none of the risk factors for this cancer and there was no lifestyle blame my doctor or I could find to pin on me. My doctor said it was not my fault. It was also determined over months of testing that I had no more cancer in my body, thankfully.

All that to say, I think your approach of "it’s not a 'how' did this happen, it’s more of 'what to do' next" is a good one. You said you thought it was pretty straightforward. What is your next step?

Lifestyle changes that helped me with my liver were eliminating sugar and intermittent fasting. Both are in my control but I have to admit that they are hard to stick to long term. I backslide often but have learned not to blame myself. I don’t drink alcohol or take drugs, don’t smoke, I eat healthy food, try to drink enough fluids and I exercise daily and that has never changed. Be kind to yourself. You sound pretty resilient for what you have already endured. You are amazing.