COVID-19 (coronavirus) and Herd immunity

 

How Do We Become Immune?

When germs enter your body, your immune system springs into action. Here's how it works:

• Bacteria and viruses like the one that causes COVID-19 have proteins called antigens on their surfaces. Each type of germ has its own unique antigen.
• White blood cells of your immune system make proteins called antibodies to fight the antigen. Antibodies attach to antigens the way a key fits into a lock, and they destroy the invading germ.
• Once you've been exposed to a virus, your body makes memory cells. If you're exposed to that same virus again, these cells recognize it. They tell your immune system to make antibodies against it.

Vaccines work in much the same way. They expose your body to an antigen that trains your immune system to fight that germ in the future. Because vaccines contain weakened or killed versions of viruses, you become immune without getting sick.

Why is herd immunity important?

Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected — not just those who are immune.

 

Often, a percentage of the population must be capable of getting a disease in order for it to spread. This is called a threshold proportion. If the proportion of the population that is immune to the disease is greater than this threshold, the spread of the disease will decline. This is known as the herd immunity threshold.

 

What percentage of a community needs to be immune in order to achieve herd immunity? It varies from disease to disease. The more contagious a disease is, the greater the proportion of the population that needs to be immune to the disease to stop its spread. For example, the measles is a highly contagious illness. It's estimated that 94% of the population must be immune to interrupt the chain of transmission.

 

How is herd immunity achieved?

There are two paths to herd immunity for COVID-19 — vaccines and infection.

 

Vaccines

A vaccine for the virus that causes COVID-19 would be an ideal approach to achieving herd immunity. Vaccines create immunity without causing illness or resulting complications. Herd immunity makes it possible to protect the population from a disease, including those who can't be vaccinated, such as newborns or those who have compromised immune systems. Using the concept of herd immunity, vaccines have successfully controlled deadly contagious diseases such as smallpox, polio, diphtheria, rubella and many others.

 

Reaching herd immunity through vaccination sometimes has drawbacks, though. Protection from some vaccines can wane over time, requiring revaccination. Sometimes people don't get all of the shots that they need to be completely protected from a disease.

 

In addition, some people may object to vaccines because of religious objections, fears about the possible risks or skepticism about the benefits. People who object to vaccines often live in the same neighborhoods or attend the same religious services or schools. If the proportion of vaccinated people in a community falls below the herd immunity threshold, exposure to a contagious disease could result in the disease quickly spreading. Measles has recently resurged in several parts of the world with relatively low vaccination rates, including the United States. Opposition to vaccines can pose a real challenge to herd immunity.

 

Natural infection

Herd immunity can also be reached when a sufficient number of people in the population have recovered from a disease and have developed antibodies against future infection. For example, those who survived the 1918 flu (influenza) pandemic were later immune to infection with the H1N1 flu, a subtype of influenza A. During the 2009-10 flu season, H1N1 caused the respiratory infection in humans that was commonly referred to as swine flu.

 

However, there are some major problems with relying on community infection to create herd immunity to the virus that causes COVID-19. First, it isn't yet clear if infection with the COVID-19 virus makes a person immune to future infection.

 

Research suggests that after infection with some coronaviruses, reinfection with the same virus — though usually mild and only happening in a fraction of people — is possible after a period of months or years. Further research is needed to determine the protective effect of antibodies to the virus in those who have been infected.

 

Even if infection with the COVID-19 virus creates long-lasting immunity, a large number of people would have to become infected to reach the herd immunity threshold. Experts estimate that in the U.S., 70% of the population — more than 200 million people — would have to recover from COVID-19 to halt the epidemic. If many people become sick with COVID-19 at once, the health care system could quickly become overwhelmed. This amount of infection could also lead to serious complications and millions of deaths, especially among older people and those who have chronic conditions.

 

How can you slow the transmission of COVID-19?

Until a COVID-19 vaccine is developed, it's crucial to slow the spread of the COVID-19 virus and protect individuals at increased risk of severe illness, including older adults and people of any age with underlying health conditions. To reduce the risk of infection:

 

Avoid large events and mass gatherings.

Avoid close contact (within about 6 feet, or 2 meters) with anyone who is sick or has symptoms.

Stay home as much as possible and keep distance between yourself and others (within about 6 feet, or 2 meters) if COVID-19 is spreading in your community, especially if you have a higher risk of serious illness. Keep in mind some people may have the COVID-19 virus and spread it to others, even if they don't have symptoms or don't know they have COVID-19.

Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Wear a cloth face covering in public spaces, such as the grocery store, where it's difficult to avoid close contact with others, especially if you're in an area with ongoing community spread. Only use nonmedical cloth masks — surgical masks and N95 respirators should be reserved for health care providers.

Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue.

Avoid touching your eyes, nose and mouth.

Avoid sharing dishes, glasses, bedding and other household items if you're sick.

Clean and disinfect high-touch surfaces, such as doorknobs, light switches, electronics and counters, daily.

Stay home from work, school and public areas if you're sick, unless you're going to get medical care. Avoid public transportation, taxis and ride-sharing if you're sick.

Thanks https://www.mayoclinic.org/,https://www.webmd.com/

Could Herd Immunity Protect Us?

Herd immunity happens when a large part of the population -- the herd -- is immune to a virus. This can happen either because these people got vaccinated or had already been infected. Herd immunity makes it harder for a virus to spread. So even those who haven't been sick or vaccinated have some protection.

The more contagious a virus is, the more people need to be immune for herd immunity to kick in. The SARS-CoV-2 virus is so contagious that experts estimate about 70% of people in a community will need to be immune to have herd protection. That number might be hard to get to without a vaccine or a whole lot of people getting sick.

If You've Had COVID-19, Are You Immune?

Health experts don't know whether we really become immune to COVID-19 after we're infected. And if we do have immunity, we don't know how long it might last. Thus far, there have been only a few incidents of confirmed re-infections. With two cases, it appears the patients were re-infected by the same strain, while the third was infected with a slightly different strain of the virus.

"Dose" of coronavirus one can get, and its connection to the severity of COVID-19

The average number of viral particles needed to establish infection is known as the infectious dose. We don’t know what this is for covid-19 yet, but given how rapidly the disease is spreading, it is likely to be relatively low – in the region of a few hundred or thousand particles, says Willem van Schaik at the University of Birmingham, UK.

Viral load, on the other hand, relates to the number of viral particles being carried by an infected individual and shed into their environment. “The viral load is a measure of how bright the fire is burning in an individual, whereas the infectious dose is the spark that gets that fire going,” says Edward Parker at the London School of Hygiene and Tropical Medicine. 

If you have a high viral load, you are more likely to infect other people, because you may be shedding more virus particles. However, in the case of covid-19, it doesn’t necessarily follow that a higher viral load will lead to more severe symptoms.

For instance, health workers investigating the covid-19 outbreak in the Lombardy region of Italy looked at more than 5,000 infected people and found no difference in viral load between those with symptoms and those without. They reached this conclusion after tracing people who had been in contact with someone known to be infected with the coronavirus and testing them to see if they were also infected.

Similarly, when doctors at the Guangzhou Eighth People’s Hospital in China took repeated throat swabs from 94 covid-19 patients, starting on the day they became ill and finishing when they cleared the virus, they found no obvious difference in viral load between milder cases and those who developed more severe symptoms.

Although it is difficult to draw firm conclusions at this stage, such studies “may impact our assumptions about whether a high number of viral particles predisposes to a more serious disease”, says van Schaik.ring the "dose" of coronavirus one can get, and its connection to the severity of COVID-19

Some young healthcare workers with a serious disease -- a result of a big viral dose?

But three questions deserve particular attention because their answers could change the way we isolate, treat, and manage patients.

First, what we can learn from the "dose-response curve" for the initial infection --- that is, can we quantify the increase of the risk of infection as people are exposed to higher doses of the virus?

Second, there is a relationship between the initial "dose" of the virus and the severity of the disease - that is, does more exposure result in graver illness?

And third, are the quantitative measures of how the virus behaves in infected patients (e.g. the peak of your body's viral load, the patterns of its rise and fall) that predict the severity of their illness and how infectious they are to others?

So far, in the early phases of the COVID19 pandemic, we have been measuring the spread of the virus across people. As the pace of the pandemic escalates, we also need to start measuring the virus within people.

Cecile G. Tamura

 Read more: https://www.newscientist.com/article/2238819-does-a-high-viral-load-or-infectious-dose-make-covid-19-worse/#ixzz6IBfJnH9R

COVID-19 (Coronavirus) affecting male fertility(testicular tissue) and damage the kidney and Proposed Management

A team of Chinese researchers led by Li Yufeng, a professor from the Center for Reproductive Medicine of Tongji Medical College in Wuhan, where the Novel Coronavirus emerged in December 2019, found that the male COVID-19 patients are at high risk of developing fertility issues.

The findings were published on the website of the hospital on March 10 and then got posted by the official website of Hubei Province on Thursday. The published report was removed after the news went viral on Chinese social media platforms.

The team of scientists revealed that the COVID-19 could get into the cells through the combination of spike protein (S protein) and angiotensin-converting enzyme 2 (ACE2) which caused tissue damage. As per the Chinese team, along with lungs, there are many other organs in the human body, such as testes, small intestine, kidney, heart, and thyroid gland which could be affected by the ACE2.

ACE2 (Angiotensin Converting Enzyme 2) has been shown to be one of the major receptors that mediate the entry of 2019-nCoV into human cells, which also happens in severe acute respiratory syndrome coronavirus (SARS). 

(SARS - coV - 2 என்ற அறிவியல்  பெயரைக் கொண்ட இந்த வைரஸின் மரபணுக்களை ஆய்வு செய்த நிபுணர்கள், அவை ஆய்வகத்தில் செயற்கையாகவோ அல்லது மரபணுமாற்றம்  செய்யப்பட்டோ உருவாகவில்லை என்றும் இயற்கையில் பரிணமித்த புதிய இனப்பிரிவு என்றும் உறுதிப்படுத்தியுள்ளனர்.  கடந்த டிசம்பரில் சீனாவின் வுஹான் நகரில் மனிதர்களிடம் நோயை ஏற்படுத்தும்  SARS - coV - 2  இனப்பிரிவைச் சேர்ந்த கொரோனா வைரஸ் தனது கைவரிசையை காட்டத் தொடங்கியது.  வுஹான் நகரில் வைரஸ் ஆய்வு நிறுவனம் உள்ளதால் கொரோனா வைரஸ் அங்கே ரகசியமாக தயாரிக்கப்பட்ட செயற்கை கிருமி என்ற புரளி எழுந்தது. “ஏற்கெனவே நாம் அறிந்துள்ள வேறு கொரோனா வைரஸ் இனப்பிரிவுகளின் மரபணு தொடரோடு புதிய இனப்பிரிவை ஒப்பிட்டு பார்க்கும்போது  SARS - coV - 2 இனப்பிரிவு வைரஸ் இயற்கையில் பரிணமித்த ஒன்று என தெள்ளத்தெளிவாக புலப்படுகிறது” என்கிறார்கள் ஆய்வாளர்கள்.

பூட்டும்  வைரஸ்களின் கள்ளசாவியும்

ஓம்புயிரிகளின் செல்களில் புகுந்து அந்த உயிரியின் செல்அமைப்பை பயன்படுத்தித்தான் வைரஸ்கள் இனப்பெருக்கம் செய்யும். எனவே எப்படியாவது ஓம்புயிரி செல்களுக்குள் செல்ல வைரஸ் துடிக்கும். ஓம்புயிரிகளின் செல்கள் தங்கள் கதவை திறந்த வைத்து வா வா என்று வைரஸ்களை அழைக்காது. செல் சுவர் கொண்டு வைரஸ்களை உள்ளே எளிதில் நுழைய முடியாமல் தடுத்து நிறுத்தும். ஆனால் கதவு பூட்டிய கோட்டை போல எல்லா நேரமும் செல்கள் இருந்துவிட முடியாது. செல்பிரிதல், செல் செயல்படுதல் போன்ற எல்லா இயக்கத்துக்கும் ஆற்றல் தேவை. பற்பல புரத பொருள்கள் தேவை. ரத்தம் எடுத்துவரும் புரத பொருள்கள், ஆக்ஸிஜன் போன்ற பொருள்கள் செல்களுக்கு வெளியில் இருந்து உள்ளே செல்ல வேண்டும். உள்ளே ஏற்படும் வேதி வினை காரணமாக உருவாகும் மாசுகளை அப்புறப்படுத்த வேண்டும். எனவே, செல்களின் சுவர்களில் கதவு போன்ற அமைப்பு இருக்கும். தேவை ஏற்படும்போது மட்டும் கதவு திறந்து வெளியே உள்ள பொருள் உள்ளே வரும். உள்ளே உற்பத்தியாகும் மாசுகள் வெளியேற்றப்படும்.

சரியான புரதப்பொருள்கள் வந்து சேரும்போது, அவற்றை செல்களின் சுவர்களில் பற்றிப் பொருத்துவதற்காக கைப்பிடி போன்ற ஏற்பிகள் இருக்கும். அந்த புரதங்களின் ஒரு பகுதி சாவியின் வடிவில் இருக்கும். செல்சுவற்றில் உள்ள கதவு பூட்டின் உள்ளே இந்த சாவி வடிவம் நுழையும்போது கதவு திறந்து புரதம் உள்ளே செல்ல முடியும். பூட்டை உடைத்து திருடன் நுழைவது போல கள்ளச்சாவி போட்டு கதவை திறந்து வைரஸ்கள் உள்ளே நுழையும். ஒவ்வொரு பூட்டின் சாவியும் வெவ்வேறு வடிவில் இருக்கும் அல்லாவா? அதுபோல ஒவ்வொரு உயிரியின் பூட்டும் கைப்பிடியும் வெவ்வேறு வடிவில் இருக்கும். இதனால்தான், எல்லா வைரஸ்களும் எல்லா உயிரிகளின் செல்களிலும் புகுந்துவிட முடிவதில்லை. இதன் காரணமாகவே, மாட்டுக்கு நோய் ஏற்படுத்தும் வைரஸ்கள், பல சமயம் மனிதர்களுக்கு ஆபத்து ஏற்படுத்துவதில்லை. அதாவது ஒவ்வொரு வைரஸுக்கும் அதற்கு ஏற்ற ஓம்புயிரிகள் உள்ளன. தனது ஓம்புயிரி செல்களைப்பற்றி துளையிட்டு புகுந்து செல்வதற்காக அந்த குறிப்பிட்ட வைரஸ்களுக்கும் அதன் மேலுறையில் செல்களின் ஏற்பிகளை பற்றி பிடிக்கும் RBD புரதம் மற்றும் செல்சுவரின்  கதவை திறக்கும் சாவி போன்ற அமைப்பு, புரதம் போன்ற சிறப்பு அமைப்புகள் இருக்கும்.

SARS - coV - 2  மரபணு தொடரை ஆராய்ந்த போது, இந்த வகை வைரஸ்களின் கூர் முனைகளில் மனித செல்களின் மீது உள்ள ACE2 என்ற ஏற்பியை பற்றிக்கொள்ளும் விதத்தில் ‘ஏற்பி பற்று’ புரதம் பரிணமித்துள்ளது என கண்டறிந்தனர். அதாவது  ACE2  என்ற பூட்டை திறக்கும் சரியான சாவி SARS - coV - 2  -யிடம் இருந்தது.)

Several researches have indicated that some patients have abnormal renal function or even kidney damage in addition to injury in respiratory system, and the related mechanism is unknown. This arouses our interest in whether coronavirus infection will affect the urinary and male reproductive systems. Here in this study, we used the online datasets to analyze ACE2 expression in different human organs. The results indicate that ACE2 highly expresses in renal tubular cells, Leydig cells and cells in seminiferous ducts in testis. Therefore, virus might directly bind to such ACE2 positive cells and damage the kidney and testicular tissue of patients. Our results indicate that renal function evaluation and special care should be performed in 2019-nCoV patients during clinical work, because of the kidney damage caused by virus and antiviral drugs with certain renal toxicity. In addition, due to the potential pathogenicity of the virus to testicular tissues, clinicians should pay attention to the risk of testicular lesions in patients during hospitalization and later clinical follow-up, especially the assessment and appropriate intervention in young patients' fertility.

According to the experts, the male reproductive function could be affected, as a large amount of ACE2 detected in testes, mainly concentrated in testicular spermatogonia, are rounded stem cells that lie in contact with the basement membrane of the seminiferous tubules.

According to the experts, the new coronavirus, known as SARS-CoV-2, enters human cells and causes tissue damage by binding its spike protein to cell membrane protein angiotensin-converting enzyme 2 (ACE2).

ACE2 is known to be present in other human organs apart from the lungs and can especially be abundant in a man’s testes. It can be concentrated in several cells which are directly related to the male reproductive abilities, including the germ cells, supporting cells and Leydig cells, the team claimed.

They added that during the SARS outbreak in 2002 and 2003, medics observed serious immune system damage in the testicles of some male patients.

Even though doctors did not detect the SARS coronavirus, or SARS-CoV, in patients’ testicles, they could suffer inflammation in their sexual organs, the study said.

Since the new coronavirus is highly similar to the SARS coronavirus and the two share the same host cell receptor ACE2, the team concluded that, in theory, the new coronavirus could cause damage to men’s testicles.

‘Therefore, for men who have had the infection, especially those who need to reproduce, it is best to undergo relevant fertility tests, such as sperm quality and hormone level tests, upon recovery to detect possible problems as soon as possible,’ a hospital report wrote.

Currently, Apeiron Biologics AG, a company founded by Penninger, is scheduled to start a pilot clinical trial for a newly-developed drug designed to decrease mortality in those affected by the virus. ‘This is where we believe our soluble ACE2 would come in,’ he explained, ‘Because ACE2 sits on the membrane and our molecule is soluble, it would soak up the virus like a neutralising antibody, so the virus cannot find its real receptor. With less virus coming, this would slow down viral infection and improve disease because the virus cannot properly get in and infect the cells. We believe, based on the discovery of ACE2 – and its function as a negative regulator of renin angiotensin, protecting heart, kidneys, liver, protecting the lung – this would make sense as a therapeutic for COVID-19.’

This, he concluded, would have two functions – taking the virus away from its real receptor by working as a neutralising antibody and, second, protecting tissues – as in the lung – from the disease. Penninger emphasised that carefully-designed placebo controlled trials in COVID patients are now needed to test the science.

Proposed Management 

Conclution

 ACE2 is an integral component of the RAS

(The renin-angiotensin system (RAS) is a signalling pathway that acts as a homeostatic regulator of vascular function . Its systemic actions include the regulation of blood pressure, natriuresis, and blood volume control. However, the RAS also plays an important local role, regulating regional blood flow and controlling trophic responses to a range of stimuli. The RAS is composed of a number of different regulatory components and effector peptides that facilitate the dynamic control of vascular function, in both health and disease ). 

Many of these components have opposing functions to accommodate a rapid but coordinated response to specific triggers.. It is highly expressed in the vasculature, the kidney, lungs, and heart where its actions on peptide signals balance and offset those of ACE. Its actions appear critical in a variety of disease states, including hypertension, diabetes, ageing, renal impairment, and cardiovascular disease. ACE2 deficiency leads to modest physiological changes. However, in states of RAS activation, the loss of ACE2 appears far more important in the development and progression of disease.

Doctors claim new coronavirus 'may cause damage to a man's TESTICLES' as they urge male patients to take fertility tests upon recovery.

Every thing about Insulin Resistance

Insulin resistance occurs cells of the body don’t respond to insulin

Insulin resistance is the name given to when cells of the body don’t respond properly to the hormone insulin.
Insulin resistance is the driving factor that leads to type 2 diabetes, gestational diabetes, and prediabetes.
Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese.
Modern research has shown that insulin resistance can be combatted by treatment methods that reduce how much insulin the body is producing or taking via insulin injections or insulin pumps.
Reducing insulin resistance can be achieved by following low-carbohydrate and ketogenic diets.

What is insulin resistance?

The role of insulin is to allow cells of the body to take in glucose to be used as fuel or stored as body fat.

It also means that glucose is more likely to build up in the blood and this can lead to too high blood sugar levels.
When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing too more insulin than healthy people.
Producing too much insulin is known as hyperinsulinemia.

Symptoms of insulin resistance

Initially, insulin resistance presents no symptoms. The symptoms only start to appear once it leads to secondary effects such as higher blood sugar levels. When this happens, the symptoms may include:

• Lethargy (tiredness)
• Hunger
• Difficulty concentrating (brain fog)

Other signs that often appear in people with insulin resistance include:

• Weight gain around the middle (belly fat)
• High blood pressure
• High cholesterol levels

If insulin resistance develops into prediabetes or type 2 diabetes, the symptoms will include increased blood glucose levels and more of the classic symptoms of type 2 diabetes.

How to know if you’re insulin resistant

Your health practitioner can use several methods to determine if you’re insulin resistant.

For example, high fasting insulin levels are strong indicators of this condition.

A fairly accurate test called HOMA-IR estimates insulin resistance from your blood sugar and insulin levels.

There are also ways to measure blood sugar control more directly, such as an oral glucose-tolerance test — but this takes several hours.

Your risk of insulin resistance increases greatly if you have excess weight or obesity, especially if you have large amounts of belly fat.

A skin condition called acanthosis nigricans, which involves dark spots on your skin, can likewise indicate insulin resistance.

Having low HDL (good) cholesterol levels and high blood triglycerides are two other markers strongly associated with this condition (3Trusted Source).

SUMMARY High insulin and blood sugar levels are key symptoms of insulin resistance. Other symptoms include excess belly fat, high blood triglycerides, and low HDL (good) cholesterol levels.

Causes of insulin resistance

Whilst the exact cause of insulin resistance is still not fully understood, it is well-known which factors can lead to insulin resistance developing.
Insulin resistance can commonly develop if one or more of the following factors apply:

• If you are overweight or obese
• Having a high-calorie diet, high-carbohydrate or high-sugar diet
• Sedentary lifestyle – taking little physical activity
• Taking high doses of steroids over an extended period of time
• Having chronic stress
• Having Cushing’s disease or polycystic ovary disease

In terms of what is happening inside the body that causes insulin resistance, researchers have observed that insulin resistance occurs in people that have:

• High levels of insulin circulating in their blood
• Excessive fat stored in the liver and pancreas
• High levels of inflammation 

Ways to reduce insulin resistance

It’s fairly easy to reduce insulin resistance.
Interestingly, you can often completely reverse this condition by changing your lifestyle in the following ways:

• Exercise. Physical activity may be the single easiest way to improve insulin sensitivity. Its effects are almost immediate .
• Lose belly fat. It’s key to target the fat that accumulates around your main organs via exercise and other methods.
• Stop smoking. Tobacco smoking can cause insulin resistance, so quitting should help (42Trusted Source).
• Reduce sugar intake. Try to reduce your intake of added sugars, especially from sugar-sweetened beverages.
• Eat well. Eat a diet based mostly on whole, unprocessed foods. Include nuts and fatty fish.
• Omega-3 fatty acids. These fats may reduce insulin resistance, as well as lower blood triglycerides .
• Supplements. Berberine may enhance insulin sensitivity and reduce blood sugar. Magnesium supplements may be helpful, too (45Trusted Source, 46Trusted Source).
• Sleep. Some evidence suggests that poor sleep causes insulin resistance, so improving sleep quality should help .
• Reduce stress. Try to manage your stress levels if you easily get overwhelmed. Meditation may be particularly helpful .
• Donate blood. High levels of iron in your blood are linked to insulin resistance. For men and postmenopausal women, donating blood may improve insulin sensitivity .
• Intermittent fasting. Following this eating pattern may improve insulin sensitivity .

Most of the habits on this list also happen to be associated with good health, a long life, and protection against disease.
That said, it’s best to consult your health practitioner about your options, as various medical treatments can be effective as well.

SUMMARY Insulin resistance may be reduced or even reversed with simple lifestyle measures, such as exercise, healthy eating, and stress management.

https://www.healthline.com/
https://www.niddk.nih.gov/

What some one Need to Know About Fatty Liver

Fatty liver is also known as hepatic steatosis. It happens when fat builds up in the liver. Having small amounts of fat in your liver is normal, but too much can become a health problem.

Your liver is the second largest organ in your body. It helps process nutrients from food and drinks and filters harmful substances from your blood.

Too much fat in your liver can cause liver inflammation, which can damage your liver and create scarring. In severe cases, this scarring can lead to liver failure.

When fatty liver develops in someone who drinks a lot of alcohol, it’s known as alcoholic fatty liver disease (AFLD).

In someone who doesn’t drink a lot of alcohol, it’s known as non-alcoholic fatty liver disease (NAFLD). According to researchers in the World Journal of Gastroenterology, NAFLD affects up to 25 to 30 percent of people in the United States and Europe.

Symptoms of fatty liver

In many cases, fatty liver causes no noticeable symptoms. But you may feel tired or experience discomfort or pain in the upper right side of your abdomen.
Some people with fatty liver disease develop complications, including liver scarring. Liver scarring is known as liver fibrosis. If you develop severe liver fibrosis, it’s known as cirrhosis.
Cirrhosis may cause symptoms such as:

• loss of appetite
• weight loss
• weakness
• fatigue
• nosebleeds
• itchy skin
• yellow skin and eyes
• web-like clusters of blood vessels under your skin
• abdominal pain
• abdominal swelling
• swelling of your legs
• breast enlargement in men
• confusion

Cirrhosis is a potentially life-threatening condition. Get the information you need to recognize and manage it.

Causes of fatty liver

Fatty liver develops when your body produces too much fat or doesn’t metabolize fat efficiently enough. The excess fat is stored in liver cells, where it accumulates and causes fatty liver disease.
This build-up of fat can be caused by a variety of things.
For example, drinking too much alcohol can cause alcoholic fatty liver disease. This is the first stage of alcohol-related liver disease.
In people who don’t drink a lot of alcohol, the cause of fatty liver disease is less clear.
One or more of the following factors may play a role:

• obesity
• high blood sugar
• insulin resistance
• high levels of fat, especially triglycerides, in your blood

Less common causes include:

• pregnancy
• rapid weight loss
• some types of infections, such as hepatitis C
• side effects from some types of medications, such as methotrexate (Trexall), tamoxifen (Nolvadex), amiodorone (Pacerone), and valproic acid (Depakote)
• exposure to certain toxins

Certain genes may also raise your risk of developing fatty liver.

Diagnosing of fatty liver

To diagnose fatty liver, your doctor will take your medical history, conduct a physical exam, and order one or more tests.

Medical history

If your doctor suspects that you might have fatty liver, they will likely ask you questions about:

• your family medical history, including any history of liver disease
• your alcohol consumption and other lifestyle habits
• any medical conditions that you might have
• any medications that you might take
• recent changes in your health

If you’ve been experiencing fatigue, loss of appetite, or other unexplained symptoms, let your doctor know.

Physical exam

To check for liver inflammation, your doctor may palpate or press on your abdomen. If your liver is enlarged, they might be able to feel it.
However, it’s possible for your liver to be inflamed without being enlarged. Your doctor might not be able to tell if your liver is inflamed by touch.

Blood tests

In many cases, fatty liver disease is diagnosed after blood tests show elevated liver enzymes. For example, your doctor may order the alanine aminotransferase test (ALT) and aspartate aminotransferase test (AST) to check your liver enzymes.
These tests might be recommended if you’ve developed signs or symptoms of liver disease, or they might be ordered as part of routine blood work.
Elevated liver enzymes are a sign of liver inflammation. Fatty liver disease is one potential cause of liver inflammation, but it’s not the only one.
If you test positive for elevated liver enzymes, your doctor will likely order additional tests to identify the cause of the inflammation.

Imaging studies

Your doctor may use one or more of the following imaging tests to check for excess fat or other problems with your liver:

• ultrasound exam
• CT scan
• MRI scan

They might also order a test known as vibration-controlled transient elastography (VCTE, FibroScan). This test uses low-frequency sound waves to measure liver stiffness. It can help check for scarring.

Liver biopsy

A liver biopsy is considered the best way to determine the severity of liver disease.
During a liver biopsy, a doctor will insert a needle into your liver and remove a piece of tissue for examination. They will give you a local anesthetic to lessen the pain.
This test can help determine if you have fatty liver disease, as well as liver scarring.

Treatment for fatty liver

Currently, no medications have been approved to treat fatty liver disease. More research is needed to develop and test medications to treat this condition.
In many cases, lifestyle changes can help reverse fatty liver disease. For example, your doctor might advise you to:

• limit or avoid alcohol
• take steps to lose weight
• make changes to your diet

If you’ve developed complications, your doctor might recommend additional treatments. To treat cirrhosis, for example, they might prescribe:

• lifestyle changes
• medications
• surgery

Cirrhosis can lead to liver failure. If you develop liver failure, you might need a liver transplant.

Home remedies

Lifestyle changes are the first-line treatment for fatty liver disease. Depending on your current condition and lifestyle habits, it might help to:

• lose weight
• reduce your alcohol intake
• eat a nutrient-rich diet that’s low in excess calories, saturated fat, and trans fats
• get at least 30 minutes of exercise most days of the week

According to the Mayo Clinic, some evidence suggests that vitamin E supplements might help prevent or treat liver damage caused by fatty liver disease. However, more research is needed. There are some health risks associated with consuming too much vitamin E.
Always talk to your doctor before you try a new supplement or natural remedy. Some supplements or natural remedies might put stress on your liver or interact with medications you’re taking.

Diet for fatty liver disease

If you have fatty liver disease, your doctor might encourage you to adjust your diet to help treat the condition and lower your risk of complications. For example, they might advise you to do the following:

• Eat a diet that’s rich in plant-based foods, including fruits, vegetables, legumes, and whole grains.
• Limit your consumption of refined carbohydrates, such as sweets, white rice, white bread, other refined grain products.
• Limit your consumption of saturated fats, which are found in red meat and many other animal products.
• Avoid trans fats, which are present in many processed snack foods.
• Avoid alcohol.

Your doctor may encourage you to cut calories from your diet to lose weight.

Types of fatty liver disease

There are two main types of fatty liver disease: nonalcoholic and alcoholic.
Nonalcoholic fatty liver disease (NAFLD) includes simple nonalcoholic fatty liver, nonalcoholic steatohepatitis (NASH), and acute fatty liver of pregnancy (AFLP).
Alcoholic fatty liver disease (AFLD) includes simple AFLD and alcoholic steatohepatitis (ASH).

Nonalcoholic fatty liver disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) occurs when fat builds up in the liver of people who don’t drink a lot of alcohol.
If you have excess fat in your liver and no history of heavy alcohol use, your doctor may diagnose you with NAFLD.
If there’s no inflammation or other complications along with the build-up of fat, the condition is known as simple nonalcoholic fatty liver.

Nonalcoholic steatohepatitis (NASH)

Nonalcoholic steatohepatitis (NASH) is a type of NAFLD. It occurs when a build-up of excess fat in the liver is accompanied by liver inflammation.
If you have excess fat in your liver, your liver is inflamed, and you have no history of heavy alcohol use, your doctor may diagnose you with NASH.
When left untreated, NASH can cause scarring of your liver. In severe cases, this can lead to cirrhosis and liver failure.

Acute fatty liver of pregnancy (AFLP)

Acute fatty liver of pregnancy (AFLP) is a rare but serious complication of pregnancy. The exact cause is unknown.
When AFLP develops, it usually appears in the third trimester of pregnancy. If left untreated, it poses serious health risks to the mother and growing baby.
If you’re diagnosed with AFLP, your doctor will want to deliver your baby as soon as possible. You might need to receive follow-up care for several days after you give birth.
Your liver health will likely return to normal within a few weeks of giving birth.

Alcoholic fatty liver disease (ALFD)

Drinking a lot of alcohol damages the liver. When it’s damaged, the liver can’t break down fat properly. This can cause fat to build up, which is known as alcoholic fatty liver.
Alcoholic fatty liver disease (ALFD) is the earliest stage of alcohol-related liver disease.
If there’s no inflammation or other complications along with the build-up of fat, the condition is known as simple alcoholic fatty liver.

Alcoholic steatohepatitis (ASH)

Alcoholic steatohepatitis (ASH) is a type of AFLD. It happens when a build-up of excess fat in the liver is accompanied by liver inflammation. This is also known as alcoholic hepatitis.
If you have excess fat in your liver, your liver is inflamed, and you drink a lot of alcohol, your doctor may diagnose you with ASH.
If it’s not treated properly, ASH can cause scarring of your liver. Severe liver scarring is known as cirrhosis. It can lead to liver failure.
To treat alcoholic fatty liver, it’s important to avoid alcohol. If you have alcoholism, or alcohol use disorder, your doctor may recommend counseling or other treatments.

Risk factors

Drinking high amounts of alcohol puts you at increased risk of developing fatty liver.
You may also be at heightened risk if you:

• are obese
• have insulin resistance
• have type 2 diabetes
• have polycystic ovary syndrome
• are pregnant
• have a history of certain infections, such as hepatitis C
• take certain medications, such as methotrexate (Trexall), tamoxifen (Nolvadex), amiodorone (Pacerone), and valproic acid (Depakote)

• have high cholesterol levels
• have high triglyceride levels
• have high blood sugar levels

• have metabolic syndrome

If you have a family history of fatty liver disease, you’re more likely to develop it yourself.

Stages of fatty liver

Fatty liver can progress through four stages:

• Simple fatty liver. There is a build-up of excess fat in the liver.
• Steatohepatitis. In addition to excess fat, there is inflammation in the liver.
• Fibrosis. Inflammation in the liver has caused scarring.
• Cirrhosis. Scarring of the liver has become widespread.

Cirrhosis is a potentially life-threatening condition that can cause liver failure. It may be irreversible. That’s why it’s so important to prevent it from developing in the first place.
To help stop fatty liver from progressing and causing complications, follow your doctor’s recommended treatment plan.

Prevention

To prevent fatty liver and its potential complications, it’s important to follow a healthy lifestyle.

• Limit or avoid alcohol.
• Maintain a healthy weight.
• Eat a nutrient-rich diet that’s low in saturated fats, trans fats, and refined carbohydrates.
• Take steps to control your blood sugar, triglyceride levels, and cholesterol levels.
• Follow your doctor’s recommended treatment plan for diabetes, if you have it.
• Aim for at least 30 minutes of exercise most days of the week.

Taking these steps can also help improve your overall health.

Outlook

In many cases, it’s possible to reverse fatty liver through lifestyle changes. These changes may help prevent liver damage and scarring.
The condition can cause inflammation, damage to your liver, and potentially irreversible scarring if it’s not treated. Severe liver scarring is known as cirrhosis.
If you develop cirrhosis, it increases your risk of liver cancer and liver failure. These complications can be fatal.
For the best outcome, it’s important to follow your doctor’s recommended treatment plan and practice an overall healthy lifestyle.
 https://www.healthline.com