The tricky thing about fatty liver is that it almost never causes symptoms early on. The liver has few nerve endings, so you do not easily feel damage. Symptoms usually only appear once the fatty change is already advanced. That is why a blood test is often the first way to detect fatty liver.
Still, there are signals that can point to an overloaded liver. Below you will read which ones, and when to act.
What are the symptoms of fatty liver?
In the early phase there are usually no, or very vague, complaints. When symptoms do occur, they can include:
- Persistent tiredness and a sense of low energy
- A full or nagging feeling in the upper right abdomen, where the liver sits
- Reduced appetite
- Concentration problems or a "foggy" feeling
- Sometimes increased sweating or a general feeling of being unwell
These complaints are not specific: they fit many conditions. So on their own they say nothing about your liver.
Why does fatty liver often cause no symptoms?
Your liver can tolerate a lot and keeps working, even when part of it is damaged. On top of that, liver damage causes little pain due to the lack of nerve endings. The result: you can have a fatty liver for years without noticing. A mildly elevated ALAT in your blood is often the first and only signal.
Which complaints fit advanced fatty liver?
As inflammation (NASH) or scarring develops, clearer symptoms can appear. Contact your doctor with:
- Yellowing of the skin or whites of the eyes (jaundice)
- Dark urine or pale stools
- Swelling of the abdomen or legs
- Persistent, unexplained fatigue
- Pain or pressure in the upper right abdomen
How is fatty liver diagnosed?
It often starts with a blood test showing elevated liver values. If suspected, a liver ultrasound follows, and sometimes further investigation. To understand what the values mean, read understanding liver values or the overview of fatty liver causes and stages.
You can have your liver values checked with the Vital Check liver function test, including review by a doctor.
Frequently asked questions
Can you feel fatty liver?
Usually not. In an early stage it causes no pain. Sometimes there is a full feeling in the upper right abdomen, but that is often entirely absent.
Is fatigue a sign of fatty liver?
Fatigue occurs with fatty liver, but is very non-specific. It can have countless other causes. Only in combination with abnormal liver values does it become meaningful.
Can fatty liver cause sweating?
Increased sweating is sometimes mentioned, but is not a typical or reliable symptom of fatty liver. Always assess your complaints together with your doctor.
References
- Younossi ZM, et al. Global epidemiology of nonalcoholic fatty liver disease - meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016. PubMed
- Rinella ME, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Journal of Hepatology. 2023. PubMed
- Vilar-Gomez E, et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology. 2015. PubMed
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