Living Well You're having a normal day at work when suddenly, you find yourself hiding in the bathroom... knowing that the building is burning. You think you're going to die then and there.
But it never happens. The building isn't on fire. Everything is fine.
Some time later, the same crushing feeling of doom returns. You can't seem to focus and keep reading the same sentence over and over... You can't sleep... You forget to make the turn that takes you to your house...
These might all sound like symptoms of anxiety and depression. But instead of your brain, they could come from what's happening in a spot in your body you wouldn't expect: your liver.
As I'll share today, there's a strong connection between the liver and mental health.
Your liver is the main detoxifier for your blood. This workhorse of your body filters blood to remove toxins from what you ingest. It also has other big jobs like helping out with blood clotting, immunity, and digestion.
Bile from the liver breaks down fats into their more absorbable form of fatty acids. That's important because some essential vitamins and minerals are fat-soluble and pair with fatty acids. This lets us absorb key micronutrients like calcium, vitamin A, and vitamin D, for example.
So, what happens if your body makes too much fat and/or has trouble breaking down fats?
You get what's called nonalcoholic fatty liver disease ("NAFLD").
NAFLD begins with steatotic liver disease, where more than 10% of the liver weight comes from fat deposits from either drinking too much alcohol or, as I'll explain shortly, from other causes.
Untreated, the disease could progress to a condition called nonalcoholic steatohepatitis ("NASH"), featuring inflammation on top of the fatty liver.
The constant inflammation and damage kickstart the process of scarring (or fibrosis). Severe scarring and permanent damage, also called cirrhosis, may follow, which can lead to liver failure or liver cancer.
Major risk factors for NAFLD include obesity, insulin resistance, abnormal cholesterol and triglyceride levels, and hypertension.
More recently, some experts have started calling NAFLD by a different name – metabolic dysfunction-associated steatotic liver disease ("MASLD") – to emphasize the metabolic problems. (Metabolic syndrome means you have a medley of metabolic problems that ramp up your risk of cardiovascular disease and Type 2 diabetes.)
Worldwide, NAFLD is the No. 1 cause of chronic liver disease and affects roughly 30% of adults. As for the U.S., one study published last year estimated that more than 40% of Americans have NAFLD. Yikes.
That number could likely increase, especially if you consider that...
- NAFLD affects an estimated 70% to 90% of obese folks. In the U.S., obesity affects about 42% of adults.
- Roughly 40% of nondiabetic younger adults aged 18 to 44 have insulin resistance. And as those folks get older, their risk of becoming full-on Type 2 diabetics grows.
- Many people with NAFLD don't experience symptoms. And that means undiagnosed cases could put that number even higher.
So as NAFLD becomes a bigger public health crisis, mental illness could also follow suit. Research has already shown links between the two...
- A 2021 study of 25,333 Koreans aged 47 on average found that about 31% of them had NAFLD. And having NAFLD was associated with a 43% higher risk of depression.
- A 2023 U.K. study found that you're three times more likely to suffer from a personality disorder if you have NAFLD.
- A 2024 systematic review and meta-analysis of about 2.1 million NAFLD patients found that about 26%, 37%, and 51% of them suffered from depression, anxiety, and stress, respectively.
The idea is that a fatty liver has a harder time detoxifying your blood of unwanted substances. So those toxins could travel up and over into your brain and build up there.
(Aside from your liver, you have a massive superhighway of vessels that acts like a complex sewage system. And no, it's not your circulatory system. But it's just as important. Impairment of this vascular network is linked to cardiovascular and bowel disease. I covered it last Wednesday in Retirement Millionaire. If you don't receive my monthly flagship newsletter, get the details here.)
Well, there's good news...
When it comes to regenerating, your liver does a stellar job (albeit, at a pace of weeks to months depending on the damage). As long as you're still in the early stages of NAFLD, the damage can be reversed in your liver – and in your brain function.
As for jump-starting the hepatic – and mental – healing process, it all boils down to my favorite first-line treatment for innumerable ailments: making lifestyle changes.
And one of my top prescriptions is to get moving...
Moving your body on the norm will decrease production and increase oxidation of fatty acids in your liver.
I love high-intensity interval training on my stationary bike. But if you don't regularly exercise, start small like grabbing a short walk after eating. I always try to take a brisk walk after lunch – it helps control those post-meal blood-sugar spikes.
To make it a habit, make that walk fun... Go walk with a friend or co-worker, or stroll around in a park surrounded by nature.
If you're stuck indoors and you don't have a treadmill, treat yourself to your favorite tunes or TV show and just walk in place. It might feel silly at first, but it's just as effective as an outdoor jaunt. As a bonus, you can swing your arms as much as you like to add more movement, and no one will be around to judge you.
What We're Reading...
- Something different: Maybe Lucy wasn't so hairy after all.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
July 16, 2024