If you have fatty liver disease, a condition also known as hepatic steatosis, chances are you don't know you have it, and even if you do, chances are you don't know what you can do about it. Curcumin offers an inexpensive way to support recovery from fatty liver disease that is side-effect free and costs just pennies per day.

What Is Fatty Liver Disease?

Fatty liver is a disease that is best known for striking people who drink heavily, but it also is a frequent problem for type 1 and type 2 diabetics, for people who have chronic viral infections, and for people who take medications to regulate the immune system.

Fatty liver is the accumulation of triglycerides in liver cells. Triglycerides are the storage form of extra calories from sugars and fat. The process that causes fatty liver is not unlike the process of fattening up a goose's liver so that it can later be harvested to make foie gras.

Many people who have fatty liver are obese, but the condition can also result from injury to the liver caused by alcoholism, exposure to industrial chemicals, viral hepatitis, iron overload disease, or malnutrition. Sometimes the disease results from a failure of the mitochondria in liver cells to burn fatty acids¹, and sometimes the problem is due to the excessive production of triglycerides inside the liver itself.

Fatty liver disease, however, develops in every individual who consumes more than 60 grams of alcohol per day. That is the equivalent of 5 or 6 glasses of wine per day, 5 or 6 beers per day, 2 or 3 drinks of hard liquor per day, or some combination thereof.

What Does Fatty Liver Disease Do to the Body?

Fatty liver disease results from a malfunction of the energy-producing mitochondria in the cells of the liver. They lose their ability to burn fatty acids for fuel and these fatty acids build up in the cell.

The build-up of fat in liver cells most frequently results from excessive consumption of alcohol. When the liver has to process large amounts of alcohol, it runs out of the B vitamins and enzymes it needs to burn fat. Fatty liver disease can also result from consuming too much fat or fructose, and as a side-effect from using aspirin, a heart drug called amiodarone, steroids, tetracycline antibiotics, methotrexate (a drug used to treat rheumatoid arthritis and certain kinds of cancer), and antiviral medications.

The accumulation of fat in the liver by itself does not usually interfere with the function. Usually there has to be some kind of 1-2 punch to trigger inflammation in the liver, such as taking one of the aforementioned medications and drinking too much, or exposure to heavy metals. Fatty liver can be present for years without causing symptoms until there is a secondary trigger for active disease.

What Are the Symptoms of Fatty Liver Disease?

Severe fatty liver disease causes many of the symptoms associated with hepatitis² and cirrhosis of the liver. People who have fatty liver disease can have jaundiced, yellow skin and eyes. They can suffer constant itching. They can suffer ascites, which is severe swelling of the torso, malaise, loss of appetite, and abdominal discomfort. In about 50% of fatty liver sufferers who are well enough to walk on their own, however, fatty liver disease can cause no specific symptoms at all.

Even if when there are no disagreeable symptoms, it is not a good idea to ignore fatty liver disease. Left untreated, especially in people who drink, fatty liver disease can lead to cirrhosis, liver cancer, a form of brain swelling known as hepatic encephalopathy, or generalized swelling of the body.

Disruption of the liver can cause disturbances in the metabolism of sex hormones resulting in menstrual disturbances in women and gynecomastia (breast enlargement) in men. In more advanced cases, the liver loses its ability to make clotting factors for the blood, and there can be severe bleeding after cuts and scrapes. The inability of the liver to process hormones can lead to problems with the kidneys and thyroid and eventually multi-organ failure.

What Is the Usual Treatment for Fatty Liver Disease?

There isn't a lot modern medicine can do for fatty liver disease other than caution against consuming alcohol and taking certain prescription drugs. These measures, however, can make a huge difference in the prognosis.

When fatty liver is caused by excessive alcohol consumption, complete cessation of drinking can result in normalizing liver function in just 2 to 4 weeks. Similar good results can be obtained by cessation of offending prescription drugs (something you should only do with the guidance of your physician).

When fatty liver is the result of a genetic factor or ongoing exposure to an environmental toxin, however, there is not a lot modern medicine can do to stop the damage. Curcumin, however, may help.

What Can Curcumin Do for Fatty Liver Disease?

The most important thing curcumin can do for people who have fatty liver disease is to stop the “1-2 punch” of fatty liver and inflammation from causing permanent damage to the liver.

The usefulness of curcumin in fighting fatty liver disease is born out by public health observers in India. Up to 38% of the people in north India carry a gene that predisposes them to fatty liver disease. Far fewer than 38% of this population, however, actually develop health problems related to fatty liver disease. This could be due to the popularity of curcumin-rich curries in the Indian diet.

It turns out that there is a scientific explanation for the correlation of eating curry and avoiding the advanced stages of liver disease. Researchers at the Institute of Traditional Medicine at the Yang Ming University in Tapei, Taiwan have found that curcumin stops apoptosis, or cellular suicide, in liver cells laden with fat. Before a liver cell activates its self-destruct sequence, it has to generate two enzymes known as phosphenol pyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase). If it does not activate these two enzymes, it does not die, and it is not replaced by the scar tissue that interferes with the flow of blood and nutrients through the liver.

But curcumin is not only useful in preventing the end stage of fatty liver disease. Curcumin is also useful in helping prevent the accumulation of fat in the liver.³

Dr. Annette Graham of the Glasgow Caledonian University in Scotland reports that curcumin helps liver cells continue to do their work of taking LDL (“bad”) cholesterol out of the bloodstream⁴, but without taking in other fatty acids that “burn out” the mitochondria of the cell. When liver cells are protected from fatty acid damage, the liver makes more bile salts, which carry excess LDL out of the body and into the waste matter of the large intestine. In this way, curcumin both stops the progress of fatty liver and enhances cardiovascular health.

How Much Curcumin Do You Need to Take If You Have Fatty Liver Disease?

If you have been told by your physician that you have fatty liver disease (either alcoholic or non-alcoholic hepatic steatosis), you need to follow all your doctor's orders and take all the medicines you are given. Curcumin is a supplement to your health routine, not an alternative to it.

It doesn't take a lot of curcumin to make a big difference in the progress of liver disease. Studies of diet and liver health suggest that as little as 80 mg a day will help protect the liver against fibrosis, cirrhosis, and failure.

But since curcumin does cause any side effects, it's easier just to take the standard dose of 400 to 1000 mg a day in a single capsule. It's OK to take brand that combines curcumin with the herb from which it is concentrated, turmeric, but don't take just the single herb. Always take a product that includes a listing of curcumin, not just turmeric, on the label.

References:

1. Kuo JJ, Chang HH, Tsai TH, Lee TY. Curcumin ameliorates mitochondrial dysfunction associated with inhibition of gluconeogenesis in free fatty acid-mediated hepatic lipoapoptosis.
   Int J Mol Med. 2012 Sep; 30(3): 643-9. doi: 10. 3892/ijmm. 2012. 1020. Epub 2012 Jun 11.
2. Shah SR, Patel K, Marcellin P, Foster GR, Manns M, Kottilil S, Healey L, Pulkstenis E, Subramanian GM, McHutchison JG, Sulkowski MS, Zeuzem S, Nelson DR.
   Clin Gastroenterol Hepatol. 2011 Aug; 9(8): 688-93. doi: 10. 1016/j. cgh. 2011. 04. 029. Epub 2011 May 13.
3. Vera-Ramirez L, Pérez-Lopez P, Varela-Lopez A, Ramirez-Tortosa M, Battino M, Quiles JL. Curcumin and liver disease. Biofactors. 2013 Jan 10. doi: 10. 1002/biof. 1057. [Epub ahead of print]
4. Kang Q, Chen A. Curcumin suppresses expression of low-density lipoprotein (LDL) receptor, leading to the inhibition of LDL-induced activation of hepatic stellate cells. Br J Pharmacol. 2009; 157: 1354–1367. [PMC free article]