What are the treatment options for fatty liver disease?

Updated: Apr 12, 2018
  • Author: Emily Tommolino, MD; Chief Editor: BS Anand, MD  more...
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No definitive pharmacologic therapy has been approved for treatment of nonalcoholic fatty liver disease (NAFLD). Management of NAFLD should include treating the associated obesity, hyperlipidemia, insulin resistance, and type 2 diabetes.

Although alcohol-induced hyperhomocysteinemia (which has been associated with endoplasmic reticulum stress leading to apoptosis and up-regulation of lipid synthesis) and its correction by betaine have been studied in animal models, no definite role of the use of betaine to treat alcoholic fatty liver in humans is available.

Weight loss and control of comorbidities appear to slow the progress of NAFLD and may reverse some of the steatosis and fibrosis. In a randomized trial, improvement on liver biopsy was seen after a 7% weight loss resulting from lifestyle changes (improved diet, exercise, and behavioral modification). [38] No established treatment is available for nonalcoholic steatohepatitis (NASH).

Although no proven medical therapy is available, a study by Foster et al found that atorvastatin 20 mg, combined with vitamins C and E, is effective in reducing the odds of having hepatic steatosis by 71% in healthy individuals with NAFLD after 4 years of active therapy. [39]

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