Never followed up on NAFLD dx, going to see dr this week & nervous
I was diagnosed (kind of?) during an abdominal ultrasound for another issue about 5 years ago at the age of 25. I was having a lot of health issues at the time, turned out to all be related to an autoimmune thyroid condition + endometriosis. The problem is, because we had much bigger concerns at the time, the doctor brushed the fatty liver finding aside and never followed up on it. I don't even know what stage I was. I completely forgot about it until a couple weeks ago when the doctor wanted to get a liver function test to establish a baseline because of a medication I was starting. My labs were completely normal, but it tickled something in my brain, and when I was talking with my mom she said "well you did have that abnormal liver ultrasound a couple years ago" and I went "oh sh*t." I did some googling, realized NAFLD is actually quite serious if not addressed, and panicked. I'm following up with a doctor this week and I'm trying not to panic spiral about it, since I have ignored it for essentially 5 years.
I never really had any risk factors other than the autoimmune issues. I was an athlete in high school, I've always been a normal weight, I do not drink at all and never have, no diabetes, no high cholesterol, and no family hx of liver issues. The only thing I can think is I always had a sweet tooth, but even then never really ate a lot of fast food or drank soda, etc, my diet just wasn't super well rounded, and I've struggled with ARFID (an eating disorder).
After my autoimmune dx and the other stuff, I actually started working out more, got back into running (10Ks, half marathons, etc), had a strict autoimmune diet, etc. So it's not like nothing changed the past 5 years. But the past year I had a nasty bout of depression and anxiety due to previously undiagnosed ADHD and my exercise and diet suffered, and so I'm worried about what we might find when the doctor looks again. I'm absolutely kicking myself for forgetting for so long and am really hoping I haven't done irreversible damage.
I'm guessing diet would be the biggest change I need to make – is it really that you need to cut out all dairy and sugar, 100%? Is it possible to still have a little sugar and dairy in your morning coffee, or is it a strict elimination diet? I have a bit of PTSD from when I did the autoimmune elimination diet – that's actually how I developed my ARFID eating disorder initially (since it's driven by food and health anxiety, not body image), so I'm really scared that this process is going to trigger that again.