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Nonalcoholic Steatohepatitis (NASH)

Learn more about symptoms, risk factors and treatment options.

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What is it?

All livers contain some fat. Normal fat levels in the liver are between 5 and 10 percent. If your liver has more fat than that, you may have fatty liver disease. MASH is a more severe form of fatty liver disease, which can begin as nonalcoholic fatty liver disease (NAFLD), also called metabolic dysfunction-associated steatotic liver disease (MASLD).

MASH causes your liver to become swollen and damaged. Over time, MASH can decrease liver function. As the liver tries to repair and replace damaged cells, the healing process can leave behind scar tissue. If the liver gets scared enough, it cannot work properly. This is known as cirrhosis of the liver. MASH can also lead to liver cancer or liver failure.

About 25% of people with MASLD go on to develop MASH.

Symptoms

Often, MASH has no noticeable symptoms at first. As it progresses, symptoms may include:

  • Fatigue and tiredness 
  • Discomfort in the upper right side of the abdomen 
  • Yellowing of the skin or eyes (jaundice) 
  • Unexplained weight loss 
  • Weakness 
  • Spider veins 
  • Itchiness

When to see a doctor

If you have symptoms that concern you or are consistent with NASH, it’s time to see a doctor. Early treatment can control your symptoms and prevent your condition from getting worse.

Causes and risk factors

We don’t know what causes MASH, but certain conditions can rise your risk of getting it. Risk factors include:

  • Being diagnosed with MASLD 
  • Obesity, especially if fat is concentrated in the belly 
  • Metabolic syndrome
  • High cholesterol
  • High triglyceride levels in the blood
  • Type 2 diabetes or prediabetes
  • High blood pressure
  • Polycystic ovary syndrome (PCOS)
  • Sleep apnea
  • Underactive thyroid
  • Underactive pituitary gland

Treatment options

The only effective treatment for MASH is to avoid alcohol, lose weight and control your risk factors. Your doctor also may recommend lifestyle changes:

  • Eat a healthy diet
  • Get regular exercise
  • Treat diabetes (with medication, if needed)
  • Reduce cholesterol and triglyceride levels in the blood (with medication, if needed)

 

It’s also important to speak with your doctor about other medications you’re taking that may affect your liver.

Through our clinical research arm, Chevy Chase Clinical Research and our Norfolk, Virginia office, we offer our patients access to the latest therapies for fatty liver disease – before they’re available anywhere else.

Testing

Your doctor can help you determine if you have MASH. They may recommend the following tests or procedures:

  • Liver biopsy 
  • Blood test
  • Imaging tests (ultrasound, X-ray, CT scan, MRI scan)

 

Prevention

You can treat or prevent many causes of MASH. Talk to your doctor about your risk factors and how to address them.

 

If you develop MASH, you may be able to prevent it from getting worse with lifestyle changes. Work with your doctor to develop a healthy fatty liver disease diet.

 

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Additional conditions

Hepatitis A

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Gallbladder Disease and Gallstones

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Primary Biliary Cirrhosis (PBC)

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The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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