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What you actually need to know about fatty liver This isn’t talked about clearly enough — so let’s fix that. Bloodwork and ultrasound are looking at two different things. Bloodwork measures liver enzymes. Those enzymes rise when liver cells are under stress or damage is already happening. Here’s the part most people aren’t told: liver enzymes can stay completely normal for years while fat is quietly accumulating in the liver. So normal labs don’t mean “nothing is going on.” They just mean the liver isn’t leaking enzymes yet. Ultrasound looks directly at the liver tissue itself. It can detect fatty infiltration earlier — before inflammation, before scarring, and often before labs change at all. This is why so many people are told: “Your labs look fine, let’s just watch it.” …while fat continues to build silently in the background. Fatty liver doesn’t appear overnight. It develops gradually, and the earlier it’s seen, the more opportunity there is for prevention, course correction, and reversal. This isn’t about fear. It’s about information. Appointments available at Atlanta Ultrasound locations in 📍 Sandy Springs | Woodstock | Duluth l Riverdale