Fatty liver on your scan but feeling fine? What it means

What is fatty liver?

Fatty liver means extra fat has built up in the liver cells. It is commonly linked to weight, diabetes or pre-diabetes, high cholesterol and triglycerides, and to alcohol use.

In many people it stays mild. In some, the fat causes inflammation over the years, which can lead to scarring of the liver. Assessment helps work out which situation you are in.

Why you can feel fine and still need a check

The liver can carry on working well while changes develop slowly. Tiredness, a vague heaviness in the upper right abdomen or nothing at all are all possible. The absence of symptoms does not tell you how healthy the liver is.

What a hepatology consultation looks at

• Your history: weight changes, diabetes, blood pressure, medicines, alcohol and family history
• Liver blood tests, including SGOT and SGPT (ALT and AST) values
• Whether the scan shows only fat, or signs that suggest more advanced change
• If needed, a test that estimates liver stiffness, to check for scarring
• Other causes of liver problems, such as hepatitis B or C, which are checked separately

What usually helps

Treatment depends on the cause and on how much the liver is affected. For many people, the main steps are gradual weight loss, regular physical activity, better control of blood sugar, blood pressure and cholesterol, and cutting down or stopping alcohol.

Some people also need medicines or regular monitoring. Your doctor will explain what applies to you, rather than a standard plan for everyone.

What to bring to the visit

• Your ultrasound or other scan reports
• Recent blood test reports, especially liver tests, sugar and cholesterol
• A list of all medicines and supplements you take
• Earlier prescriptions related to your liver or sugar