The truth about fatty liver

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The majority of doctors will tell you that there is nothing you can do to reverse fatty liver and that health problems such as cirrhosis and liver failure may be in your future that they will address with the awful “solution” of liver transplant.

The truth is the opposite: fatty liver is easily and readily reversible in virtually everybody, provided you take action before irreversible changes take place and are given the right information and tools. In this video, I discuss the three basic phenomena that drive fat deposition, liver damage, and inflammation that lead to this condition:

  1. Carbohydrate consumption that drives de novo lipogenesis, the liver’s conversion of sugars to triglycerides
  2. Insulin resistance that puts de novo lipogenesis into overdrive
  3. Dysbiosis and SIBO that floods the portal circulation draining into the liver with inflammatory compounds (e.g., metabolic endotoxemia)

Reverse these conditions, as we do in my programs, and fatty liver easily, quickly, inexpensively becomes a thing of the past with normalization of AST, ALT, GGT blood tests and reversal of fat deposition by ultrasound, MRI, or CT scan.


let’s talk about this very common condition called fatty liver, in which fat has entered the liver and over time, can do damage to the liver tissue. It’s become incredibly common. About a third of all Americans, about a third of all Americans, now have fatty liver. If you’re overweight, there’s about a 65% likelihood that you have fatty liver, and if you’re obese, there’s about a 90% chance — almost guaranteed — that you have fatty liver.

Why is it important to know if you have fatty liver? Well, that fat infiltration of your liver can lead over time to fibrosis — fibrous tissue deposition, and inflammation, and then cirrhosis. That is a terrible and irreversible situation that leads to a condition called portal hypertension, where your abdomen swells and fills with fluid. You eventually have liver failure. The “treatment” is liver transplant.

Screen text: Blood tests: AST, ALT, GGT
Now sadly, the doctor says something like “there’s nothing we can do”. So maybe he saw your AST and ALT or GGT blood tests were elevated, and then he told you that it was not viral hepatitis (ruled out by blood tests). Maybe he did an ultrasound, or an MRI, or a CAT scan of your abdomen, and said “Nope, there’s fibrous tissue or fat excess fat in your liver. You have fatty liver.”

Why is it important to reverse fatty liver? Because if you don’t reverse it, your risk for all those diseases skyrockets: coronary disease, liver cancer, other forms of cancer, and even dementia. The truth of it is: it is incredibly easy to reverse, and you can do it within weeks. But to get there, let’s first talk about why people develop fatty liver. What are the mechanisms that leads to this damage, accumulation of fat and damage to the liver?

Screen text: de novo lipogenesis
The first is a relatively recently discovered process called de novo lipogenesis (a mouthful, I know). All that means is your liver is very effective at converting any kind of sugar or carbohydrate into triglycerides, or fats. Triglycerides are fats — all fats are triglycerides. Let’s say I drink a sugary soft drink, or I eat whole grain bread (it’s made of amylopectin A — the carbohydrate grains is amylopectin A), which is extremely rapidly converted to glucose (sugar).

Any carbohydrate or sugar I feed my liver is converted into triglycerides — fructose especially — fructose is an extremely potent trigger of de novo lipogenesis. Fructose as in sucrose, as in high fructose corn syrup or agave nectar (an especially terrible form of fructose). Any sugar: fructose, sucrose, glucose, grains, go to the liver, where it’s converted to triglycerides.

Some of those triglycerides exit the liver, and that’s why you have high blood triglycerides when you have fatty liver (in addition to the elevation of those liver markers AST, ALT, GGT). I would define, by the way, “high triglycerides” as any level above 60 milligrams per deciliter. That means almost everybody has some degree of high triglyceride / fatty liver.

Some of the triglycerides don’t get released in the bloodstream, but stay in the liver, where they incur damage. The process of de novo lipogenesis the liver’s conversion of sugar and carbohydrates to triglycerides, is the fundamental process driving fatty liver: fat accumulation in the liver.

Screen text: Insulin resistance
Insulin resistance — another fundamental process, that’s typically present in virtually everybody who has fatty liver. It means the body, including the liver, is not responding to insulin. One of the responses to that is the pancreas (the pancreatic beta-cells) produce a lot more insulin, to force sugar into the liver, into muscle, into the brain and other organs, but that high insulin level also amps up de novo lipogenesis. People who have insulin resistance, whether it’s just a highish blood sugar (a little above normal), or pre-diabetes, or type-2 diabetes — their livers are revved up to produce more triglycerides, many of which accumulate and damage the liver.

Screen text: Dysbiosis and SIBO
Thirdly, people who have fatty liver all have dysbiosis (disrupted bowel flora), and most of them have SIBO (small intestinal bacterial overgrowth). When you have SIBO, unhealthy bacterial species have proliferated, and then ascended up from the colon (where they’re supposed to stay), into the ileum, jejunum, duodenum, stomach. In other words you have a 30 foot long infection.

The entire gastrointestinal system drains into something called the portal circulation. That’s the blood circulation that drains into the liver. The liver is the direct recipient of a tenfold increased level of metabolic and inflammatory markers. The liver is battered by inflammatory markers, and it causes liver inflammation. This amps up the whole process of damage from accumulating triglycerides. Unhealthy changes in bowel flora, especially SIBO, are the third process that drives fatty liver.

What do you do about this? Well, if de novo lipogenesis is the big driver of triglyceride accumulation in the liver, don’t eat foods that cause de novo lipogenesis, right? That’s why in my Wheat Belly and Undoctored programs, we banish all wheat, all grains, all sugars, and we cap net carbs to no more than 15 grams net carb per meal. That alone reverses fatty liver within weeks. You can stack the odds in your favor, both of the reversing fatty liver fully, and of also reversing other health conditions, including your risk for coronary disease (heart disease), taking maximal benefit of reversing type II diabetes, reducing your dementia risk, reducing cancer risk — by reversing insulin resistance — that second process we talked about.

That’s why in my Wheat Belly and Undoctored programs, we supplement vitamin D to achieve a 25-hydroxy vitamin D blood level of 60-70ng/mL (to obtain maximum benefit). We supplement omega-3 fatty acids to achieve an intake of EPA and DHA of 3000 to 3600 milligrams per day (from fish oil).

We supplement magnesium. Because we drink filtered water, all the magnesium has been removed. We try get in 500 milligrams or so of magnesium, preferably as my magnesium water recipe, or as one of the more absorbable forms of forms of magnesium, like magnesium malate or magnesium glycinate. You’ll find this, by the way, exhaustively discussed in all my books; my Wheat Belly books (including my newest book, the Revised and Expanded Wheat Belly) as well as my Wheat Belly blog. So, we supplement magnesium.

We supplement iodine, because many people now have iodine deficiency, and many people have thyroid dysfunction: some from iodine deficiency, some for other reasons — that’s a whole conversation of its own — but we aim for optimal thyroid status — so very important.

The third process driving fatty liver, that is, dysbiosis and SIBO — that’s a bit more complicated. We start by cultivating healthy bowel flora. How do you do that? Eat no sugars; in other words, follow the diet that does that. There are some basic steps you can take to avoid disrupting disrupting bowel flora, like minimizing your exposure to antibiotics — a big deal — only taking if they’re absolutely necessary, avoiding herbicide and pesticide residues in food by choosing organic foods whenever possible. Do not eat GMOs like genetically modified corn or soy, because the Bt toxin and glyphosate are massive disruptors of bowel flora. Avoid chlorinated drinking water. Filter your water.

Those are some basic steps you can take to start the process of restoring a healthy microbiome. Then, a high potency multi-species probiotic is helpful in the beginning, lots of inclusion of fermented foods, like kefirs, kombuchas, yogurt that’s properly fermented — so see my Wheat Belly blog conversations on how to properly ferment yogurt — not the garbage you buy in the grocery store, fermented sauerkraut, fermented pickles (you can buy or you can make it on your own too, very easy to do, inexpensive). So, a multi species potent probiotic, fermented foods to supplement your probiotic, and prebiotic fibers. You’ll find conversations about prebiotic fibers my Wheat Belly blog. I also have some YouTube videos about that.

Now, SIBO is sometimes eradicated by these basic efforts, but a lot of people still have persistent SIBO and SIBO, like fatty liver, is epidemic — it’s out of control, it’s everywhere, it’s probably about 1 in 4 to 1 in 3 of all Americans have SIBO to one degree or another. That’s a more complex conversation. It involves breath detection for hydrogen gas, that you can do on your own, by the way. You don’t need the doctor to do that. It’s very easy, using a smart phone enabled device. Then we eradicate it using very select regimens of herbal antibiotics. And we also add some other supplements to increase the efficacy of your herbal antibiotic regimen. And then we follow a very strict program after antibiotics, to help cultivate a return to healthy bowel flora, and prevent very common recurrences. That’s more complicated; a bit more than we’re going to cover right now. You will find other videos in my channel about SIBO. You’ll also find lots of conversations about SIBO in my Wheat Belly blog.

If you think you have SIBO, go to my Undoctored and Undoctored Inner Circle websites. That’s where we dive deep, and I have two-way conversations with people to help them identify SIBO and manage it. I will tell you while I love giving you tools to work out on your own, without the doctor, at very little cost, SIBO is one of the exceptions where you do need a little bit more insight, a little bit more benign guidance, help. You can talk over “gee, I took the Candibactin AR/BR, and I’m still having this issue”, “I did take N-AcetylCysteine (that’s a biofilm disrupter for increased efficacy) but this happened, where I’m having some peculiar effects”, or “what’s the best probiotic to add after after my antibiotic course”.

There’s lots of issues to cover in that — point being: you have magnificent magnificent potential for control over fatty liver. It won’t come from the doctor. It’s it’s got to come from you. This this video on YouTube is just the start. It’s just an overview to get you aquainted with this idea you can explore this further in my Wheat Belly blog, my Undoctored blog, and my deep dive under Undoctored Inner Circle. If you’re interested in the full therapeutic program, I invite you to get a copy of my newest book, which is the Wheat Belly Revised and Expanded edition. The original Wheat Belly doesn’t go into all this detail — it’s only about history of wheat and what agribusiness did to corrupt it. Wheat Belly Total Health, Wheat Belly 10-Day Grain Detox; those books expand the therapeutic program, but I put it all together so you have the entire program in one resource and my new Wheat Belly Revised and Expanded edition.

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