Nonalcoholic Steatohepatitis (Nash)

NASH has been in the news lately, particularly prolific on searches regarding liver health.

The acronym sounds ominous. But just what is NASH? Are you at risk? And if so, what should you do about it?

In this article we’ll demystify a condition that’s more common than you might think…and potentially more treatable, if you catch it at the source.

NASH: What IS It?

You’ve undoubtedly heard of NAFLD (non-alcoholic fatty liver disease). Now enter NASH, a similar condition but with potentially more serious consequences.

NASH stands for nonalcoholic steatohepatitis. Like NAFLD, alcohol is not implicated in this condition (unlike alcoholic liver disease). Also similar are some tie-ins such as metabolic syndrome (more on this in a minute).

But perhaps more ominously, while both NAFLD and NASH can remain silent in the body for years – even decades – NASH implies that actual damage has occurred, or is in the process of occurring, within the body.

Inflammation is also implicated in NASH, potentially compounding the issues already associated with the condition.

Is It Dangerous?

Unfortunately, NASH involves damage to the liver (that’s one of the classifications of the disease). This means whether you have outward symptoms or not, if you have NASH, it needs to be addressed.

According to researchers, though alcohol is not implicated in NASH, its effects are virtually “indistinguishable” from alcoholic hepatitis, a potentially dangerous chronic inflammation of the liver.

Signs and Symptoms

NASH may have no symptoms at all. When it does, they may include any of the following:

  • Fatigue and general weakness
  • Unexplained weight loss
  • Pain in the upper right-hand quadrant of the abdomen

Because these symptoms could point to a different condition, and because NASH may be symptomless in some individuals, it’s important to be screened regularly by your doctor.

Diagnosing NASH

Different doctors use different criteria and testing methods to diagnose NASH.

Your doctor will probably use a combination of tests including gathering a list of your symptoms, taking a medical history, noting your height, weight and age, taking a family liver health history and tests such as blood testing to confirm or rule out related issues (such as elevated triglycerides or an elevated fasting blood glucose level), imaging such as a CAT scan and MRI, and possibly a liver biopsy (though this may be unnecessary if your doctor feels she has gathered enough information already).

Conditions That May Be Related to NASH

Nash appears to have a tie-in to negative overall health, particularly metabolic health, weight and exercise levels.

In studies, NASH has been linked to:

  • obesity
  • glucose intolerance/insulin resistance (which may lead to a Type II diabetes diagnosis)
  • metabolic syndrome
  • elevated triglycerides

The Good News

There’s a bright spot in all this: because various conditions related to diet and exercise issues may contribute to the development or worsening of NASH (see above), this also means an individual suffering from the condition may be able to control it by making changes.

If the damage is not too severe (your doctor will grade your liver damage level and inform you of where you stand in this regard), you may be able to help heal your liver from the damage NASH has caused.

Your doctor will probably recommend lifestyle changes, such as losing weight at a slow and safe rate, exercising more, and changing your diet to include more whole foods.

If you suspect NASH, or if you’d simply like to keep tabs on your health and prevent problems from cropping up in the first place, practice a healthy lifestyle of a whole foods diet, regular exercise, regular and sufficient sleep, monitoring your stress levels, and maintaining a healthy body weight.

  • Tired Guest says:

    where did the metabolic syndrome “more in on this in a minute” information go ?

    I am experiencing some issues with excercise intolerance that has progressively gotten worse over the last 9 months, and still getting worse despite iron infusions. Doc just had blood drawn to check liver enzymes … what are the looking for ?

    Part if this degradation has been exertional acidosis? (Lower serum pH after intense exercise during lung function test)

  • Linda says:

    Hi Greg….I was diagnosed with NASH last week, not just a fatty liver. Now I am concerned about my body, my diet and my ability to overcome. I have begun to walk at least a mile a day but my diet is my worry. I believe I am and have been eating a ‘bad’ diet for years. Can you give me some advice. This is very concerning. Thanks

    • Greg says:

      Hi there. What is your diet like currently? What about your diet makes you feel it could be a ‘bad’ diet? Have you asked your doctor this question and gotten her recommendations?

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