How to Reverse Fatty Liver

If you’ve had a history of gallbladder problems, chances are you’ve been informed about having a fatty liver. Are you aware of the significant connection between these two conditions? It’s crucial for individuals with a history of gallbladder disease to understand fatty liver disease in order to effectively reverse and prevent its progression.

Nonalcoholic Fatty liver disease is increasingly prevalent as one of the most widespread liver diseases globally today. In fact in the general population we are seeing about 20-30% of  NAFLD diagnosis today and these statistics are expected to exceed over 40% in Americans by 2030 as we see an increase in metabolic syndrome.

As a integrative gallbladder nutritionist and someone who has helped TONS of clients reverse fatty liver,

I wanted to educate and empower you with the knowledge and the tools you need to optimize your liver health. In this blog we will discuss what causes fatty liver, the connection to gallbladder disease, and how to begin reversing fatty liver.

Why is my liver so important?

The liver is often recognized as the main detox organ, but did you know it has over 500+ functions in the body.

The liver supports:

  • Fat metabolism
  • Production of bile which aids in fat digestion, detoxification and serves an antimicrobials
  • Blood sugar balance
  • Estrogen metabolism and clearance
  • Activates thyroid hormones
  • Activates vitamin D
  • Produces cholesterol and triglycerides
  • Nutrient storage tanks for iron, vitamin b12 and fat soluble vitamins
  • Maintains stable weight

As you can see your liver truly is a powerhouse organ so it is important we work on supporting it daily through our dietary and lifestyle habits. So now that we understand what our liver does, lets start to dig into what is a fatty liver and the causes so we can get started working on reversing it!

What is fatty liver? 

Nonalcoholic fatty liver occurs when there is an accumulation of fat in the liver that if not addressed can progress to liver damage, NASH, cirrhosis. When there are high levels of fat concentrated in the liver causing the liver not to function properly. A healthy liver contains some amount of fat, but it becomes a problem when it reaches about 10% of liver weight. Having higher levels of fat in your liver is associated with diabetes, high blood pressure and kidney disease.

How to Reverse Fatty Liver

Causes of fatty liver:

Anytime we have a diagnosis, its important to asks ourselves why? What caused our liver to develop excessive amounts of fat? Knowing our why, or the causes can help us identify actionable steps to reverse the issue. So when we look at causes of fatty liver there are many to consider.

Research shows the two main drivers for fatty liver are insulin resistance and obesity. However there are many other various drivers of NAFLD. Let’s discuss some of the most common ones below:

Diet: The main driver of NAFLD is regular consumption of refined sugars, refined flours, high fructose corn syrup.  Too much fructose or refined sugars has to be digested and the liver stores basically the excess sugar to fat and stores it.

Gut health: Recent research has focused on investigating the influence of gut health on fatty liver disease. This involves exploring the bidirectional relationship between the liver and the gut, referred to as the gut-liver axis. Essentially, when the gut experiences inflammation or displays signs of bacterial imbalances like SIBO, H. pylori infection, leaky gut, or parasitic infections, these disturbances can also increase risk of NAFLD through the gut-liver axis.

Metabolic syndrome: Overall high blood pressure, high triglycerides, increased abdominal fat, insulin resistance, type 2 diabetes all contribute to inflammation, oxidative stress and liver damage.

Change in bile acid metabolism: And what we are learning is the connection with gallbladder removal, specifically the changes in bile acid metabolism causing issues with fat and glucose metabolism.

Thyroid: Thyroid hormones play a vital role in liver function and metabolism. Inadequate levels of these hormones can lead to fatty buildup in the liver, hindering its ability to process fat and raising the likelihood of developing non-alcoholic fatty liver disease (NAFLD). Hypothyroidism also exacerbates the risk of insulin resistance and disrupted glucose metabolism, further contributing to NAFLD susceptibility. 

Gallbladder Removal: Change in bile metabolism following removal can affect glucose and fat metabolism, insulin sensitivity, detoxification and gut microbiome. All factors that can lead to liver fat accumulation.

Environmental toxins: PFAS, BPA, heavy metals and endocrine disruptors are the most common toxins that can contribute to the progression of NAFLD.

Symptoms of fatty liver: NAFLD builds up over time. Most aren’t aware they have it or have symptoms. Ealy stage fatty liver does not cause problems, but can lead to cirrhosis. However, since your liver controls over 500+ functions in the body, early signs of poor liver health or early onset of fatty liver include:

  • Fatigue
  • Abdominal swelling
  • Accumulation of upper abdomen fat
  • Yellowing of skin, eyes- jaundice
  • Red Palms
  • Enlarged spleen
  • Indigestion to fatty foods
  • Body odor
  • Bad breath
  • Itchy skin
  • Headaches
  • Weight gain, weight loss
  • High cholesterol, blood pressure, triglycerides
  • Low testosterone and libido
  • Blood sugar over 100, elevated insulin levels

Gallbladder and Fatty Liver Disease Connection

NAFLD and gallstones- which comes first?

Typically Nonalcoholic fatty liver disease (NAFLD) comes first and Gallbladder issues proceed. Why is this? Insulin resistance is a key feature of both NAFLD and GD. Insulin resistance is associated with accumulation of liver fat and the role of supersaturation in bile salts. Supersaturation of bile is the main driver of cholesterol gallstones and sludge.

How to Reverse Fatty Liver

Gallbladder removal and fatty liver disease:

NAFLD becomes a higher risk after gallbladder surgery and this is due to the change of bile acid metabolism following gallbladder removal. Bile acids play a role in regulating lipid (fat) and glucose metabolism. The changes in bile acids without a gallbladder has shown to increase low density lipoprotein production, insulin, triglycerides and cholesterol. This is one reason why of many it is important we continue to support healthy bile metabolism without a gallbladder. And we do this by supporting the liver, healthy bile flow with herbs and bitter foods and in some cases bile salt supplements.

How to reverse fatty liver

Many think the answer to reversing fatty liver is restricting food, going keto or doing some fancy cleanses, but I want to remind you that your liver controls over 500+ functions, and no cleanse is going to reverse fatty liver. Reversing fatty liver and optimizing our detox pathways requires 365 days of effort. And the most powerful thing is that reversing fatty liver lies in our hands. We have control to reverse I through our diet, lifestyle, movement and supplementation.

Our daily choices can either hurt or support reversal fatty liver so when we get started reversing fatty liver the first step is identifying liver stressors in our diet and lifestyle and start making smart swaps for things we can control in our daily lives.

Step 1: identify and remove liver stressors
  • Diet high in processed, packaged foods, refined carbohydrates, refined sugars, and inflammatory industrial seed oils.
  • Gut bacteria infection or imbalance- parasites, bacteria, candida, liver flukes
  • Lack of exercise
  • Pesticides, herbicides, food additives
  • Medication, PFAS, BPA, heavy metals
  • Constipation
Step 2: Replace with a liver healing diet and lifestyle

A liver healing diet is a well-rounded diet that is balanced with quality protein full of amino acids to support phase 2 detoxification, fiber to optimize drainage pathways and pull toxins out and health fats to reduce down inflammation.

In addition it can be helpful to optimize key nutrients in our diet through foods rich in Vitamin B, Vitamin C, Selenium, Vitamin E, Choline and amino acids. (show slide of foods rich in each)

Step 3: Balance Blood Sugar

Insulin resistance is one of the most common drivers of fatty liver today so balancing blood sugar is extremely beneficial in reversal of fatty liver. Here are some basic blood sugar balancing tips to get started with:

  • Include no less than 30 grams of protein at your main meals
  • Avoid all naked carbohydrates. Example, oatmeal or banana on its own. Always pair with a protein and/or fat.
  • Opt for lower glycemic carbohydrates. I like to reference glycemic load to portion control complex carbs like potatoes, rice, oats and fruit.
  • Walk following heavy meals
How to Reverse Fatty LiverStep 4: Move our bodies

Exercise has so many physical, mental and emotional benefits for our health. It can help to boost our immune system, improve digestion, reduce stress and promote better sleep. Regular exercise also helps to maintain and increase antioxidant levels. For fatty liver specifically, I recommend a combination of strength training and low impact cardio. Some research shows this type of exercise boost glutathione levels, but strength training specifically helps improve lean muscle mass thus improve insulin sensitivity and reduction of liver fat.

Step 5: Swap out controllable toxins

Your liver is responsible for processing so many toxins on a daily basis. PFAS, BPA, endocrine disruptors and heavy metals are the most well known toxins that may also contribute to fatty liver. Unfortunately, we live in a very toxic world and will only be able to reduce down toxins as much as possible. I recommend swapping out controllable toxins within our environment through by opting for:

  • Nontoxic beauty, skincare, household cleaners. Shop my favorite products here.
  • Glass containers over plastic
  • Filtered water sources
  • Steel, glass or nontoxic cookware
Step 6: Targeted supplementation
  • B vitamins specifically help to support methylation and phase II detoxification.
  • Glutathione or NAC. NAC specifically helps to support glutathione production
  • To improve bile composition, I recommend 1000-2000mg of Taurine daily along with Ox bile or TUDCA. Using herbs with dandelion, artichoke, burdock can also be useful to help promote bile flow.
  • Lastly I recommend CDP choline to help break down fat deposits in the liver

Ready to take care of your liver the right way?

So today, we’ve learned a few things you need to do if you want to prevent or reverse fatty liver. 

You also know that your gallbladder and liver are two sister organs so one can not be healthy without the other.

As an integrative gallbladder nutritionist and someone who has helped hundreds of people to optimize both their gallbladder and liver health,

I know how confusing it can get to navigate this journey without the right support and guidance by your side.

So if you’re looking for more tools to take you to the next level on this journey, 

I invite you to join the Gallbladder Saver Society where a community of warriors helps to support you with your liver/gallbladder issues. 

Here you’ll find educational resources and live Q&A sessions with me to help you get your questions answered and avoid any unwanted symptoms that may arise.

So take charge of your health, and learn all the tools to manage your problems with ease and confidence. Join the Gallbladder Saver Society today! 


Teng ML, Ng CH et al (2023) Global incidence and prevalence of nonalcoholic fatty liver disease. Clin Mol Hepatol. 29(Suppl):S32-S42. doi: 10.3350/cmh.2022.0365. Epub 2022 Dec 14. PMID: 36517002; PMCID: PMC10029957.

Slouha E, Biput SJ et al (2023) Non-alcoholic Fatty Liver Disease and Gallstones: A Systematic Review. Cureus. 15(9):e45027. doi: 10.7759/cureus.45027. PMID: 37829934; PMCID: PMC10566311.

Luo D, Chen XP et al (2023) Cholecystectomy and risk of liver disease: a systematic review and meta-analysis of 27 million individuals. Int J Surg. 109(5):1420-1429. doi: 10.1097/JS9.0000000000000332. PMID: 36999804; PMCID: PMC10389609.

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