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A fatty liver is a condition in which there is excessive deposition of fat throughout the liver. It can occur related to drinking alcohol, but also can occur in persons that do not drink alcohol. Over time, the excessive deposition of fat in the liver can cause irritation and inflammation of the liver, which may also lead to cirrhosis.
High iron levels are measured in the blood and are primarily a concern because of a condition in which there is genetic disposition to absorb excessive amounts of iron, referred to as hemochromatosis. In most people, if there is an adequate amount of iron, the absorption through the gut decreases. However, persons with hemochromatosis do not decrease the absorption in response to adequate iron levels, so the iron levels in the blood increase. As the iron levels increase, iron can deposit in tissues, primarily the heart, liver, pancreas, and skin. Over time, the iron deposition in the liver can cause inflammation of the liver or cirrhosis.
The treatment of fatty liver is the avoidance of alcohol and treatment of any underlying condition that may be affecting the liver,\. Hemochromatosis is a genetic disorder that results in excessive absorption of iron, as noted above. Treatment of hemochromatosis involves removing large amounts of blood, similar to donating blood, on a regular basis.
Fatty liver can occur with hemochromatosis, but both can also occur separately. The hemochromatosis is more serious than the fatty liver, as it is a greater risk to develop cirrhosis, but if the fatty liver is severe enough to cause cirrhosis, it can also be serious.
The interpretation of the liver enzymes must occur in association with other findings. It is true that if at the stage of inflammation (hepatitis), a mild elevation in liver enzymes would indicate mild disease. However, liver enzymes may also be only mildly elevated if the liver has progressed to cirrhosis. When the liver has reached the stage of cirrhosis, the liver enzyme levels do not indicate severity of disease. If the two conditions are related, the fatty liver could be due tot he liver irritation associated with the hemochromatosis. Generally speaking, neither condition is due to medicines, although certain medicines may exacerbate conditions that contribute to fatty liver, such as obesity, and medicines or supplements that contain iron will worsen hemochromatosis.
Cirrhosis is scarring of the liver, which results in worsening liver function. The outcome depends upon the severity of the disease and whether it is caught early enough to be treated. Untreated hemochromatosis can result in cirrhosis, but also heart failure and pancreatic dysfunction (including diabetes). If the hemochromatosis is identified early and treatment started, these complications are typically completely avoided and the long-term outcome is good.