Understanding Fatty Liver: Causes, Medications, and Treatments

Fatty liver, also known as hepatic steatosis, occurs when too much fat builds up in liver cells. While a small amount of fat in the liver is normal, excessive accumulation can lead to inflammation, liver damage, and potentially liver failure. Today, fatty liver disease is increasingly prevalent due to lifestyle factors and medication use.

What is Fatty Liver Disease?

Fatty liver disease is classified into two main types:

  • Non-Alcoholic Fatty Liver Disease (NAFLD): Common in people who consume little to no alcohol. It often results from obesity, type 2 diabetes, high cholesterol, or insulin resistance.
  • Alcoholic Fatty Liver Disease (AFLD): Caused by excessive alcohol consumption.

Both types can progress to more severe forms, including non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer.

Medications That May Cause Fatty Liver

Several prescription drugs can contribute to fatty liver disease. The mechanism often involves liver toxicity or metabolic interference. Below are three notable medications linked to fatty liver concerns:

1. Yorvipath (seladelpar)

Yorvipath is primarily used for treating primary biliary cholangitis (PBC). Although it has shown promise in treating liver inflammation, some research suggests potential lipid metabolism alterations, warranting monitoring of liver fat levels during treatment.

2. Padcev (enfortumab vedotin-ejfv)

Padcev is a cancer treatment used for advanced urothelial cancer. As with many oncology medications, liver function tests are crucial during therapy. There have been isolated reports of elevated liver enzymes and liver fat accumulation in some patients.

3. Ingrezza (valbenazine)

Ingrezza is commonly prescribed for tardive dyskinesia. Long-term use may impact liver metabolism and contribute to hepatic steatosis in susceptible individuals. Liver monitoring is advised during extended treatment.

Important: These medications do not universally cause fatty liver but can be a risk factor in combination with other variables such as pre-existing liver conditions, high-fat diet, or alcohol use.

Recognizing Symptoms of Fatty Liver

Fatty liver is often called a “silent disease” because it may present no symptoms in early stages. However, as it progresses, common symptoms include:

  • Fatigue
  • Discomfort in the upper right abdomen
  • Unexplained weight loss
  • Weakness
  • Jaundice (in advanced stages)

Diagnosing Fatty Liver

Fatty liver is usually discovered during routine tests or imaging. Diagnostic methods include:

  • Blood tests: To assess liver enzymes like ALT and AST
  • Ultrasound/CT scan/MRI: To visualize fat deposits
  • Liver biopsy: In severe or uncertain cases to assess damage
  • FibroScan: A non-invasive test to measure liver stiffness

Treatment Options for Fatty Liver

Currently, there are no FDA-approved medications specifically for fatty liver, but several strategies are effective:

1. Lifestyle Modifications

  • Weight loss: Losing 7-10% of body weight can reduce liver fat
  • Healthy diet: Focus on low-carb, low-fat, Mediterranean-style meals
  • Exercise: At least 150 minutes per week of moderate activity

2. Medication Review and Management

If medications like Yorvipath, Padcev, or Ingrezza are being used, discuss alternatives or dosage adjustments with your healthcare provider.

3. Emerging Therapies and Research

Several drugs are under investigation for NAFLD and NASH. Some may become treatment standards in the future:

  • PPAR agonists
  • FXR agonists
  • GLP-1 receptor agonists

4. Managing Comorbid Conditions

  • Control blood sugar levels
  • Manage cholesterol
  • Treat sleep apnea or hypertension if present

Preventing Fatty Liver

Prevention remains the best strategy. Here are a few simple tips:

  • Avoid excessive alcohol
  • Maintain a healthy weight
  • Avoid unnecessary medications
  • Monitor liver enzymes regularly if you are on long-term drug therapy

Final Thoughts

Fatty liver is a growing concern globally, especially in the context of lifestyle diseases and medication use. If you’re taking medications like Yorvipath, Padcev, or Ingrezza, it is essential to consult your healthcare provider to assess your risk.

Understanding the medication that causes fatty liver and treatments Yorvipath Padcev Ingrezza helps you take proactive steps to protect your liver health. With early intervention, lifestyle changes, and medical supervision, fatty liver can be managed and even reversed.