What is NASH and how do you know if you are at risk?

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Nonalcoholic steatohepatitis, also known as NASH, is an aggressive, severe form of nonalcoholic fatty liver disease (NAFLD). When NASH progresses, it can cause liver inflammation, fibrosis, cirrhosis, and eventually liver failure or cancer.

NASH is closely related to obesity, pre-diabetes, and diabetes, and is often qualified as a “metabolic” disease. Its symptoms, however, are often silent or non-specific to NASH, making it difficult to diagnose. In fact, many NASH patients may not know they have it until late stages of the disease. We share key symptoms and how to know if you are at risk.

Are you at risk for NASH?

NASH is heavily influenced by lifestyle, particularly for individuals with high sugar and fat diets and sedentary routines. It is distinct from other fatty liver diseases that are caused by alcohol intake or medication side effects.

Some individuals are more at risk for NASH than others, but the following conditions can be considered risk factors for NASH: 

  • Hypertension
  • Heart disease
  • High blood lipid levels
  • Obesity
  • Type 2 diabetes
  • Insulin resistance
  • Metabolic syndrome
  • High cholesterol
  • High triglycerides

If you experience a combination of these risk factors, you should ask your doctor for a NASH screening. NASH can happen in people who have none of these risk factors, too.

There is no single test that can diagnose NASH. Your doctor will start by asking you questions about your health to get a more holistic picture of your case. To see if fat is building up in your liver and to rule out other diseases, your doctor may do tests such as:

  • Blood tests
  • Abdominal ultrasound
  • CT scan
  • MRI scan

The next step is a liver biopsy, which is the most reliable method today to see if you have NASH. In a liver biopsy, your doctor takes a sample of tissue from your liver and checks it for signs of NASH.

Key NASH symptoms

As mentioned above, NASH is a “silent” chronic disease. Most patients feel no particular symptoms. NASH is typically revealed because of complications due to the severity of the disease, meaning it has already progressed to advanced stages.

As NASH progresses and liver damage gets worse, you may start to have symptoms associated with liver disease (which could be linked to other related and unrelated conditions):

  • Fatigue
  • Moderate pain or discomfort in the upper right area of the abdomen
  • Weight loss for no clear reason and loss of appetite
  • Swelling in the legs
  • Jaundice (yellow discoloration of the skin and eyes)
  • General weakness
  • Confusion and/or slurred speech

If you have any questions or sudden symptoms, you should consult with your doctor as soon as possible.

The liver is the powerhouse of all your metabolic processes. When affected by NASH, the liver is damaged and inflamed, which can cause liver failure or cancer down the line. In addition, a liver impacted by NASH releases molecules into the bloodstream that can be harmful for the cardiovascular system, putting NASH patients at risk of experiencing a major cardiovascular event. 

Diagnosed with NASH or, based on your health history and symptoms, think you may have NASH? A clinical trial evaluating the safety and efficacy of investigational treatments may be right for you. Click the link below to see if you’re eligible to participate in a study.