From the Guidelines
Fatty liver disease can indeed cause fatigue, and the most effective way to manage it is through lifestyle modifications, including a Mediterranean diet and regular exercise, as recommended by the most recent and highest quality study 1.
Key Recommendations
- Focus on a Mediterranean diet rich in fruits, vegetables, whole grains, and healthy fats, while limiting processed foods, sugar, and alcohol 1.
- Aim to lose 5-10% of your body weight through regular exercise, such as 150 minutes weekly of moderate activity like walking 1.
- Stay hydrated and ensure adequate sleep, as these can help improve overall health and reduce fatigue.
Rationale
The liver plays a crucial role in processing toxins and regulating metabolism, and when it is infiltrated with fat, it can lead to inflammation and fatigue 1.
Management
- Therapeutic lifestyle interventions, including dietary changes and regular exercise, are recommended for patients with nonalcoholic fatty liver disease (NAFLD) at low risk of advanced fibrosis 1.
- Weight loss of any magnitude is beneficial, and even modest weight loss (approximately 5%) can lead to reversal of steatosis 1.
- Selected patients may benefit from approved medications that promote weight loss, as well as from bariatric surgery, but these should be individualized based on the severity of obesity and comorbidities 1.
From the Research
Fatty Liver and Fatigue
- Fatigue is a common symptom in patients with chronic liver disease, including fatty liver disease 2, 3.
- The pathogenesis of fatigue in chronic liver disease is complex and multifactorial, involving both peripheral and central causes 2, 3.
- Fatigue can have a significant impact on the quality of life of patients with fatty liver disease, affecting their ability to be physically active and socially engaged 3.
Treatment of Fatty Liver Disease and Fatigue
- Several treatments have been studied for the management of fatty liver disease, including metformin, pioglitazone, and vitamin E 4, 5, 6.
- Metformin has been shown to improve liver function tests, insulin resistance, and liver fat content in patients with non-alcoholic fatty liver disease (NAFLD) 4, 5, 6.
- Pioglitazone has also been shown to improve liver function tests and liver fat content in patients with NAFLD 4, 6.
- Vitamin E has been studied as a potential treatment for NAFLD, but its effectiveness is still unclear 5.
Management of Fatigue in Fatty Liver Disease
- The management of fatigue in fatty liver disease is complex and may involve a combination of lifestyle modifications, behavioral therapies, and pharmacological interventions 2, 3.
- Further research is needed to understand the pathogenesis of fatigue in fatty liver disease and to develop effective treatments for this symptom 2, 3.