24 years old Fatty Liver patient

This is a letter I received not a long time ago from David, a 24 years old man, who was diagnosed to have a fatty liver:


2 Months ago I was told I have Fatty Liver Disease. I am 24 years old, I weight at 260 pounds, 5’11” tall. I am over weight and I have more fatty mass than muscle mass. Knowing that I have this disease is draining my mind and creating a lot of stress because I just don’t know how bad I have it.

What makes it more stressful is the fact that I have lost 17 pounds since January of this year and I don’t know how I did it. I read that weight loss is a sign of advancement of the Disease. The only thing I have changed is that I have been eating a healthy breakfast in the morning that includes lots of fruit and no exercise. The other thing that I had done was take synthroid for my thyroid functions. I took the pill for 3 months or so and stopped taking it around January. I am stilling losing weight to this day and it is driving me nuts.


Can you tell me at my age should I be worried about the weight loss as a sign of advancement? I just pray that its not that far along so that I can have a chance to exercise and eat better to turn this disease around. What can I do to see just how bad I really have it. Your prompt response would be greatly enjoyed.

Few hours later I sent him the following answer:

Before I can answer to your questions, I need to know some missing details.

First of all, which type of fatty liver disease do you have? Alcoholic or nonalcoholic fatty liver disease?
Have you performed any abdominal ultrasound test for fatty liver diagnosis?

Second, have you done any liver function blood tests? If so, what were the results? Specifically, the results of liver enzymes ALT and AST.

You are 24 years old; meaning the change the disease isn’t advanced yet. It takes decades for a fatty liver to advance to a much serious liver conditions.

Waiting for your reply.
Dr. Mark Bar-Gomel

David replied:

I have NAFLD. A ultrasound was preformed on my liver to determine that I have NAFLD. My blood test results were: AST = 82, ALT= 161. Tests were done 12/16/08.

My report produced from the ultrasound is as follows:

FINDINGS: The liver is difficult to penetrate and has a coarsened echotexture.
No hepatic mass or intrahepatic biliary ductal dilatation is seen. The
pancreas appears normal. The gallbladder is normal. Right kidney is normal.
Common bile duct measures 3 mm. No free fluid is seen.

IMPRESSION: The appearance of the liver suggests hepatic steatosis. No focal
hepatic lesion or intrahepatic biliary ductal dilatation is seen.

I hope you can answer my questions with the information given above. With that said, In general what can I eat to help my liver out? I heard lemon juice is okay? Is this true? What else if you have any other ideas.

My answer to him:

From the information you provided, it is my honest though that your condition is reversible. I’m positive your weight loose is not an indication for advanced stage of the disease.
To reverse the condition, it will require from you to change your life style and eating habits.

Regarding lemon juice, the answer is yes. There are some indications that lemon juice is good for a fatty liver. You can also read the foods for fatty liver article that gives a good guideline for what you should eat.

28 replies
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  1. mr68gto
    mr68gto says:

    Hello Dr. If you could comment on this US please?

    Liver: Limited evaluation due to overlying shadowing bowel gas. This is suggestion of coarse hpatic echotexture. A discrete lesion is not identified.

    Gallbladder: Normally distended. No pericholecystic fluid, gallbladder wall thickening, shadowing calculi or sludge. Negative for Murphy’s sign.

    Bile Ducts. No abnormal intra or extrahgepatic biliary ductal dilatation. Extrahepatic common duct measures 2.3 mm


    Spleen: Normal measuring 9.9cm in maximal dimension

    Impression: 1. Limited exam due to overlying shadowing bowel gas
    2. Limited visualization of the liver. There is suggestion of coarse ghepatic ecghotexture which is nonspecific and could represent hepatocellular disease.

    Does this sound like Fatty Liver, Cirrhosis, or something bad?

    ALT, AST, Billirubin all all well within limits. Creatinine in limits but towards high end. INR is 1.1.


  2. Anitha
    Anitha says:

    Hi, I am so worried and confused. please help me with an answer. I am 37 year old and a mother of 2 aging 14 and 13. I have been over weight for almost 10 years. last month i have been for a ultra sound and the result came as Hepatomegaly with fatty infiltration and distended galbladder. I have intramural-subserosal fibroids(2. one is big and one small) in uterus. I have nabothian cysts also. I do not have bad food choices but i do not think i have good food choices either. I am not an alcoholic. I have regular periods and in the fatty liver section of ultra sound they stated that it measures 174 or so. My doctor said it is nothing to worry and have given no medications what so ever and just said to loose weight. I just happened to look into internet and all the descriptions are scaring me. I am getting depressed when I see my family. what should I do. should I just go with my doctors opinion and get my ultrasound after 6 months or should i do something else. I know I sound tensed but I hope you would understand my situation. I have never been worried about my health as my annual routine blood tests never showed cholesterol or triglicerides and i thought that was enough. I cant loose my weight over night but I am loosing my mind. I also have fibroids in breast for the past 10 years(when i was in normal weight too) and reading these informations is confusing me. please help me with an answer. Thank you.

  3. phillip
    phillip says:

    Hi I am Phillip…after one year, I took this morning an upper abdomen ultrasound…the results shows that Liver is enlarged with increased echogenicity with homogenous parenchyma. Hypoechoic region is seen anterior to the gallbladder fossa and prota hepatis. Portal vein and hepatic vessels are not dilated with anechoic lumen
    Intrahepatic and extrahepatic ducts are not dilated.
    Common bile duct measures 0.4 cm
    Gallbladder wall is not thickened with no evidence of intraluminal echogenicity within.
    Pancreas and spleen are normal in size with homogenous parenchyma.

    my question is: What does it mean?

    thanks and kindest regards

  4. Jessica Ramirez
    Jessica Ramirez says:

    Im 26 years old now and gained weight after having my first child. I am 5’5 and went from 125 to 155(after pregnancy) and could never loose the baby fat which was basically just some pudge in the belly area. So when i found out i had fatty liver i was pretty shocked. My AST got as high as 53 and my ALT got to 166. I did tons of different labs and ultrasounds and other tests to try to figure out what caused it and why I have it. Not predisposed to anything no diabetes, high cholesterol, no family history, no liver diseases such as any of the hepatitis’s. The ultrasound came back saying I had fatty spots in my liver and my liver was surrounded by fatty tissue. My doctor told me not to take any more medications which for me had been benedryl for allergies and tylenol for headaches on very rare occasion. I didnt drink alcohol, smoke, or do drugs so that wasnt an issue. But I did eat out ALOT. Basically I stopped eating out. And watched my portion sizes. I also tried to eat fish, chicken, and only small portions of lean loin meet. Ate lots of veggies and fruits. And In 1 month i started to notice a Huge change. my levels went down to AST 44 and ALT 101 and one month later which is this month I just got my lab results in and my levels have dropped to AST 27 and ALT 53! So what I am saying is that if you can just make small changes… small simple changes that in the long run will better improve all aspects of your quality of health “anyways” i believe that if you CAN lower your levels! Just cut out fast foods, eat the correct portions, exercise at least 10-30 minutes a day, and eat better quality foods, lay off the alcohol, and medication (if you can) > because your liver has to filter out this medication and if it is getting high levels(ALT and AST) – its already getting damage and it needs to repair itself and rest which makes it harder because it has to do more work with medication….(at least that was my theory). But I am proof that it has worked! So dont give up!

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