Does Metformin help or worsen NAFLD?


I know it reduces the sugar the liver outputs. Is this sugar the liver is trying to output from stored fat? Would that then mean it’s holding onto fat it shouldn’t be? Although Metformin I read improves insulin sensitivity, which a good thing to help against NAFLD I guess.

(Bacon is a many-splendoured thing) #2

I don’t believe metformin has an effect, one way or the other.

The sugar produced in the liver is made from amino acids, not fat. Fatty liver disease is the result of overloading the metabolic pathway that handles ethanol and fructose. When that pathway is overloaded, it produces droplets of fat, from a process called de novo lipogenesis. Sometimes that fat can get exported in a VLDL particle, but oftentimes there is too much fat, and the result is that it accumulates and causes fatty liver disease.

The good news is that when we cut back or eliminate alcohol and sugar consumption, the liver very quickly deals with that fat. There was a study done at a paediatric obesity clinic at the University of California at San Francisco, in which they reversed the fatty liver disease of a group of their patients in about 10 days.


Seems that it helps decently when people are diabetic, but not as much otherwise, common sense tells me the diabetic (like most) were doing a crap job of managing it and thats why there was a difference between them and non-diabetics. Either way Metformin is a very good glucose disposal agent, which obviously has benefits. Plus the alleged anti-aging effects. For a Keto’r though, may or may not make a huge difference since you’re starving yourself of most fructose.


I very rarely eat grains or any other carbs. Maybe a handful of times per year. It has dramatically improved my blood glucose, from near 10 A1C down into the low 6’s. But I do still take 2000 mg of Metformin and it does help with my blood sugar. (Maybe because it decreases the conversion of excess protein to sugar – gluconeogenesis – I dunno.) But I have fatty liver and I don’t eat carbs and I don’t know why.

(Peter - Don't Fear the Fat ) #5

I’m not a Doctor but the biggest effect on my HbA1c was weight loss and the Keto life. 11 to 5.4


Same here…changing the diet helped tremendously… but the metformin still helps.