PCOS, Insulin Resistance and NAFLD

A particularly serious implication of PCOS and insulin resistance that you should be aware of and informed about is NAFLD (non-alcoholic fatty liver disease) NAFLD is a fatty inflammation of the liver not due to excessive alcohol use. It’s related to insulin resistance and metabolic syndrome (the underlying cause of PCOS)

NAFLD is characterized by fat deposits in the liver, without yet manifesting signs of inflammation and fibrosis in the liver.  If the fatty liver progresses to the stage of inflammation and fibrosis, that is called NASH, or non-alcoholic steatohepatitis, a more serious condition. 

Normally, the liver contains about 5% fat.  When the amount of fat in the liver doubles, healthy liver cells are replaced by fat cells, hence the name "fatty liver." The medical term for this is steatosis.  Fatty liver has now become the most common cause of abnormal liver blood tests (also called liver function tests) in the U.S.  NAFLD is most prevalent among overweight women over age 40 with insulin resistance.  High insulin levels and obesity provide a surplus of fatty acids and triglycerides to be stored in the liver as fat.

Most women don’t present to doctors with any specific symptoms. Some women however complain of exhaustion, general tiredness, and lack of energy. Occasionally, patients report having a mild right upper quadrant abdominal pain.  Mild jaundice is sometimes noted but in rare cases. Typically, NAFLD is diagnosed by abnormal liver function tests taken with a blood test.

Not everyone with insulin resistance develops fatty liver, but everyone with NAFLD does have insulin resistance or metabolic syndrome. Therefore, it seems that both environmental and genetic influences factor into the likelihood of suffering from fatty liver.

There are a number of things you can try that may prevent the onset of NAFLD.

It is important to improve the way your body responds to insulin. You can improve your insulin sensitivity with diet modification, exercise and nutritional supplementation.

Sustained, gradual weight loss is one way to help your body use insulin more efficiently. It is important to lose weight gradually as rapid weight loss may actually exacerbate NAFLD.

Start improving your diet by reducing carbohydrate and saturated fat intake. By eliminating an excess of carbohydrates from your diet you have less sugar in your system that requires the production of more insulin. People with insulin resistance, need to produce more insulin to break down sugar in the blood because their insulin receptors and working inefficiently.

Begin taking supplements like fiber, antioxidants, and herbs to support the liver.

 It is recommended that a person at risk for NAFLD reduce or eliminate alcoholic beverage consumption from their diet. As alcohol affects the liver directly, doing what you can to avoid alcohol is a great way to support your liver’s health.

Nutritional counseling and guidance may be a useful tool for people at risk for NAFLD.

 All of these steps can help to prevent the onset or reduce the severity of NAFLD.

PCOS is just one of the complications that can stem from insulin resistance. By making positive changes to your diet, lifestyle and exercise plans you may be preventing further complications and more severe disease states.