You've been told you have a fatty liver. Maybe you got an unpleasant remark hinting that you drink too much, even though you barely drink. Or your symptoms started with your gallbladder, and the advice was to have it removed.
What's rarely mentioned is that a fatty liver and gallbladder problems often have the same cause: a liver that has been overburdened for a long time. Removing the gallbladder takes the problem away where you feel it, but not where it actually sits. Because the origin of your symptoms is in your liver.
To understand why that is, and what you can do about it, it helps to first know what your liver actually does for you all day.
The jobs your liver does
You can compare your liver to the manager of your body. It has roughly three big jobs.
The first and most important is that your liver serves your brain. For your brain, a stable blood sugar is hugely important. Too high blood sugar is brought down by insulin, and when your blood sugar drops too low, your liver makes sure glucose is produced so your blood sugar rises and the supply to your brain is guaranteed.
The second: whatever is absorbed from your food passes through your gut wall and ends up in the small blood vessels around your intestine. Through the blood, these nutrients are first transported to your liver. There they are stored, processed and sent on to wherever they're needed in your body. Your liver is in that sense the distribution centre of your body: everything arrives there and is distributed from there.
And the third job, together with your kidneys: your liver makes sure waste products are filtered and removed.
Three important and demanding jobs your liver does day in, day out to keep your body running well. In a 'normal' situation this is manageable for your liver. Yet there are many factors that can overload your liver, which is how a fatty liver can develop.
Why gallbladder problems are often a liver problem
One of the ways your liver removes waste is through the bile and the bile ducts. If your liver has been struggling for a while, the composition of that bile changes, and that eventually causes problems in your bile ducts. This can happen because the bile becomes too thick, or because a lot of toxic substances are removed through the bile, which can cause inflammation in the bile ducts or the gallbladder.
In conventional care the conclusion is drawn: let's take out the gallbladder. That removes the symptom where you feel it. But the underlying problem, that your liver is under pressure and the composition of the bile, isn't solved by it. People often feel some relief after the gallbladder is removed, but it's a matter of time before the complaints become noticeable in the liver, because that's where the problem was building up all along.
On top of that, a removed gallbladder has a big effect on how well you can digest the fat in your meals. Your gallbladder is a kind of holding reservoir. As soon as you eat a meal with a lot of fat, the gallbladder is squeezed so the bile ends up in your digestion. There, the bile helps to emulsify the fats so your body can absorb them. When your gallbladder is removed, you lose this reservoir function and the bile drips into your digestion continuously. As a result you digest fats less well, and many people find that fatty meals cause complaints. To make this liveable, they have to make conscious choices about their meals so they don't take in too much fat at once.
Besides the physical discomfort that removing a gallbladder causes, and the loss of the capacity to digest and absorb fats, it also often turns out that this wasn't the actual cause of the complaints, so after a while people are back to square one, with a body that is still giving complaints. That's why it's so important to look not only at the bile and gallbladder, but at the liver behind it.
NAFLD and NASH: two stages
A fatty liver comes in two forms, and it's good to know which. The first is NAFLD, non-alcoholic fatty liver disease, meaning a liver that has become fatty. The second is NASH, where on top of that fattiness there is also inflammation and scarring (fibrosis) in the liver. With NASH your liver is in further decline.
If you have your liver examined, ask specifically whether it can be determined which of the two it is. It matters for how serious the situation is and how much urgency there is.
What puts your liver under pressure
A liver doesn't get fatty just like that. There's usually a long period of heavy strain before it. Below you'll read about a few of the biggest culprits.
A blood sugar that keeps spiking
Soft drinks, sugar in your coffee or tea, sandwiches with sweet toppings, and a lot of starchy products like bread drive your blood sugar up.
On top of that comes factory-made fructose, the sugar found in soft drinks and processed products. When it arrives in your liver, your liver has to work hard to convert those sugars into usable building blocks for your body. Processing them demands an enormous amount of energy from your liver. Over time its own capacity declines because it's overtaxed in this process.
Many people with a fluctuating blood sugar from a sugar-rich diet recognise the typical afternoon dip: the feeling around three o'clock that you briefly crash. If you switch to less processed food, many people notice they get through the day more steadily with more energy, that they have fewer snack cravings, and that they also become calmer in their thinking.
Food that burdens your liver
Besides factory-made sugars such as granulated sugar, high fructose corn syrup and the sugars added to supermarket products, there are two more groups that have a big influence on the strain on your liver. These are gliadin, a protein from wheat, and casein, a protein from cow's milk. These give your liver extra work to process them.
In our practice we see that many people improve when they reduce or leave out those two for a while. If you change your diet, do it gradually, because gliadin and casein can have a mild morphine-like effect, which means they can be addictive. Your body can keep asking for them, with a kind of withdrawal feeling.
If you're looking for a replacement for yoghurt or quark, don't choose a soy variant, because soy is hormone-disrupting. You're better off choosing an almond milk or a coconut yoghurt. With coconut yoghurt, watch the fat content. Some varieties are very high in fat, where that amount of fat can cause complaints. There are also varieties with limited fat, which are better tolerated.
A disrupted digestion and gut flora
A third important factor is how your digestion works and the make-up of your gut flora. If the bacterial balance in your gut isn't right, you digest your food less well and absorb fewer nutrients, so a nutrient deficiency can develop and processes in your body can run less smoothly. At the same time these disruptions can lead to insufficiently digested food particles getting in, but also bacterial fragments (LPS) and even Candida if it has grown out of proportion. These are all factors that are transported through your bloodstream to your liver first, where it gets to work clearing this extra load of waste.
A simple check to see how your digestion is going and whether the make-up of your gut flora is reasonably healthy: take a look in the toilet. Is there a firm brown banana, or does it look more like chocolate mousse? That last one is a signal that something in your gut isn't going well, and that directly affects your liver.
Strain from outside
As a final factor in this article, there are the influences from outside that give your liver extra work. Think of factors in your lifestyle, the environment you live in, and the additives in and on our food and drink.
This starts with your environment: do you smoke, do you live near a busy motorway where you breathe in a lot of exhaust fumes, do you use a lot of deodorant or perfume?
It's also about what you eat and drink every day. Do you eat a lot of processed products with added glucose or fructose? Do you take in a lot of artificial colours, flavours and fragrances? And then there's our fruit and vegetables, where, if you don't consciously choose an organic variety, you take in pesticides that can affect your body negatively.
These are all factors that can contribute to damaging your cells, including those in your liver.
What you can do to take the pressure off
The hopeful thing is that your liver has a remarkable capacity to recover, if you take away the strain. The biggest gains are in your food.
- Remove the biggest burdens. Think of products with factory-made sugar or fructose, such as soft drinks, sweets and sweet spreads. Also limit, as much as possible, the fast, processed carbohydrate sources such as bread, rolls and pasta. Phase out wheat and cow's milk gradually rather than all at once, because of that withdrawal feeling.
- Choose good fats. Replace low-fat spreads, margarine and frying products with butter and coconut oil. Eat something from the sea regularly, such as herring, salmon or mackerel: that provides the omega 3 fatty acids your brain and your liver run on. If you eat little fish, a good fish oil is a valuable addition.
- Eat more eggs. The yolk is full of choline, a substance that protects your liver cells and helps prevent fat from building up in your liver. You might think: aren't eggs bad for my cholesterol? That's an outdated idea. New insights show that only about 5% of your cholesterol level is influenced by your diet. Two eggs a day is fine, and here too, choose the organic variety.
- Eat antioxidants. Antioxidants counter damage to your body's cells. You get them from real food such as vegetables, fruit and herbs like turmeric, and from raw honey. The purer and less processed you eat, the less your liver has to clean up. Choose organic varieties where possible.
- Reduce your weight gently if you're overweight. Be aware that your body can store waste products in fat cells. So it's important not to lose weight too fast, because that releases waste products at high speed which overload your liver even more. Lose weight slowly, and do this with guidance if needed.
These are, in broad strokes, the underlying causes of a fatty liver. In practice, other factors can play a role from person to person. Based on a thorough intake and specialised laboratory testing, it becomes clear what the underlying causes are, after which targeted guidance can begin.
Want to know what we can do for you? Schedule a free intro call. In that conversation we look at your personal situation and discuss what we can do for you.