5. Abnormal Liver Blood Tests

Sometimes the first clue isn’t a physical symptom at all.

A routine blood test may show elevated levels of liver enzymes such as ALT or AST.

These enzymes can increase when liver cells are injured.

But elevated liver enzymes do not automatically mean fatty liver.

They can also occur because of alcohol, medications, viral hepatitis, muscle injury, autoimmune conditions, and many other causes.

Conversely, a person can have fatty liver while having normal liver enzyme levels.

That’s why doctors may combine blood tests with medical history, physical examination, and imaging rather than relying on one laboratory result.

6. Yellowing of the Skin or Eyes

Yellowing of the skin or the whites of the eyes is called jaundice.

Jaundice can occur when bilirubin builds up in the bloodstream.

It is important to understand that uncomplicated fatty liver does not usually cause jaundice.

When jaundice develops, it can indicate more significant liver dysfunction or another condition affecting the liver, gallbladder, or bile ducts.

If you notice new yellowing of the eyes or skin—especially together with dark urine, pale stools, abdominal pain, confusion, or severe weakness—seek medical evaluation promptly.

7. Swelling in the Abdomen or Legs

Swelling can occur in advanced liver disease.

When significant liver dysfunction develops, changes in blood flow, protein levels, and fluid regulation can cause fluid to accumulate in the abdomen, a condition known as ascites.

Swelling of the legs and ankles can also occur.

But this is generally not an early warning sign of ordinary fatty liver.