Benefits of Probiotics in Nonalcoholic Fatty Liver Disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) is an intermediate condition characterized by changes in liver tissue and elevation in certain liver-specific enzymes. While not immediately life-threatening, untreated NAFLD may lead to more severe health conditions. As with many health conditions, there are coexisting factors that can contribute to NAFLD. We’ll address the contributing factor of an unhealthy colon and how a high-potency probiotic could help.

Depending on testing methods, upwards of 25% of Americans may suffer from this condition. Given the prevalence of NAFLD, it is reasonable to ask how it has become such a common health challenge. One possibility involves the influence of blood chemistries that provoke adaptive changes in liver tissue. Lipopolysaccharides are one class of chemistries involved in these changes.

The LPS Factor

Gram-negative bacteria shed lipopolysaccharides (LPS) in the digestive tract. In cases where there is an increase in intestinal permeability, such as with the presence of intestinal disease, LPS may enter the bloodstream, where it eventually enters the liver. The liver can become stressed if sustained exposure occurs, prompting protective measures. While well-intentioned, these protective measures contribute to harmful changes in the tissue and ultimately compromise the functionality of the liver.

The Gut Factor

Many dietary and environmental factors may contribute to a condition known as “leaky gut syndrome,” including herbicides, gluten-containing grains, candida albicans overgrowth, Small Intestinal Bacterial Overgrowth (SIBO), alcohol consumption as well as other food intolerances/allergies. Essentially any pro-inflammatory influence that is significant or prolonged enough may cause the intestinal lining to lose integrity. Under ideal circumstances, the intact tissue is very selective about what passes into the bloodstream. In a leaky gut scenario, undigested proteins and toxic chemicals may cross through the compromised intestinal lining, leading to unbalanced blood chemistry. Since many toxins find their way to the liver to be neutralized for elimination, any increase in exposure to these elements would necessarily stress the liver. This increased exposure can initiate the accumulation of fatty substances, which interfere with normal liver function.

Diagram of increased intestinal permeability, bacterial translocation, and liver absorption.

Figure source: Nicoletti A, Ponziani FR, Biolato M, Valenza V, Marrone G, Sganga G, Gasbarrini A, Miele L, Grieco A. Intestinal permeability in the pathogenesis of liver damage: From non-alcoholic fatty liver disease to liver transplantation. World J Gastroenterol 2019; 25(33): 4814-4834 [PMID: 31543676 DOI: 10.3748/wjg.v25.i33.4814] Accessed 12/7/2022

The Role of Probiotics

One promising strategy to improve intestinal barrier function employs a high-potency probiotic containing bacterial species known to assist in resolving inflammation in the digestive tract. In a 2019 clinical study, the probiotic formula Visbiome (also known as VSL #3 or the De Simone Formulation) was shown to improve liver conditions in patients diagnosed with NAFLD. Several mechanisms were proposed to explain this outcome. Aside from the anticipated reduction of inflammatory processes in the gut, probiotics also have the potential to inhibit pathogenic bacteria and improve immune function.

Fortunately, NAFLD is reversible if caught early. Along with other lifestyle changes and assuming no additional liver pathologies, removing the negative stimulus of LPS exposure may encourage a return to normal tissue tone and function. If you have been diagnosed with NAFLD, you may want to consider adding Visbiome to your routine.


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Nicoletti A, Ponziani FR, Biolato M, Valenza V, Marrone G, Sganga G, Gasbarrini A, Miele L, Grieco A. Intestinal permeability in the pathogenesis of liver damage: From non-alcoholic fatty liver disease to liver transplantation. World J Gastroenterol 2019; 25(33): 4814-4834 [PMID: 31543676 DOI: 10.3748/wjg.v25.i33.4814]

About the Author

Joel Hall

Coastal Pharmacy & Wellness Staff

At Coastal, Joel is our go-to guy for anything related to supplementation and the complex role nutrients play in every bodily function. Although he may be reserved, helping people find their way to optimal health drives what he does. If you see him staring intently at his computer screen, he’s most likely researching something that most of us can only partly understand. He loves sharing his accumulated knowledge and spends as much time as necessary to explain things in a way to help you make good health decisions. He's been working in the wellness arena since the early 2000's and has been in the pursuit of nutritional knowledge since way before that. You can find him behind the wellness desk Tuesdays through Saturdays. For more information read our profile on Joel.


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