Fatty liver disease: Daytime sleepiness and other ‘non-specific’ symptoms

NHS Choices: Liver Disease

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Non-alcoholic liver disease (NAFLD) is a potentially life-threatening condition characterised by a build-up of fat in the liver. It is strongly tied to chronic disease markers, such as obesity and high blood sugar levels. Partly what makes NAFLD so deadly is that it is mostly symptomless.

However, there are growing reports of non-specific symptoms tied to NAFLD.

Although not tied to a definite diagnosis, non-specific symptoms can interfere with quality of life.

According to research published in the journal Karger, patients with NAFLD describe a range of non-specific symptoms, which include fatigue and daytime sleepiness.

“On direct questioning, problems with memory and concentration are frequently described by those with NAFLD, with our studies confirming that 50 percent of NAFLD patients experience mild cognitive symptoms and up to 46 percent moderate or severe cognitive impairment,” warned the study researchers.

What’s more, a history of falls is common in NAFLD, the researchers found.

The proportion of recurrent fallers is significantly higher in a NAFLD cohort compared to controls, emergency medical attention and hospital admission all significantly more common in the NAFLD group, they found.

According to the researchers, falls are also considered a direct consequence of autonomic nervous system dysfunction.

Recent studies have confirmed the presence of autonomic nervous system dysfunction in those with early stages of NAFLD.

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Autonomic nervous system dysfunction is a condition where the autonomic nervous system (ANS) does not work properly.

This governs the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels.

How is NAFLD diagnosed?

“NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out,” explains the NHS.

But blood tests do not always pick up NAFLD.

“The condition may also be spotted during an ultrasound scan of your tummy,” notes the NHS.

This is a type of scan where sound waves are used to create an image of the inside of your body.

Can I reduce my risk?

Experts don’t know exactly why some people accumulate fat in the liver while others do not.

However, chronic disease markers have been tied to NAFLD risk.

According to the Mayo Clinic, these include:

  • Overweight or obesity
  • Insulin resistance, in which your cells don’t take up sugar in response to the hormone insulin
  • High blood sugar (hyperglycaemia), indicating prediabetes or type 2 diabetes
  • High levels of fats, particularly triglycerides, in the blood.

“These combined health problems appear to promote the deposit of fat in the liver,” explains the Mayo Clinic.

The health body adds: “For some people, this excess fat acts as a toxin to liver cells, causing liver inflammation and NASH, which may lead to a buildup of scar tissue in the liver.”

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