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Fatty Liver Disease and Thyroid Disease- Heres the Connection

Fatty liver disease, also known as nonalcoholic fatty liver disease (NAFLD), is a common medical condition characterized by an accumulation of excess fat in the liver. This condition has gained considerable attention not only for its connection to insulin resistance and metabolic disorders but also for its association with thyroid dysfunction. The link between fatty liver disease and the thyroid highlights the intricate interplay between hormones and liver health. In this article, we will explore the relationship between fatty liver disease, insulin resistance, and the thyroid, shedding light on how addressing these connections can potentially improve liver health and overall well-being.

Maybe you just got back from your doctor’s office for a routine follow up on your thyroid and you were now told that in addition to thyroid disease you have a fatty liver.

Should you be concerned about this fatty liver?

How did you develop a Fatty Liver?

How serious is a Fatty Liver?

Did my thyroid cause my fatty liver. Ok…..Well you probably didn’t wonder about that one, but that’s exactly what I’m going to talk about today.

Hey there, I’m Dr Hagmeyer and today we’re looking at fatty liver disease and the connection to thyroid disease, as well as some important things you need to consider when it comes to treatment. At the end of the video I will also go over some of the most important strategies to treat fatty liver disease. Let jump into this but let’s start with basics.

What is a “Fatty liver?”

Just as the name Implies fatty liver refers to abnormally high levels of fats otherwise known as lipids that have become concentrated in your liver. In past, researchers felt that this was a problem that only happened in people who over indulged in alcohol, but then when patients were asked about how much alcohol they drink per day, per week or per month they had to create a new category for people who don’t drink and hence the name Non-alcoholic fatty liver disease or NAFLD.

stages of fatty liver disease

In fact, A 2020 study in the Journal of Clinical and Translational Hepatology  stated that “in the last 20 years, NAFLD has become one of the most common liver diseases in the world, where one in 4 people struggle with this.” In the U.S., millions of people have NAFLD and they are for the most part told not to worry about it. I don’t know about you, but my liver wasn’t designed to be fatty and when we consider how important our liver is, I’m not ok with having a fatty liver. So, let’s talk about this fatty liver and how it develops, what you can do about and its relationship to your thyroid gland. ‍

What Causes Fatty Liver?

Fatty liver disease and insulin resistance are closely intertwined conditions that often go hand in hand. Insulin resistance occurs when the body’s cells become less responsive to the hormone insulin, leading to elevated blood sugar levels. This, in turn, can trigger the accumulation of fat in the liver, resulting in fatty liver disease. The relationship between these two conditions is bidirectional, as fatty liver disease can also exacerbate insulin resistance.

Understanding the link between fatty liver disease and insulin resistance is crucial in managing and preventing the progression of both conditions. Lifestyle modifications, including regular exercise, a balanced diet, and weight management, can help improve insulin sensitivity and reduce liver fat accumulation, ultimately promoting better liver health and metabolic function. By addressing insulin resistance, individuals can effectively manage fatty liver disease and reduce the risk of associated complications.

If you or a loved one was told you have a fatty liver, the research is clear that you have couple of underlying health problems going on.

  1. NAFLD is associated with obesity.
  2. Insulin resistance or prediabetes you’re on your way to becoming a diabetic or are one
  3. Metabolic Syndrome (high BP, abdominal obesity, too many bad cholesterol, not enough good cholesterol) and…….
  4. (that’s what I will be talking about today)

When it comes to hypothyroidism, some studies show that having hypothyroidism is an independent risk factor for NAFLD. This doesn’t surprise me at all. I did a video and wrote several articles that talked about thyroid hormones and how they increase cholesterol production in the liver. So, if you saw that video, or read my articles on Thyroid and Heart disease, it’s probably no surprise that there is link between NAFLD and thyroid disease as well.

Fatty Liver Disease and Hypothyroidism

Fatty liver disease and hypothyroidism, a condition characterized by an under-active thyroid gland, have been found to be interconnected. Thyroid hormones play a crucial role in regulating metabolism, including the breakdown and utilization of fats in the liver.

When the thyroid gland is not functioning properly and produces insufficient hormones, it can lead to a slower metabolic rate and an increase in fat accumulation in the liver, contributing to the development of fatty liver disease. On the other hand, fatty liver disease itself can also impact thyroid function, potentially causing further disruption in hormone production and regulation. Recognizing the link between fatty liver disease and hypothyroidism is essential for comprehensive diagnosis and management.

Research shows that not only can hypothyroidism be an independent risk factor for NAFLD, but so can subclinical hypothyroidism. (*)  Subclinical hypothyroidism (SCH), also called mild thyroid failure, is diagnosed when thyroid hormone levels (T3 or T4) are within the normal lab range, but your TSH is elevated. (Mild Thyroid failure)

What I found to be so interesting, is that the higher the thyroid stimulating hormone (TSH) level, the greater the risk of NAFLD. (*) Here’s What’s going on with your thyroid. One of the things I have talked a lot about are T3 thyroid hormone levels.

Fatty Liver Disease and Hypothyroidism

The Thyroid gland makes T4 thyroid hormones and from this T4 your body convert that T4 into T3 in the liver, kidneys and in the gut.  T4 doesn’t do much in your body which is why so much emphasis is placed on having optimal T3 levels and frequently check your T3 and free T3 levels in blood. Well…

When you have decreased T3 inside your cells, you slow down your mitochondria ability to make ATP. This is why you feel fatigued, brain fog and gain weight.

When T3 levels are low, your cells aren’t turning that glucose into energy. If the mitochondria can’t burn this glucose (this fuel), we have glucose/sugar backing up in the blood. So now if you get your bloodwork done you find out that you’re diabetic, prediabetic or insulin resistant.

That extra glucose floating around your blood can’t be used by your liver and muscles, so your body converts it into triglycerides and then eventually it gets stored as fat around the belly, arms and legs.

Insulin resistance starts in the liver. It’s one of the first tissues that become insulin resistant. When you become insulin resistant, we know that there is chronic inflammation going on.

Well….. this causes another problem for the thyroid. Inflammation is your thyroids worst enemy.

With this inflammation our bodies become terrible thyroid convertors. Meaning we don’t convert T4 into T3 the way we are suppose to. The end result is Low T3 thyroid hormone and all the problems that ensue due to low thyroid levels. Now….the other problem besides this insulin resistance is that Thyroid hormones are essential for liver function and liver metabolism.


Low thyroid hormones promote fatty infiltration of the liver, and also  impair its ability to metabolize fat. So those are two very important ways NAFLD starts. Problems with blood sugar and problems with low thyroid hormone levels.

The link between fatty liver disease and thyroid disease is clear in that once again research shows that early diagnosis and treatment of hypothyroidism and treatment of blood sugar problems –helps prevent the development and progression of NAFLD(*). But modern medicine is failing diabetics the same way it’s failing its thyroid patients. These two diseases are like head and tails on a coin.

Follow These Steps To Start Revering Fatty Liver Disease 

What can you do? 

  1. You have to Lose weight- Diet, Exercise, balance hormones
  2. You’ve got to reduce stress because stress triggers inflammation. Stress creates hypothyroidism, elevated Reverse T3 levels and Low T3.
  3. You need to improve your sleep quality because when we don’t sleep well, we can’t heal and repair well.
  4. You need to reduce the processed foods and sugars in your diet. You need to follow an anti-inflammatory diet like Paleo or the Mediterranean diet.
  5. We need to address subclinical infections because many times subclinical infections are at the root of people’s immune, inflammatory, and autoimmune issues.
  6. You need to optimize your blood sugar levels and any problems with insulin resistance. Lastly,
  7. You need to address any toxicity issues that are present. When the liver gets compromised as in the case of fatty liver, it can’t detoxify all the toxins it comes in contact with on a daily basis.

Important Points To Remember

  • Thyroid hormones are essential for liver function and liver metabolism.
  • Without proper T3 levels you get fats infiltrating the liver, impairing its ability to metabolize fat, and increasing the risk of NAFLD.(*)
  • Hypothyroidism increases the risk of developing insulin resistance and impaired glucose metabolism, another risk factor for NAFLD.(*)
  • Up to 90% of hypothyroid patients have abnormal lipid values. (*)
  • Hypothyroidism increases the risk of impaired fat processing. Up to 90% of hypothyroid patients have abnormal serum lipids,(*) including high cholesterol and triglyceride levels.(*) These are all risk factors for NAFLD.
  • Approximately 17% of people with NAFLD have hypothyroidism.(*)
  • Hypothyroidism increases the risk of being overweight or obese, (*) which are risk factors for NAFLD. On average, hypothyroid patients weigh 15 to 30% more than when thyroid function is entirely normal. (*),(*)
  • You may need the help of a functional medicine practitioner to help you with this process. If you’re told you have fatty liver, there’s probably a thyroid mechanism. Hypothyroidism and insulin resistance is likely at the root of the problem.

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