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The Keto Diet and Fatty Liver

Is the keto diet good for a fatty liver (NAFLD)?

Yes, the key to healing a fatty liver is to reduce lipogenesis inside the liver. Fat accumulates in the liver when excess sugar (fructose and glucose) are introduced.

Once glycogen reserves are full, sugar is not needed for energy, so it is stored inside the liver and results in fatty infiltration. The keto diet reduces sugar, insulin, and triglycerides and lowers fat stored inside the liver.

Lipogenesis is the metabolic formation of fat through the glycolysis and metabolism of carbohydrates.

Keto Diet is effective for reducing fatty liver

Drastically lowering fructose, high fructose corn syrup (HFCS) and other simple carbohydrates have shown to reduce the build-up of fat in the liver, (hepatic fat accumulation)

The Ketogenic Diet’s foundation is low carbohydrate, moderate protein, and high fat. The Keto Diet, therefore, reduces lipogenesis and reduces fatty infiltration of the liver and has the potential to reverse fatty liver disease (NAFLD).

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Under Doctors supervision, Keto can be an effective fatty liver disease treatment and improve liver function tests.

This study on Pubmed confirms it. What’s also interesting about this data is the suggestion that the impairment to the gut microbiome and associated endotoxemia also contributes to the risk of NAFLD.

Fructose induced lipogenesis
Low carb diet slows down Lipogenesis

So besides reducing simple sugars, repairing and improving digestion will improve a fatty liver. This article focuses on improving Keto Digestion and repairing the gut microbiome.

It is estimated that 31% of the US population has a fatty liver.

Prolonged and excessive accumulation of fat into the liver (NAFLD) can further develop into what is known as NASH (Non-Alcoholic SteatoHepatitis).

NASH can further result in scarring of the liver (fibrosis), cirrhosis and chronic liver disease and finally liver failure and death. Scarring of the liver (fibrosis) can also result in the liver becoming more susceptible to developing liver cancer.

NASH is directly linked to the epidemics of metabolic syndrome, insulin resistance, obesity, pre-diabetes, and diabetes.

Stay away from fruit to heal your fatty liver.

The science just keeps mounting that the ketogenic diet can improve fatty liver disease. In almost all cases Keto reduces triglyceride levels in the body.

This study shows after 24 weeks on the ketogenic diet the average triglycerides levels went down from 275 to 100. 

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Furthermore, this study makes the case that excessive accumulation of triglycerides (TG) in the liver is a significant risk factor for developing cirrhosis of the liver. This study even refers to fatty liver disease as diabetes of the liver.

How to heal a fatty liver with keto (video)

The amazing ketogenic liver

The liver weighs about 3 pounds and performs about 500 vital functions in your body. The liver and gallbladder produce bile acids which help you break down fat. It also has the amazing ability to perform gluconeogenesis and ketogenesis.

The process of gluconeogenesis is the ability to convert amino acids and fat into glucose. It’s the reason we can go on extended fasts without developing low blood sugar. The liver can just make the glucose it needs without any ingested carbohydrates.

Efficient bile acid and glucose (gluconeogenesis) production are extremely important to someone on a high-fat/low-carb ketogenic diet.

When you restrict carbs and deplete your muscle sugar (glycogen), you enter into a state of ketosis and your liver converts fat into ketones.

Fatty Liver Disease: The Silent Killer

There usually are no symptoms associated with fatty liver disease. Many people go years with the condition and only discover it during routine blood work during a physical.

Word of advice, if you are unsure see your doctor and ask for a blood liver function test.  Ask your doctor to go over the results with you and ask for a copy to keep for your records.

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So you have a fatty liver now what?

Your doctor will likely start to perform tests on you. There is no definite “single test” that will absolutely confirm a fatty liver. He will first test you for hepatitis and when that is negative will order an MRI or CT scan and a liver biopsy.

But if you are pre-diabetic, type 2 diabetic or even if you are overweight (overfat) there is a strong possibility you have excessive fat accumulation in your liver.

No pill or drug Can heal a Fatty Liver.

Much like type 2 diabetes, there isn’t really a drug that can heal fatty liver disease. Your cells have become resistant to insulin and the glucose/fructose are not being used as energy properly (muscle/liver glycogen).

Since blood sugar (glucose-fructose) can’t be stored, some are excreted out through your kidneys (frequent urination) and the rest is converted into fat through lipogenesis. Your body is storing the excess energy as fat for use at a later time.

Fat is stored in your body’s fat cells. Fatty liver develops when the liver stores fat because liver glycogen becomes full and never has a chance to empty.

When you eat a low carbohydrate diet, fast or conduct prolong exercise your body pulls energy from the liver as liver glycogen.

The average American eats way too many carbohydrates, never fasts and/or never conducts prolonged exercise so the liver never gets emptied of liver glycogen.

So the liver, through lipogenesis, converts the muscle sugar (glycogen) to fat and stores that fat in itself. Hence, fatty liver or better known as non-alcoholic fatty liver disease (NAFLD).

The keto diet is also a fatty liver diet.

Here’s the good news. When you start the ketogenic diet and deplete your glycogen levels, among the first place it (fat) is drawn from is your liver. Just as your liver gets fat before the rest of your body, the liver gets lean before the rest of your body.

Depending on your fat levels, insulin resistance, inflammation and the strictness of your ketogenic diet, the liver can begin to heal within 3-12 months.

Matcha Green Tea improves liver health
Matcha Green Tea

Slow and steady wins the race.

The liver is unique in that it can heal, repair and regenerate itself. However, there is evidence that if you lose the fat to quickly it can shock your liver and actually increase the liver’s stress levels. In the beginning, especially if you lose the fat too quickly you could even see an increase in the liver enzyme stress markers.

Especially the Bilirubin levels, sometimes bilirubin doesn’t go down right away. The ideal situation is you lose the fat out of the liver slowly as it has a chance to heal itself. Look for an average of 5-10 pounds a month. The Ketogenic Diet will help but ease into it slowly.

Fasting can cleanse the liver and reverse fatty liver disease.

This technique makes total sense. Fasting lowers insulin and stimulates fat burning. When you conduct intermittent fasting the body draws the stored energy out of the liver to use as fuel. With nothing coming into the body, the liver has less detoxification work to do and can focus on healing itself.

An extended fast of more than 36 hours can also invoke autophagy. It (autophagy) can speed up the liver’s ability to regenerate because Autophagy is the process where the body devours damaged or redundant cellular components.

Put fewer toxins into your body to heal a fatty liver:

Eliminate the toxins that are entering the body. The liver is the master detoxifier so the less poison you are putting into your body the more it will ease the burden of your liver.

Here is a list of toxins to avoid:

  • Eliminate hidden sugars
  • Weedkiller (herbicides)
  • Bug spray (pesticides)
  • Tylenol (acetaminophen)
  • Heavy metals (drink filtered water)
  • Seed oils (Bad fats)
  • Alcohol
  • Statins
  • Antibiotics
  • Plastics (biphenyls)- use glass containers
  • Solvents (carbon tetrachloride/vinyl chloride)
  • Antibacterial soaps (Triclosan)
  • Sodium hydroxide (lye)-oven cleaner
  • Household cleaners (ammonia, bleach)
  • Carpet Shampoo (Perchloroethylene)

Take care of your teeth and gums to heal your liver.

heal a fatty liver with healthy gums
Liver health correlates to gum health

There are some alarming studies that show a link between gum disease and liver disease. You can read the study here.

It appears that periodontal bacteria, such as A. actinomycetemcomitans and P. gingivalis, circulating in the blood causes inflammation in the liver and disrupts the beneficial bacteria in our gut.

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Brush and floss your teeth daily and make sure to get your teeth cleaned every 6 months along with an annual examination. If you use a mouthwash be sure and not swallow any and rinse your mouth well afterward. If you swallow any antibacterial mouthwash it could damage the beneficial bacteria in your stomach.

Here are some things that can help your liver function:

fatty-liver-diet-menu
Keto supplements than can detoxify your liver

Liver Cleansers

Take Liver Antioxidant Supplements:

NAC can help reverse fatty liver disease
NAC can boost glutathione

Antioxidants and polyphenols help your liver repair itself by eliminating free radicals. Caffeine can help mobilize free fatty acids for fat oxidation. B-complex vitamins assist the liver detoxification process.

NAC is a precursor to glutathione which is the master antioxidants.

This study shows that Co-Enzyme  Q10 improves AST liver stress tests (10) and reduces inflammation.

Here are some keto supplements that can help heal a fatty liver:

  • C0-Enzyme Q10
  • NAC- N-acetyl cysteine
  • Choline
  • Free-range, pasture-fed, organic eggs
  • Green Tea (matcha)
  • Broccoli sprouts
  • Taurine
  • Berberine (herb)
  • Vitamin E
  • Astaxanthin
  • Omega 3 fatty acids (fish oil)
  • Coffee
  • Milk thistle (silymarin)
  • Lemon and lime juice
  • Turmeric
  • Grapefruit
  • Artichoke leaf
  • Dandelion greens
  • Flaxseed meal (organic)
  • Inulin and chicory root
  • Distilled water and activated charcoal
activated charcoal can detoxify the liver
Charcoal caps can absorb toxins
  • Branch chain amino acids (BCAAs)
  • Methionine
  • Betaine S-adenosylmethionine
  • Metformin (prescription only)

Some fermented foods that support a healthy liver:

Fixing your digestive health can help your liver heal.

How to make beet Kvass (video)

In summary, a fatty liver can be reversed with knowledge and discipline. Reducing sugar intake, lowering carbohydrates, exercising, removing the toxins entering your body and ingesting the correct ratio of healthy foods and supplements will greatly increase the odds that you will have a lifelong happy liver.

How to get started on keto (video)

Antioxidants can also help heal the liver. Here is an informative article on the Best Antioxidants.

Robert Bryant

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