Fatty liver disease's early sign can show up in legs: Doctor issues warning and how to identify

Liver health is becoming an increasing concern globally, with lifestyle-related diseases now among the leading health challenges. Conditions such as fatty liver disease, often linked to obesity, poor diet, and sedentary habits, can develop silently over years before causing serious complications. Early detection is crucial, yet many people overlook subtle warning signs that could indicate liver damage. Surprisingly, one of the earliest indicators may appear not in the liver itself, but in the legs.

The overlooked leg symptom
Dr. Pradip Vekariya, a gastroenterologist based in India, has drawn attention to an early sign that patients often dismiss—swelling in the feet, medically known as pedal edema. He explained that this symptom can signal liver damage and should not be brushed aside as a result of simply standing too long or walking more than usual.

Pedal edema occurs when excess fluid builds up in the lower limbs. To check for it, doctors advise pressing firmly on the skin above the ankle for a few seconds. If an indentation, or “pit,” remains after removing the finger, it may be a sign of pitting edema, a condition linked to liver issues.

Dr. Vekariya warned that fatty liver disease has become increasingly common and stressed that ignoring early symptoms can allow it to silently progress into cirrhosis. He urged people to seek medical guidance if they notice swelling in their legs, noting that timely diagnosis and treatment can prevent serious complications.

What is fatty liver disease?
Fatty liver disease, medically called hepatic steatosis, develops when excessive fat accumulates in the liver, limiting its ability to function properly. Small amounts of fat are normal, but too much can be harmful. The condition is broadly categorized into two types. Alcoholic fatty liver disease (AFLD) is caused by heavy alcohol intake, while non-alcoholic fatty liver disease (NAFLD), also called metabolic dysfunction-associated steatotic liver disease (MASLD), is linked to factors such as obesity, type 2 diabetes, high cholesterol, and poor lifestyle habits.

Both forms of fatty liver can advance to more severe stages, including cirrhosis and liver cancer. According to WebMD, about 20% of individuals with NAFLD may develop metabolic dysfunction-associated steatohepatitis (MASH), previously known as NASH, which involves liver inflammation and cell damage.

Risk factors and prevention
The causes and risk factors of fatty liver disease differ depending on the type. For AFLD, excessive alcohol use is the main contributor, and abstaining can reverse much of the damage if detected early. For NAFLD, risk factors include obesity, insulin resistance, high triglyceride levels, metabolic syndrome, hypothyroidism, and certain medications.

Lifestyle changes remain the cornerstone of prevention. Doctors recommend weight management, regular physical activity, and balanced diets rich in vegetables, lean proteins, and healthy fats. WebMD highlights that reducing sugary drinks, following a Mediterranean-style diet, and incorporating coffee or olive oil may provide additional support for liver health. Managing conditions like diabetes and high cholesterol also plays a critical role.

Experts stress that while fatty liver disease can be silent in its early stages, subtle signs like pedal edema should not be ignored. As Dr. Vekariya explained, health issues neglected today may become life-threatening tomorrow. Regular health check-ups, awareness of risk factors, and early lifestyle adjustments remain vital in protecting liver health.