If you have been diagnosed with non-alcoholic fatty liver disease (NAFLD), you probably have questions.
Unfortunately, NAFLD is not a very commonly talked-about physical issue; most people you meet won’t know what it is, much less what questions to ask. Where do you begin with this diagnosis that may be entirely new to you?
If you’re uncertain where to go from an NAFLD diagnosis, here are some important questions to bring to your doctor so you can better understand your condition.
1. What caused it?
This is a tricky question, as your NAFLD may not have any one clear origin. There are markers for NAFLD (see below), but it can be hard to pinpoint an exact cause.
Nevertheless, your doctor may see other issues that could have contributed to your NAFLD. If so, she may have some suggestions as to how she believes your NAFLD developed, and clues as to what to do to improve your condition. Ask what she thinks and you may get the jumping-off point you need to start tackling the problem.
2. What stage am I at?
How you and your doctor treat your NAFLD will partially depend upon what stage you are at with the condition. In general, the stages of NAFLD are:
- Steatosis – excess fat around the liver (usually, > 5%).
- Non-alcoholic steatohepatitis (NASH) – a more severe form of the condition, and comparatively rare.
- Fibrosis – some damage has occurred, and scar tissue is present.
- Cirrhosis – atrophy of the liver and severe scarring.
If you haven’t had symptoms up until now, OR if your symptoms aren’t extremely problematic, the likelihood is that you are at steatosis (sometimes called Stage 1). Odds are your condition is very treatable and may even be reversible, so don’t be afraid to ask your doctor what stage you’re at. The information will be invaluable to your treatment.
3. What tests should I have?
If your doctor suspects NAFLD, she may suggest tests to confirm her thoughts. Only one test commonly used to diagnose NAFLD – biopsy – is invasive, and the biopsy should be minimally so, with a small incision and fast recovery. The biopsy involves taking a very small amount of liver tissue and having it observed in a laboratory. Usually, this type of biopsy can be done on an outpatient basis.
However, particularly if she feels the condition is still in the initial stages, your doctor may do an ultrasound and/or order blood tests instead. A blood test high in certain enzymes suggests NAFLD, and an ultrasound can measure approximately how much fat is in and around the liver.
4. What lifestyle changes should I make?
If you have certain issues, such as being overweight or not being active enough, making changes might help your fatty liver condition resolve. Your doctor may suggest:
- eating more fruits and vegetables and reducing the amount of refined foods you eat
- drinking more water
- getting active (at least 30 minutes per day, 5 days per week of activity)
- making sure you get adequate rest each night
- reducing or eliminating your alcohol intake (for some patients)
5. Should I be taking any medications?
There are no medications that have so far been confirmed to reduce or cure NAFLD. However, your doctor may suggest drugs if other conditions exist along with your NAFLD (blood pressure or cholesterol drugs, for example). She may also order Hepatitis A and B vaccinations, as the liver is compromised and may be less able to fight off infection.
6. What else should I be looking out for?
Certain conditions appear to be more prevalent in patients with NAFLD. That doesn’t mean you will get them, but you’re at higher risk (or may already have one or more). Ask your doctor whether you should be tested/monitored for:
- Type II diabetes
- High levels of triglycerides in the blood
- Polycystic ovarian syndrome (PCOS)
- Hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)
- Heart disease
Knowing what questions to ask will help you achieve greater health and healing of your NAFLD. Remember: don’t ever be afraid to ask your doctor questions. It’s your body, your health and your life. Treat it with gentle care – and with plenty of knowledge.