FattyLiver - MASH
A condition where excess fat builds up in the liver
Fatty liver disease, also known as non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), is a condition where excess fat builds up in the liver. It's often linked to obesity, type 2 diabetes, hypertension and high cholesterol. Usually it is asymptomatic, but it can progress to more serious conditions like non-alcoholic steatohepatitis (NASH) or MASH, which eventually over years lead to liver damage (cirrhosis) and failure.
MASH, formerly known as NASH, is a serious liver condition characterized by fat buildup, inflammation, and potential scarring (fibrosis) in the liver. It is a progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as NAFLD. MASH can lead to serious complications, including cirrhosis and liver failure. We are using FibroScan and blood tests (Fibrosure) to make early diagnosis and provide treatment to you. Recent trial data from Semaglutide and Resmetirom has shown promising results. Semaglutide trial shows a resolution of steatohepatitis in 62% of patients, compared to 25% in resmetirom trial. In the Semaglutide trial, 37% patients had reduction in fibrosis stage, compared to 26% in resmetirom trial. Our first choice of medication is Semaglutide. We expect FDA approval for semaglutide for fatty liver in the near future. In the meanwhile, we have partnered with the compounding pharmacy to provide you with the treatment. Semaglutide monthly cost is $200, and it is shipped directly to your home.
Key aspects - MASH
- Etiology:MASH is strongly linked to metabolic syndrome, which includes conditions like obesity, type 2 diabetes, elevated triglycerides/LDL cholesterol, low HDL cholesterol and high blood pressure. In the Asian population, fatty liver is commonly diagnosed in individuals with normal body weight, referred to as Lean fatty liver.
- Progression:It can progress from simple fatty liver (steatosis) to inflammation and scarring (fibrosis). However the progression is not predictable. Long term studies show fibrosis is more prevalent in women, and hispanic population. In our clinic, we have a significant number of older hispanic females affected with cirrhosis from underlying MASH. Now, all this is preventable and curable before you develop cirrhosis.
- Symptoms:MASH often progresses silently, with many individuals experiencing no noticeable symptoms until the disease is advanced leading to cirrhosis. Cirrhosis is the end stage liver disease that leads to multiple complications like GI bleeding, fluid overload, liver cancer and early death.
- Diagnosis:Diagnosing MASH typically involves a combination of blood tests, imaging (like FibroScan), and potentially a liver biopsy in some cases. Early diagnosis is helping our patients to be started on treatment (Semaglutide/Remetirom) and stop progression of liver disease.
- Treatment:Lifestyle changes, including weight loss through diet and exercise, are crucial. In March 2024, the FDA approved a drug called resmetirom, marketed as Rezdiffra, for treating MASH. Recent data from the Semaglutide trial has shown far better results compared to resmetirom, and it is pending FDA approval. 62 % resolution of steatohepatitis with Semaglutide, compared to 26% with resmetirom. Tirzepatide phase 2 trial data has shown comparable results to Semaglutide. We have been providing semaglutide treatment as weight loss treatment through our online virtual clinic (www.myzoomclinic.com) since 2022. Our patients apart from losing weight have benefitted from halthing progression of fatty liver to fibrosis, and even down grading of fibrosis to a lower stage.
- Importance of Early Intervention:Identifying and managing MASH early is crucial for preventing severe liver damage and its complications. Please schedule your FibroScan appointment to get a total fat and fibrosis score for your liver.
