Hello, Health Champions! Today, we're going to talk about the absolute fastest way to reverse a fatty liver. This is such an important topic because 35 to 40% of the world's population has fatty liver today—that's several billion people.
There are two classifications of fatty liver. The first is called alcoholic fatty liver, and the second is non-alcoholic fatty liver. It used to be that alcohol was basically the only reason someone had a fatty liver, so fatty liver was simply an alcoholic fatty liver.
Today, however, the vast majority of fatty livers are non-alcoholic. As I was prepping for this video, I came across some questions where people were asking, "Can you have both an alcoholic and a non-alcoholic fatty liver? " Online, the answer was "yes," but we need to understand that a fatty liver is just a fatty liver—you can't have two kinds, but you can have two causes.
Those causes would be sugar and alcohol. Some people may have alcohol as the primary cause, some may have sugar, and some may have both, but in the end, all you have is a fatty liver. One of the fastest ways to reverse a fatty liver is fasting.
If you did an extended fast, say, for a few months, that would probably take care of the fatty liver. However, I would never recommend such a long fast, especially if it's not supervised. There are people who have fasted for that length of time under medical supervision, but I still don't feel that's the optimal way to do it.
Instead, I recommend some form of intermittent fasting. When you do intermittent fasting, keep changing it up. Don't just stick to one pattern.
For example, you could do OMAD (one meal a day) for a while, then switch to a 42-hour fast occasionally, and perhaps do 16:8 fasting most of the time. Some people may prefer to base it on OMAD, while others may prefer 16:8. Find what you feel best with, but even so, change it up a bit.
This way, you keep your body adapting, which is always a good thing. When we talk about fatty liver, we need to understand that there are different degrees of severity. We can talk about fat in the liver, where there is some degree of fatty infiltration, but you could also reach a more severe state where you have inflammation and, eventually, some actual tissue damage and reduced functionality of the liver's functional tissue.
In grade one, which is what most people have, there is mild to moderate infiltration of fat in the liver, but there is no inflammation and no damage. The fat itself, early on, is not damaging—it’s just there, starting to infiltrate the liver. Therefore, if you run some blood work and get liver enzymes such as ALT, AST, and GGT, which are classically considered liver enzymes, you probably wouldn’t see a change in those unless there was some damage or inflammation.
In grade two, there is a bit more fatty infiltration, along with some inflammation and possibly some tissue damage. Here is where you might start seeing the liver enzymes go up. In grade three of fatty liver, there is severe infiltration, severe inflammation, and probable tissue damage.
If fatty liver progresses further, it can turn into NASH, which is non-alcoholic steatohepatitis. The “-itis” at the end indicates inflammation, so now we definitely have inflammation, and this is where tissue damage begins to appear. If this continues to progress, it can lead to cirrhosis and even cancer.
This is why we want to catch it at an early stage. It’s an incredibly common condition, but it is reversible and very closely related to insulin resistance and type 2 diabetes. In fact, it is almost synonymous with type 2 diabetes.
The next thing you want to do is stop drinking alcohol, and we're going to go through some reasons that most people probably don’t think about. First of all, alcohol turns into fat. When the liver metabolizes alcohol, the excess energy turns into fat.
In the process of metabolizing alcohol—breaking it down and turning it into fat, which is a less harmful substance than alcohol—the liver uses up certain nutrients. So, the more alcohol we consume, the more these nutrients are depleted, which predisposes us to a deficiency. The liver needs these resources to perform its usual functions, but when more alcohol and sugar are present, more nutrients are used up for the wrong purposes.
Some of the main nutrients affected are vitamins B2, B3, vitamin C, and glutathione, which is the body's primary intracellular antioxidant. Glutathione keeps the body clean by breaking down free radicals and reducing oxidative stress. Alcohol is also a diuretic, affecting the brain and pituitary by blocking a hormone called antidiuretic hormone (ADH), which helps balance fluid levels in the body.
When the pituitary releases ADH, the kidneys reabsorb more fluid and sodium. However, if alcohol suppresses ADH, the kidneys reabsorb less fluid, resulting in a diuretic effect, which makes you go to the bathroom more often. Anyone who’s had a drink or two knows that you end up going to the bathroom a lot more.
One of the biggest reasons people get a hangover is that they lose so much fluid and so many electrolytes. This is why margaritas are served with salt on the rim—the salt helps compensate for the loss of sodium due to reduced ADH. Alcohol also affects nutrient regulation in the body.
It decreases the absorption of certain nutrients and increases the excretion of others, leading to lower levels of vitamins A, B1, B6, B9, and B12, as well as minerals like magnesium, zinc, sodium, and potassium. However, alcohol increases the absorption rate of iron, which can be problematic for most people, especially if they are insulin resistant. Excess iron can lead to a condition called hemochromatosis, or iron overload, which can mimic insulin resistance and make it harder to reverse.
Iron overload is also harsh on the pancreas and liver, which are crucial organs in managing insulin resistance. Lastly, alcohol interferes with choline, a nutrient incredibly important for liver function, fat metabolism, and reversing fatty liver. Next, you’ll want to eliminate sugar.
When we talk about sugar, we’re usually referring to table sugar, added white sugar, high-fructose corn syrup, or similar substances, which are roughly 50% glucose and 50% fructose. High-fructose corn syrup is closer to 45-55, but the principle is the same. The reason to avoid these sugars is that they contain two molecules: glucose and fructose.
Fructose, which makes up about 50% of table sugar by weight, is almost as damaging to the liver as alcohol. Only the liver can break down fructose, and it imposes a similar level of stress and nutrient depletion on the liver. Everything we discussed about alcohol—how it depletes nutrients and stresses the liver—applies similarly to fructose.
The big picture effects are devastating, especially when it comes to children, who often consume far too much of this sugar. If you had to choose between giving your kids vodka or fructose—like a sugary cereal and orange juice versus a shot of vodka or two—it’s almost a toss-up in terms of the harm it can cause. So let's talk about moderation because that means different things to different people.
That's a very popular saying, "All things in moderation," and yes, I agree, but what does that mean? So I think with alcohol it should be one to two drinks per day, but not every day, and typically it's going to depend on body size. But typically they talk about one drink a day for women and up to two drinks a day for men.
And then when it comes to sugar, the recommendations are that we should eat no more than 50 grams per day or 10% of calories, but in reality, most countries today eat more than 100 grams of added sugar per day. And it's not just the United States, and the United States isn't even in the top. There are a lot of countries eating over 100 grams of sugar a day.
But in my opinion and my experience, I think moderation when it comes to sugar is something somewhere between 10 to 20 grams per day, and that's for someone who is healthy, not someone who's trying to reverse a condition. That's someone who's trying to maintain and also someone who does not have such strong addictive tendencies that they fall off the wagon, that if they have 10 to 20 grams, then they start sugar binging. But if you're watching this video, chances are that you are trying to reverse a fatty liver disease and/or type 2 diabetes, and again, most of the time these two are synonymous because they coincide most of the time.
And in those cases, I think that you should have zero added sugar. There's really no reason to add that extra load if you're trying to clean up that liver and give it the best possible chance. And then we also want to reduce carbohydrates overall, and the heaviest sources of carbohydrates, the densest sources, are things like rice, grain, bread, and pasta because they are anywhere from 60 to 80% pure glucose.
So unlike table sugar, which has about half glucose, half fructose, starch doesn't have any fructose, and that's why table sugar is so much worse, but starch still raises blood sugar because it is 100% of these glucose molecules, and they are strung together in very, very long chains of hundreds or thousands of molecules, and they get broken down very, very quickly. We have enzymes in the mouth called amylase that start chopping off these glucose molecules very, very quickly, and glucose has a high glycemic index, so starches, most of these starches, actually have a higher glycemic index than sugar. So that means when we eat a starch, it raises blood sugar faster, blood glucose goes up faster if we eat bread than if we eat sugar, and anytime blood glucose goes up, now we're going to have high insulin.
If we do this frequently, now we get insulin resistance. But as you probably know, lots of human cultures have eaten rice and grain and bread and pasta for thousands or hundreds of years, and they don't develop metabolic diseases until they add both of these together. When you have the starch and the sugar, now you start creating problems.
But if you're trying to reverse it, once you've established the problem and you're trying to reverse it, now you need to try to remove both of them as much as possible. So if you're healthy and just maintaining your metabolic health and you're insulin sensitive, I think that your carbohydrate intake should probably be somewhere between 30 and 100 grams per day, and most of that should be high-fiber vegetables. But if you're trying to reverse a condition like fatty liver or type 2 diabetes, now I think you need to go down from there and come down maybe to somewhere between zero and 50 grams a day.
And I don't think that zero is a great idea all the time. I think that even if you're trying to be in ketosis some of the time, then you don't have to be at zero. You can still eat a lot of non-starchy vegetables because you need that fiber; you need that variety of plant food to maintain your gut health.
The next thing you want to do to reverse a fatty liver is to increase healthy fats, and this doesn't mean that you go on a fat binge or you go crazy, but you also can't be afraid of fats because the things that damage the liver are sugar and carbohydrates, and if you're going to drop those down, you need to get some other source of energy. You can't just eat protein, and that's the problem with a lot of people. When they go from a traditional or a high-carbohydrate, high-processed food diet, now they just try to eat less sugar and less carbs, but you have to fill in something else.
Otherwise, you're going to starve. So healthy fats come from things like avocado, from nuts and seeds; it comes from wild fish, from grass-fed meat; there is healthy fat in pastured eggs and chickens. And then you want to cook with things like extra virgin olive oil, grass-fed butter, and coconut oil.
So ideally, if you get the really high quality of wild fish and grass-fed meat, now you don't have to go for the low-fat varieties. It's okay if it has a little fat in it. But if you can't find those good sources all the time, then try to get the lean version, and then instead you want to add in some cooking fat of a good quality.
And next, you want to reduce your toxic load, and this is something that a lot of people miss. They've heard of organic food, and they know that's a little bit better because they spray stuff on food, but we really need to understand how much of a burden this is for the body. Because when they test chemicals, they test them one at a time, and they test them on some animals, and they raise the dose until the animal dies, and then they reduce the level, and they say maybe 1% of that is safe.
And this is how we get chemicals that are generally regarded as safe, or GRAS. But they don't test these chemicals together, and in our environment, we have 3,000 to 5,000 chemicals in our immediate environment, in our air, food, and water every day. So even tiny, tiny, tiny amounts add up because there are so many of them, and this is why it's something that we need to start paying attention to.
And one thing that you can do is to eat organic. I don't eat 100% organic, but I eat most things organic, and I have learned sort of which ones really matter. So I would never buy berries or apples or something like that that are not organic because I know they are on the dirty dozen list.
And this dirty dozen list changes from time to time, so you want to go and look up what the most sprayed plants are in your area, and whatever food they use the most pesticides and chemicals on, you either buy organic or you don't eat it; you eat something else. Next thing a lot of people miss are things like natural cleaning products. All these things that you spray and you wipe and you put on things, they are actually chemicals that once you get in the body, the liver has to break them down, those toxins.
Same thing with personal care hygiene products and cosmetics. Try to do the natural as possible. Also, use glass and stainless steel for your cooking.
Don't store food in plastic; never heat things in plastic. I think it's okay to keep some dry goods maybe in plastic, but never heat them, never keep liquid, and especially not acidic liquids with any type of acidity like tomatoes or lemon juice or something like that in plastic because it is going to leach plastic into the liquid. Also, when it comes to cookware, you want to make sure you don't use Teflon or aluminum cookware or aluminum foil or anything like that.
And then it's probably a good idea to get a water filter. If you're in a house and you know you're going to be there for a while, it's probably worth investing in a house-wide water filter because you can't drink the tap water, and you don't want to drink water from plastic bottles. So either you buy things in glass bottles, which gets very expensive, or you get some kind of water filter.
And you can put one on the tap; that's okay, but again, if you're in a house, it might be worth getting a house-wide system. And to reverse your fatty liver as fast as possible, it's a good idea to exercise, to increase your exercise, but you want to increase the aerobic exercise. Aerobic means "with air," which means that you don't exercise to the point of muscle burn or heavy huffing and puffing, because then you are not aerobic anymore.
The advantage of aerobic exercise is that you can do it for a long time. Aerobic exercise uses mostly fat, and it is also low-stress on the body. These are all good things because it's low stress, you can do it for a long time, and it uses almost exclusively fat.
If you have time, I would suggest doing this for 30 minutes or more; you can do it for several hours if you like. Then there's anaerobic exercise. A lot of people, when they go to the gym, join a spin class, or go to some sort of organized aerobics, are actually doing anaerobic exercise because they drive the heart rate so high that you get muscle burn and start huffing and puffing.
The problem now is that you’re not just burning fat but a mixture of fat and carbohydrates. When you use those up, you tend to want to compensate by eating more carbohydrates afterward. It is also much harder and places much more stress on the body, so especially if you're not very fit or young, your body may tend to break down more with anaerobic exercise.
It's not that you can't do it at all—just don't overdo it. If you enjoy it, do it once or twice a week, but do the bulk of your exercise as purely aerobic. There’s also a special category called HIIT, or high-intensity interval training.
This is where you do something super intense for a very short time. Now, again, you're using fat and carbohydrates, but I still recommend this, even though it's very high-stress, because it challenges the body. When you challenge the body, it has to adapt, get better, and release a lot of growth hormone, which is fat-burning.
So even if you just do your high-intensity training for a few minutes, you still release growth hormone, which increases your metabolism and fat burning for hours or even days afterward. The key is not to overdo it. For example, if you're running or sprinting up a hill, you might sprint for 15 to 30 seconds, then take a break for 30 seconds to a minute.
Do this maybe three to five times, but no more. The total intense time might be no more than three minutes for the entire workout, and you don’t do that more than two to three times a week because it can become too much and start breaking down the body. But if you do it just right, it can be incredibly beneficial.
So, you do a lot of aerobic exercise, some anaerobic if you enjoy it, and very little HIIT. The next step to reverse fatty liver is to add in some liver-friendly foods. These would be things like leafy greens and cruciferous vegetables.
They contain compounds that are very beneficial and assist the liver in breaking down toxins and reversing fatty liver. Some examples are broccoli, cauliflower, arugula, and Brussels sprouts. Then you want to add in some omega-3-rich foods.
Omega-3 fatty acids are found in foods like salmon and sardines, but eggs can also be hugely beneficial, specifically the egg yolk, not the white, as it’s the yolk that contains these nutrients. Make sure it’s a high-quality, pasture-raised egg, as mass-produced eggs don’t have good omega-3 ratios. A mass-produced egg could have a 20:1 omega-6 to omega-3 ratio, while pasture-raised eggs would be closer to 1:1, so quality is critical.
You also want to add seeds like flax, chia, and hemp, which are rich in omega-3. However, don’t rely solely on these, as depending on your genetics, stress level, and health, you may not convert much or any of the omega-3s in flax and chia into the essential fish-oil-type fatty acids EPA and DHA. Also, include garlic and turmeric; I would throw in ginger as well, as they contain compounds that can assist the liver.
There are also supplements you can take. It’s best to get most of your nutrients from food, but if your liver is stressed or you live in a toxic environment, you might need some extra help. Vitamin E is beneficial, and the supplement I use in the clinic is called Cataplex E because it’s a pure food-based source.
I often use fish oil, such as Super Omega or cod liver oil. You want a fish oil with high dosages of EPA and DHA so you’re not taking a dozen capsules for minimal benefit. Then there are supplements that directly support the liver; my favorite is Livaplex from Standard Process, and they also have a product called choline, a nutrient that helps the liver.
Choline is found in egg yolk, but adding a bit extra might be a good idea. I'll include some links to good sources below. There are several things you can do to increase how fast you reverse fatty liver, but the number one fastest way is to combine all of them.
Don't try to fix it overnight or go crazy with one thing—just do all of them. A little progress in many different areas will make a big difference quickly. So, do some intermittent fasting, stop alcohol and sugar, increase your exercise the way we discussed, reduce your carbohydrate intake to a level your body can tolerate without slowing down fat burning in your liver, and increase healthy fats.
For every decrease in carbs, increase fats. Then reduce toxins and support your liver with good food and some supplements. And, of course, losing weight is always beneficial.
There is something called a fatty liver index, which is a formula that predicts if you have fatty liver. It considers your body mass index (BMI), waist circumference, blood triglyceride levels, and a liver enzyme called GGT. Of these factors, BMI and waist circumference are the most significant, while triglycerides and GGT matter less.
Most people with large bellies likely have fatty liver. Not all, because it is possible to be overweight and metabolically healthy, but most of them do. Losing weight is important, and everything we’ve discussed here is the fastest, safest, and most stable way to lose weight.
Losing weight, in this case, would simply be a side effect or a bonus from doing all these things. If you enjoyed this video, you're going to love that one! And if you truly want to master health by understanding how the body really works, make sure you subscribe, hit that bell, and turn on all notifications so you never miss a life-saving video!