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. Phillip
    Phillip says:

    Good day. the previous liver ultrasound i have posted here dated Dec. 23rd was based from their initial findings I took online and was not the official findings because when I took my result after three days this was the findings.

    The liver is slightly enlarged measuring 15.67 cm with increased echogenicity.
    Hypoechoic region is noted anterior to the gallbladder.
    Ducts are not dilated. Common bile duct measures 0.3 cm


    May I ask you again to explain further. Do I have to worry? thanks and kindest regards.

    PHILLIP says:

    Hi. I am Phillip, 30 yrs old. this morning I had my liver ultrasound and the results shows that my
    liver is normal in size with increased echogenicity with homogenous parenchyma.
    Ducts are not dilated. Common bile duct measures 0.3 cm

    my question is : Is this reversible?

    Thanks and kindest regards..

  3. Kirtan
    Kirtan says:

    Hello Doctor,

    I have recently been diagonized with a fatty liver. I have a distended belly since the last 5 days now..I was an alcoholic and a smoker… Below are my reports for the sonography.

    Liver is mild enlarged in size and shows increased echopattern. No mass lesion identified. The hepatic veins are clear and patent. Gall bladder shows no obvious abnormality. Common Bile duct measures 3mm in diameter. Pancreas obscured. Spleen is normal in size and echopattern.

    Both kidneys are normal in shape and position. Nomral echogenicity and cortico medularry differentiation is noted. No hydronephrosis or mass lesion is seen.

    Renal length and A.P of right are 102 mm and 92mm. For the left it is 92 and 44 mm….

    Please let me know if this could be a cancer or something.

    I also have done the blood reports and my SGPT/ALT us 70 u/l where the ref range is 30-65.

    SGOT – 28 u/l with a ref range of 0-40

    RBC is 4.30 mill/cmm with a ref range of 4.5 – 5.5

    MCH is 32.6 PG with a ref range of 27.5 to 31.5

    Eosinophils is 1% with the range of 2-10.

    Smear Evaluation is adequate.

    WBC is 8700/cmm

    MCHC is 32.8%

    HCT is 42.7

    Creatinine is 0.9 mg/dl

    Gamma GGT is 28 and lipase is 129 u/l.

    My height is 5.8 and my weight is 70kgs.

    Please let me know what might be the disease.. Cancer? Pancreatic or some? I have a little pain on my lower right abdomen if I sit for prolonged hours.And my belly gets full even after a short meal…

    Appreciated Dr Mark.

  4. Michelle
    Michelle says:

    My nephew 24 yrs old died oct 16 2010 and the autopsy showed he had a fatty liver and that the reason for his death was that his liver failed we where unaware any thing was wrong he was not at all over weight but was know to knock back a few anyway this has been a real shock and I just want to know how could this even happen to a kid that was practically the picture of health

  5. Monica
    Monica says:

    Recently I went to a neurological doctor Because my PCP Dr thought I had fibromyalgia.
    The neurological DR said she is still unsure if I have fibromyalgia but I am deficient in Vitamin D and B12. So she gave me a vitamin regiment.
    A few weeks prior to the follow up appointment she advised me that my liver enzymes were elevated and needed to be redone, and advised me to NOT drink alcohol, nor take pain medication .
    She stated if I did need pain medication take it at the lowest dose. I followed most of the instructions all though I did have a beer here and there but nothing in access. Well earlier this week they redid the test and by Friday and I had 3 voice mails from her office to call them back.
    When I did call them back they said make an appointment with a liver specialist and make it ASAP. They really stressed to make the appointment fast and that it is urgent. So now my weekend is shot because I am overly worried and to make it worse they have not given me any liver function test results. They only said the numbers were much worse this time.
    Any idea Dr. Mark Bar-Gomel why the urgency because of the increased numbers?

    • Mark Bar-Gomel
      Mark Bar-Gomel says:

      Hi Monica,
      As I don’t have the number and the test results your doctors have, I really can’t reply to your condition.
      I urgently suggest you meet the doctors as soon as possible to hear out the development.
      If your liver enzyme levels are elevated dramatically, it could mean a more serious disease than fatty liver, but again, I cannot comment without the test results.

      Wish you full health.

  6. brandy
    brandy says:

    Well i seen this post while lookin up things bad for a fatty liver, All i have to say is try havein it be 2 months after ur 21st bday and find out u have a fatty liver, i was the youngest person in the liver specialist, It was a bit embaressing, But now i am 25 yrs old and im still kickin.. But good luck to u just loose weight n eat good, thts wat i did..

    • Mark Bar-Gomel
      Mark Bar-Gomel says:

      Hi Brandy,
      Thanks for sharing your experience; it’s really helpful for all other people to understand that proper life-style is really the core issue with fatty liver.

      Dr. Mark Bar-Gomel

  7. Roxanne
    Roxanne says:

    Hi Dr.Mark,
    i went for a scan for my liver and abdomen as i was experiencing a hard distended belly for about a year, also painful at the belly button area.
    A week later, my report showed that i have fatty liver……im 20 yrs old.
    i dont drink alcohol and i also rarely eat fried foods, so why is that?
    The doctor told me its nothing to worry about….but i totally disagree….im trully worried and want to find out the real cause of it and what exactly to do to fully cure it. My mum was also diagnosed with it and i really want to help her too…..what should i do now?

  8. Farah
    Farah says:

    Good Day doctor Mark!!

    My husband was diagnosed a week ago with moderate fatty liver disease.

    He has severe pain on his right side since 14 yrs, he went to many doctors but was only diagnosed a week ago!!

    He has no blood tests done just an US that also shows in the gall bladder cholesterol crystals!!

    I was wondering what other test should be done and is his condition reversible??

    what should he eat?? is fish ok??

    Thanks alooot:)

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