Feeling tired all the time has become so normal that many people barely question it anymore.
You might wake up feeling unrefreshed, rely on caffeine to get going, experience an afternoon slump, or feel as though your energy and mental clarity have slowly faded over the years. Often, we put this down to stress, age, hormones, or simply having a busy life.
But for some people, ongoing fatigue can be linked to how well the body is coping with food, energy demands, and day-to-day pressures — including a condition called MASLD.
A quick reminder: what is MASLD?
MASLD stands for Metabolic Associated Steatotic Liver Disease. It’s the newer name for what was previously called non-alcoholic fatty liver disease.
The change in name matters because it reflects what’s really going on. MASLD isn’t about alcohol — it’s about the body struggling to manage energy efficiently. This includes keeping blood sugar steady, processing fats properly, and coping with repeated demands from modern life.
Many people develop MASLD without realising it, often because it can progress quietly and routine blood tests may still appear “normal”.
When tests are “normal” but you don’t feel well
Many people live with ongoing tiredness for years. Blood tests come back within normal ranges, they’re told “everything looks fine”, and there’s no clear explanation for why they feel the way they do.
Over time, people often stop pushing for answers and simply accept that low energy is part of life.
But “normal” test results don’t always reflect how well the body is functioning — they often just tell us that nothing is seriously wrong yet. They don’t always capture the early signs that the body is under strain or having to work harder than it should.
Why the liver matters for energy
The liver plays a central role in keeping energy levels steady. It helps to:
- Store and release glucose between meals
- Process fats and turn them into usable fuel
- Support the breakdown of hormones and waste products
- Act as a buffer when blood sugar rises or falls
When the liver is under strain, these jobs become harder work for the body. Over time, this can show up as persistent tiredness, even if sleep and lifestyle habits haven’t obviously changed.
Rather than being a separate issue, fatigue is often one of the earliest signs that the body is struggling to keep things balanced.
How MASLD-related fatigue can show up day to day
People rarely suspect a liver issue because the symptoms feel vague and familiar. Instead, they often describe things like:
- Feeling tired most of the time, even after sleeping
- Needing coffee, sugar, or snacks to function
- A noticeable dip in energy during the afternoon
- Brain fog or difficulty concentrating
- Feeling shaky, irritable, or flat if meals are delayed
- Craving carbohydrates when energy is low
- Struggling to lose weight despite “eating fairly well”
These experiences are common and easily dismissed — but together, they can point towards deeper imbalances in how the body handles energy.
Blood sugar swings and energy crashes
One of the key drivers behind MAFLD is difficulty keeping blood sugar stable. When this happens, energy often rises and falls in sharp peaks and dips.
This can lead to:
- Sluggish mornings
- Feeling sleepy after meals
- Afternoon crashes
- Feeling “hangry” or unwell when meals are skipped
The liver normally helps smooth out these fluctuations. When it’s already overloaded, the body has less capacity to cope — and fatigue becomes more obvious.
Why tiredness can feel constant rather than dramatic
MASLD is also linked to a low-level, ongoing stress response in the body. This isn’t the kind that causes obvious pain or illness, but more like a background drain on energy.
At the same time, the liver is responsible for processing hormones and everyday toxins. When this workload builds up, the body often shifts into a “just get through the day” mode rather than one that supports vitality and resilience.
This is why the tiredness associated with MASLD often creeps in slowly and becomes something people adapt to, rather than question.
Why MASLD is so often missed
MASLD is frequently overlooked because:
- Standard liver tests may still fall within normal ranges
- Symptoms are non-specific and develop gradually
- Fatigue is commonly blamed on stress, age, or hormones
- The focus is often on weight rather than how the body is functioning
As a result, many people are told that everything looks fine, even though they don’t feel fine.
The encouraging part
The good news is that MASLD is highly responsive to the right kind of support. When the body is given what it needs to manage blood sugar, process fats, and reduce its overall workload, liver health — and energy — can improve significantly.
This doesn’t require extreme diets or perfection. Small, consistent changes can make a meaningful difference over time.
Functional nutrition doesn’t replace medical care — it looks at how the body is coping before problems become more obvious, and supports systems that may already be under strain.
When it’s worth looking a little deeper
If fatigue has quietly become your normal, especially alongside energy crashes, cravings, or feeling less resilient than you used to, it may be worth exploring what’s happening beneath the surface.
This isn’t about self-diagnosis, but about listening to the signals your body may be sending.
Working with a nutritional therapist can help identify patterns that aren’t always obvious on routine tests, and create a personalised approach that supports your body rather than pushing against it.