Most people with fatty liver or NASH have no symptoms. When symptoms do occur, they are not dramatic and typically not specific. Fatigue and weakness are examples of these such symptoms. Sometimes a patient will complain of pain or discomfort over the area of the liver, which could be caused by the stretching of the liver covering due to the increase in fat deposits and inflammation. The pain is usually dull and aching, not intense, sudden or severe. There is also no predictable pattern when the pain occurs.

Symptoms and Signs of Fatty Liver in TCM include:
1. Pattern of Accumulation of Phlegm-damp
Main symptoms: over-weight, choking sensation in chest and in the Liver region, dizziness, fatigue, poor digestion, nausea, vomit, greasy coating.

2. Pattern of Stagnation of Qi and Blood
Main symptoms: rib pain, stabbing pain in the heart and chest, dark complexion, petechia in the skin, hypogloeeis varicosity, ecchymosis at the tip of the tongue.

3. Pattern of Liver Qi Stagnation
Main symptoms: swelling pain along the ribs, chest distress, dry mouth, constipation, red tongue, greasy coating, rapid pulse.

4. Pattern of Kideny and Liver Yang Deficiency
Main symptoms: choking sensation in chest and in the Liver region, fatigue, poor digestion, nausea, vomit, pale complexion, deep pulse.