8 Symptoms of Fatty Liver Disease in Women Doctors Say Are Easy To Miss After 50
Plus see the medications that can help—including Ozempic
Key Takeaways
- Fatty liver disease symptoms in women often appear subtly after menopause.
- Facial redness, itching and fatigue can all be sneaky signs of liver trouble.
- Losing just five to 10 percent of your body weight may help reverse fatty liver.
If you’ve been feeling a little “off” lately—a bit more tired than usual, maybe some fullness in your upper belly—your liver could be trying to tell you something. Nonalcoholic fatty liver disease (NAFLD) is often called a “silent” condition, and that’s exactly what makes it so tricky. Nearly a quarter of US adults have non-alcoholic fatty liver disease, according to the National Institutes of Health, yet most people have no idea anything is wrong. For women, the risk rises sharply after menopause. Knowing the symptoms of fatty liver in women could protect your health for years to come.
What is fatty liver disease?
Recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), the condition occurs when more than five percent of liver cells contain fat droplets, says Kathleen Corey, MD, director of the Massachusetts General Hospital Fatty Liver Clinic. Over time, that excess fat can trigger inflammation and scarring called fibrosis, which—left unchecked—can progress to cirrhosis and raise the risk of liver failure and liver cancer. Research in Hepatology shows fatty liver prevalence has jumped more than 50 percent in the past three decades.
What causes fatty liver disease? The menopause link
Younger men typically have higher rates of fatty liver than younger women, but that shifts at midlife. “When menopause happens, all of a sudden it equals out,” Dr. Corey says.
Woman's World Answers
The reason comes down to hormones. Estrogen helps the liver burn fat, explains Fred Pescatore, MD. When estrogen drops, fat buildup is more likely to accumulate in the organ. A Harvard University study found that menopause more than doubled women’s odds of a fatty liver diagnosis.
Other major risk factors for fatty liver disease include:
- Type 2 diabetes. Fatty liver affects more than 70 percent of people with the condition, per research in Diabetes Spectrum.
- Excess belly fat
- High triglycerides paired with low HDL cholesterol. This combination can raise fatty liver odds by as much as 820 percent, according to a study in Lipids in Health and Disease.
- Diet heavy in processed foods
- Lack of exercise
Symptoms of fatty liver in women
Here’s the catch: “Most people are asymptomatic,” Dr. Corey says. When symptoms do appear, they’re easy to brush off, especially in the early stage of the condition. Women should watch for these symptoms of fatty liver disease:
- Discomfort in the upper right abdomen—more of a pressure or fullness than sharp pain
- Fatigue or feeling generally unwell, says gastroenterologist Sheena B. Patel, MD
- Elevated liver enzymes discovered during routine blood work
Surprisingly, your face can reveal symptoms of fatty liver disease in women, too. According to gastroenterologist Maria Hernandez, MD, of Gastro Health, possible facial signs include:
- Rosacea: redness, pimples and broken blood vessels
- Spider veins on the face or trunk
- Darkened skin on the back of the neck linked to insulin resistance
- Itching that affects about one in five people with fatty liver per research in Biomedicines
- Jaundice: yellowing of the skin and eyes that signals advanced disease
Fatty liver disease can be reversed
Here’s the heartening part: Fatty liver disease is highly treatable, especially when caught early. Losing just five percent of your body weight may improve MASLD, while shedding seven to 10 percent can help reverse the more advanced form, MASH, suggests a study in Current Obesity Reports. Full reversal typically takes about a year.
Need help reaching a healthy weight? Consider a supplement like Self Nutrition Everyday Metabolic, which supports your body’s production of GLP-1 to curb cravings and regulate blood sugar.
Fatty liver disease treatment options that work
Aside from losing weight to reduce extra fat in the liver, these lifestyle changes can help:
Eat foods good for fatty liver
Research in Nutrients found that swapping one serving of starchy carbs daily for leafy greens like kale or broccoli rabe lowered fatty liver index scores in three months. Adding 4 tablespoons of ground flaxseed daily produced liver fat reductions up to six times greater, per Food & Function. Two large oranges a day, three to four cups of coffee and a square of dark chocolate may also help.
Move a little more
A Journal of Hepatology study found that adding 2,500 steps a day reduced chronic liver disease by 38 percent. Resistance training three times a week plus 150 minutes of moderate activity like brisk walking or pickleball also lower liver fat.
Consider these supplements for fatty liver
Berberine reduced liver fat by 53 percent within 16 weeks in PLOS One research. Milk thistle, vitamin D, N-acetylcysteine, vitamin E, vitamin B3 and turmeric may also support liver health and reduce the risk of liver damage. (Learn more about the best supplements for fatty liver.)
Mind your meals and sleep
Eating less than two hours before bed raises fatty liver risk, so aim to have more of an early-bird dinner. Also smart: Catching up on sleep over the weekend, which helps protect your liver.
Ask your doctor about medication for fatty liver disease
Ozempic’s active ingredient semaglutide may reduce liver fat, says Edmond Hakimi, DO. A New England Journal of Medicine study found 59 percent of NASH patients on high-dose semaglutide improved. The FDA also recently approved Rezdiffra specifically for fatty liver in people with NASH and moderate-to-advanced scarring.
“It’s important to know that people have [fatty liver] so that they can act upon it,” Dr. Corey says. If you have any risk factors, ask your doctor about screening at your next visit—your liver will thank you.
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