Fatty Liver Is No Longer Rare — It’s a Metabolic Wake-Up Call
- Marnie
- 5 days ago
- 5 min read
You don’t have to be a drinker to have liver issues. In fact, I see it all the time in my clients who eat well, work out, and are told their labs are ‘normal.’
If you're…
constantly fatigued,
stuck in a weight loss plateau,
bloated no matter what you eat,
or just not feeling like yourself —
👉 your liver might be struggling silently.
And the worst part? Most people (and even many doctors) don’t catch it until they’re already too far down the wrong path.
What We’re Dealing With: A Metabolic Liver Crisis
This condition used to be called Non-Alcoholic Fatty Liver Disease (NAFLD) — now renamed Metabolic-Associated Steatotic Liver Disease (MASLD) — because alcohol is no longer the main culprit.
The real root?
👉 Metabolic dysfunction, stress, processed foods, environmental toxins, and hormonal imbalances.
This matters because liver disease is:
🔄 connected to weight gain
🌫️ linked to brain fog and fatigue
🩸 a major red flag for diabetes and heart disease
👉 And you can have it even if you’re thin, healthy, and don’t drink.
Top 7 Root Causes I See Every Week
Functional nutrition asks: Why is fat building up in the liver in the first place?
The following are 7 key root causes I often see driving fatty liver in my clients — even when conventional testing doesn’t catch it.
1. Blood Sugar Imbalances + Insulin Resistance
Chronically elevated blood sugar and insulin signal the body to store fat, especially in the liver.
Even “normal” blood sugar can hide dysfunction if insulin is elevated.
Fasting insulin >5–7 can indicate the body is already under metabolic stress.
Elevated triglycerides, low HDL, and abdominal weight gain all point toward poor glucose handling and insulin resistance — core drivers of liver fat accumulation.
👉 Belly fat, fatigue, or sugar cravings and or crashes? Time to dig deeper.
2. Excess Fructose and Ultra-Processed Foods
Unlike glucose, fructose is processed almost entirely by the liver — and when consumed in excess, it can overwhelm your liver’s ability to metabolize it, leading to fat accumulation.
You’ll find high amounts of fructose in:
High-fructose corn syrup (in sodas, sweetened teas, condiments, packaged snacks)
Agave syrup and other processed sweeteners labeled as “natural”
Fruit juice concentrates in protein bars, energy drinks, and flavored yogurts
Low-fat and diet foods that replace fat with added sugars
Sports drinks, flavored waters, and even some plant-based milks
Because fructose doesn’t trigger the same insulin response as glucose, it often flies under the radar — but it heads straight to the liver for processing, where it’s converted to fat when consumed in excess.
This is why you’ll often see fatty liver in people who may not eat large portions — but regularly sip sweetened beverages, eat processed convenience foods, or rely on packaged “health” snacks.
👉 These sneak into "healthy" diets and overload your liver.
3. Toxin Load: Environmental and Endogenous
Your liver is your primary detoxification organ. When your body is overloaded with:
Pesticides, plastics (like BPA), and personal care chemicals
Mycotoxins from mold exposure
Pharmaceuticals or hormonal birth control
Gut-derived endotoxins (like lipopolysaccharide, or LPS) from dysbiosis
…it prioritizes neutralizing those over fat metabolism.
👉 In other words, your liver becomes too busy detoxing to do its other jobs like regulating cholesterol, hormones, and blood sugar.
4. Chronic Stress + Cortisol Dysregulation
Chronic stress raises cortisol, which promotes gluconeogenesis (the breakdown of muscle to make glucose) and increases blood sugar — which then leads to more insulin and more fat storage.
High cortisol also:
Alters bile flow and liver enzyme production
Worsens gut permeability, increasing the liver’s toxic load
Steers the body toward catabolic breakdown and fat preservation
👉 This is why people under stress often gain weight around the midsection — and why their liver suffers even without poor diet.
5. Nutrient Deficiencies: Choline, B Vitamins, Magnesium, Zinc, Carnitine
These nutrients are critical for liver function, fat metabolism, and detoxification:
Choline: essential to export fat out of the liver; deficiency = fat accumulation
B vitamins (B2, B3, B6, B9, B12): support methylation and detox pathways
Magnesium: needed for over 300 enzymatic reactions, including insulin sensitivity
Zinc: supports bile production and antioxidant protection in liver cells
Carnitine: shuttles fat into mitochondria for burning — low levels = fat storage
👉 A standard diet, especially a low-protein or plant-based one, often comes up short in these nutrients — particularly if gut absorption is impaired.
6. Gut Dysbiosis + Leaky Gut
A disrupted gut microbiome can send inflammatory compounds and toxins straight to the liver via the portal vein.
Bacterial overgrowth = higher production of LPS
Leaky gut = LPS and other inflammatory compounds reach the liver
This leads to steatohepatitis, inflammation on top of fat buildup
This is one reason why so many people with SIBO, Candida, or IBS also show signs of liver dysfunction — it’s all connected.
👉 Bloating, constipation, skin issues? Your gut may be leaking toxins straight to your liver.
7. Low Bile Flow + Poor Digestion
Your liver produces bile to help digest fats and carry toxins out of the body.
Gallbladder issues
Low-fat diets
Estrogen dominance
Chronic stress
…your body can’t clear toxins or metabolize fats efficiently, leading to backup and storage in the liver.
This is also why hormonal imbalances and fatty liver often show up together.
👉 Your liver makes bile. Low bile = poor fat digestion = toxic buildup = liver stress.
Blood Work: Early Patterns You Shouldn’t Ignore
Many clients I see don’t have elevated liver enzymes, but they do have signs of early liver stress — if you know what to look for:
Marker | What It Could Mean |
ALT > AST | Early liver stress |
GGT | Bile sluggishness or oxidative stress |
Ferritin high | Inflammation and iron overload |
Triglycerides >100 | Insulin resistance, poor fat metabolism |
Triglycerides <60 | Poor fat digestion, bile insufficiency, under-eating, adrenal or mitochondrial stress |
Insulin >5 | Insulin resistance |
MCV/MCH high | B12/folate deficiencies |
ALP low | Zinc/bile insufficiency |
Total Protein / Albumin low | Poor absorption or liver synthesis |
👉 These patterns are subtle — but they tell a powerful story before major issues arise.
What About Low Triglycerides?
Most people worry about triglycerides being too high — and yes, that’s a marker for metabolic dysfunction.
But triglycerides that are too low (especially <60) can be just as telling. I often see this in clients who:
aren’t digesting fats well
have gallbladder issues
are under-eating or avoiding fat
have mitochondrial dysfunction or adrenal fatigue
👉 Low triglycerides can indicate poor bile output, low stomach acid, or overall poor nutrient absorption — all of which stress the liver in a different way.
The Bottom Line: Fatty Liver Is Reversible — But Only If You Catch It Early
If you feel foggy, tired, inflamed, or stuck in a weight loss plateau… it might not be about willpower or exercise — it’s not all in your head. And it’s not just about food.
👉 Your liver might be the missing link.
In functional nutrition, we look at patterns, not just red flags. We use your labs, functional testing and symptoms to create a personalized roadmap — so you can take action before it turns into something more serious.
Want to know what your labs say about your liver and metabolism?
If you're feeling tired, bloated, foggy, or just off — it's time to take a closer look.
✨ Don’t wait until your doctor says something’s wrong.✨ Don’t assume feeling “off” is just part of aging.
👉 Book your free 15-minute consult today to find out if your liver (and metabolism) are asking for support — and how functional nutrition can help you feel like yourself again.